Similarly, at some point, most who conclude their troubles are serious also con- clude they need treatment but that being mentally ill is an important part of their identity. As one person explained to sociologists David Karp and Lara Birk:
I am a mental patient. I am a depressive. I am a depressive (said slowly and with intensity). This is my identity. I can’t separate myself from that. When people know me they’ll have to know about my psychiatric history, because that’s who I am.
This change in identity, even if it helps individuals find appropriate treatment, can raise difficult questions about the self. First, those considered mentally ill are often feared and rejected by others, even if their symptoms disappear over time. Those who identify as mentally ill typically hold the same views and thus experience increased depression, increased social isolation, and lower self-esteem. This does not mean, however, that treatment is not worth it, but it does mean that stigma can partially cancel out its positive effects.
Second, the goal of psychiatric treatment is to change essential components of the self: feelings, emotions, and ways of thinking. Especially when the treatment relies on external forces such as surgeries or drugs, it raises the question of whether one’s thoughts and feelings are really one’s own. Am I a happy person, or am I just happy because of the drug? Am I in love with my girlfriend, or is the drug making me feel that way? And so on. Such questions can lead individuals to experiment with drugs and drug dosages to try to find a way to feel not only healthy but also truly themselves.