Who Am I? When Mental Illness Shapes Identity

Developing an identity is the task of adolescence and young adulthood. Young people break away from families and begin to understand the answer to the question, “Who am I?” But what happens when those years are interrupted by a bout of mental illness? What if a teen enters treatment for depression, an anxiety disorder, an eating disorder, or addiction? What does that young person then believe about his identity? How does a diagnosis change the answer he gives himself to the question, “Who am I?”

Contrary to common perception, one is not simply Mentally Ill or Mental Well. Mental illnesses are not divided neatly into those who are afflicted, and those who are spared. Many illnesses are time limited, or highly responsive to treatment and quick to enter into remission. The tragic loss of a parent to cancer can lead to an episode of depression, but even in the face of such a tragedy, many recover and go on to live a healthy, full life, free of recurrences. Others respond well to treatment and become stable with only minor ongoing treatments. A low dosage of medication or regular contact with a caring therapist can provide stabilization, and people can live symptom free. 

While stabilization is good news, sometimes identity has already been shaped by the presence of an illness. Sometimes teens and young adults ask, “Who am I?” and answer with “I am anorexic,” or “I am depressed.” 

Adopting mental illness as an identity has longstanding effects. If I grow into my adult years believing I am obsessive compulsive instead of believing that I am a normal, healthy young person, how might that affect my future? Will I be willing to take risks and try new things if I believe stress might bring on another bout of illness? And what if my experience with a previous episode of illness was disabling? If I was disabled by my symptoms and took a medical leave of absence from school, or delayed starting my first job, what will I believe about my future ability to work during periods of distress? Will I have the confidence to challenge myself? Will I believe I am capable of anything I endeavor to try? 

Believing that my mental illness defines me may result in reluctance to take on difficult tasks or roles. “How can I take this job? I am Bipolar.” “I probably shouldn’t have children. How could I reliably take care of them? I have PTSD and Panic attacks.”

Forming an identity around illness can be an inevitable part of receiving care during vital stages of emotional development. Even though the treatment team never says, “You are your illness,” a developing young person often draws the conclusion that she is, in fact, one and the same with her disease. 

In addition to stabilizing symptoms of mood, thought, and behavior, our young patients and clients need to hear us as professionals specifically say, “You are not your illness.” “These symptoms can be time-limited, and after a short course of treatment, you can stabilize and go on with your life as planned.” “Many people live healthy full lives after an episode like the one you have had.” “You can still live the life you had envisioned before this started.” “Your life doesn’t have to be limited because of the problems you have faced.”

Posted on January 11, 2016 .