The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) describes identity disturbance as a “markedly and persistently unstable self-image or sense of self” and notes it is one of the key symptoms of borderline personality disorder (BPD). Of course, people without BPD struggle with identity disturbance, too. But people with BPD often have a very profound lack of sense of self, or loss of identity. If you struggle with the feeling that you have no idea who you are or what you believe in, this may be a symptom you can relate to.

Understanding Identity

Identity is often thought of as your overarching sense and view of yourself. A stable sense of identity means being able to see yourself as the same person in the past, present, and future. In addition, a stable sense of self requires the ability to view yourself in the same way despite the fact that sometimes you may behave in contradictory ways. Identity is quite broad and includes many aspects of the self. Your sense of self or identity is thought to include the following elements:

Your beliefs and attitudesYour perception of your abilitiesYour ways of behaving (even as these change)Your personality and temperamentYour opinionsThe social roles you play

Identity can be thought of as your self-definition; it’s the glue that holds together all of these diverse aspects of yourself.

Why Identity Is Important

Having a sense of identity serves many different functions. A strong identity can help you adapt to changes. While the world around you is constantly changing, if you have a strong sense of self, you essentially have an anchor to hold you while you adapt. Without that anchor, changes can feel chaotic and even terrifying. In addition, having a strong identity allows you to develop self-esteem. Without knowing who you are, how can you develop a sense that you are worthwhile and deserving of respect?

Signs

Identity disturbance is sometimes called identity diffusion. This refers to difficulties determining who you are in relation to other people. Some people with BPD may describe this as having difficulties understanding where they end and the other person begins. People with BPD often report that they have no idea who they are or what they believe in. Sometimes they report that they simply feel non-existent. Others even say that they are almost like a “chameleon” in terms of identity; they change who they are depending on their circumstances and what they think others want from them. For example, you might find yourself being the life of the party at social events, but having a somber and serious demeanor at work functions. Of course, everyone changes their behavior to some degree in different contexts, but in BPD this shift is much more profound. Many people with identity disturbance in BPD say that in addition to changing behavior, their thoughts and feelings change to match the current situation. For example, they might frequently change their minds about the following:

Their careerFriendshipsAspirationsTheir opinions and beliefsOther major life decisions

As a result, many people with BPD struggle to set up and maintain healthy personal boundaries and have difficulties in their interpersonal and intimate relationships. They may also have trouble committing to values, goals, and jobs. In addition, those with identity disturbance find that their moods change frequently and unpredictably.

Relationship Issues in BPD

Those who are struggling with identity disturbance in BPD commonly have trouble forming close relationships with other people. Someone with identity disturbance likely experiences the negative effects of low self-esteem, including a lack of self-respect and personal boundaries. This can make it especially difficult to form bonds with other people. Another relationship challenge for those with identity disturbance is feeling a lack of support or meaninglessness in their relationships. Feeling an “emptiness” inside is common for those with identity disturbance. Since it’s hard for them to find meaning within themselves, they may face challenges finding meaning in relationships with their family, friends, and romantic partners.

Causes

There has been very little research on the identity problems associated with BPD, but there are many theories as to why people with BPD often struggle with identity. For example, Marsha Linehan, PhD, a leading BPD researcher and the founder of dialectical behavior therapy (DBT), believes you develop an identity by observing your own emotions, thoughts, and feelings, in addition to others’ reactions to you. All of these factors can make it difficult to form a coherent sense of self, because internal experiences and outward actions are not consistent. In addition, many people with BPD come from chaotic or abusive backgrounds, which may contribute to an unstable sense of self. If you determine who you are based on others’ reactions to you, and those reactions have been unpredictable and/or scary, you have no framework for developing a strong sense of identity. The ability to understand the mental states of yourself and others is known as mentalizing. This is especially difficult for those with identity disturbance and BPD. This means they struggle with comprehending human behaviors and intentions, making it extra challenging for them to know themselves and others intimately. One study published in 2017 showed that this problem with mentalizing may play a key role in why people with BPD struggle so much with identity diffusion and interpersonal relationships.

How to Find Yourself

So how do you go about answering the question Who am I? Of course, there is no magic solution for identity problems. However, most treatments for BPD include components that can help you begin to discover who you are and what you stand for. Often, the first step is finding a good therapist who can help you work on identity problems. Treatments for BPD that may help with identity disturbance include:

Cognitive behavioral therapy (CBT): This type of therapy can help identify any limiting beliefs a person has about themselves or others, making it easier over time to form relationships. It also addresses underlying anxiety and mood symptoms. Dialectical behavior therapy (DBT): This helps someone cope with intense emotions and control destructive behaviors. Mindfulness is often a technique used in DBT. Mentalization-based treatment (MBT): In MBT, a therapist helps a person with BPD improve their interpersonal skills. This type of therapy aims to strengthen their understanding of what they and others are thinking or feeling. Transference-focused psychotherapy (TFP): In TFP, as a client engages with their therapist, aspects of their identity disturbance plays out in the treatment relationship in many of the same ways they would with someone in their personal lives. This provides a way for the therapist to support an integration of different aspects of the patient self. Schema-focused therapy (SFT): SFT integrates a variety of psychotherapeutic techniques to try and help patients change entrenched, self-defeating patterns, or schemas, that might be be contributing to challenges with identity.

In addition, there are ways that you can work on identity disturbance on your own. You can begin to discover what you view as meaningful in your life. This type of self-discovery may be most effective in conjunction with therapy, especially as people with identity disturbance tend to struggle to find meaning. Knowing what’s most important to you can connect you with a greater sense of identity. Many people find creative outlets to be helpful ways to express and learn about themselves.

A Word From Verywell

Everyone struggles with identity issues. You’re not alone if you sometimes wonder who you are and what significance your life has. If you struggle with identity disturbance, know that there are health care professionals and many treatment types that can help. With the right support, you can overcome identity disturbance—and other symptoms of BPD.