Self-esteem
Why self-esteem is important to your quality of life
Boosting self-esteem has been a popular pursuit on the path to mental wellness in the West. We naturally believe that high self-esteem, defined as our assessment of our own ‘value’1, is linked with an improved quality of life.
But self-esteem, in and of itself, may be overrated. Research on the topic shows that self-esteem (although potentially related to happiness, initiative and persistence after failure) is more often the result of accomplishments and skills than a direct cause of good outcomes2,3. Additionally, we need to be careful, as inflated self-esteem can lead to narcissism (or ‘self-admiration’), bullying and lack of concern for others, which often hurts people or pushes them away3. On the other hand, very low self-esteem can lead to depression, low motivation and suicidal thoughts2.
A basic problem with self-esteem is that it involves social comparison i.e. “how good am I compared to everyone else?”3 Yet failures, flaws, imperfections and pain are inevitable for everyone at different points in our lives, and no one person is ‘better’ than another. What’s needed, as with most things in life, is balance: feeling good enough about yourself to stay motivated and inspired, but avoiding the belief that artificially boosting your self-‘worth’ or self-esteem will change your life. In itself, it probably won’t. And besides, quick self-esteem “boosts” are hard to come by4.
Still, having a healthy relationship with yourself is vital to wellness, and that’s where the concept of self-compassion comes in.
The role of self-compassion
The concept of self-compassion includes the desire to ease your suffering and treat yourself with kindness. It involves seeing your experiences as part of a larger common human experience5, and developing an attitude of non-judgment towards yourself and towards your own pain, flaws and failures. Rather than needing to compare ourselves to others to establish self-worth, self-compassion means seeing struggle as part of the human condition. Instead of needing to feel better than someone else to maintain self-esteem, self-compassion allows a person to take comfort in knowing that everybody shares a common humanity – both in our suffering and our imperfections as well as in the positive aspects of ourselves.

Self-compassion doesn’t imply passivity, though. Acceptance and non-judgment towards the parts of yourself that you’d like to change can make it easier to pay attention to what needs to change, and can improve your ability to effectively change it5.
Self-compassion has been shown to help people suffer less and have a better quality of life4. In particular, research studies show that self-compassion is linked to lower levels of stress, anxiety and depression6 as well as better resilience to negative events5. It’s linked to feelings of happiness, optimism, gratitude, autonomy (or ‘independence’), competence, connectedness to others, self-determination, emotional intelligence, wisdom, initiative, curiosity, flexibility and life satisfaction7.
Having a kind and accepting relationship with yourself is especially important when you live with bipolar disorder. Studies show that people living with bipolar disorder can have a negative view of themselves8. There is some evidence that self-compassion is lower in people with bipolar disorder compared to people without the condition9,10 and that lower self-compassion may be associated with greater severity of depression10, anxiety and emotion regulation difficulties11.
Stigma and quality of life
Further, people living with bipolar disorder often encounter stigma: negative stereotypes and attitudes (e.g., of being different, damaged or undesirable in some way). Stigma is experienced at three levels: structural (in organizations like hospitals or workplaces), social (in society and in relationships) and internalized (self-stigma, or stigmatized beliefs that a person directs towards themselves).
Structural stigma is often found in healthcare settings, where people feel dismissed because they live with mental illness. Others who engage in paid work legitimately fear that disclosing their diagnosis to employers or colleagues might impact how they’re perceived, or might even limit their opportunities.
Social stigma is felt in relationships. It refers to people making unjustified negative assumptions about people who live with mental illness. For instance, automatically assuming that having a mental illness must make it very difficult to hold down a demanding job.
Self-stigma is where a person directs stereotypes and negative beliefs about people with mental illness towards themselves. For example, thinking “I’m not good enough because I have bipolar disorder”. It’s challenging enough to live in a world where others might stigmatize you, but to believe these negative views makes it even more difficult to live with the condition. Self-stigma can contribute to false negative beliefs about your abilities. It’s related to people not accessing mental health treatment, and with ending treatment too early. A study of self-stigma in people with bipolar disorder found that participants frequently experienced it—identifying shame, self-blame, self-doubt, self-judgment and self-loathing as part of their daily experience of living with bipolar disorder12. These participants reported that self-stigma greatly affected their quality of life. However, one study found that people who live with mental illness felt hopeful when they talked about the importance of learning about their illness and skills to manage difficult thoughts and feelings, and building strong relationships.

How you can take action
Self-compassion is a portable source of support, available 24 hours a day, 7 days a week, even when family and friends are unavailable. Just like you would put a Band-Aid on a physical cut, self-compassion is a way of caring for your emotional wounds. You can choose to improve your self-compassion and to reduce self-stigma. Self-compassion can be taught and practiced when it’s made a commitment to practice. Just like developing any habit, it takes a bit of effort to establish this new behaviour. But even a few weeks of self-compassion practice has been shown to decrease suffering and improve wellness13.
Be attentive to your own needs. |
The first step in this practice is learning to be sensitive to your own needs and distress, so that you can be warm and kind to yourself13. If it’s hard for you to pay attention to your inner experiences (such as thoughts, body sensations and feelings), mindfulness training or the help of a therapist may be useful.
There are a variety of exercises to practice self-compassion. |
There are a variety of exercises to practice self-compassion. Some involve the practice of noticing your judgments and trying to foster a gentler attitude towards yourself so that you get into the habit of engaging in compassionate responses automatically – to yourself, as well as others. It’s important to remind yourself that it’s human to make mistakes and have imperfections, and that you are not alone in your suffering. Finally, you can practice being mindful by keeping your attention on the present moment, even when it includes suffering. In this way, you might learn to let go of rumination about negative experiences, while staying aware of your distress and needs and also while providing support for yourself13.
Accept your human vulnerabilities and limitations, especially when first diagnosed. |
Self-compassion can be especially important when a person is first diagnosed with bipolar disorder. Self-compassion works against stigmatizing thoughts (e.g., thoughts of being ‘damaged’ or ‘weak’) and instead helps you to adopt an attitude of accepting human vulnerabilities and limitations. Similarly, it can be helpful to notice when you get stuck in “should” statements: for example, “I should be able to manage my symptoms without help,” “I should snap out of this depression.” At times like these, accepting your challenges and providing yourself with gentle self-care can go a long way in empowering you to seek help and to live better with bipolar disorder. If you notice that you have a lot of unhelpful “rules” or “should” statements in your life, it’s helpful to explore where these rules came from and the pros and cons of living with them. If you see these rules to be unhelpful, see if you can try to adopt healthier rules that allow room for more acceptance in your life. This will take a lot of practice: noticing when you fall into old habits, then trying to commit to your healthier new rules.
Utilize strategies from Cognitive Behavioural Therapy (CBT). |
There is not a lot of scientific literature on effective ways to stop self-stigma; however, Cognitive Behavioural Therapy (CBT) strategies can be helpful if you struggle with a negative self-image. If you have unjustified or exaggerated negative beliefs about yourself, you can have a self-image that is unnecessarily bleak or discouraging. One helpful strategy is to identify when you have distorted negative thoughts about yourself, for example, “Because I got one question wrong on the test, I’m a failure” or “No one called me today, so I must be unlovable”. Or you may catastrophize, for example, thinking, “I’ve ruined everything” or “I will never change”. These thoughts often lead people to avoid trying, or to be passive, which may reinforce negative thoughts. But once you learn to become aware of unhelpful thought patterns, you’ll have the ability to evaluate them. Try checking the facts by asking yourself:
- Do these thoughts help me?
- Am I seeing the complete picture?
- What other perspectives might there be?
- What would I say to a friend in the same situation?
- Am I ignoring any positives in this situation?
- What would be the most helpful action here?
Last, you can try to shift your focus to the important task of identifying your positive qualities and accomplishments, judging these in terms of your own values. If you strongly value being helpful to others, then you focus your attention on times when you have supported other people. The more you focus on your own positive behaviors or qualities, the more you can experience a gradually increasing sense of self-esteem. As an extension of this approach, try setting behavioural goals: activities that you are going to begin or increase that reflect your personal values. Once again, if you place a high value on being helpful to others, then set yourself the homework of assisting another person once in the next week: try to be specific about what you will do and for whom, then plan to do this at a particular time during the week.
References |
- Smith, E. R., & Mackie, D. M. (2007). Social Psychology (3rd ed.). Hove: Psychology Press
- Harter, S. (1999). The construction of the self: A developmental perspective. New York: Guilford Press.
- Neff, K. (2003). Self-Compassion: An Alternative Conceptualization of a Healthy Attitude Toward Oneself. Self and Identity, 2: 85–101.
- Barnard, L. K. & Curry, J. F. (2012). The relationship of clergy burn-out to self-compassion and other personality dimensions. Pastoral Psychology, 61(2): 149-163.
- Leary, M. R., Tate, E. B., Adams, C. E., Batts Allen, A., & Hancook, J. (2007). Self-Compassion and Reactions to Unpleasant Self-Relevant Events: The implications of treating oneself kindly. Journal of Personality and Social Psychology, 92(5): 887.
- MacBeth, A. & Gumley, A. (2012). Exploring compassion: A meta- analysis of the association between self-compassion and psycho- pathology. Clinical Psychology Review, 32(6): 545-552.
- Neff, K. D., & Costigan, A. P. (2014). Self-compassion, wellbeing, and happiness. Psychologie in Österreich, 114-117.
- Nilsson, K.K., Jorgenson, C.R., Craig, T.K.J., et al. (2010). Self-esteem in remitted bipolar disorder patients: A meta-analysis. Bipolar Disorders, 12: 585-92.1.1.
- Døssing M, Nilsson KK, Svejstrup SR, Sørensen VV, Straarup KN, Hansen TB. Low self-compassion in patients with bipolar disorder. Compr Psychiatry. 2015;60:53-58. doi:10.1016/j.comppsych.2015.03.010
- Yang Y, Fletcher K, Michalak EE, Murray G. An investigation of self-compassion and nonattachment to self in people with bipolar disorder. J Affect Disord. 2020;262:43-48. doi:10.1016/j.jad.2019.10.0421.
- Fletcher K, Yang Y, Johnson SL, et al. Buffering against maladaptive perfectionism in bipolar disorder: The role of self-compassion. J Affect Disord. 2019;250:132-139. doi:10.1016/j.jad.2019.03.003
- Suto, M., Livingston, J.D., Hole, R., et al. (2012). Stigma shrinks my bubble: A qualitative study of understandings and experiences of stigma and bipolar disorder. Stigma Research and Action, 2: 85-92.