Is There a Disorder that Involves Uncertainty About Identity?

Reader’s Question

I have suffered from depression in the past, but I believe the depression is just one symptom of a bigger issue. Are there any disorders associated with being unable/unwilling to know who you are or what you want at all? I think I’ve been paralyzed in my life for a long time because of this kind of confusion. On the one hand, I probably should be thankful that I have the freedom of being 30 and can do whatever I want. But I’m still always asking myself: “What is it that I want to do?” I have literally drowned myself in options (e.g., different schools, post grad programs, music/HR/web design, etc.). I’ve though about moving across the country. I’ve also been questioning my sexuality. Although I’ve been in a committed hetero relationship for 7 years, we’re more like friends.

Any thoughts?

Our Clinical Psychologist’s Reply

There is a vast spectrum of syndromes describing disturbances of the “self.” When a person’s sense of who they are and where they’re going is so extreme and causes sufficient distress or problems in life, such disturbances can rise to the level of a disorder. At the extreme end of the spectrum would be Borderline Personality Disorder (BPD). However, when a person is still in the formative years, or when a person is an adult but doesn’t meet the criteria for borderline personality, the diagnosis of Identity Disorder can be appropriate. Uncertainty about life roles, sexuality, personal image, etc. are all par for the course with identity disturbances and other disturbances of the self. Mood disturbances are also common in individuals struggling to find a stable sense of who they are or want to be.

At the milder end of the spectrum are uncertainties about personal identity that don’t cause significant distress or impair a person’s ability to function in a socially adaptive manner. Sometimes individuals with many different talents and interests can have difficulty pinning down an occupational identity. Sometimes, individuals learn to accept and cherish their ability to invest in diverse pursuits. Individuals who tend to be relatively “free spirited” (i.e., are uncomfortable with too many internal and/or external “boundaries”) have difficulty pinning down just what they want in intimate, sexual, and other relationships.

Sometimes, the difficulty a person has establishing a stable sense of self has to do with trauma experienced during their formative years. Residual scars from trauma can interfere with the normal course of personality development and give rise to other psychological “symptoms” as well. Individuals whose identity disturbance is trauma-based generally need some therapy or counseling to aid them in the process of solidifying a sense of self.

Psychotherapy and counseling can be valuable tools in getting to know yourself better, coming to accept yourself more fully, and discovering those aspects of yourself that may or may not need to change in order for you to be happier and more fulfilled. There are professionals who specialize in helping individuals with varying disturbances of the self. Treatment for symptoms alone (e.g., depression) can reduce one’s overall level of stress but can’t address the factors that might be impacting one’s ability to gain a stable sense of personal identity.