I have bipolar. During manic episodes I feel on top of the world and there is gaiva that isn’t normally part of how I function. I do struggle with gaiva sometimes anyway, but it gets ramped way up when I’m manic. Does that count against me? I’m trying to be humble but I fail a lot. Also, do misdeeds and bad middos during times of mental illness count? When it says Hashem doesn’t want to be with a person who has gaiva, does that also mean me when I’m manic? How can I change that?
We all have to try and do the best that we can, after that H-shem is the one to decide,as He is the one who really knows what is going on inside of us.