The Functional Domain of Identity

Establishing a stable identity is one of the main developmental tasks of adolescence. During this vulnerable period of life, many internal and external influences can impair this development, which can result in identity disturbance or diffusion. In the DSM-5 Alternative Model of Personality Disorders, identity disturbance is one of the core aspects of impaired personality functioning, especially in borderline personality disorder. The association between depression and identity disturbance seems to be bidirectional. Severe confusion about oneself can increase the risk of subsequent depression. On the other hand, early starting depression can disturb the process of shaping a stable identity. In empirical studies and clinical practice, there is a frequent comorbidity between personality disorders and depression. Chronic emptiness reflecting a detachment from sense of self is one of the shared symptoms between these two disorders and is linked to identity disturbance. In adolescent patients suffering from depression and personality disorder, identity diffusion, if present, should be a crucial target of psychotherapy.