Desperate For a Sufficient Identity

By: Camden Baucke, MS, LLP

How do you introduce yourself?

I’ve pondered this question ever since I spoke with a stranger on a train from Frankfurt to Brussels.

Sitting across from him, we introduced ourselves. I told him my name, where I’m from, and my profession.

He gave me a curious look and chuckled, telling me that in his experience, Americans often introduce themselves through a profession—or a diagnosis. It was just one stranger’s take, but it stuck with me.

My mind went scattered—what did he mean? How else would I introduce myself?

That conversation pointed to a question worth sitting with: why do so many of us reach for identity through what we do, or what we struggle with?

Why does our occupation become us, and our diagnoses come to describe our entire being?

In this article, I’ll look at the ways we search for identity in places that can’t fully hold it, and the issues this can bring into the therapy room.

Occupational Identity

Identifying with your role is the age-old way to introduce yourself: “I’m a nurse… I’m a librarian… I’m an engineer.”

If you work as a doctor or lawyer, your status might be especially tied to your occupation.

But I say “work as,” not “are“—because occupation, on its own, isn’t a stable identity.

It’s a title placed onto a self that exists independently of it. You can be fired, retire, or change careers entirely. Your occupation will end, and you will still be who you were before it began.

An identity tied to occupation is also tied to the instability of performance and outcomes.

You’re an engineer one minute; one failed product test later, you’re at risk of feeling like a “bad engineer,” and by extension, a “bad person.”

If your sense of self-worth depends on achievement in your occupation, that foundation will always feel a little shaky—even when you succeed.

Diagnostic Identity

If achievement isn’t a sturdy enough foundation, people sometimes turn to their differences instead.

In therapy, one of the bigger barriers to recovering from depression is identifying as a depressed person rather than as someone experiencing depression.

That distinction matters clinically—when pain becomes who someone is rather than something happening to them, it can be harder to do the evidence-based work of addressing the beliefs, circumstances, or behaviors contributing to it.

Anxiety works the same way. When it becomes an identity, it can sometimes overshadow the real, treatable psychological mechanisms underneath it.

Many clients want to feel better but are hesitant to question the anxious or depressed identity itself—they want relief, while still holding onto the identity of someone in pain.

Neurological Identity

Many neurological experiences also become identities—some more stable than others.

“Neurodivergent” has become a meaningful, healing word in mental health spaces, reframing differences in neurological functioning as simply different, not inherently broken or bad. Autism and ADHD are the most common diagnoses claimed under that umbrella, and for many people, that language has been clarifying and validating.

At the same time, misinformation about autism and ADHD is widespread online—an estimated 40–60% of related social media content is inaccurate. That matters because the social symptoms associated with autism and the attentional symptoms associated with ADHD overlap with a number of other conditions: anxiety, depression, OCD, unresolved trauma. These are conditions with different treatment approaches, and conditions that are very treatable.

There’s a deeper problem with self-diagnosis than just bad information: people are not reliable narrators of themselves. We are all, to some degree, biased for or against our own self-image, and that bias shapes which label feels true long before any evidence does.

It’s why a narcissistic individual will often self-label as simply “confident” or “different in a good way,” while someone who is genuinely suffering and self-effacing will reach for a label that explains their pain without implicating anyone, including themselves.

Neither is assessing their own patterns accurately—they’re both interpreting themselves through the same lens that’s part of the problem. That’s precisely what a trained clinician is positioned to see from the outside, and what self-assessment structurally cannot.

This is part of why neurological diagnoses require a trained professional and a formal assessment, rather than self-diagnosis from a checklist or a video. It’s the same reason we gatekeep who performs heart surgery. We don’t ask surgeons to “earn” the right to operate as a way of putting up barriers for its own sake—we do it because misdiagnosis or the wrong intervention can cause real harm, and because some assessments require training and outside perspective most of us don’t have on ourselves.

Mental health diagnostics work the same way. A professional assessment isn’t a hurdle to jump before your identity becomes “valid“—it’s there to make sure that if something else treatable is going on underneath, like anxiety, depression, or trauma, it doesn’t go unaddressed while a different label takes its place.

If you’ve been formally assessed and diagnosed with a neurodivergent condition, identify however feels true to you. And if formal assessment isn’t accessible to you right now, that’s a real and common barrier worth naming—the goal isn’t to make anyone feel shut out of language that fits them, but to make sure that fit is actually checked against what else might be going on.

Identity as Permission

You don’t need a successful occupational identity to earn permission to seek happiness. You don’t need a diagnostic identity to permit yourself to love who you are through your differences and your pain.

So why do we reach for identity so readily? Because identity often functions as a kind of linguistic permission slip—permission to be who you are and feel what you feel. But you don’t have to cling to a label to live the essence of what that label describes.

Your brain may work differently than others’—and that’s okay. You’re allowed to be different without a diagnostic label to justify it. What labels often miss is that words are only representations of what’s real. You, and the world, exist regardless of what we call it.

What Identity Does Not Permit

Neither occupational nor diagnostic identity is permission to mistreat others.

You might feel you need to earn your occupational identity, and push aside anyone who gets in the way of becoming who you “are.” You might snap at someone and rationalize it as an extension of your “anxious” identity.

But even the most severe mental health conditions, even the most disorganized attachment style, are never sufficient justification for harmful behavior. No occupational need or diagnostic difference can rationalize harm to another person.

Identity Without Rationalization

You aren’t worthy only because of the work you do. You aren’t worthy only because you have a way to explain your difficulties or your differences.

Identity doesn’t need to be a tool you wield—it can simply be an expression of self that doesn’t require a label. You don’t need an identity label to give yourself permission to be who you truly are, or to feel what you feel.

Humanize yourself as more than a bundle of conforming words. Your existence needs no language to be known—and it’s okay to be different from everyone else.