What’s the Difference Between Healthy and Unhealthy Guilt?

How to tell the difference when they feel the same.

Key points

  • It can be confusing to understand the difference between healthy and unhealthy guilt.
  • Healthy guilt can help us see when we’ve wronged somebody, make amends, and maintain healthy relationships. 
  • Guilt becomes unhealthy when it’s excessive or misplaced, for example guilt over something beyond our control.
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Guilt is the feeling that bubbles up in us when we feel that we have done something wrong. When healthy, guilt serves a positive purpose. It helps us see when we’ve wronged somebody, it encourages us to make amends and improve, and it helps us maintain healthy relationships. The capacity to feel appropriately guilty shows that we have a strong inner compass. It motivates us to change our behavior to avoid future harm.

But guilt, if unhealthy, can be detrimental when it becomes excessive or misplaced. Unhealthy guilt occurs when we take responsibility for things beyond our control, harm we did not cause, actions already amended, or things that require no apology. Unhealthy guilt may also begin as healthy guilt but fail to subside, leading to overwhelming self-flaggelation and self-criticism. Healthy guilt becomes unhealthy when we become unable to forgive ourselves for past mistakes. While healthy guilt can be the foundation of building new behaviors, unhealthy guilt may become the foundation of a negative downward spiral that both creates harm and even impedes progress by making it difficult to move beyond the guilt itself.

Research supports the importance of healthy guilt and the case against unhealthy guilt. A study by Hoffman et al. (1982) found that children who displayed a healthy sense of guilt were more likely to exhibit prosocial behavior and empathy towards others. Another study by Tangney et al. (2007) found that individuals who experienced healthy guilt were more likely to have higher levels of moral reasoning and be less likely to engage in unethical behavior. Guilt itself is not the enemy. Healthy guilt is a necessary component of living a meaningful, connected life with others.

In contrast, unhealthy guilt can have negative effects on mental health. A study by Moser et al. (2011) found that excessive guilt was associated with symptoms of depression and anxiety, and that individuals who experienced unhealthy guilt were more likely to engage in self-punishing behaviors. Another study by Hagen et al. (2011) found that feelings of excessive guilt were associated with increased levels of stress and physical symptoms.


The main difference between healthy and unhealthy guilt is the source and intensity of the guilt. Healthy guilt is a natural and appropriate response to wrongdoing, whereas unhealthy guilt is an excessive and misplaced sense of responsibility or a lack of forgiveness following healthy guilt.

Sometimes, unhealthy guilt can masquerade as accountability. After we make amends for past wrongdoing, continued guilt can feel like taking appropriate responsibility for harm. Surely the worse we feel, the better a person we are? When we feel more guilt than is necessary or hold onto guilt far beyond the time required, we feel like we’re being a good person and motivating ourselves to change. But accountability is not meant to be excessive, it is supposed to be appropriate. And when we take responsibility for things that weren’t in our control, or hold onto guilt for years even after amends were made, we are not helping anyone.


Hagen, R., Hjemdal, O., Solem, S., Kennair, L. E., Nordahl, H. M., & Fisher, P. (2011). Excessive guilt predicts depression, anxiety, and somatization in young adults: A 5-year longitudinal study. Journal of Counseling Psychology, 58(3), 314–325. https://doi.org/10.1037/a0023653

Hoffman, M. L., Saltzstein, H. D., & Zembar, M. J. (1982). The role of guilt in the development of altruism. Child Development, 53(4), 1179–1192. https://doi.org/10.2307/1129018

Moser, J. S., Huppert, J. D., Foa, E. B., & Hajcak, G. (2011). Immediate and long-term effects of guilt on the neural response to faces. Emotion, 11(4), 991–1000. https://doi.org/10.1037/a0023503

Tangney, J. P., Stuewig, J., & Mashek, D. J. (2007). Moral emotions and moral behavior. Annual Review of Psychology, 58, 345–372. https://doi.org/10.1146/annurev.psych.56.091103.070145

About the Author

Sarah Epstein, LMFT is a Marriage and Family Therapist in Dallas, TX and Philadelphia, PA (virtually), and the Amazon bestselling author of the book Love in the Time of Medical School.


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