Due to the unpredictable nature of manic-depressives, it is impossible to rely on them for responsible action and judgement. While they may be very alert and mentally capable during their manic phase, they can experience extreme feelings of guilt and unworthiness and even lean toward suicidal tendencies in their depressive modes. As manic-depressive psychosis is not immediately recognizable, unknowing persons may get involved in the patient's manic schemes, only to be disappointed when the intended outcomes never materialize.