What to Do When IBS Lowers Your Self-Esteem

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Does having IBS make you feel bad about yourself? A chronic health problem like IBS can often have the effect of dragging down a person's sense of self-worth. It is hard to feel good about yourself when your body does not allow you to function the way you would like to be functioning. Unpredictable symptoms make it hard to commit to plans or get things done, both of which are important factors in boosting a person's self-esteem.

Chronic health problems like IBS can also negatively impact your self-esteem due to your concerns as to how you are perceived by others. You worry that others will see you as someone who can't be counted on or as someone who is a royal pain because of your special health and diet needs. It is hard to think that others will value you, when your health problems makes you question yourself.

Further compromising your self-esteem is the fact that because IBS involves digestive symptoms there is an element of shame and embarrassment that is not experienced by people who have other types of chronic illness. In addition, the lack of "real" physical findings on diagnostic testing may also make you feel worse about yourself. One study showed that IBS patients had lower self-esteem than people who have inflammatory bowel disease (IBD), a health problem with similar symptoms. Because of the lack of overt inflammation, there remains the stigma that people with IBS are somehow doing this to themselves--the old "it's all in your head" type thinking.

This attribution of physical symptoms to a personal failing is certainly going to make a person feel bad about themselves.

For all of these reasons, it becomes essential that you take steps to counter-act the downward drag that IBS can have on your self-esteem.

Self-Esteem vs. Self-Confidence

Before we discuss how to fix the problem, it is important that we are clear on what is meant by self-esteem.

Self esteem is basically how you view yourself, in other words, what you think your worth is, often in comparison with other people. Self confidence is more situation-specific, e.g. are you confident enough to introduce yourself to a stranger or to give a speech in public. You might have confidence in certain of your abilities or confidence as to how you would conduct yourself in certain situations, but still have low self-esteem. IBS may affect both. The fear of needing to be near a bathroom or the fear that you cannot function of debilitating pain may interfere with your ability to feel confident that you can manage a certain situation, thus affecting your self confidence. However, the bigger problem is when IBS makes you feel bad about yourself -- that because you have a chronic digestive problem this somehow makes you a less valuable person.

Common Thinking Errors

An important aspect of cognitive-behavioral therapy (CBT) is to replace thinking errors that contribute to unnecessary emotional distress.

Here are some examples as to how our brains work in a way that contributes to us feeling bad about ourselves:

1. Negative Filter

Most human beings have a negative filter when it comes to how we think about ourselves. A prime example is that we will minimize and forget a compliment within minutes, but magnify and hold onto a criticism for decades! There must be a biological advantage to this--possibly the benefit of an awareness of possible threats. However, what is good for the survival of the species is not necessarily good for our individual happiness.

2. Our View of Others vs. Our View of Ourselves

Think about how you assess other people. Isn't it true that you decide rather quickly if someone is likable, smart, and/or attractive. And doesn't this assessment stay very sticky over time? In other words, your smart friend can say or do something dumb and it doesn't change your opinion as to how intelligent they are.

On the other hand, our appraisal of ourselves tends to be very detail-focused and often is constantly changing. If we have a bad hair day, we decide we look terrible. If we make a mistake, we feel like an idiot. We say the "wrong thing" to someone else and we are convinced that they are now going to hate/reject us.

Feeling Good About Yourself Even If Your Body Feels Bad

The following strategies can help you to replace these thinking errors, as well as to counter-act all of the negativity surrounding having a chronic health problem:

1. Come Up With a Healthy Overall Self View

You are not your IBS! It is important to keep in mind that IBS is something that has happened to you--you did not do this to yourself. Even if anxiety is a trigger for your symptoms, it is still a biological process that is at work here. It is important to look past your brain's negative filter and focus on all of the other wonderful things that make you you! Other people do not look at you and only see IBS, they view you as a well-rounded person who happens to have problems with your stomach.

See if you can work on internalizing a more steady view of your self-worth and pay less attention to the voice in your head that is constantly pointing out your failures. And, if you can keep in mind that other people already have a fixed, global assessment of your like-ability, you don't have to continue to sweat the small stuff. It doesn't matter if your IBS prevents you from meeting a commitment, the other person will attribute your failure to come through on your IBS, not on you personally.

Anecdotally, I have heard from many people who have IBS that they actually work harder and take on more responsibility than is necessarily good for them to make up for the fact that they have IBS. If you can remember that you don't need to prove your worth to anyone else, you can ease up on this self-pressure. Cutting yourself some slack will reduce anxiety--something that is certainly going to help your digestive tract to function more optimally!

2.  Write a Self-Esteem List

It might be helpful to sit down and make a list of all of the qualities that define you and the roles that you play in life. Your negative brain will be challenged by this exercise; it will want to minimize and qualify all of the good things about you. Or, your training in "not being conceited" may make it hard for you to actually acknowledge your personal strengths and talents. If you are really stumped, ask someone who loves you to help you to fill out the list.

Keep this "Self-Esteem List" in a place where you can refer to it frequently. If you have a bad IBS day (or weeks!), the List can serve to remind you that you are so much more than a person with a screwed-up digestive tract. Don't forget to keep adding to this list! Every time you receive a compliment or accomplish a task, counteract your brain's tendency to minimize these positives and add them to the list. When you are feeling low, drag out the list and refresh your memory as to all of the things that make you a unique, wonderful, valuable human being. You will then see that although having IBS has a negative impact on your life, it doesn't have to have a negative impact on what you think about yourself.

Sources:

Bengtsson, M., et.al."Anxiety in close relationships is higher and self-esteem lower in patients with irritable bowel syndrome compared to patients with inflammatory bowel disease " European Journal of Internal Medicine 2013 24:266-272.

Donoghue, P. & Siegel.M. (2012) "Sick and Tired of Feeling Sick and Tired" (New Edition) New York: W.W. Norton & Company.

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