Receiving a mental health diagnosis can feel very validating. Struggling with mental health before being diagnosed can feel very isolating and often leaves people with self-blaming thoughts (i.e., “I shouldn’t feel this way” or “What is wrong with me?”) or trying to downplay how they feel. Being diagnosed can make people feel seen, heard, and understood, and often creates a sense of belongingness as they are now able to relate to others with similar struggles. It is usually true of people who have struggled for a very long time before seeking help. They may suddenly feel that everything makes sense after receiving such a diagnosis. Due to this, it makes complete sense why some people tend to identify very strongly with their diagnosis. However, there is a flip side to this, and sometimes, when people receive a mental health diagnosis, they relate to it so deeply that they begin to over-identify with it to a point where it is no longer beneficial.
It is noteworthy to define what a mental health diagnosis truly is. A mental health diagnosis is simply a collection or pattern of symptoms (including patterns of thinking, feeling, or behaving) that present together and cause a significant impact on one’s ability to function in life. These symptoms can shift, change, improve, and worsen over time, depending on how one decides to proceed once diagnosed. While a diagnosis can provide a general picture of how someone who struggles with a specific diagnosis may present, these diagnoses can look very different from person to person. It is why mental health clinicians often say that we “treat the symptoms and not the diagnosis.” A mental health diagnosis can benefit the treating providers because it helps with care planning and allows them to identify better which treatment interventions may be most helpful for the client. However, there is no one-size-fits-all approach for any diagnosis.
What does “over-identification” even mean?
Simply put, “over-identification” means the tendency to relate to someone or something to an extreme or excessive amount, to the point where it can cause negative impacts. Suppose a person is over-identifying with a diagnosis. In that case, it means they are using the diagnosis as a basis of their self-concept, identity, who they believe they are, and how they believe others see them as a person. It can look different depending on the diagnosis and the person, and how we react to a diagnosis can be influenced by various factors. It is not to invalidate the fact that mental health diagnoses can be highly debilitating, but rather to highlight the fact that although mental health can cause such severe impairment, it still does not define who you are as a person and gives hope that the layers of symptoms can eventually be improved with proper treatment to help the struggling person feel like their true self again.
Examples and potential negative impacts of “over-identifying” with a mental health diagnosis:
- Overly focusing on the limitations of the diagnosis. After receiving a diagnosis, it is common to look for all the ways it holds you back currently or could potentially be in the future. While it is fair to analyze the impact the diagnosis has on your life, if you only focus on the limitations it causes, it can result in you overlooking the progress you have made despite the diagnosis. An example of this is globally labeling yourself: One receives a diagnosis of depression and begins labeling themselves as a “depressed person.” This type of thinking can be harmful because how we think about ourselves impacts how we feel and behave. If you label yourself as a “depressed person,” it will lower your self-esteem and cause continued feelings of sadness, resulting in continued behavioral symptoms of depression, such as telling yourself you will be unable to achieve certain things because you are depressed. It can be helpful to start by shifting your language from “depressed person” to a person who struggles with symptoms of depression,” which will challenge this type of thinking.
- Allowing personal stigma regarding a diagnosis to dictate how you see your future. An example of this is an individual with a Bipolar Disorder diagnosis. The individual becomes overwhelmed by the stigma associated with it. They then convince themselves that because of their diagnosis, they will be unable to achieve many of their goals in life, which becomes a self-fulfilling prophecy. They may become ashamed of their diagnosis and make this the basis of how they view themselves, resulting in them feeling stuck in many ways. However, if they looked at the truth of the diagnosis, they would recognize that it is a biological disorder that can be very well managed with the proper medication and awareness of how their symptoms present.
- Using the diagnosis to excuse behaviors. If a person makes their diagnosis based on “who they are, “there can be a tendency to use it as an excuse for their behaviors. For example, people with ADHD often struggle to manage their time, which causes late deadlines and delayed task initiation. Someone who “overidentifies” with the diagnosis may say, “Well, I have ADHD, this is just the way I am, and I will probably always be this way,” with no attempt to improve this symptom. On the other hand, someone who has a healthy way of relating to the diagnosis may say, “I do have a diagnosis of ADHD and am aware that time management is a symptom I struggle most with and am actively working on it by trying out time management strategies.”
- Over-interpreting the symptoms or using the diagnosis to explain everything about themself. Indeed, the DSM often fails to fully encompass the range of how a person with a diagnosis could present in the world. The issue with this is that it leaves much room for suggestion, interpretation, or over-analyzation of other patterns of behavior that become misattributed to the diagnosis. Social media and technology have worsened it. While there are some positives to social media, such as finding community and obtaining more accurate information about mental health, social media has also allowed misinformation to spread when people who are not licensed clinicians go on these platforms and speak about mental health diagnoses. Social media has also become a place where people tend to overattribute symptoms or behaviors as a part of a mental health diagnosis or attempt to “self-diagnose.”
Identity is defined as “an individual’s sense of self-defined by (a) a set of physical, psychological, and interpersonal characteristics that is not wholly shared with any other person and (b) a range of affiliations (e.g., ethnicity) and social roles (APA).” Our true identity should include our unique personal values, traits, interests, and self-expression. A mental health diagnosis has had an influence on shaping certain parts of who you are and a part of your identity. However, there is so much more to you than the diagnosis itself.
Personality Disorders
When talking about this topic, it is paramount to specifically mention personality disorders, as it is very valid for people to wonder how they can separate a personality disorder diagnosis from their personality as a whole. People with personality disorders display a pattern of thinking, feeling, and acting, which can influence how they think about and interact with themselves, others, and the world. Personality disorders consist of traits that tend to be very rigid or extreme. In therapy, we help the client create more balance and flexibility in their life by softening up some rigidly expressed traits to improve functioning. These rigid traits often block the true inner self from showing up. However, once improvement starts, it allows the individual’s true personality and identity to come through.
What if I was diagnosed sooner?
Sometimes, when people struggle all their lives with an undiagnosed mental health condition, they convince themselves over time that these symptoms are a reflection of who they are as a person and blame themselves, which can lead to issues with self-esteem and self-worth. Suppose they were overidentifying with the symptoms and attributing them to being a personality trait of theirs throughout their life. In that case, it makes sense why many people overidentify with the diagnosis once they are officially diagnosed. When undiagnosed and untreated for so long, the symptoms can sometimes take over, which is why proper diagnosis is so important. With that being said, remember that rather than that diagnosis being “who you are,” it allows you to move forward and take action in a way that enables you to uncover your true self, which over your life may have become hidden by these untreated and undiagnosed mental health symptoms. After receiving the diagnosis, it is common to wonder how things could have been different if you had known this sooner. It is okay to validate that it feels unfair to have had to go through life without such critical information, while also working towards a place of radical acceptance that, while you cannot change the facts of the situation, you can choose what to do with it moving forward.
It’s all about balance
Like anything in life, but especially with this concept, looking at it through a balanced lens is key. Receiving a proper mental health diagnosis can help provide clarity on what you are experiencing and feeling and can help forge the best path forward. It allows the individual to take control of their symptoms and learn to manage them so they can go on to live their best life and become their true self.
