When You’re Struggling with Self-Loathing in Bipolar Disorder

Many people with bipolar disorder struggle with self-loathing. Maybe the self-loathing starts as the depressive phase does with all sorts of awful thoughts about yourself. Because that’s how depression works: It outright lies, and inflicts pain.

You can’t do anything right. You’re an abject failure. You’re also stupid. And worthless, and no one will ever really love you for you. You are not attractive or thin or strong enough. You are weak, and you are an embarrassment.

Maybe it happens after a manic or hypomanic episode, because you feel terrible about what you did or said during that time. And the regret, remorse and shame turn into self-hatred.

Maybe the self-loathing lingers always, swimming under the surface, or “simmering at a low temperature,” as clinical psychologist Cynthia G. Last, PhD, said. Last specializes in treating individuals with bipolar disorder in Boca Raton, Fla.

“If I’m being ‘real,’ I always hate myself,” said Gabe Howard, a writer and speaker who has bipolar I disorder. “Nothing I ever do is good enough. It doesn’t matter what I achieve, I will always find a way to tear it down…”

“It’s worse when I actually fail—like if a project goes poorly, or like when I was going through my divorces. It’s worse when I’m depressed.”

When people compliment Howard, he assumes they’re making fun of him. He requests reassurance often: Was that OK? Is that what you wanted? “Then I try to figure out if they are lying to me.”

Many of Last’s patients also say they hate themselves. “They say it in a very venomous way.” Or they’re mortified by their behavior. “Sometimes they are so frustrated by their perceived inadequacies that they act out by hitting themselves on the side of the head with their hand. I’m sorry to say this isn’t uncommon.”

When Katie Dale, who has bipolar I disorder, changed schools in 11th grade, and had a hard time making new friends, she started to hate everything about herself, too—her looks, personality, school performance, what she said or didn’t say. She also felt like the weakest link on her soccer team, which deepened her self-hatred.

Dale would obsess about her supposed flaws, compare herself to others and put oppressive expectations on herself. This led her to feel like she wasn’t “worth anyone’s time, energy, or love.”

Today, Dale is a mental health advocate and caseworker who loves helping others find peace of mind. She blogs at BipolarBrave.com, and lives in the Midwest with her husband. With treatment, her self-loathing has diminished. “I am still particular about my looks, but I have had to learn a lot about forgiving myself and being kind to myself.”

Treatment has helped Howard, too. “Before [treatment] the self-loathing was so bad I didn’t bother to attempt anything because I just hated myself so much. Now I assume I suck at it—but I keep doing it. Believe it or not, that is progress.”

For Jessica Gimeno, treatment for her bipolar II disorder, and various near-death experiences have silenced her once shattering thoughts. Gimeno is a mental health writer and speaker who is best known for her award-winning TEDx Talk, “How to Get Stuff Done When You Are Depressed.” In addition to her mood disorder, she also has five autoimmune conditions, including myasthenia gravis, which leaves her in constant pain, and almost killed her at age 24.

In the past, Gimeno’s self-loathing showed up as ruminating thoughts any time anything went wrong—any time there was an awkward social interaction, or a misunderstanding over email. She would panic that she did something terrible, and replay the situation over and over in her mind.

What Helps to Shrink or Silence Self-Loathing

Treatment isn’t the only reason Dale’s self-loathing has diminished. It’s also thanks to her faith: “reading the Bible and God’s promises about what He thinks of me, reminding me that I’m loved and beloved, and that nothing I do can separate me from His love. Grasping this truth and planting it deep into my heart makes a big difference.”

Faith is paramount for Gimeno, too. “As a Christian, I believe that God is there with me when I suffer and I believe that spending time with God is my joy—there’s this verse that says, ‘the joy of the Lord is our strength.’ Faith allows me to have peace in the turmoil.”

Gimeno also doesn’t have the time or energy to overthink things anymore. She’s constantly tired from the autoimmune problems. She’s watched friends die from the same diseases she has.

“Time is a very important thing to me, and I cannot waste it.”

Similarly, she’s had a powerful shift in perspective. Just several months ago, she attended a social gathering—the first one in five months, after enduring a traumatic event. She made an awkward comment and she didn’t think the host liked her.

“The old me before I acquired all these autoimmune illnesses, when I was younger, would have relived that encounter at the party over and over again. The battle-tested version of me today is like, Was this a life or death situation? No. Nobody died. Then, it’s no big deal. Not everyone is going to like me, and that’s OK. As I write this, I have friends who are dying slow painful deaths now due to their autoimmune diseases—a party gone wrong is just a party gone wrong.”

Pep talks and reminders of the incredible hardships she’s faced help, too. “If I’m nervous about a thing that makes a lot of people nervous like giving an important presentation before a board meeting, I’ll give myself a pep talk like a trainer gives his boxer in between rounds. I tell myself, “…is this meeting harder than having your neck cut open and glued back together? Is this harder than having surgery without anesthesia? Then, it’s not hard. Go in there and do it.”

For Howard, honest, direct conversations are vital. “If my wife tells me she is happy with me, I believe her. Because I trust her to tell me when she is unhappy.” The same is true for his Psych Central podcast co-host, who he trusts to tell him when a show went well (and not-so well).

Howard also regularly repeats this quote from Ralph Waldo Emerson in his head: “To laugh often and much; to win the respect of intelligent people and the affection of children; to earn the appreciation of honest critics and endure the betrayal of false friends; to appreciate beauty, to find the best in others; to leave the world a bit better, whether by a healthy child, a garden, a redeemed social condition; to know even one life has breathed easier because you have lived. This is to have succeeded.”

Exercises to Try

Gimeno suggested readers write down what you’re proud of, and turn to this list any time you doubt yourself or feel down. This “can be anything from accomplishments that the world considers ‘success’ to the other things that are important to you like just surviving. This year, I survived a traumatic event. That survival won’t be something I list on my LinkedIn profile, but it’s a big deal to me.”

Howard keeps positive emails, awards and mementos, and turns to them when he’s feeling awful. What things can you keep that remind you of your strengths and just how capable you really are?

Last, author of the book When Someone You Love is Bipolar: Help and Support for You and Your Partner, stressed the importance of replacing self-loathing thoughts with helpful, supportive thoughts. You can practice this by taking out a piece of paper; writing the negative thought on the left side; and writing at least three thoughts that challenge that hateful thought.

Last shared this example: You think, “I hate myself. I have to take five medications to be OK!” You come up with the following thought that actually serves you (and is very much true!): “Bipolar disorder is an illness. It’s not my fault I have it and have to take meds for it. People with other types of illnesses have to take meds too to be OK.”

And that’s the thing: Bipolar disorder is an illness. As Last said, you didn’t choose to have it, and you couldn’t have prevented it. “[T]he condition doesn’t define who you are as a human being; you have bipolar disorder, but you aren’t bipolar disorder.”

Last likened it to hypothyroidism, which she has. “I have thyroid disease but, of course, it’s not the essence of who I am.” And neither is bipolar disorder.

And here’s another thing: You don’t have to wait until the self-loathing lifts, until you finally feel good about yourself to treat yourself with kindness. Start treating yourself as though you appreciate and love yourself, as though you’re absolutely worthy. And start doing it right now.

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