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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Bipolar Wellness Center Webinars Connect. Learn. Engage. CREST.BD CREST.BD

Self-Esteem

Featuring: Dr. Stephen HinshawCREST.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 BDWhy increased self-compassion and decreased self-stigma are important to your QoLHow you can take actionTools and resources

Webinar focus

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The good and the bad of life with BD

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 good and the bad of life with BD

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, self-compassion and self-stigma 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-esteem, self-compassion and self-stigma Self-compassion

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

Self-esteem, self-compassion and self-stigma Stigma

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structuralsocial self-stigma

Self-esteem, self-compassion and 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, incompetenceDehumanization:Perception that person with mental illness isn’t fully humanSingle word changes perceptions1

Self-esteem, self-compassion and self-stigma Stigma

1Martinez, 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/practicesThus, likelihood (though not certainty) that such individuals will internalize these beliefsAntidotes: identity, group solidarityDouble 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

2Nilsson, K.K., Jorgenson, C.R., Craig, T.K.J. et al. (2010). Self-esteem in remitted BD patients: a meta-analysis. BipolarDisorders, 12: 585-92. 3Suto, 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

4MacBeth, A. and Gumley, A. (2012). Exploring compassion: A meta-analysis of the association between self-compassion and psycho-pathology. Clinical Psychology Review, 32(6): 545-552.5Neff, K.D., and Costigan, A.P. (2014). Self-compassion, wellbeing, and happiness. Psychologie in Österreich, 114-117.6Sirey, 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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How you can take action

A portable source of support, available 24-hours/day, 7 days/weekMay 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 imperfectionsSimilarly, 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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How you can take action

Not something you inherently have or don’t have: a commitment you can practiceJust 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 approachesWhen 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 valuesSet 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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ResourcesSelf-CompassionThis 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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ResourcesThat’s Just Crazy Talk DVDDVD 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/

http://www.bdwellness.com/

http://www.bdqol.com/

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Acknowledgments

CREST.BD Self-Esteem & Bipolar Disorder Slides

Education