Hi readers,

When we have a mental illness, how does that affect our sense of self?

Have you ever wondered whether a mental illness is something external to who you are – to be treated and eradicated so that you can return to your normal self – or something that is intrinsically part of you, that enters your life and changes who you are in a lasting way?

Linda Logan wrote an article for the New York Times Magazine called “The Problem With How We Treat Bipolar Disorder” in which she reflects on her long-term struggle with mental illness and claims that the transformation of self was one of the most difficult parts of it. As bipolar disorder can involve an unpredictable cycle of manic and depressive episodes, Logan found it challenging to experience the parts of the self that would come out during bipolar episodes and reconcile those behaviours with the self that she thought she knew. Logan describes an incident where a man came to her support group after trying various grief groups, telling her “Everyone there was grieving over the loss of another person. I was grieving for myself. For who I used to be before and who I am now.”

What is the self?

When attempting to define the self, modern day psychologists take into account self-identity, self-esteem, self-regulation and self-improvement, and view the self as a complex, multi-faceted theoretical entity. The self is shaped in large part by our schemas – mental structures comprised of thoughts, feelings and memories linked to a common theme. Our observations of ourselves in the world and in relationships with others develop schemas organized around themes such as competence, strength, and lovability. Although we generally experience a sense of continuity and unity of the self, there can be different and even competing states of identity based on things like patterns of behaviour through time and interactions with others.

How does the self interact with mental illness?

With these ideas in mind, how do mental illnesses like bipolar disorder affect the self?

One study found that some people with bipolar disorder experienced confusion, contradiction and self-doubt that made it difficult to establish continuity in their sense of self and impacted their identity development. Another study found that people with bipolar had difficulty differentiating between the self and the bipolar disorder, and were unsure which their “real self” was.

So is mental illness separate from who you are, or is it a part of your identity?

A recent movement has sparked debate over whether disability or illness is integral to who a person is. For example, some believe that a hearing-impaired person should not feel the need to get a cochlear implant because we should all accept and embrace what is normally seen as a limitation. This movement is called neurodiversity, and questions whether conditions should be thought of as illness or simply part of a person’s individuality.

Should we address the self more in treatment?

In her article, Logan discusses why the self is rarely addressed when supporting clients. One researcher told her that his work on mental illness and identity was seen as less important than other symptoms that clients experience such as cognitive impairment and suicidal thoughts. However, another psychologist claimed that there has been movement towards treatments that recognize the role the self plays. This psychologist said that clients often tell her, “I just want to be the person I used to be.”

How can we integrate self and identity?

Research has found that people with bipolar can integrate self and identity through methods such as practicing self-acceptance and incorporating different aspects of the self. Understanding and gaining insight into how mental illness can influence self-identity and how we can work towards treatment that addresses this is important to those who have a mental illness as well as their clinicians, friends, family and partners, and is something we can all consider moving forward.

Do these ideas resonate with you? Do you have a mental illness, and has that impacted the way you think about who you are?

Thanks for reading!

*This post was based on a podcast episode I wrote about mood disorders. If you’re interested in these ideas, feel free to listen to the full episode (and other episodes relating to clinical psychology) here.

**You can read the New York Times Magazine article here.

The views expressed in this blog are my own, and do not necessarily reflect the policies or views of the University of Victoria. I monitor posts and comments to ensure all content complies with the University of Victoria Guidelines on Blogging.