Who am I? Questions arise about self-esteem in patients with bipolar disorder

Self-esteem building is essential for everyone’s emotional health. People with a steady and stable sense of self-worth are better able to take care of themselves in the face of negative emotions and handle stress. They’re well-adjusted, and they just feel better in general. Who doesn’t want to have a healthy self-esteem?

Emotional disorders often threaten our sense of self-esteem. Low self-esteem is a factor in anxiety, depression, and bipolar disorders, making it more difficult for those with these disorders to find recovery and move on with their lives. Discovering new and better ways to build a strong sense of self-esteem may be pivotal in overcoming these emotional disorders and reducing the havoc they wreak on an individual’s life.

Self-esteem is especially problematic for those with bipolar disorder. One reason is that those with bipolar disorder experience a fluctuating sense of self-esteem. When manic or hypo-manic, their self-esteem soars, and they develop a grandiose sense that they are invincible. When depression hits, their self-esteem plummets, and they often stop dead in their tracks. After a few passes through this cycle of fluctuating self-esteem, they may lose the ability to trust themselves, making their sense of self even more tenuous.

Recently, researchers took a look at whether or not unstable self-esteem continued to be a problem for those in remission from their bipolar disorder symptoms. They compared patients with bipolar disorder, unipolar depression (consistently down), and a healthy control group. They measured self-esteem through diaries kept by each individual, looking for markers of self-esteem and positive or negative affect.

They found that fluctuating self-esteem persisted, even when a bipolar patient was in remission. This leads them to believe that the fluctuating self-esteem seen in bipolar patients may be part of their temperament and a marker for vulnerability to the disorder. It could also mean that their fluctuating self-esteem is linked to changes in neurotransmitter levels, the brain chemicals that control mood and contribute heavily to the patterns of bipolar mood swings.

This may not appear very hopeful. If study participants still lacked steady, stable sense of self-esteem even in remission, is there any hope for self-esteem building in bipolar patients? This research may point to a need for more directed therapy with a focus specifically on self-esteem for those seeking treatment for bipolar disorder. Also, the study does not report whether or not those in remission were able to change their behavior when faced with bouts of fluctuating self-esteem. If they were still able to engage in positive, self-supporting behaviors, even when experiencing a cycle of low self-esteem, the presence of these fluctuations may not be so damaging.

© Copyright 2007 Insight Journal Online Magazine.

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Stability of self-esteem in bipolar disorder [NIH.gov Study]
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