Culpability in mortal sin?

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Struggling1

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How do we know whether a sin that has sufficiently grave matter and is performed willingly is mortal. For an instance how are we supposed to evaluate how our understanding of the matter is if we don’t understand it? How does mental illness play into culpability. What about if you don’t seem to have a conscience? How do you then also repent and go to confession if you don’t feel sorry but are trying to do the right thing?
 
How does mental illness play into culpability.
It can certainly diminish it.
What about if you don’t seem to have a conscience? How do you then also repent and go to confession if you don’t feel sorry but are trying to do the right thing?
Assuming these are part of the one question. Feeling guilt is not needed for contrition but a will to stop committing the sin is.
 
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