Like most aspects of bipolar disorder, self-esteem is volatile. Everyone has fluctuations in self-esteem. Insecurity, doubt, boldness and egotism. These are all examples of stages of self-esteem that everyone experiences. Mostly they surround circumstances- a job interview, creativity, performances. These can all affect how we feel about ourselves. Hopefully they are predictable and mostly positive. In bipolar disorder, however, self-esteem can seem rarely attached to circumstances. It’s usually our moods that carry our self-esteem, and that can lead to an introspective whirlwind throughout the three stages of bipolar disorder.
One of the symptoms used in diagnosing bipolar disorder is a feeling of worthlessness. This goes beyond the frustration of “I can’t do anything right.” It is a gut-wrenching, heart-searing, melt-into-the-sofa feeling that makes you sure your mere existence is getting in the way of how the world should function. Sounds a little dramatic, right? Absolutely, but when you’re in it, you don’t realize that.
A lot of this feeling is due to self-stigma. We talk about stigma a lot, but usually in dealing with stigma coming from outside the mental-illness community. There is a whole other world of stigma that we place upon ourselves. As much as we want people to understand what we go through as bipolar patients, we simultaneously blame our condition on ourselves and are guilt-ridden for any negative outcomes our illness may cause. Can’t attend a social function because of my depression? That’s bad and I should feel bad because I can’t control myself enough. At the same time, we also overestimate the reaction from our peers to our perceived shortcomings. In essence, we think our missing out had a much more negative effect than it actually did. When they tell us it’s fine that we missed out and they weren’t offended, we don’t believe them and think they’re trying to spare our feelings. It’s an oxymoron of sorts. We feel horribly about ourselves yet have the view that we have more of an impact than exists in reality. Cue the next cycle when we come to that realization.
Disclaimer: I very rarely experience true mania. Those of us with bipolar II tend to go for hypomania, which has similar but mostly less extreme consequences. However, I do identify with occasional self-esteem boost that comes with it. I’ve told my therapist numerous times that I look forward to the more manic stages of bipolar disorder because it feels like an escape. Mostly during these phases I’m just easily agitated, stressed and even more hypersensitive to stimuli, so I cherish the times I get to feel on top of the world.
Grandiosity is a common term used to describe a manic phase. Confidence shoots up until it is perceived as arrogance. We’re not faking it either. At that point we really do feel superior. We’re smarter, more in control, more talented, more skilled. I get chatty in circumstances in which I usually would not, and later regret it. I have an uncontrollable desire to prove that my perception is correct.
In a more positive manner, I work harder to achieve goals because I’m more certain they are attainable. I make plans for the future because I feel they are worthwhile and have a higher likelihood of coming to fruition. I’m more likely to laugh instead of cry, to be bold rather than cower, to have passion rather than fear.
A euthymic phase is basically the “normal” phase between a depressive state and a manic state. This is the only time that using the word “fine” to describe how you’re doing is appropriate. I will save my rant on this subject for another time. In a euthymic phase, it could be imagined that self-esteem would be at a baseline level as well. Everyone has an average self-esteem whether high or low. When averaged out, there is not much difference in self-esteem between those with bipolar disorder and those without. If anything, self-esteem rises in those with bipolar disorder due to the severity of increased self-esteem in a manic phase. This could lead you to believe that when bipolar patients are in a euthymic state they’re not really any different than someone without bipolar disorder. Sadly, that’s the wrong conclusion.
Even between severe cycles, bipolar patients have more negative outcomes. There is a more consistent pessimism and perfectionism. Bipolar II patients especially tend towards neuroticism. This doesn’t go away no matter what phase we’re in. It’s a trait as permanent as the bipolar disorder itself. Another curiosity is that, though we hold ourselves to sometimes impossible standards, we don’t usually hold others to those same standards. They’re fine the way they are. We’re the ones we think need to change. The way out? The classic combination of therapy, medicine, support and time.