Stuck in the Sick Role: How Illness Becomes an Identity

By Melissa Stennett Deuter

Mental health crisis often hits just as young adults are attempting to leave their families and create lives of their own. It’s no surprise that a mental health problem can leave a young adult feeling directionless on the journey toward fully independent adulthood. Young adults are hit harder than any other stage by the effects of a new mental illness. To understand why, we need to look at development.

Human beings are remarkably adaptable to our environments. Most of us absorb language and culture with no effort at all as small children. We are designed to sponge up this hidden knowledge at different stages of our development, supported by the brain’s balance at each unique stage.

Imagine how limited language and cultural learning would become if a young child spent most of her time isolated, in silence. Environment alters the course of development at key stages. Forming language in early childhood has a lot in common with forming identity in early adulthood. First, the brain is wired to receive the fundamental lessons of the stage, and then life experiences shape the outcome.

If my late teens and early twenties are filled with academic success and solid friendships, it’s reasonable to expect that I will learn to believe I am capable and likable. By contrast, if those years are marked with failure and rejection, I’m more likely to believe myself incapable and unlovable. The late teens and twenties are a time for experimenting in the world, and learning to understand our personalities, strengths/weaknesses, and interests.

So, what then is the impact of the growing mental health crisis of our current youth? When record numbers of teens and twenty-somethings take psychiatric medications and receive diagnoses that label them with life long brain diseases, what do they believe about themselves? Perhaps that they are broken and will never live normal lives. This leaves young people lost, adrift during a developmental stage that shapes identity.

How can mental health professionals help mitigate the effects of a new illness on identity formation?

To start, professionals can change the way we educate young patients and their parents. Too many young adults are told after a first episode of illness to expect a life of chronic disease, despite the reality that this is simply untrue for a large percentage of them. Instead, professionals can tell patients to continue treatment, and work with their healthcare team to make decisions, but that many people with mental illness achieve a full recovery. Some patients reach a point where treatment is no longer necessary, and others live healthy lives with simple long-term treatments.
Also, we should maintain an awareness of development and discuss how various stages of brain and social development lead to transient symptoms, which might pass with time and improved coping skills.
And finally, professionals can do more to offer hope. “You’re not stuck this way,” should be our refrain for all of the people suffering and seeking our help.

Lost at Sea: Mental Health Crisis in the Young Adult Years

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