Sunday, 22 November 2020

The Connection between Chronic Illness and Self Esteem

 (TRIGGER WARNING: Internalised fatphobia, body image, weight, mental illness, medication)

I've rarely had high self esteem, thanks to years of bullying, but my self esteem has taken such a knock since I've had chronic illnesses.

Throughout my treatment of chronic physical and mental illness, I have been on various medications, some of which have caused considerable weight gain. I try so hard to be body positive but I don't feel like me anymore and I'm desperate to get back some of my old self. I worry that others will think I've given up taking care of myself even though a combination of meds with weight gain side effects, inability to exercise sufficiently, and comfort/stress eating due to depression and anxiety, have led to significant weight gain and body change. I follow body positive people on Instagram in order to help with the disordered thinking I have about weight and diet. I read anti-diet books too. I think any change (not just weight gain) can have a serious effect on a person's self esteem. In my experience, in the past I have been known as the "skinny one", so I suppose, wrongly, I have made it part of my identity. I have liked being called things like "pixie", "petite" etc and when I don't see myself that way anymore, I feel very disappointed, at a loss, as if I've lost part of my identity and need to take on a whole new one which I don't particularly like. I know that this counts as fatphobia and I try so hard to reject those awful thoughts.

My balance problems and chronic pain, that come with Fibromyalgia and Hypermobility Syndrome, have changed the way I walk. I am a bit wobbly, I walk with my feet turned in (as much as I try not to), sometimes I limp. I have been stared at and mocked for this, and so my self esteem has taken a hit. I try not to let it bother me, but if I notice someone is staring, I am extremely aware of my manner of walking.

I often need to go to the toilet, due to Irritable Bowel Syndrome, Overactive Bladder Syndrome, and some bowel/stomach problems that are yet undiagnosed. If I'm particularly bad, I have to cancel plans last minute. Even if my friends are very understanding and compassionate, friends in the past haven't been and this has affected my self esteem too. I feel like a flaky, disappointing inconvenience, rather than a valuable friend. I feel all I do is annoy people and let them down. I know I cannot help this, because I would not do this if it weren't for my physical and mental illnesses, but it does not stop me from feeling this way.

Bladder and bowel issues can be (although they needn't be!) embarrassing and seen as a bit disgusting. I find I refer to them as "TMI problems" and try to describe them as delicately as possible to friends or people in Facebook groups. A lot of people have problems like this though, and a problem with bladder or bowel is nothing to be ashamed of! I do worry about it affecting my dating prospects though, although I would not want to be with a partner who was immature and easily disgusted by my health issues!

Part of mental health is self esteem, but mental health problems in themselves can have a severe impact upon self esteem. (Are you with me?). I'll explain. Anxiety can hold back so many things a person may want to accomplish for example. This could be taking on a dream job, travelling, or maybe even just meeting a friend for coffee. When someone has to cancel plans like these, or when they feel panicky whilst doing them, it can have a real knock-on effect. They can be frustrated with themselves for cancelling or acting in a "not normal" way. They may worry that others will pick up on the anxiety or the fact that they have cancelled multiple plans, and may treat them differently. I've certainly lost friends due to the way I've acted! These were friends I had felt quite close to as well. It does make you feel very low about yourself, as if there is something fundamentally wrong with you. 

Carrying on the mental health conversation, when very depressed we may push people away and isolate, maybe because we don't see a point in talking, maybe because we feel we are not worthy of friendship, maybe because we feel overwhelmed. There are many reasons why someone may isolate. The consequences of this could be losing friends, friends acting differently, friends not reaching in to persuade you to talk. Of course there could be many reasons why a friend might act differently that doesn't necessarily mean they see you as any less of a friend to them. When very depressed though, personally, I will perceive any change in their behaviour as a direct reflection on me and my personality. I may isolate, but I still want friends to reach in and try to contact me. If they don't, I feel that maybe they weren't that close to me after all and "of course" that's my fault for acting the way I do. I feel I can't help how I act though, so I believe I can't do anything about it. And therefore, self esteem = rock bottom. 

I'm constantly told by friends to not care what people think. I'm OK and I don't need to change for anyone. This is easier said than done though, especially when chronic physical and mental illness have ripped away my sense of self and confidence. I have a lot of paperwork from past CBT sessions, to do with negative thinking, all or nothing thinking etc. When very depressed, I don't see the point in looking through them. I also don't feel I deserve to have high self esteem. I think we all deserve to feel good about ourselves if we are good to others though. We beat ourselves up far too often, and usually for very small (although not to us) reasons.

I hope, in time and with practise, we will get that self confidence back.

What knocks your self esteem? Have you found ways of building yourself back up? Comment below!


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