Those diagnosed with a mental illness often ask themselves: What if my sense of self is dependent on my illness, even decades after diagnosis?

Editor's note: What does it mean to be ‘mentally ill’? In this weekly column, Sneha Rajaram writes about navigating through a ‘mentally ill’ life — encompassing aspects that are both everyday (medications, rights) and contemplative (the universality of suffering)

As our collective awareness of issues surrounding the autism spectrum has increased, I’ve repeatedly come across the debate of people-first language vs identity-first language: for instance, whether to say “person with autism” or “autistic person” respectively. The question for people with an illness or for the differently-abled (let’s say “diff-abled”) is: Do you see yourself as a person first, a person who has an illness or a diff-ability, or do you see your condition as part of your identity? Many of us are neither here nor there, but somewhere on the spectrum. And even for the undiagnosed: How many of you forge an identity out of your suffering? How many would like to be defined by your adverse social, personal, and childhood experiences–and how many wouldn’t? And how much does it matter either way?

When in doubt, I usually turn to those particular Buddhist teachings that tell you not to identify with your thoughts, feelings and body sensations–well, usually. For instance, spiritual teacher Eckhart Tolle, who is not a self-professed Buddhist but whose teachings emphasise the importance of presence in the here and now, has this to say:

The mind unconsciously loves problems because they give you an identity of sorts. … This is not to deny that you may encounter intense inner resistance to disidentifying from your pain. This will be the case particularly if you have lived closely identified with your emotional [pain] for most of your life and the whole or a large part of your sense of self is invested in it. What this means is that you have made an unhappy self out of your [pain] and believe that this mind-made fiction is who you are. In that case, unconscious fear of losing your identity will create strong resistance to any disidentification. In other words, you would rather be in pain ... than take a leap into the unknown and risk losing the familiar unhappy self.

But in the case of suffering and identity I must blaspheme: I think an identity can be precious and empowering if done right. So I turn to another Buddhist teaching, commonly known as the raft simile: A person who needs to cross a river puts great effort into building a raft. The raft takes her safely across. When she reaches the other bank, should she abandon the raft, in which she has invested so much and which has been so helpful to her, or should she carry it around on land as she continues her journey?

Some rivers are crossed more easily with an identity. It can lend much-needed pride and self-esteem to those who have none.

It allows us to define ourselves in response to those who seek to define us. It makes the invisible visible and amplifies the voice of the silenced.

At what point does an identity cease to empower and begin to limit us? Some of us encounter this line in the sand several times a day. Each of us must answer that question for ourselves in each situation we encounter in our lives.

As for me, I find myself saying “I am bipolar” more often than “I have bipolar”. For us diff-abled or ill people who lean towards identity-first: What is the danger of personal suffering becoming who you are entirely, as Eckhart Tolle warns? What if your sense of self is dependent on your illness, even decades after diagnosis?

Many years ago, my then-psychiatrist told my then-boyfriend: “Once the medication kicks in you’ll be able to separate her nature from her illness.” This simplistic idea of how medication works is unavoidable in society and psychiatry. But the more disturbing aspect of such a statement is that, for me, there is no true nature vs illness. There is only time and flux. If my nature before I fell ill was A, then it changed as I became ill and now it’s closer to B. The future holds an unknown C. All of these are my “true natures”, insofar as I believe in such a concept. Even if I hadn’t fallen ill, my nature would’ve changed as I aged–perhaps more subtly. I don’t want to be an outsider to my sense of self, to my “true nature”, and identity-first thinking helps with that. Should I still be fighting for that teenager who was very different from who I am today? I don’t feel that would serve any purpose.

The drawbacks are severe, however. First, the investment in suffering. Second, the unwillingness to try to get better. And third, worst of all, the petrification over time of a dynamic, empowering, creative identity into one of the oldest, most stagnant identities ever: the victim. (Pre-dating my mental illness diagnosis, this identity is very strong in me.)

Spiritual teacher Caroline Myss calls this “woundology”. The “seductive power of wounds”, as she phrases it, can make us addicted to the attention and sympathy of those around us. Some of us fear losing more than just our sense of self if we get better – we could lose some of our relationships too, especially those that are predicated on a common feeling of victimhood.

Language is everything. This debate of people-first vs identity-first language is not “just semantics” about political correctness. Reading about it leads to a familiar feeling of seesawing that warns me I’m falling into binary thinking: I am convinced that we can and should learn when to use a raft and when to leave it behind–to juggle both ways of being ill/diff-abled and learn when each serves us best.

​Read more from this series here​