Liver disease and lack of morals/perso... - British Liver Trust

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Liver disease and lack of morals/personality changes?

acjb007 profile image

For the past three years I've been living with liver disease and chronic cirrhosis. After a tough time in hospital where I nearly lost my life my doctor prescribed me 40mg citalopram and 80mg propanal. Since hospital I have totally turned my life around by getting a promotion at work. Clearing my debts and facing my demons head on. I'm a positive happy person and well liked and respected. Every now and again due to medication and the sate of my health I suffer from sleepless nights, rare feelings of impending doom, intense emotions, positive and negative. I've been a great colleague at work and I'm proud of all I've achieved which has kept me focused and on the right path. However on Saturday after a long 9hr shift with no breaks or food I had an opportunity to steal and in an out of character moment my morals slipped and I wrongly took advantage of the situation. My work history is clean of stealing or gross misconduct and I have never been in trouble with the police. I have felt nothing but utter Discust at my actions and guilt. It just isn't the type of thing I'd do. I took around £15 worth of groceries. Random products which I could pay for. I didn't hide what I was doing and it's almost like my mind wasn't functioning right. I have access to thousands of pounds on a daily basis yet took much less. Theft Is theft I I know it was wrong. I am putting this on here for advice as it frightened me and I'm seeing my doctor today to check on mental state and and that my dosage is right. I've been on the same amount for 3 years daily.

Could not eating and lack of sleep and taking my meds late in the day on an empty stomach cause me to act immorally? Has anyone on here acted out of character with liver disease or taking these medications? Any advice is much appreciated as I don't want to ever behave like this again. Thanks :-(

19 Replies

Everyone has a moment of madness, regardless of any medications they may be on or any illness they may have. We're all tempted to blame the disease or the meds on our behaviours but sometimes they are not the reason. Hope things work out for you.

Hello acjb007,

Welcome to HealthUnlocked. This sounds like it could potentially be Hepatic Encephalopathy though of course only a Doctor can diagnose this with certainty. Below is the explanation of this condition taken from the British Liver Trust Website:

What is Hepatic Encephalopathy (HE)?

Hepatic encephalopathy (HE) refers to the changes in the brain that occur in patients with advanced, acute or chronic liver disease and is one of the major complications of cirrhosis. It can occur suddenly in people with acute liver failure but is more often seen in those with chronic liver disease.

How does HE develop?

One of the things your liver does is to change harmful substances in the body to make them harmless. However if the liver is unable to fully function these ‘toxins’ can build up in the bloodstream. HE occurs when the liver cannot remove certain toxins and chemicals such as ammonia from the blood. These then enter the brain and can cause both physical and mental changes such as HE. Certain factors can trigger an episode of HE in liver patients – see our publication for full details.

What are the symptoms? (This publication can be downloaded for free here -

HE symptoms can range from mild to severe and can vary from person to person. Symptoms can develop rapidly or slowly over a period of time. Patients with HE can have both physical symptoms and reduced mental function.

Mild symptoms may include:

mild confusion


personality or mood changes

stale or sweet odour on the breath

poor judgement

poor concentration

change in sleep patterns

worsening of handwriting or small hand movements

Severe symptoms may include:

unusual movements or shaking of hands or arms

extreme anxiety


severe confusion

sleepiness or fatigue

severe personality changes

jumbled and slurred speech

slow movement

HE can be an emergency so it is important to seek advice from your doctor as soon as your symptoms begin. If you have already been diagnosed with HE and you feel like your condition is worsening then seek medical help as soon as possible.

It sounds like it may be worth discussing this with your doctor and perhaps taking a print out of the HE publication so that they are aware of the full situation.

I hope this has been helpful for youand all the best with your condition and treatment.

Kindest regards,

Holly Dawson

British LIver Trust


Citalopram is generally prescribed as an anti-depressant, have you been diagnosed with that? The reason I ask is that a lot of us on this site have suffered from Hepatic Encephalopathy (HE) for which a usual prescription is Lactulose and Rifaximin. Some symptoms of HE can be changes in character behaviour. I know some GPs don't like to prescribe Rifaximin owing to its cost (I've seen quotes for £800 per box of 56 tabs.

As I said I'm not a doctor but it may be worth you asking the question regarding HE. Good luck.


Bolly profile image
Bolly in reply to

And propranolol is prescribed for anxiety. Could a diagnosis of anxiety and depression be mistaken for HE by a doctor?

patsy1234 profile image
patsy1234 in reply to Bolly

propranolol is a beater blocker too lacalose stops build up of amomia that causes the confusion

I have suffered with depression and anxiety. Luckily my meds have kept me balanced and stable so far. My doctor said it's unlikely my meds would cause me to act out of character but low sugar levels due to not eating could have caused me to act irrationally. She is going to book some tests. Hepatic Encephalopathy is interesting as I haven't heard of it before. When I was in hospital I remember thinking situations were real and even called my mum while in high dependency unit saying I was going to wait in the waiting room as I'd been told I was going to another ward. Looking back this was not possible as I was wired up to every machine possible and I couldn't walk due to loss of blood. I do have very strange vivid dreams and either sleep for hours in the day or can't sleep at night. I knew what I was doing was wrong but felt like it was okay. I did feel extremely guilty afterwards but at the time I just wasn't myself. Almost like I was in a day dream. Does this sound like symptoms of HE?

The weird thing is I know I've broken the trust at work but so far everyone who works with me has been supportive. I guess this shows that it just was so out of character. I do shopping almost every day after work and have helped stop shoplifters. I'm aware there is a lot of cctv and I even had a colleague talking to me when I took the items. It's just all too strange. It doesn't add up. I had the money to pay, I didn't do it for a thrill. I even paid for expensive vitamins yet took a ready meal which was cheaper. You'd think I'd take the expensive items and pay for the cheaper ones.

My main worry is if I lose my job I'll end up where I was a few years ago and spiral back into depression and self abuse. When confronted by my manager I could have said it was an accident or made up some excuse but I didn't I admitted fully I stole and it was unacceptable. I know work have a duty of care but is there any thing I can use to save my job? I'm going to say lack of breaks is one reason which I feel led to my actions. Liver disease can cause confusion and low blood sugar levels. Add that to not eating and the pressure I'm under and the worry in my personal life. I had been anxiously waiting for my CT scan results too which were long overdue. My doctor agreed this could all lead to a moment of weakness which is out of my control.

Sorry to hear this. I take it you work for a supermarket. Are you in the union? If so contact your rep and tell them what's happened. They will be able to advise you.

I do work in a supermarket. I have a rep but I'm not on a union. My disaplinary hearing is tomorrow

cazer profile image
cazer in reply to acjb007

Sounds like you need medical evidence before the hearing. Think you must inform them that your doc is reviewing meds etc and get to the liver specialist before work make any big decisions.please get advice befpre hearing. ..

Sounds like it could be h.e especially if you disturbed sleep andother probs.maybe best bet is if work sign you off until the necessary facts are found.dont belittle your medical probs it could be the whole reason why it happened. Good luck.

It sound like you are under a lot of stress from different sources. I do hope things work out well for you. Not sure if this is a situation where it's best to just hold your hands up and say it was a moment of madness out of character rather than try to "blame" something else: the company rest policy, your meds, your health etc etc. whatever you do, good luck you sound like one of the good guys, lol!

Avux99 profile image
Avux99 in reply to Bolly


Whilst what you did was morally wrong, all things considered, I think you are being way, way, way, way, WAY too hard on yourself.

Theft is theft? Yes but there is theft on a mammoth scale and theft on a petty scale. This was petty theft.

Whilst not advocating theft of course , I also think you need to put it into perspective. If you are working for one of the big supermarkets, a £15 loss is pretty much absolutely nothing at all. They probably make that much profit every single minute (if not second).

It's not as if you are one of those carers we hear about with depressing regularity defrauding someone with dementia of their life savings is it for instance?

As long as it was a one off, in your situation with everything you've got going on, I would have just kept quiet and had a word with myself (and maybe have given a £15 donation to the British Liver Trust!) rather than now deal with all the extra grief. You are looking at potential job upheaval and the instability that may bring when you've got bigger fish to fry, right?

briccolone profile image
briccolone in reply to Bolly

I agree with that-explain the medical issues and put your hand up-I doubt whether fair minded colleagues would judge..


You have only just heard of Hepatic Encephalopathy, you have not been diagnosed with it, but I suspect there is a fair chance you have it, and unless your GP is unusual, he will have little knoledge of it either. You may need to get to a liver specialist, even a transplant centre as H.E. is very much misunderstood. I have some experience in explaining how H.E. can get you into trouble!! Been there, got the T shirt etc.

I was diagnosed with severe H.E. and I did some very out of character things.

I ended up in court (unfairly) and in the end the case was dropped "due to insufficient evidence" as I said it was unfair in the first place, but my behaviuor was the initial problem, and this WAS from my H.E.

I see you have a tribunal today, I would demand (request) a delay whilst you investigate H.E.

""Every now and again due to medication and the sate of my health I suffer from sleepless nights, rare feelings of impending doom, intense emotions, positive and negative."" you say, might not be due to medication!!!!

I experienced all that too, I was / am on a smaller dose of citalopram, and I was fortunate enough to be on Rifaximin (prescribed by the transplant centre NOT my GP who did not believe (until told by transplant centre) that I had severe HE

The list from Holy Dawson is real! I am the sort of person who reads a list like that and says thats is for sensitive types who are uptight about their well being.....the list is real! I had many of those symptoms, the way I describe my position was I (on occasion) had ZERO inhibitions, this lead me to be an arse, whist I was being an arse I was happy, I felt my behaviour was cool, it was only after when I "came down" (mood swings) I might realise I was out of order, even though it seemed OK to me. for me it was clearly a bout of mental illness, clearly, and it was odd as I could see from both sides of reality, one I was being "mad" and out of order (Lack of inhibitions) and from the other side my behaviour seemed OK (lack of inhibitions)

A story of a HE sufferer : He like me had his driving license suspended, he wanted to get the keys, strip naked, and drive around town....... he was not previously a nudist, nor one who drove without insurance, MOT or driving license, he was a "normal" middle of the road family man........ without inhibitions and a bit crazed from H.E. he (or I) could have eaisly stole £15 (and possibly with no clothes!!!!!)

Check out H.E. !!

If you want to talk, P.M. me and we can arrange a chat.


I hope your work is understanding; maybe try to get advice from the specialist re H.E. I know what you mean though; what I would like to know is can you have H.E and your liver still be compensated?; I have experience re what I would call a personality change/ bouts of aggression/ extreme emotions; but I think some people might just think a person is mentally ill or its just the way they are rather than H.E (even with cirrhosis) and how would you actually know whether it is, or is not, H.E?

So I got dismissed. I'm utterly devistated. I opened up about my cirrhosis and liver disease. I told them I had been suffering confusion and felt my health or medication was to blame. I had all my medical notes and a pile of studies off the Internet which they ignored and said it was irrelevant. They said there is no excuse for theft and would be terminating my contract instantly.

I have 5 days left to appeal. I've spoken to lots of legal people and they say at best I could ask for a nutral reference as a negative one would majorly set me back and could potentially lead to a relapse. I understand work have a duty of care as I have cirrhosis and liver disease. I've been told as an employee work should have kept an eye on me and knowing I was an alcoholic asked for my health updates to make sure they were looking after me. Basically I'm clutching at straws to find any grounds I can make the company look at fault. Either to get my job back, a pay out or a good/nutral reference. I know my doctor will write to them explaining my vulnnerablity and what their actions may cause. I hope that would be enough to frighten them onto reconsidering their decision. Any advice is much appreciated.

Dear acjb007

You just posted an answer a reassuring one to a question I had and for that I thank you. You sound like a very warm hearted decent person with a wealth of experience and if you want my opinion your ex employers didn't deserve you!

Would it, could it be at all possible for you to work within the social services ? Or undertake the necessary training to do so? Given your experience and past history you could help many people and give them advice and support.

Good Luck for whatever new job you go for!

Awww that's really bad news..i think your right about the liver disease being the cause of this...i am a very calm person but recently noticed i have terrible mood swings and sometimes my words come out back to front..i can't sleep at night or during the day and have become very depressed and my memory is zero..i don't know if it's the liver problem or not but i am not the same person anymore..sad that they don't take all of this into consideration before they act...can you get something from your consultant to explain that your liver disease can affect the brain when there is a build up of toxins in the blood? you have no need to steal they should take all of this into consideration!

I spoke with Acas today and ran through the whole situation. They said basically although I did wrong and work made a few errors there is no case for an appeal. However as my employer point blankly refused to look at my medical history and notes they have jeopardised the whole disciplinary. My notes etc were in a folder which remained shut during the whole process. Below I've cut and pasted what they sent me. 

Ignoring evidence in favour of the employee’s mitigation whilst considering the evidence against it Even where an employer is convinced that the employee is in the wrong, any explanation or evidence to the contrary should not be disregarded; it should be investigated properly. Employers must ensure that they do not ignore any medical reports and that they do not fail to act on any recommendations made in them. All evidence that the employer intends to rely on should be provided to the employee ahead of any disciplinary hearing to allow adequate time to prepare a defence.

Acas also said what Teaboy2 mentioned. They have a duty to monitor my health. Liver disease can be classed as a disability and work should have made adjustments to meet my medical needs. 

I'm seeing my doctor tomorrow to get a letter backing up that my condition can cause irrationall thoughts, confusion, memory loss etc. 

Acas said these factors are more than a valid reason to appeal as even though I did wrong work should admit failure to carry out the disciplinary fairly by ignoring my serious health issues and as a company ignoring my medical needs while under their employment. 

Watch this space. ....

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