The Impact of Self Esteem Building for Bipolar Disorder

Building self-esteem is a crucial component of therapy for individuals with bipolar disorder, as it can directly impact how a person copes with symptoms, reduces internalized stigma, and improves overall functioning. Below you’ll learn more about strategies for building self-esteem in therapy and how this impacts overall wellbeing.

Understanding the Link Between Self-Esteem and Bipolar Disorder

• Low self-esteem is common, especially during depressive episodes, and can increase vulnerability to stigma and worsen outcomes.

• High self-esteem during manic episodes may appear inflated but is often unstable and not grounded.

• Addressing fluctuating self-perception helps stabilize mood and foster resilience.

  
  

Reducing Internalized Stigma

Internalized stigma (self-stigma) refers to the negative beliefs a person holds about themselves due to their diagnosis.

Strategies:

• Psychoeducation: Normalize bipolar disorder by educating about the neurobiological basis and prevalence.

• Cognitive restructuring: Challenge and reframe negative thoughts such as “I’m broken” or “I’m a burden.”

• Narrative therapy: Help clients rewrite their personal story, focusing on strengths, values, and growth.

• Affirmation exercises: Practice daily affirmations focused on self-worth and capability.

• Support groups: Facilitate connection with peers to share experiences and reduce feelings of isolation.

  
  

Building Self-Esteem in Therapy

Cognitive-Behavioral Techniques

• Identify core beliefs and automatic thoughts related to self-worth.

• Challenge distorted thinking patterns, e.g., all-or-nothing thinking, catastrophizing.

• Replace with balanced, evidence-based thoughts.

• Use self-esteem worksheets (e.g., “positive qualities list,” “success log”).

Behavioral Activation

• Schedule and engage in activities that foster a sense of accomplishment and pleasure.

• Start small, such as hobbies, social interactions, or volunteering, and build up.

Strengths-Based Therapy

• Focus on identifying and using personal strengths in daily life and treatment.

• Encourage reflection on past achievements and skills.

• Use strength inventories or values clarification exercises.

Compassion-Focused Therapy (CFT)

• Develop a self-compassionate internal voice to counteract harsh self-criticism.

• Practice compassionate imagery and mindfulness exercises.

• Use techniques like writing letters from a compassionate perspective.

Supporting Emotional Regulation and Symptom Management

• Teach mood monitoring to identify early warning signs of mood shifts.

• Incorporate DBT skills (emotion regulation, distress tolerance, interpersonal effectiveness).

• Encourage routine and structure to help stabilize mood and reduce uncertainty.

Therapeutic Alliance

• A strong, validating therapeutic relationship is central to rebuilding self-esteem.

• Therapist Role:

  
  

  • Affirm the person beyond the diagnosis.

  • Emphasize progress and effort over perfection.

  • Create a space for clients to express fears about judgment or relapse.

Cultural and Identity Considerations

• Address how stigma and self-esteem are shaped by culture, gender, sexuality, and community support.

• Adapt strategies to respect and integrate the client’s identity and values.

Measurement and Goal-Tracking

• Use validated tools like the Rosenberg Self-Esteem Scale or Internalized Stigma of Mental Illness Scale (ISMI).

• Track self-esteem over time alongside mood symptoms.

• Celebrate progress, not just symptom reduction.

  
  

Incorporating self-esteem building into therapy for individuals with bipolar disorder is not only empowering but essential for long-term recovery and resilience. By addressing internalized stigma, fostering a balanced self-view, and reinforcing personal strengths, clients can develop a more stable sense of identity and worth that endures beyond mood fluctuations. These strategies help clients not only manage symptoms more effectively but also reclaim their agency and confidence in everyday life. Ultimately, self-esteem work becomes a foundation for healing, growth, and a more compassionate relationship with oneself.