Questioning yourself? You’re not alone. For many who live with bipolar disorder, one of the most challenging aspects can be the feeling of self-loathing.

Many of us are familiar with self-doubt. It’s that inner dialogue that makes us question our decisions, lifestyle, or value as a person. Am I good enough? Am I smart enough? Am I attractive enough?

These may be questions we’ve all asked ourselves at some point.But self-loathing, especially as a symptom of bipolar disorder, is on a different level.

For those living with bipolar disorder, it may be difficult to manage feelings of self-loathing and to open up about it with loved ones. But with the right understanding and treatment, it’s possible to manage these feelings and live a more balanced, fulfilling life.

When we think about bipolar disorder, we usually consider the changing moods, thoughts, and behaviors that go along with this mental health condition. However, what’s less discussed is the specific feeling of self-hatred that may arise during a depressive episode.

Self-loathing can be an overwhelming emotion. It may cause self-hatred or low self-esteem that exceeds helpful or typical self-criticism and awareness. It can be so severe that you consider self-harm or have suicidal thoughts.

Bipolar disorder, formerly known as manic depression, is a mental health condition that causes severe changes in mood.

During a manic or hypomanic episode, you may feel unusually “up,” energized, or irritable.

During a depressive episode, you may feel unusually “down,” sad, indifferent, or hopeless. According to the National Institute of Mental Health (NIMH), depressive episodes are characterized by:

  • lethargy or restlessness
  • changes in appetite
  • decreased or absent sex drive
  • difficulties with concentration and decision-making
  • feelings of sadness, emptiness, guilt, worry, or hopelessness
  • decreased interest in usual activities
  • trouble falling asleep, waking up too early, or sleeping too much
  • inability to experience pleasure
  • thoughts of self-harm or suicide

Research shows that a low mood is associated with a lower self-image. Self-loathing may be at the core of many of these symptoms, such as feelings of worthlessness or guilt.

It can also arise from the bipolar disorder diagnosis itself. You may feel like you aren’t going to achieve all that you wanted to or live the life you always imagined for yourself.

Thoughts

Sometimes, self-loathing thoughts can sound like:

  • I’m not good enough.
  • I’m different from everyone else.
  • I don’t deserve to be here.
  • No one likes me.
  • I’m a burden on my family.
  • What’s the point?

Behaviors

Self-loathing can change the way you act. Some examples include:

  • having trouble applying yourself at work or school
  • neglecting basic chores and personal hygiene
  • avoiding social situations
  • eating too much or too little
  • drinking alcohol or using substances in excess

Relationships

Self-loathing can add another layer to relationships. This includes:

  • avoiding interaction with others
  • choosing unhealthy relationship dynamics
  • ending relationships because you feel unworthy
  • having a hard time taking compliments from others
  • behaving in a self-sabotaging way, like fighting or cheating
  • having a hard time being vulnerable in relationships

Psychotherapy

You don’t have to go through this alone. You may find it helpful to seek support through the American Psychological Association’s (APA) Psychologist Locator.

Cognitive-behavioral therapy (CBT) is a type of therapy that can help you identify unhelpful thought patterns, beliefs, or behaviors that contribute to your sense of self-loathing.

Dialectical behavioral therapy (DBT) can help you practice radical acceptance around your circumstances and feelings living with bipolar disorder, including self-loathing. Research shows that dialectical behavioral therapy (DBT) can help those living with bipolar to:

  • learn mindfulness
  • develop skills for distress tolerance
  • decrease emotional reactivity
  • improve psychological well-being

Journaling exercises

Self-love exercises, like journaling, may be difficult to practice when you’re living with bipolar disorder. While this may seem like a small piece of advice, this exercise can actually make a big difference.

Take out a piece of paper, and write one of your unhelpful thoughts on the left side. Then, on the right side, write at least three thoughts that challenge that unhelpful thought. It could look like this:

No one likes me.1. My parents love me.
2. My dog can’t wait to see me when I get home.
3. My best friend totally “gets” me.
I’m a burden on my family.1. Everyone brings challenges in relationships, big and small.
2. My family loves me unconditionally.
3. If they needed help, I would do the same for them.
I’m ashamed of my diagnosis.1. This isn’t my fault.
2. This is like any other medical condition that needs support.
3. Plenty of people live happy, healthy lives with bipolar disorder.

By doing this, you’re vocalizing your unhelpful thoughts in order to process them, while counteracting them with more positive and useful ones.

Praise list

Start a praise list on your phone using a notes app. Every time someone gives you a compliment, write it down. On days when you’re feeling low, review the list for some reassurance.

To get your list started, ask your friends and family what they love about you.

Affirmations

Find a sticky note and write down a list of three things you love about yourself. Place the note on a mirror that you use often or next to the front door. When you see the note, take a pause and recite these affirmations to yourself, hand over heart. You can create a new one every day, each week, or any time it feels natural.

If this feels too cringey at first, jot down things that you’re grateful for related to you. For example:

  • I love my eyesight, which helps me watch movies I love.
  • I love my hands, which help me make things.
  • I love my voice, which helps me talk to people I love.

Brain dump

It can be useful to have a place to store difficult feelings, other than in your mind. A brain dump in the form of a journal or small notebook may make you feel lighter. Plus, you can study yourself and try to identify patterns.

When you’re having negative thoughts, write them down in a stream of consciousness until you feel better.

Perspective

If you’re upset about your diagnosis, it may be useful to remember that living with bipolar disorder wasn’t your choice. It would be the same as having a physical condition, like thyroid disease. Know that it’s not your fault.

This mental health condition doesn’t have to define you, either. No matter how a bipolar disorder diagnosis might make you feel, it’s possible to manage your symptoms.

If you’re living with self-loathing, you’re not alone. It’s a common symptom of bipolar disorder, particularly during a depressive episode.

While self-loathing may impact your everyday life, it’s possible to manage this symptom with psychotherapy, journaling exercises, and self-care strategies.

It can also be useful to hear from people who are having similar experiences as you. Next, read this article on what it’s like to live with bipolar disorder.

If your self-loathing is coming from the diagnosis itself, try to go easy on yourself — you didn’t ask for this. Like any other medical condition, the right treatment plan can help you have a happy, healthy life.