May 16, 2005 2:47 PM   Subscribe

I hate myself. This is a problem.

I hate myself. No, I mean I REALLY hate myself. I have been struggling with this since the age of 12. I am now in my late 20s. I don't hate my personality so much as I just hate my body, or more specifically being IN my body. I am disgusted by my human-ness, if you will. (Perhaps there is a term for this.)

I have had a long and exhausting battle with acne. I barely went outside for 4 years because I was so ashamed of my appearance. I gradually came to realize that I have a hormonal imbalance and now I cannot go off birth control or chaos will ensue. Then, last year I came to the devastating realization that I have rosacea. Ha! What a dirty, dirty trick. In addition to this progressive skin disease I have also experienced progressively worsening gum recession due to an as yet unidentified cause. No dentist can tell me what is wrong with me. I have bruxism and wear a mouth guard but it hasn't helped.

When I look at myself in the morror I see only my flaws. I don't need to be a super model; I just want to be me--minus all of these disorders and diseases. I am consumed with thoughts of "fixing" myself. Something close to panic sets in with each passing day. I am pathetic and mull over the fact that I am poor and will never be able to afford dental implants, cosmetic surgery, etc.

Most days I could really care less if I died. I don't want to get out of bed. Ever. But the kicker to this rant is that I am in love with the man of my dreams. He is my everything. I rely on him 100%. Needless to say, he has been deeply hurt by my depresion. After 5 years together I think we are both at the breaking point.

The crux of our neverending argument is that he feels he is #2 in my life--#1 being my self-hatred and the amount of time and energy I devote to it. I can't really argue with his statement because it is true. I try to reassure him by telling him that he IS #1 in my heart and that I don't purposely place anything or anyone above him. It's just that frequently, without even realizing it, in my mind I am more consumed with my own agony than I am with my love for him. I want to be the person he deserves but I think I have run out of ideas. I don't know how to change my viciously negative thought patterns.

I have been through all kinds of therapy and been diagnosed with everything from body dysmorphic disorder to post-traumatic stress to severe clinical depression. I don't think more therapy is the answer. I have taken enough psychology classes and paid for enough 1-hour sessions that I already know the strategies and theories--it's a matter of implementing them.

I've tried Prozac, Celexa, Paxil, Sam-e, and St. John's Wort. No success. Currently, I am trying Wellbutrin but it's too early to tell. I'm not expecting much.

I guess I should say that my depression isn't solely based on my appearance. It's all connected. I don't have the confidence to achieve the things I want in life. I have a degree in the arts but I, predictably, work in an office. If I hadn't experienced this myriad of health/appearance issues, I really think I would have liked to be the next Dian Fossey or Jane Goodall. Or perhaps tecahing children in Africa or South America. Now I feel that I am restricted to the "developed" world because of my dependence on certain medications, the constant threat of a nervous breakdown, and my selfish attitude.

I think my questions are:
1. How can I stop hating myself so much?
2. What can I do to stop incessantly thinking about hating myself and letting it invade my relationship?

I'm sorry this is so long. If anyone cares to bite at this from any angle and try to make sense out of me...
posted by anonymous to Health & Fitness (55 answers total) 12 users marked this as a favorite
What works for me might not work for you, so YMMV. But I will offer what I can.

I think first you need to trust that great man you are with. Do you trust him? If so, then trust that he has made a good choice in being with you. He is with you for a reason. He is not blinded by love or whatever other excuse you would like to provide in order to continue hating yourself. He loves you for a damn good reason. He finds you attractive. Now trust him.

I have a disorder that involves pulling my hair out. For years, people in school and even relatives picked on me or told me to "just stop". I hated my appearance due to this for years. Then at some point, I chose to simply accept it. Obviously this decision didn't happen overnight, but I accepted that I pull my hair and that I'm going to have bald patches, and the world can go to hell if they don't like it. I'm not here to please them, after all. I'm here for myself, and part of that is accepting myself and moving forward. I know you are in this pretty deep and hearing someone say "accept it" might not work. I'm just saying what worked for me.

Wellbutrin took over two weeks to work for me, and then two additional weeks each time I increased the dosage. Hang in there, hopefully it will help you.
posted by veronitron at 2:59 PM on May 16, 2005

It seems you are running through all the answers that someone might contribute here. In the end, therapy is the only way to cope as I see it and then it really is only coping (me being of the school of thought that we never can really change ourselves, only learn to not let our neurosis debilitate us -- on preview -- sort-of what veronitron is leading to).

You say you've "been through all kinds of therapy". Is this the crack where we can set the lever? Many people are never through with therapy -- it is not something that has no real end -- although one might take a break from it. Get back on it I would say -- no drug should be taken without it as an accompaniment.

(I am not a doctor, therapist etc. but I've been around individuals with similar problems. I'd say more but I would need to post anonymously.)
posted by Dick Paris at 3:07 PM on May 16, 2005

Considering how many people must have offered you advice on this (all those therapists, etc) I feel like anything I suggest will be old news to you, but sometimes you just have to hear things the right way, somehow, so apologies for anything that sounds obvious -

a) you love this man. That means you have to respect him. That means you have to respect his opinion. His opinion is that you are worthy of being loved. If you really love him, it's your responsibility to see how cool you are.

b) you have to just make a choice to drop certain obsessions. I know that is much easier to say than to do, but even so, you simply have to make an executive decision. You'll probably fail, for a while anyway, but you can't let that stop you. You make the decision to be(come) a certain kind of person, and you just don't let it bother you that you keep fucking up. Stay focused on what you're going to do, not what you have or haven't done already. Stay focused on the choice you've made and not the results so far.

c) support groups or 12 step programs can be really useful for the right sort of person, and there are programs like that for just about every kind of issue (esp. if you live in a metro area). The same programs can really rub other people the wrong way, but you might find it worth checking out.

d) projects or hobbies that get you out of your head can be great therapy. art, music, and exercise come straight to mind for me - you can get lost in painting or playing the piano or hiking alone in the woods or swimming laps.

e) is it worth limiting the number of mirrors around you? If you really get caught up in physical appearance, maybe trying to retrain yourself to literally be less reflective wouldn't be a bad thing! Try concentrating on all the enjoyable visual and aural experiences you have of the world itself, instead of those related to you. Go to the park and look at the trees, etc.

f) with depression in general, it is worth evaluation your personal goals, what you really want in life etc. You should not feel restricted by medications. I have also spent much of my life on medications, and have felt that restrictedness, too (I can't drive, for instance, due to medical issues), but you have to find ways that allow you to get what you want out of life anyway. Remember that everyone has some limitations, plenty of people worse off than you, blah dee blah, and honestly try to find a path that will be fulfilling.
posted by mdn at 3:10 PM on May 16, 2005

I'm trying to think outside the box here, but have you tried thrill-seeking? You hate your body, so why not abuse it with something like extreme skateboarding, kickboxing or downhill cycling. Think Fight Club, only for real.
posted by mischief at 3:15 PM on May 16, 2005

I've had a couple periods of self-loathing and managed to work myself through them by a slow process of changing my focus (similar to veronitron).

I had to start with doing something positive. One thing that worked well once was volunteering to help out at a dog adoption place. Then I wrote it down in a journal saying what I had done. I'd try to write down in this journal every positive thing that happened to me, that I did, or that I thought. Nothing negative was allowed in the journal (including negative positves, things like "a meteor didn't hit me" wasn't allowed as an entry either). If I didn't write anything in it, that was fine. Maybe I did the dishes before they were crusted over, or maybe I paid the bills on time, whatever it was, if it was positive, it went in there. Over time, it got easier to find things that were positive. Plus, re-reading all the positive things reinforced that there were good things happening in my life. Eventually I found that I didn't need the journal anymore, and I had accepted myself for who I was ... and I was much more resilient to that dreaded self-loathing feeling.

as veronitron stated YMMV ... but it worked for me.
posted by forforf at 3:16 PM on May 16, 2005

Maybe going to teach children in South Africa is just what you need. Sometimes I wonder if a lot of our depression and self-hatred are produced by the circumstances of life in the affluent western world, and if going somewhere where just simple life is enough to be thankful for would cause us to realize how ridiculous all of our expectations are. Of course, it's easier for me to say this than to actually put it into practice.

On preview, forforf's comment about volunteering at the dog shelter kind of reflects what I had to say - something about taking the focus off of oneself and onto those who are just glad to be alive and who really need our help.
posted by matildaben at 3:19 PM on May 16, 2005

I was clinically depressed for a while, and although the medications did have an effect, solving the underlying issues "cured" me completely, and I haven't taken anything in years.

So, instead of putting all this energy into hating or trying to treat a depression that may not exist, how about putting it into fixing the issues you see with yourself? It doesn't sound like you're dysmorphic, it sounds like you really do have medical issues that need treatment. You say your acne was controlled by birth control pills--that's great. If you still have outbreaks, or really want to get off the pill for whatever reason, see a dermatologist. There are many highly effective treatments for acne that aren't available over the counter. Same with rosacea.

And the same for your gum issue--see a good periodontist. Even if they don't know the cause, periodontal surgery can work wonders.

In other words, it doesn't sound like you're depressed, it sounds like you're unlucky in the health department, which can make anyone feel under the weather.

If the expense is an issue, quite honestly, acne and rosacea treatments should be far less expensive than therapy and anti-depressants, and while I don't know the extent of your periodontal issues, you owe yourself at least an initial visit to a periodontist.
posted by trevyn at 3:19 PM on May 16, 2005

a really good therapist will help you cut through the "i know how already" stuff and get to the "so why haven't i done it?" stuff, and then on to the "ok, this is what it feels like to feel incrementally better, even if it's a very tiny increment, and how can i be patient with myself about that" stuff. it's not the only answer, but it can be a better answer than it sounds like you've had from therapists in the past. best of luck.
posted by judith at 3:21 PM on May 16, 2005

I just want to point out that your question was really well written, anonymous. Unlike most anonymous questions, you set out all the issues very clearly; no one has asked for more information.
As for advice: I've had terrible problems with birth control affecting my mood. I know a few other people that have had similar psychological problems when on birth control that virtually disappeared when they stopped taking birth control. For me, my self esteem plummets, I hate myself, I get suicidal. As other people have said, there are other ways to treat acne besides hormones. I would suggest you find a very sympathetic doctor and either try switching to a different birth control pill or go off it completely.
Good luck!
posted by nprigoda at 3:31 PM on May 16, 2005

None of us is always happy with our appearance nor do we always feel happy about our human-ness. We preen and pine and hope and dream for better realities. But generally these are fleeting or occasional thought patterns, often associated with depressive periods or as a result of life circumstances. You are telling us about longstanding obsessional frames of thinking and I'm sure you know yourself that there's unlikely to be any quick fix.

Implementing those behavioural/thought strategies you've learnt from the psychologist sessions is the way back. The question is, how do you generate the motivation and lasting stamina in practising of these techniques?

I'm inclined towards 3 possible solutions, all of which will require motivation and committment.

First would be to enter into some sort of convenant with yourself in which you approach this situation practically and gather all the books and reading material you've no doubt collected during your previous counselling. Allot say 30-60 minutes every day to firstly organize them logically and construct a schedule for these techniques (and I certainly don't know enough to attempt any outline of possibilities in this regard and rely upon your advice that you acquired a certain amount of knowledge previously) and you stick to it religiously. In this situation I would also seek and enlist the aid of your SO, if not to help you with the techniques themselves, but at least so he will both give you support and latitude and also see that you are making a constructive effort.

Second would be a support group, perhaps focussed on depression where you would be able to share more fully of your feelings in a safe environment and gain feedback and help and friendship to help you keep following an upward path towards more favourable thinking patterns.

Lastly and particularly if these other possible scenarios for one reason or another aren't successful or you don't feel you can pursue them, I would most seriously consider returning to a professional, but I would strongly advocate a psychiatrist this time so that the medication side of things can be tweaked to its most advantageous and so that you can also engage in therapeutic talkfest. You might need to shop around, as you probably know, to find one compatible, but I think with the longstanding nature of the situation as you describe it, expending a bit of energy finding the right person will pay off in the long run. It may even be that during a holiday from work, they recommend that you attend somewhere as an inpatient - do it. Intensive treatment may be a very beneficial way to get you over that first hump towards acceptable well-ness. Best of luck.

on preview .. I type slow....I may be repeating some/all. If so, take it as a seconding. (now I'll go read them)
posted by peacay at 3:32 PM on May 16, 2005

To extend what mischief and matildaben have already said:

It must be the case that a lot of our mental ills are exacerbated, if not positively caused, by the fact we pass our days dealing with essentially trivial issues. Most of us in the developed world simply never deal with mortal issues; but humans evolved facing them on a daily basis. Most of us humans simply don't function "normally" if we're never really called on for anything beyond the daily round of mundane, phone-it-in, first-world role playing.

You need perspective.

You know that your misfortunes, painful as they are, are as nothing next to those of a mother who has lost a child, yes? And how many mothers lose their children every day in this world? So, really—and I know I'm not telling you something you don't already know—your attitude ought to be one of profound thankfulness. That it isn't, however, is not some horrible reflection on you. You aren't morally deficient because you are obsessed by your problems; you just haven't gotten the requisite perspective, because you can't get that perspective from an armchair.

Put yourself bodily on the line. Go into the wilderness, where you have to deal with the basic human needs 24 hours a day. Better, go teach in a third-world country, where your problems will be dwarfed by those of the people around you. You'll find that you have to remind yourself to hate yourself—you'll have too much else that matters on your mind.

My apologies if you have done this already, but I suspect you haven't. Think about it—when was the last time you met a Peace Corps volunteer with self-hatred issues?
posted by bricoleur at 4:21 PM on May 16, 2005 [2 favorites]

Semi-full disclosure: I've been depressed most of my life. I've been in therapy three times, not to mention the therapists I visited once or twice and then quit seeing. (And there were a lot of those.) I take Wellbutrin and Effexor, and have managed to wean myself to one therapy visit every three weeks.

I know what you're dealing with isn't easy.

My ex-husband said to me once, after a fierce bout of self-loathing, "Do you really think I'm that stupid? Do you really think I would want to be with someone who is that bad?" I could tell by his tone that he was genuinely hurt; it had gone beyond confusion. It's one of the things I'll never forget, and one of the things that motivated me to get real help.

You already know that you have to fight for your relationship. (It's a shame you won't fight for yourself, but the fight is what's important, no matter what prompts it.) Turn that need to fight into the energy it takes to start the therapy "thing" again. Maybe even try couple's therapy, since there are two of you involved.

One of the therapists I stopped going to see was a marriage counselor; therefore, my then-husband was with me. Neither of us liked the therapist, but we gave it a good try, and the guy did say one thing that was important. He told me, "[Your husband] is worried about you. I'm worried about you." That's not even advice, but it was the best thing he said for the three months we saw him. I needed that third party to tell me that yes, I was worth worrying about, and that my ex was worried.

As Dick Paris said, medication needs to include therapy. To turn that upside down, though, give the medicine time to work. No psychotropic is a miracle drug that will make you better overnight, but when you find the right drug or combination of drugs, meaningful therapy suddenly becomes possible. At least for me, I was able to reason clearly enough, think clearly enough, see clearly enough that all the same old crap I had been hearing for years made sense and I could decide on a plan of action. I compare it to when I first got glasses -- I didn't know I was supposed to be able to see across the room, or that the television picture was so sharp.

It also helped that I finally found the right therapist. I have been counseled by some wonderful people, but only this one got through to me. I don't know if it was a coincidence that she was more highly educated than the others (she had a Ph.D.), or had been practicing longer.

I think what I'm trying to say is that there is reason to keep struggling with the seemingly-endless rounds of therapy and new meds. Eventually, it clicked for me.

On preview, what trevyn, Judith and peacey said. Keep trying to find the root of your physical problems, a good therapist will help you get beyond the knowing to the doing, and, if you aren't already, see a psychiatrist for your medications. A family doctor isn't equipped to handle the problems you are having.

I hope I haven't worried you by talking about my ex-husband. Before I got myself straightened out, I thought the sun rose and set with him. As you say, he was "my everything." About a year after the medicine and the therapy clicked, I left him. Turns out he wasn't so great after all. (Diagnosable workaholic, and I don't mean that as a joke.) But I don't mean to imply that's true in your case!
posted by Jaie at 4:23 PM on May 16, 2005 [1 favorite]

You are loved, anonymous. Somebody loves you. That means a lot. You should stop and think about what it really means, to be loved. Especially to be loved when you hate yourself so much.

I empathise with the sort of self-hatred you describe; particularly bodily disgust. Have you ever read Sartre's "Nausea"? I read that when I was a self-loathing adolescnet and it resonated with me hugely. Note: it will not make you feel better, but it will let you know you're not alone in these feelings.

But someone loves you. Consider that this person's judgement might be better than yours. Don't you respect this person who loves you? Don't you respect their opinion? How do you think it makes him feel to have you effectively telling him that he loves something disgusting?

If we consider ourselves and our bodies in a relentlessly negative light it is extremely easy to be relentlessly disgusted. We have pot bellies, acne, BO, halitosis, unwanted hair, distended pores, varicose veins, blackheads, cellulite, hairy moles, bad teeth.... oh, we can have a fine old time considering the infinite inadequacies of our human form and existence. But even the most misanthropic and depressive of us must also - if we are honest - recognise that there are fine, even beautiful things there too. A sparkle and smile in the eyes. Shared confidences. The easy joy of mutual understandings and shared experiences. The gentle touch in the stillness of a shared night. Soft kisses on chapped lips. And even when we are alone: stillness, the flow of our thoughts, the things we can do with our bodies and minds, the way we can choose to fight life's light and shadows or dance with them.

We are all ugly/beautiful. Life is ugly/beautiful. Deny neither the ugliness nor the beauty. The beauty is there, and your lover recognises it. You owe it to him and yourself to stop resisting it and start recognising it too.

Good luck.
posted by Decani at 4:51 PM on May 16, 2005 [12 favorites]

My (completely uninformed) suggestion is to make a list of all the ways you could express love for yourself and your body, and to start doing those things. Gradually introduce new good habits one by one and gradually eliminate behaviors that reinforce the negative thought patterns. You could start with something as simple as making a point of flossing your teeth, making an effort to drink a little extra water, or taking a daily multivitamin, and build up to taking regular vigorous exercise. The point is that there is always something small enough that you can get started right now. If you act like you love yourself, you'll start feeling like you love yourself. Admittedly, my depression has been mild in comparison to yours but these kind of little changes have really helped me.

Also, if you've had all your skin care advice from your general practitioner, try figure out if there is a way you can afford a consultation with a dermatologist. I found this to be a worthwhile investment. Good luck.
posted by teleskiving at 4:59 PM on May 16, 2005

Not to get you down even more than you already are, but the Peace Corps is very hard to get into. Teaching in a foriegn country is as easy as knowing how to speak English, which you already have a good comamnd over.

I concur with mischief's advice, though. You need to do something that takes up all your mental & physical energy so you don't have the time/inclination to think about yourself. I'm sorry I don't have anything else to offer except, well, Good luck.
posted by Civil_Disobedient at 5:21 PM on May 16, 2005

Make your bed everyday. I saw this on TV 25 years ago. It cured my chronic depression. I have only told two other people about this and it helped them incredibly. Make your bed everyday. I think you will notice a difference.
posted by snowjoe at 6:01 PM on May 16, 2005

It sounds like you are letting obstacles get in the way of pursuing adventure. Yet these adventures - whether it's being Jane Goodall or teaching children or just visiting a faraway place - are going to give you the confidence you need and help you put your physical problems in context and see that they're not the end of the world.

So start planning a trip to teach kids somewhere. There are many firms that place people abroad for teaching positions. The new situation and challenge will help you change your perspective. Maybe your man will even want to come with you.

I also second investigating birth control as a cause of some of your depression - it made me depressed as all hell.
posted by mai at 6:03 PM on May 16, 2005

I second what nprigoda said about birth control pills - they caused terrible mood problems for a good friend of mine too, but doctors didn't seem to make the connection. You may want to ask a dermatologist if there's any possible alternative. Also, even if you can't commit to a full year of teaching or other work, I've always found that just visiting a different country is often so exciting and distracting that it helps jolt me out of unhappiness. I haven't experienced your extent of depression, but maybe it could help you a little, too?
posted by xammerboy at 6:04 PM on May 16, 2005

Here's a suggestion. Make two lists:

1) What are things that make you feel good when you do them?
2) What are things that make you feel good after you do them?

Concentrate on doing the things in list #2. (For me, that's exercise and yoga; I find after I've devoted an hour to them in the morning that the rest of the day goes much more easily, as much as they annoy me when I'm actually doing them sometimes. They also make me feel much more centered in my body.)

(Phrase the question, also, as: "If I loved me a whole lot, what would I do for me?" Then do those things.)

Also not a bad idea to make another two-part list. Part 1 is specific things you want to do--goals you want to attain, of whatever kind. Key word here is "specific": that means you don't have to judge whether you've attained them, it's right there on paper. Part 2 is a ridiculously detailed list of the intermediate steps you have to take on the way to every goal in part 1. Then cross out each step as you accomplish it. Each step, on its own, is not hard at all.

Does this address your feelings toward yourself and your body directly? No; but it makes it much easier to help yourself.
posted by 88robots at 6:04 PM on May 16, 2005

Not a recommendation for everyone, but for me it's like this: having some personal debt hurts me far less emotionally than does trying to live with certain fixable problems. For example, if I try to save money on food, I usually end up gaining weight. Then I feel bad in my clothes (and can't buy new clothes due to trying to save money), then I feel insecure talking to new people, I am less charming, I'm not confident in my relationships, I take fewer risks, and I get fewer opportunities. So, when my budget won't suffice, I use credit to be able to keep eating the fresh vegetables and premade salads that keep my body in check.

The key is figuring out before you spend the money whether what you're paying for will really fix everything and enable you to stop dwelling on it. For me, the big issues are maintaining my weight and waxing. I don't use credit for clothes and haircuts because if my weight is good and my limbs are smooth, I feel fine about all the rest. For you, having a regular dermatologist or some corrective dental work or a flight to Costa Rica might be the key that ends the big worries. And if you have any non-free habits that you do for comfort, you may even be able to cut them out in exchange for the peace of mind (e.g. cable tv = dental co-pay). Or maybe someone who loves you would happily lend or give you the extra money?

My second suggestion echoes what some others have said: find a different body-based obsession to replace your current ones... such as marathoning or eating raw or hardcore yoga. Diverting focus is a good thing, but keeping it in the "body" realm might change your appreciation for the vessel you've got. (Not to mention that being expert in something is always good for conversations in situations where you might otherwise start feeling weird and wondering if people are noticing your flaws.)
posted by xo at 6:17 PM on May 16, 2005

Re: teaching

Two friends of mine have gone to Africa (one to Uganda, one to Ghana) for a month through Global Volunteer Network. Very very positive experiences.

Best advice I can give regarding new hobbies -- don't tell anyone at first. Nothing worse than announcing your new thing and then feeling like a jerk for not having "results" after a couple of weeks.

Honestly, not to sound like some weirdo shill for subscription DVD services, but my Netflix subscription (combined with cancelling cable) has been a lifesaver. Without the I-don't-even-like-this-show but I-watch-it-anyway-TV, I'm renting entire film festivals' worth of movies. The habit of more edifying entertainment has jumpstarted me back into better reading material, too. Turns out that I had let the slow ooze of how dumb and shallow and banal life can be really get to me and into my expectations of myself.
posted by desuetude at 6:44 PM on May 16, 2005

Response by poster: I also dealt with extreme self-loathing. Two things got me over it:

1) At the lowest point of my life, I asked myself why I was thinking and behaving in a way that made things worse. This didn't mean I stopped believing terrible, inaccurate things about myself--it's just instead of obsessing on those things I let it go.

Let it go. These things about your appearance--they don't matter. Life matters. The things you enjoy matter. The happiness of your loved ones matter. Life is too short and there are too many wonderful things in it to think about the bad.

2) Realizing that other people genuinely liked me and there were likeable things about me. I had to go through #1 to get friends, I was that broken. But you've already clearly got people who love you--if you were the terrible, ugly creature you think you are do you think they'd hang around? They're not faking it. They see the parts of yourself that you don't see. They see you and they love you, despite any problems you think you have. This is all the more reason to let your problems go. They are happy with you--be happy with yourself, believe me, nothing, no amount of physical attractiveness, nothing would make them happier than for you to just take the weight off your shoulders, enjoy life, and let the light shine from your eyes.

It helps tremendously to stop focusing on how bad your problems are and put them in perspective. Plenty, plenty of people have it worse off. Think about the good parts of your life.

If you want to help people, you don't have to go to South America. Start by working and volunteering locally--this will satisfy your desire to do social work and allow you some flexibility with job options. You can use this as a springboard later to do the Peace Corps work if you decide your medications aren't as crucial as you thought they were.

Finally, you're not a shallow, selfish creature. You're human. Every single human on the planet wants to be beautiful, every single human wants to be loved and desirable. It's natural. What you have to understand is that these things have nothing to do with each other; if anything, being loved and showing love causes beauty, not the other way around.

(Finding a different body-based obsession can be a very bad idea. You're just treating one obsession with another obsession without fixing the underlying problem. See, I tried doing that and the result was bulimia. Don't do yoga because you want a body you can love--do yoga because you already love your body and want to take care of it.)
posted by Anonymous at 7:04 PM on May 16, 2005

'I have been struggling with this since the age of 12. I am now in my late 20s. "

"I have been through all kinds of therapy."

These two statements cannot be true at the same time.

"I have taken enough psychology classes and paid for enough 1-hour sessions that I already know the strategies and theories--it's a matter of implementing them."

You need to get back into therapy and stick with it, not play little games with yourself, wasting your money and the therapist's time. You're not done with therapy after a certain number of sessions. That much is pretty obvious in this case.
posted by raaka at 7:12 PM on May 16, 2005

Try meditation (the indian kind). Find a decent teacher in your area, and stick to it. I think you need to find some way to make peace with yourself, and I can't think of better way than the internal route.
posted by dhruva at 7:18 PM on May 16, 2005

These two statements cannot be true at the same time.

Unless of course, the therapy was ineffective.

But you've already clearly got people who love you--if you were the terrible, ugly creature you think you are do you think they'd hang around?

You'll convince yourself that they're humoring you aor hanging around out of pity.

Look, I have no answers to this question. I've dealt with my dislike of my own appearance by completely neglecting it and reveling in slovenliness. It's quite liberating. But that's probably bad advice.
posted by jonmc at 7:20 PM on May 16, 2005

For me, hating myself and refusing to take care of myself are two sides of the same coin.

You can't force yourself to love yourself. You can force yourself to take care of yourself. So do it. Dress as well as you can afford. Eat as healthy as you can manage. Make a point of reading books you'll enjoy (or renting movies, or going to shows, or whatever). As everyone else is urging, take the best care you can of your health problems. Treat yourself really damn well.

If you're anything like me, you'll find it's difficult. You'll want to quit being nice to yourself. You'll feel like you don't deserve it, or it's not worth the effort. That resistance is proof that you're doing something worthwhile — that you're really challenging yourself. If you feel resistance, force yourself to keep at it. You need to train your brain to recognize that you deserve good things no matter what.

YM, of course, MV. This is what worked for me. Try it and see if that resistance is there for you; if it is, push the hell out of it until you can see the other side.
posted by nebulawindphone at 7:37 PM on May 16, 2005 [1 favorite]

Well it doesn't sound like you're actually suicidal which means you're already ahead in the game than many I've known. Seems to me like you're just stuck in a rut. For the last 20 years you've carefully cultivated and developed this terrible mindset and collection of habits that just feed upon themselves. You need to make a change--the bigger the better. Give away all your posessions. Get out of the country. Join the Peace Corp. The worst that may happen is you'll end up too poor and hungry to waste time going over each of your flaws again and again.

Like Dylan said, either get busy living or get busy dying.
posted by nixerman at 7:38 PM on May 16, 2005

The book Feeling Good, despite the cheesy title, was very helpful for me in teaching me how to change my thoughts which were causing (and caused by) depression.
posted by callmejay at 7:48 PM on May 16, 2005

I have nothing to add to the excellent advice given so far except for this story.
posted by euphorb at 8:03 PM on May 16, 2005

No time to read all of the above suggestions, but I'm sure there are many good ones. Now for some more extreme options:

Go skydiving. I always accept that I might die when I jump out of a plane, and I'm always thankful when the chute opens, and I just glide around watching the ground for a while.

Rent a high-powered jet ski, and go to town. This isn't for everyone, but it is the closest thing I've found to skydiving that doesn't involve a plane. Just avoid crowded areas.

Do something that you would never think of doing. Whatever you are thinking of, do the opposite. Live life. Nothing makes you appreciate life like being near death.

And there is always mescaline, but I wouldn't recommend it unless you have a handler, and are ready to accept things you might not be ready to accept. Google for San Pedro. I normally wouldn't even mention it, but it will change your perspective on things.

Any of the above will change your life, hopefully for the better. Best of luck. You'll get through it.
posted by bh at 8:23 PM on May 16, 2005

Reading your question made me realize that I share some of this... while I'm lucky in some ways, I can suggest:

Do something to make you proud of yourself. Then you will feel worthy. Make it something worth your time, but that you feel will probably yield a good result.

You've got your wits (I'm worried about mine sometimes); you've got a lot of your health. If you want to be beautiful, create something beautiful. You didn't say what "arts" but, even if it's the performing arts, this implies a sympathy with the beauty of life that you can use in more lasting art forms.

If it's important to you, you can make a plan that will get you enough money to get the dental implants, etc. Or to travel _somewhere_.

Look at what you _have_; make a list. These are your resources. Then make a plan or some art.

And if you want to train your mind to focus on what _you_ think is important, make a plan to do that.

Just get there a solid step at a time, and know that the steps will lead where you want.
posted by amtho at 8:23 PM on May 16, 2005

I got to this too late in the game as well, but I wanted to take a minute to say a couple of things:

First, I agree with all of the recommendations to get off the birth control. I think that, especially for people who are already prone to mood problems, it makes them much worse. There are plenty of other things that will control your acne...a dermatologist will help. I had extremely bad acne for all of my teenage years and some of my adult years so I can say that I do know how you feel. Acne is terrible.

Second, therapy can be so excellent, if you find the right person. I don't know that I agree that they have to have a Ph.D.... mine was a social worker who had been practicing for years. She helped me so much.

Third...medication can take a really long time to work. I take Celexa, and it was a good 8 weeks before I really noticed differences that were remarkable. Give anything you try some time to work. Also, see a psychiatrist if you are able. They know what they're doing.

Fourth--do you exercise? It helped me a whole lot. It is the one part of my life that I will never change.

I can't say any more than anyone else has....they're all great ideas.
posted by fabesfaves at 9:26 PM on May 16, 2005

Just because I forgot to add--I have been on two different birth control pills and both times I got insanely depressed. I wanted to be clear that I've had the same experiences as the others who commented.
posted by fabesfaves at 9:27 PM on May 16, 2005

"Don't let the troubles in your head steal too much time you'll soon be dead." This keeps life in perspective for me. Self-loathing is just a silly thing to do. Consider thinking from an existential viewpoint and you'll see that simple things that everyone takes for granted are really amazing. I think we forget that we live on a big rock that spins really fast and we have no idea where we are hurtling towards. The notion of how we came to be is alone enough to at least stop thinking about a little acne problem. And without further ado here is the meaning of life. Be warned, its powerful stuff.
posted by pwally at 11:16 PM on May 16, 2005

I really like forfof's suggestion, but it seems to me that this is more likely (more of) a physical problem than an emotional one:

* Symptoms began at the age of puberty

* Symptoms include acne and rosacea

* Birth control pills exert some benefit

If you haven't already, I would say you need to see a good endocrinologist, and get a serious, in-depth assessment. You already realize that you have hormonal issues, but if they are serious or complicated with other possible problems, then of course you are miserable and your emotions are out of control. Just look at what happens to perfectly healthy women during menstruation, pregnancy and menopause. I suspect that your psychological trouble and your skin trouble simply arise the same source: a serious hormone imbalance which may possibly be complicated by something else. If you haven't rigorously explored this avenue of diagnostic inquiry, I think it should be your first priority!
posted by taz at 11:22 PM on May 16, 2005

Everyone has already covered any suggestions I have, so I just want to chime in with a "me, too" for depression while on the Pill. I was having full-on screaming fits because I was crying so hard, often for no reason at all. I thought I was just dealing with a break-up badly, but it seemed so extreme that I wondered if it was a side-effect of the pill. I went off it, and the fits stopped within two weeks.

On the other side, a former roommate of mine went on it to control her PMS, and two weeks later she had turned into a moody hermit, never coming out of her room, never having enough energy to do anything, never wanting to talk to anyone. I confronted her about it, and she said that yeah, she should call her doctor... and just let it slide, and let it slide, because she was so depressed that she didn't see the point.

In my experience, depression is a more common side effect of the pill than anyone seems to realize.
posted by occhiblu at 12:11 AM on May 17, 2005

Chiming in with the 'I was horribly depressed on birth control pills' but I wouldn't go so far as to say 'come off them NOW' - just look at when you started taking them. Did things get worse then? I tried two kinds, and with both I was crying for a large portion of EVERY day and simply found I couldn't function. I hated myself too, and gave my poor boyfriend a terrible time - I came off them quite suddenly after realising that there were other ways to live. I was on them for birth control, but found they also cleared my skin up nicely - however, feeling so much better far outweighs having spots. I realise your skin problems have been much worse than that.

I *knew* that my depression was caused by the pill, and I went and told my GP this, and she said that it was pretty common and that I should try another kind - I did try one more kind, and within a week I was feeling as I had done, so came off them immediately and have not had the courage to try them since then. Horrible things.
posted by altolinguistic at 1:00 AM on May 17, 2005

Most people have features they do not like about themselves. You are an intelligent lady and you have a partner who loves you. Think about the things you love about him and the things you enjoy in life. Plan activities that make you happy. Don't let the self loathing consume you, life is too short and wonderful.

Consider seeing an endocrinologist, dermatologist and naturopath.

Good luck and I hope things improve for you.
posted by Chimp at 2:48 AM on May 17, 2005

Somebody posted this as a throw-away comment in the Chappelle thread, and I thought you might like to see it:

people find problems in order to justify their happiness set point

I think that's very true. We tend to think that psychological issues are straightforward cause-effect in nature: we're sad because we think of sad things, etc. In actuality, it is often the reverse: we think of sad things because we feel sad. You're unhappy, so you find reasons for that unhappiness. The solution is to create happiness, in any possible way.

Get off the birth control. See an endocrinologist. Volunteer at an animal shelter. Get outside.
posted by yesster at 6:16 AM on May 17, 2005

(I'd just like to play devil's advocate and point out that the Pill helped, not hurt, my emotional stability. I'm not discounting the other experiences mentioned, just offering another Pill-taking depression-prone account.)
posted by desuetude at 6:19 AM on May 17, 2005

Change everything. Move away, to S. America if that's what you wish. Make a new you. Forget the meds, they are only crutches.

If that's too bold, then try acupuncture for your conditions. I can offer no other help for your emotional state, but I wish you well.
posted by eas98 at 7:55 AM on May 17, 2005

Just as one final comment -- I'd be loathe to agree with those who advocate your dumping either the birth control pill or the antidepressives. Please don't do that of your own volition -- you really need to speak to (at least) a GP, if not a dermatologist and a psychiatrist -- be guided by their advice. It's their job.
posted by peacay at 8:46 AM on May 17, 2005

I keep re-reading your story and I'm wondering if you really want to change. This is not a criticism, by any means. The feelings you have are ongoing, right? It has been several years, and it sounds like you have tried quite a few methods to overcome your negative feelings, to no avail. You obsess about it. The self-loathing affects your relationships, takes time out of your day, and holds you back from your goals.

Bearing all that in mind, I wonder if the self-loathing has become entrenched in your identity. Who are you if you can't beat yourself up? Hell, even nature is picking on you, randomly messing with your appearance and your health. You have spent so many years living this way, thinking this way, how can you change?

I don't know the answer. Even if I did, everyone has to find their own way, so my advice probably wouldn't work for you. But I wonder if you've got a stake in staying the way you are. There is the old cliche, sometimes the hell you know is better than the hell you don't know. Are you comfortable in "the hell you know"? You've been there so long, I imagine you've built up so many behaviors and expectations that may have originally been ways to cope, but now they've become habits.

Think about fears. If you were to change your habits and behaviors, what would happen? Would you lose your excuse to withdraw, to be sullen, to keep avoiding the work it might take to achieve your goals? Or are you afraid that even if you change, and are willing to do the work needed to turn things around, your friends will continue to cast you in your old role? These are pretty good fears, and you might be able to come up with a few more. It is only when you become more afraid of living this way for the rest of your life, or of losing a relationship you hold dear, that you'll be motivated to change.

Anyway, enough psychobabble. Two things that struck me while reading over the comments in this thread:
1.) Someone suggested volunteering, which can be an excellent way to get some perspective on your problems, and
2.) Some form of "clean slate" might be helpful, too. Even if it's just once or twice a week, being around people who don't know you will allow you to work out new habits and coping techniques that are less destructive.

You sound like a great person, I imagine you have a wry sense of humor for all you've been through. Good luck!
posted by whatnot at 9:01 AM on May 17, 2005 [1 favorite]

I too had severe acne from 11 until this year (I am 30). Everything the derms tried to give me failed. I finally got a prescription for accutane and 6 months later I am completely clear for the first time in almost 20 years. I cannot even begin to describe how much this helped my own self esteem.

I will grant you that accutane is not without its own host of nasty possible side effects - I had a few, but in the end, it was completely worth the 6 months of trouble.

As for moving to another country - I believe some time in another country, esp one that does not speak your native language is wonderful for your world view. However, if your feelings about yourself are as persistent as they seem, it may just mean you are miserable in another country.

I highly suggest having your esteem/depression issues worked out before moving to another country. It is very common to have some depression after moving to another country - it doesn't sound like you need any extra.
posted by jopreacher at 9:23 AM on May 17, 2005

People are often told, "Just stop." They reply that it's not that simple. They say you can't understand unless you've been there, and they insist it's a complicated problem that is far more serious than others seem to understand.

Speaking as someone who has suffered serious problems, who has overcome them, and who yet continues to battle them every day: Yes, it is that simple. "Just stop." Every day is a fight. Some days are wins, some are defeats. I'm responsible for both.

I can't offer any magic tricks. You've heard, "Take one day at a time." I can't tell you how to implement that wisdom. But once it clicks for you, it's a leap forward. It also helps to remember that there are people who are paralyzed, hobbled, widowed, orphaned, kidnapped, robbed, raped, and murdered -- and if they can keep on going, it's downright shameful if I can't lace up my boots and join 'em in the world.
posted by cribcage at 9:57 AM on May 17, 2005

Does the clay say to the potter,
"What are you making?"
Does your work say,
"He has no hands?"

posted by quonsar at 10:46 AM on May 17, 2005

in all mah born days, i never thought ah'd hear quonsar quote the bible.
posted by whatnot at 11:50 AM on May 17, 2005

There's so much good advice and feedback in this thread that it's hard to single anyone out. I will say, though, that Decani's advice is beautiful and wise. And also that Snowjoe is absolutely right about the "make your bed everyday" mantra. I finally started doing this about 3 or 4 years ago after my ex-bf's grandmother told me it was one of the things that had kept her happy her whole life. I can't explain why it helps, but it does.

I've struggled with body/beauty issues for at least 20 years myself. One of the tricks that sometimes helps me is to directly challenge the "voice" in my head (note: not a literal voice -- I may have self-esteem issues, but luckily no dissociative disorders). That is, I decide to stop thinking of that "I'm ugly/ inadequate/a failure/whatever" message as some sort of neutral truth, and instead characterize it as just some negative, opinionated voice that doesn't know what the hell it's talking about. In other words, that voice "telling" me I'm ugly is an idiot. The voice says I'm ugly, but that voice doesn't know anything true or useful. That voice doesn't know tonight's winning lottery numbers. That voice has bad taste in music and literature. That voice isn't the one that makes my nephews laugh with glee when I play with them.

So give yourself permission to tell that voice to shut up. Seriously. Say it outloud if you have to. And then in that silence, listen for a kinder, gentler, loving, wiser inner voice that's been waiting to speak up for so long.
posted by scody at 12:28 PM on May 17, 2005 [1 favorite]

I'm 29 and still have acne. I've suffered depression since childhood. I'm horribly fat. Birth control makes me feel awful. And I hate myself to the point of being sick.

People can tell you that there are worse things in this world than your situation, but that doesn't help. People saying they understand doesn't help much. Getting out and doing something each day helps, even if it's just going out to get the mail. Keeping a journal or blog helps. Joining an online support group helps. Meds can help depression, but they won't cure. You've tried three antidepressants that are very similar, perhaps a different kind of antidepressant will help. I hope Wellbutrin does some good. Antibiotics can help acne. Realizing that this man truly loves you despite your flaws will help. If he was really disgusted by you, he wouldn't have stuck around for so long. Finding the love of your life doesn't happen often, so cherish it, don't take it for granted, and thank whatever deity you believe in that you've found each other. My boyfriend also is frustrated by my self-hatred, but somehow he still loves me.

You can either live in your own version of hell, or try to get out of it. I'm trying to change one small thing at a time. It's very slow going, but it is helping. Change small things first and work up to the big things. I know how difficult it is to even try when you feel like there's no point and no hope. But if you don't try, you'll never get out of this misery.

I truly hope you find something that will help you love yourself. No one deserves to live like this.
posted by lomaran at 12:48 PM on May 17, 2005

I agree with fabesfaves - exercise is hugely important, it doesn't have to be obsessive. If you're not doing any, your body will feel like it's stuck, not capable of developing or improving in any way, and your mind will believe it. Worst of all, if you never exercise, you won't realise this is going on because your body just feels normal to you.

I'm sporadic in my exercise attempts, but whenever I start up again after a break, I suddenly feel like my body is going places and becoming an exciting, strong, pleasurable place to live. That's a good feeling.

That's quite apart from the benefits exercise is documented as having with wider mental health issues. Sounds like you would benefit from exploring lots of different avenues, but this would be a good one - find something you can do regularly, maybe brisk walking somewhere without many people if you feel self-conscious.

Also, I'm a devout optimist, I believe we can change ourselves for the better if we're dissatisfied with the way we are, so good luck!
posted by penguin pie at 1:43 PM on May 17, 2005

Mod note: fixed desuetude's link
posted by jessamyn (staff) at 12:58 PM on May 18, 2005

I have (had) similar beliefs about myself. My suggestion is this: Take a weekend and a couple of days off of work, go to Unleash the Power Within, and for those four or five days participate fully, no matter how silly you feel. This event is put on by a guy who got started in his careers by changing deeply ingrained beliefs (such as clinical phobias, working with patients that psychologists said would never be cured of their fear) in a very short period of time. He works with the general population now, but his approach is still basically the same.

If you believe that these kinds of things are corny or stupid, believe me when I say I did too. I was dragged to this event by a family member, and I felt dumb as I went through the process. But it was worth it.

It costs a fair bit of money, but like I said, it's worth it. If you really can't afford it, email me (my email address is temporarily in my profile) because I may know some people who know some people who can get you a reduced rate.
posted by gd779 at 4:47 PM on May 18, 2005

anonymous, self-hatred is a very difficult thing to deal with because when someone suffers from self-hatred, they not only hate themselves, but they also hate themselves for hating themselves.

I know that could sound pretty daffy to some at first, but there's something profound in there. There is a lot about self-hatred and other forms of depression that is very connected to unexpressed emotion.

This is the part where people can tend to react in a hostile manner to what I'm about to say. There is so much judgment against doing real *emotional* work to deal with these kinds of difficulties. People can immediately respond with, "What, so you're saying that if I just cry about it, it will all be okay? I'm not five, you know."

But I wonder, how many of us actually let ourselves feel everything we need to feel. In my own past, self-hatred has been very connected to rage. Deep, powerful rage against something. But when we judge against rage, whether it's from a feeling that it's inappropriate, or that it wouldn't do any good, or whatever, then that rage becomes a feeling of defeat. A part of us is incredibly angry at the status quo and feels a primal need to change, and another part of us is telling us that there is nothing to be done for it, and that we must accept it.

And that's where the error happens. The anger at the status quo is meaningful, and must be accepted. Even if it's true that you cannot do anything about it. You've got to accept that you're angry about it.

And what I mean by accepting anger is not that you must silently admit that you are angry and then everything will be okay. Go kick the shit out of a beanbag. Go scream into a pillow. Get into it. Give your body the physical signal that you are finally going to listen to your rage and express it. Expressing rage is not the same thing as being violent, and it's a judgment that needs to be challenged. Express it until you are done. You'll know when you are. You'll reach a point where you start to feel real compassion for yourself. If you go into it with an intent to accept more of yourself, it won't feed the self-hatred. All you have to be sure of is not to harm yourself or another.

It might not be rage, it might be grief. It could be any form of intense emotion inside that is somehow stuck, or blocked, and stagnating. There are different kinds of tears. When I was struggling with my own depressions, I had a lot of familiarity with the thin hot tears that came from frustration and desperation. But there's the other kind of thick warm tears that really do cleanse out some of these internal struggles we have. (You'll know if you get really hungry for food afterward.)

Just like stress can lead to ulcers, repressed anger can lead to the kinds of physical symptoms you describe.

Finally, don't listen to the people that tell you that it's all about choice or pulling yourself up by your bootstraps or by somehow trying to condition yourself out of it. Do not go the route that involves shoving more of yourself outside of yourself. There's something deeper going on here. The self-hatred is a symptom, and a clue - there's the part of you that hates, and there's the part of you that is hated. The part of you that is hated might be suffering and might be hard to recognize, but somewhere in there is a part of you that is trying to stick up for itself. If you can find compassion for that and see it in a new light, you'll have made a lot of progress.
posted by tunesmith at 12:02 AM on May 19, 2005 [2 favorites]

I agree with people saying you ought to go to some third world country and put yourself to work. After living within that frame of resources, problems, daily grind - your life here in the west will look and feel like paradise.
posted by trii at 7:22 PM on May 27, 2005

Sexiness is in the eye of the beholder. I once worked with a woman who had elephant man's disease. About ten minutes in to working with her, I realized she was a flirt. Amazingly, I enjoyed flirting with her. She had a boyfriend and all of that too. I think there is so much more to all of this than your physical appearance, even for girls. Guys just want girls to like them.
posted by Ironmouth at 7:49 PM on December 5, 2005

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