CREST.BD Self-Esteem & Bipolar Disorder Slides

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CREST.BDBipolar Wellness Center Webinars
Connect. Learn. Engage.

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Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
Self-Esteem

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Connect. Learn. Engage.CREST.BDCREST.BD
Self-Esteem
Featuring: Dr. Stephen Hinshaw
CREST.BD Member,
Professor of Psychology and
Former Chair of the Psychology
Department,
UC Berkeley and
Vice Chair for Psychology,
Department of Psychiatry,
UC San Francisco

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The good and the bad of life with BD
Self-esteem, self-compassion and self-stigma
Self-compassion, self-stigma and BD
Why increased self-compassion and decreased
self-stigma are important to your QoL
How you can take action
Tools and resources
Webinar focus

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The good side:
With optimal support, care and empowerment,
people with BD can flourish, leading healthy,
fulfilling lives, making creative, innovative and
important contributions to society

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The bad side:
The world can be a tough
place for people with BD
• Symptoms
• Impairments
• Stigma

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Boosting self-esteem has been a popular pursuit
on the path to mental wellness
Self-esteem, in and of itself, may be overrated
• Too low, and motivation suffers
• Too high, and motivation suffers for different
reasons
Self-esteem

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Includes the desire to ease suffering and heal with
kindness. It involves:
• developing an attitude of non-judgment and kindness
towards pain, flaws and failures
• seeing experiences as part of a larger common human
experience
• doesn’t necessarily imply passivity
Self-compassion

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Stigma strong for all forms of mental disorder,
with BD no exception
Stigma constitutes stereotypes, prejudice, and
discrimination
Stigma

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structural
social
self-stigma
Stigma occurs at three levels:

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Why do structural and social stigma occur?
Structural Reasons:
System justification, in hierarchical societies (all!)
Conditioning:
Pervasive media images of violence, incompetence
Dehumanization:
Perception that person with mental illness isn’t fully human
Single word changes perceptions1
Stigma
1
Martinez, A., Piff, P. K., Mendoza-Denton, R., & Hinshaw, S. P. (2011). The power of a label: Mental illness diagnoses,
ascribed humanity, and social rejection. Journal of Social and Clinical Psychology, 30: 1-23.

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Self-stigma and BD
Nearly all members of stigmatized groups are aware of
the culture’s stereotypes/beliefs/practices
Thus, likelihood (though not certainty) that such
individuals will internalize these beliefs
Antidotes: identity, group solidarity
Double whammy: disorders themselves likely to fuel
demoralization, but self-stigma multiplies the risk

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Self-stigma and BD
People with BD view themselves negatively2
Research has shown that people with BD describe
self-stigma as a common occurrence — identifying
shame, self-blame, self-doubt, low self-judgment
and self-loathing as part of their daily experience
of living with BD3
2
Nilsson, K.K., Jorgenson, C.R., Craig, T.K.J. et al. (2010). Self-esteem in remitted BD patients: a meta-analysis. Bipolar
Disorders, 12: 585-92.
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Suto, M., Livingston, J.D., Hole, R., et al. (2012). Stigma shrinks my bubble: a qualitative study of understandings and
experiences of stigma and BD. Stigma Research and Action, 2: 85-92.

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Why increased self-compassion and decreased
self-stigma are important to your QoL
Higher self-compassion linked to:
• lower levels of stress, anxiety, depression4
• increased happiness, optimism, independence, social
connections and QoL5
Even controlling for initial levels of symptoms, self-stigma predicts:
• lack of treatment seeking
• early termination from treatment6
4
MacBeth, A. and Gumley, A. (2012). Exploring compassion: A meta-analysis of the association between self-compass
ion and psycho-pathology. Clinical Psychology Review, 32(6): 545-552.
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Neff, K.D., and Costigan, A.P. (2014). Self-compassion, wellbeing, and happiness. Psychologie in Österreich, 114-117.
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Sirey, J. A., Bruce, M. L., Alexopoulos, G., Perlick, D., Raue, P., Friedman, S., J., & Meyers, B. (2001). Perceived stigma
as a predictor of treatment discontinuation in young and older outpatients with depression. American Journal of
Psychiatry, 158: 479-481.

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A portable source of support, available 24-hours/day,
7 days/week
May be especially important when first diagnosed with BD
Self-compassion helps to counter stigmatizing thoughts (e.g.,
of being ‘damaged’ or ‘weak’) – helps instead to adopt an
attitude of accepting human vulnerabilities and imperfections
Similarly, can be helpful when you get stuck in “should”
statements (e.g., “I should be able to manage my symptoms
without help”, “I should snap out of this depression”)
Self-compassion

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Not something you inherently have or don’t have: a
commitment you can practice
Just like developing any habit, takes a bit of effort to establish
this new behavior
First step is learning to be sensitive to your own needs and
distress
Self-compassion

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How you can take action: CBT approaches
When you have distorted negative thoughts about
yourself, e.g., “No one called me today, so I must be
unlovable”
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?

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Shift your focus to your positive qualities and
accomplishments, judging these in terms of your own
values
Set behavioural goals: activities that you are going to
begin or increase that reflect your personal values
How you can take action: CBT approaches

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Tools and Resources

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Resources
Self-Compassion
This website is by one of the originators of Mindful Self-
Compassion, Dr. Kristin Neff, and has many self-compassion
exercises, video and audio clips and readings.
http://www.self-compassion.org/

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Resources
That’s Just Crazy Talk DVD
DVD recording of a play written
and performed by mental health
educator Victoria Maxwell, who
lives well with BD. The play has
been the focus of two research
projects that showed it was
effective in reducing stigmatizing
attitude towards people with BD, in
particular in healthcare providers.
http://www.victoriamaxwell.
com/?product=thats-just-crazy-
talk-dvd

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For more information and resources,
visit our Bipolar Wellness Center at:
http://www.bdwellness.com/
To assess your quality of life,
visit our QoL tool at:
http://www.bdqol.com/

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Acknowledgments

CREST.BD Self-Esteem & Bipolar Disorder Slides

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CREST.BD Self-Esteem & Bipolar Disorder Slides