Why identity is important to your quality of life
Everybody has a unique sense of self, or identity. Our identities capture all the meaningful roles, relationships, characteristics, values, commitments, behaviours and associations about ourselves that combine to paint a complete picture of who we are. Whether or not we live with bipolar disorder, a solid sense of identity is important for health and wellbeing. At the same time, as we grow from life experiences, our identities grow with us.
We also understand (or interpret) the world through the lenses of our identities – that is, based on the beliefs and experiences that make us who we are. In this way, our identities can become more solidified or set. For example, if you have an identity that includes being a helpful person, you may be more likely to see a situation as an opportunity to be helpful and needed, making you feel more helpful. Or if instead, part of a person’s identity includes feeling like an outsider, they may see the same situation as uninviting and avoid it, making them feel like even more of an outsider. Therefore, how we see ourselves can actually shape who we are.
Similarly, when our sense of personal identity is overly negative, unstable or uncertain, it can become confusing and difficult to set personal values or establish stable roles and relationships.
Bipolar disorder can present many challenges around identity. Some people living with bipolar disorder have described the onset of the condition as a disruption in their life story and identity1. For these people, being diagnosed with bipolar disorder altered their life course and required them to take time to think about and re-evaluate their sense of self1. This disruption may be even more critical when symptoms of bipolar disorder first start in youth, when a sense of identity is still being discovered and solidified. But no two people have the same journey. While some people describe identity difficulties caused by their diagnosis, others report positive changes, seeing their bipolar disorder as a transformative or life-altering process1.
One particular challenge is role engulfment, a state in which your identity becomes entirely based on one aspect of yourself or one role that you fill, undervaluing or ignoring other aspects and roles2. When you struggle with role-engulfment, you may view yourself in an overly narrow way. In the case of bipolar disorder, you may experience role engulfment when you define yourself primarily by your illness: “I am bipolar” or “I am mentally ill”. Sometimes it may seem that others place this ‘illness identity’ on you1. A healthier option may be to see bipolar disorder as only one aspect of who you are, so that the condition does not capture all of you; for example, “I am a person with bipolar disorder, and also a mother, a caring friend, someone who values the environment…”). You have strengths, characteristics, values and goals that go well beyond your bipolar disorder. However, there can be times in your illness, especially when coping with a difficult mood episode, when focusing almost solely on managing your bipolar disorder can be an effective strategy to regain health and wellness.
Another challenge is that the emotional turbulence (those out of control ups and downs) of bipolar disorder can make it more difficult to establish a stable sense of self. If you sink into a deep depression, you may view yourself in an exaggeratedly negative way, ignoring your gifts and accomplishments. This creates a “negative identity” based upon what you unrealistically see as inescapable and continual failures and weaknesses. If you rise into a hypomanic/manic state, you may view yourself in an exaggeratedly positive way. In that manic state, you may struggle to distinguish between your true capacities and the beliefs about your capabilities that are fueled by your mania, or between your true priorities and the ones that suddenly seem important.
Building a stable sense of identity takes consistency and commitment to certain values over time – but bipolar disorder can involve dramatic changes in your feelings, thinking and behaviour which can strain your ability to maintain consistency. The bottom line is that it may be hard at times to distinguish between your true identity and the changing symptoms of bipolar disorder3, but that you can, with practice and commitment, develop insight into who you are versus what aspects of your behaviour come from the disorder.
How you can take action
The aim is to develop a stable, positive identity that keeps you in touch with the full range of your values, abilities and roles, rather than focusing only on limitations placed on you by bipolar disorder4. Here are a few steps you might take to help you develop and maintain a healthy sense of self:
Try to develop a sense of self beyond your illness. For example, try making a list of your characteristics (values, roles, strengths and abilities, interests, priorities, habits, etc.) in two columns. First, list characteristics that are related to bipolar disorder, such as "I suffer from rapidly shifting mood”; or "sometimes I go on impulsive spending binges". Second, list characteristics that are not part of bipolar disorder, such as "I enjoy playing tennis" or "I'm a helpful person". Most of your characteristics are not caused by bipolar disorder – if you have trouble identifying your characteristics outside of your diagnosis, have a supportive friend or family member help you with this list. Once you've got your list made up, review it as a way of reminding yourself that you are much more than ‘bipolar’. In this way, bipolar disorder can be seen as “something I manage, not who I am”5.
Try to show others that, while you are more vulnerable to persistent mood states like depression or mania, you still have day-to-day or moment-to-moment changes in emotions, just like everyone else. You can be excited or happy without being manic, or sad and frustrated without being depressed. Teaching yourself and others to help tell the difference between normal changes of emotions throughout the day from mood episodes can be very important to feeling supported and validated by others.
Identify negative messages you may be giving yourself about your bipolar disorder, like "having this illness means I’m flawed". These kinds of internal messages can be the focus of Cognitive Therapy, which helps individuals to identify negative thoughts that are unrealistic, unfair or unhelpful, to challenge these thoughts and to replace them with thoughts that are more realistic, fair and helpful.6 They can also be an example of self-stigma. Remember that friends, family members or healthcare providers can help you to challenge negative thoughts and come up with more realistic and helpful ones.
Instead of approaching your bipolar disorder as one huge, overwhelming problem, try thinking of it as a series of specific, smaller problems which you can manage using your creativity, problem-solving ability, personal values, skills, strengths and social support network. Now, write these specific problems in one column, and, in another, a strategy for managing each one. By using this approach, it is easier to be more realistic about bipolar disorder and see it as something that gives rise to problems, but not something that defines who you are. Remember that friends, family members and healthcare providers can help you to come up with strategies or ways for managing each of these bipolar disorder-related problems.
When exploring your different characteristics, see if you can be gentle and accepting with the parts of yourself that you would like to change or that are not in line with who you’d like to be. Being critical towards yourself causes unnecessary hardship. Being kind to yourself can help to give you strength and can even help you make changes for the better.
If you would like to make changes in your life, explore what values are important to you. There is no ‘perfect’ or ‘correct’ set of values: everyone has their own unique values that they consider important. Make a list of the ones that you feel are important. Once you have your list, try making realistic, specific and attainable goals that support each value.