How do I learn to like myself?
June 17, 2019 6:25 AM   Subscribe

I hate myself - I hate that I envy my friends, hate that I have a fear of missing out on information to the extent that it paralyzes my life and means I never actually DO anything. I hate my depression, hate that I have been taking antidepressants for 15 years and am no better, hate that spending time with my own family makes me uncomfortable, hate that I have zero ambition to get out of the dead end job I hate.

Hate feeling tired all the time, having no energy to play with my daughter

I hate being so cynical about everything- feeling like I am intellectually superior to people when I am not, I am just quick witted enough to bluff my way. I hate that I objectify women in my mind

I have very few friends (surprise surprise) and I alienate myself from the ones I do have as well as my family

No alcohol (excuse I use is I fear addiction) or non-prescription drugs. I take 60mg Cymbalta/Duloxetine every day along with cyclazine, lanzoprazole and tramadol all on prescription but still suffer from headaches every day. I have essential tremors in my hands and some facial twitching. My sleep is poor usually waking several times per night

I love my wife (god knows why she even likes me!) and my beautiful daughter but I fear that some day I am going to cross a line and not be here for them any more
Therapy is not really an option as the NHS won't provide any more than 6 weeks of it (I have had several sessions) and I am too poor to go privately
posted by mrbenn to Health & Fitness (23 answers total) 35 users marked this as a favorite
It definitely sounds like the meds aren’t working. It’s good that you’ve tried therapy. What happened when you brought up these issues? Can you take all the therapy that they cover at least? Have you been open with your partner about how you are feeling? Commit to accountability with her such that if she says you need to see a doctor, do it. Your awareness of your depression is a good step but your symptoms, anxiety and rumination need more looking at. I’m sorry you’re going through this.
posted by amanda at 6:45 AM on June 17, 2019 [7 favorites]

Ha, I almost could have written this question. I recently read this book and found it somewhat helpful.

It sounds like you also have anxiety issues. Have you talked to a doctor about anxiety medication? My social anxiety improved a lot with medication, much more than it did with therapy or mindfulness or any other non-drug thing. I recommend at least trying it.
posted by a strong female character at 6:54 AM on June 17, 2019 [7 favorites]

I'm sorry you're suffering like this. I can see why you'd reach out here. I know there are no easy or quick answers here, but I wonder if physical activity could be a piece of the puzzle. Something you can throw yourself into. Running, cycling, or a team sport. There are proven physiological benefits to mental health associated with exercise. And communities form around different activities. These can be a way to connect socially that don't depend on always being at your best since everyone is focused on a common activity.
posted by latkes at 6:55 AM on June 17, 2019 [4 favorites]

Note; I am not a therapist or psychologist, I am not your therapist or psychologist. I can't even definitively say what is prompting this idea.

Agreed that it sounds like the meds aren't working, and that may be a place to start. It sucks that the therapy has a finite end date. However, I wouldn't rule it out entirely - there may be some private places that have a sliding-scale payment plan, and you may be able to afford that. Just putting that out there.

What came to my own mind, though, was...maybe taking on some kind of simple, routine, low-commitment, repetitive volunteer project or service. I'm talking seriously repetitive and routine - like, if there's a weekly soup kitchen at a local church, turn up once a week to do something like wash dishes. Or if there's some kind of civic organization or theater company that regularly sends out mailings, help them stuff envelopes. You don't have to talk to anyone at length if you don't feel like it, the work will be mindless and low-stress but it will be low-level constant, and everyone will be so grateful that you're even there that they will be showering you with positive feedback.

I sometimes find that if I'm ruminating a lot and stuck in a mental loop, if I take on some task that is just complicated enough, it distracts me from that thought pattern for a while, and that helps. But not anything too complicated, lest I mess up and just bounce back down again into "oh I fucked up this sucks". (For me, that's canning tomatoes on the anniversary of 9/11, which is a day I'm likely to do that kind of thinking.)

Something to consider, anyway.

Good luck.
posted by EmpressCallipygos at 6:55 AM on June 17, 2019 [14 favorites]

Hi, I am someone who can slide into the types of thought patterns you are describing. For me, something that has helped tremendously is to follow an exercise routine that is vigorous enough so that my mind turns off for a little while. This has taken a number of different forms - brisk walks, running, cycling/inline skating, weightlifting, swimming, participating in an organized team sport. I find that when I have a brief respite from the constant internal monologue that tells me that I ain't shit, it's a lot easier to tune it out when it does come back.

I'd also nth the suggestion of looking into sliding-scale therapy options. It doesn't have to be a forever thing, but a therapist can help you come up with some strategies to rebuff the self-loathing.
posted by coppermoss at 7:12 AM on June 17, 2019 [6 favorites]

When I was in therapy for many similar issues, my therapist recommended a number of CBT (cognitive behavioral therapy) worksheets that were about the subject of self worth and self esteem. Though I found the discussion of these worksheets very valuable after I'd completed them, the worksheets themselves also had value, and a lot of them look similar to things I've seen online searching for "CBT for self esteem," so maybe that could be an avenue to explore?
posted by xingcat at 7:16 AM on June 17, 2019 [2 favorites]

I am not a therapist nor your therapist and this is not psychological advice.

My best friend struggles the way you do. shitty internal monologue, lack of motivation, hatred for his own actions. The advice that I give him, which works sometimes and well enough those times that I give him this pep talk regularly, is that the difference between the person you are and the person who does things you want is..just doing the things.

There is no pre-condition for any of the behaviors you want to have. The friend in question struggles with following through with responsibility, and then the shame spiral that follows and destroys any other sort of positive behavior. When he's having these spirals (say, over the crushing guilt of not mowing the lawn or something) I remind him that all he has to do is ignore the spiral and just go mow the lawn. And, like magic, he has returned to being a responsible roommate and nothing else in the world is affected.

He has, and maybe you do too, a problem with ascribing actions and behavior some Grand Moral Meaning based on how he feels about doing certain things, which he thinks counteracts the actions of doing them. And it doesn't. You don't have ambition or feel ambitious to carry out the very routine, boring actions of finding a new job.
posted by FirstMateKate at 7:39 AM on June 17, 2019 [43 favorites]

Some of your more physical symptoms sound a lot to me like the sort of physical symptoms I get that make taking a norepinephrine reuptake inhibitor (in my case Strattera) not viable long-term, especially if you're needing to take something regularly for nausea. Definitely don't alter anything on your own, but seriously consider documenting as much of this as you can and going in and asking for a plan to transition to something else, if most of this stuff came up after you started the Cymbalta and doesn't have any other obvious explanation. Feeling physically terrible and not sleeping will do a number on your mental health, just by itself.

Definitely think that looking into books/workbooks/etc to work on stuff on your own is a surprisingly viable thing these days--you might want to explore things that are associated with not just CBT but also DBT and ACT methodologies to see what works for you. But the other stuff just sounded so familiar, and the other treatment for my mental health issues was so much easier when I didn't feel 24/7 terrible, that I thought I'd mention the possibility.
posted by Sequence at 7:59 AM on June 17, 2019 [5 favorites]

Speaking of worksheets, this How Self Talk Causes Emotions chart is something I keep a link to remind me to avoid what it calls "crooked" thinking and instead to think straight (see the diagram). It also is a chart that reminds us to avoid "musturbation" (notice the spelling) meaning to steer clear of insisting we, they or everyone "must" do something(s) or else! The chart has some typos but for a free chart on the Web it packs an awful lot of insight, and you can, of course, branch out from there to read about the related concepts.

I am not a therapist or any kind of doctor, just someone who found this chart, saved a link and am now sharing the link with you.
posted by forthright at 8:21 AM on June 17, 2019 [11 favorites]

I'm very much not a doctor, but I have a close family member with essential tremor, and know that many of the medications they've taken over the years have induced depression, and they've had to take an anti-depressant simply to counteract this side effect. So if you're asking your current anti-depressant to do double duty, the dose might be insufficient. I'm not sure how many doctors are involved in your care, but if it's more than one, there might not be anyone looking at the whole picture. I have no experience with the NHS, but in the States, I've always found pharmacists really helpful in sorting out potential interactions. Consider all of that a shot in the dark.

Regarding liking yourself, I think the most helpful technique I ever learned in therapy was reframing (you can google "cognitive reframing" for more info). For me, it involved my therapist handing me a bunch of handouts with four (I think?) columns and a strict command to fill them out whenever something happened that provoked a negative reaction. It was irritating as all hell, but I did it.

I've more or less internalized this process, but the four questions, as I remember them, were:

- What happened?
- What did you do?
- Why did you do it? (Note: this was meant to be an honest look at your emotions and triggers. Answers like "I'm a total fucking asshole" were not permitted. This column always took the most time to fill out.)
- How could you have done it differently?

Starting out, my answers covered external events, like someone cutting me off then slamming on their brakes. So it would go:

- Someone cut me off and slammed on their brakes.
- I honked my horn, cursed creatively and excessively at full volume, then tailed them for a few blocks.
- Fear. This is a city full of terrible drivers, many uninsured, and I am almost always on edge because I have to be so alert at all times.
- I could have taken deep breaths and reassured my scared self that everything was okay.

Once I got the hang of that, I turned it more internally, so every time I said something terrible to myself, I would stop and try to get to the root of what I was really feeling, and what I could do other than calling myself awful names.

I can't emphasize how annoying this was to get started as a regular practice. But it has stuck and helped me tremendously.

Another helpful thing, when caught up in a negative thought pattern, is to ask yourself, is this how I would talk to a close friend/spouse/child/puppy dog? Whoever you can muster up more compassion for in the moment. Then think about what you would say to them and direct it to yourself.

Finally, I saw your mention of daily headaches. Chronic pain is a HUGE thing to deal with. Maybe finding a support group, whether in person or online, would help.

Good luck to you.
posted by fairfax at 10:40 AM on June 17, 2019 [13 favorites]

the NHS won't provide any more than 6 weeks of it (I have had several sessions) and I am too poor to go privately

The NHS does have therapeutic services beyond a few weeks of CBT, and they can be accessed. But it's not easy, as you know already. Ask the therapist for a recommendation for further treatment to your GP; they should be confirming the outcome of the treatment anyway, and it's clearly done nowhere near what you need. Show them the text of this post. Ask your GP for a referral for further treatment. I can't promise these steps will work, but you are clearly very poorly at the moment. If you're not getting the help you need, I'd suggest an advice service like the CAB, and asking them to support you in pushing the NHS to act.

Also, does your employer offer any external counseling through its employee assistance programme? They're usually short term things, but at least it would be someone with some of the appropriate qualifications you can talk to.

You need to make sure your healthcare providers understand that you have a life-threatening illnesses. This is hard to do, and if you can get someone to support you at appointments, it would probably be a good idea.

If you can tell your wife about how your feeling, please do. You need and deserve help, and I am sure your wife wants to give you all the help and can.

The things you hate about yourself are symptoms of your illness (and, ok, with objectifying women, of sexist beliefs and perceptions your culture has given you, which, yes, are shitty, but which you can get better at, and are clearly motivated to get better at. Just keep trying: it's all you can do, but it is enough). There's no way to prove that to you, but I think you still know it somewhere, because you're asking this question.

I'm sorry this is such a draining and dark and terrible time. I have reason to believe it can get better. Thank you for asking for advice. Finding the strength to do that is a huge part of protecting your mental health.
posted by howfar at 10:53 AM on June 17, 2019 [3 favorites]

Ask the therapist for a recommendation for further treatment to your GP; they should be confirming the outcome of the treatment anyway

Just to reiterate this part - as I learned last year, your GP has a formal responsibility to coordinate the care that you get from all other services within the NHS. Some GPs are essentially clueless about mental health, but some of them are very very good indeed. Having a GP who gets it is worth a lot. If your current GP isn't pulling their weight, you can audition a few others - either in your current practice, or if they don't cut it, you can switch practices.

I switched practices mostly because my old place was bad for availability of appointments (everyone had to phone at 8:00am - by 8:05 the day's appointments were full). In the new practice, I saw four different doctors before I found my current GP, and now I see her & her only, because she is very very good. They're out there, but they can take a bit of finding.

Even aside from any actual treatment that I received - my experience of finding myself & my own needs sufficiently deserving that I took the time to seek & find effective help was itself therapeutic. Yes, I am a person who can ask for help, and receive it. So are you - your question here proves that already.
posted by rd45 at 1:44 PM on June 17, 2019 [4 favorites]

I'm so sorry. Do you feel able to post where you are? You might already have this well covered, but in case not - where I am, as well as the short NHS referral CBT options, there are also sometimes charities and non-profits that offer free CBT or counselling and other options like CBT supervised by phone/online. But they come and go, so it can be hard to research when you're feeling rubbish, and I don't think GPs are always very well-versed in them. If you felt able to post your location, there might be someone who knows of some current other options for you, to save you having to hunt around when you're already feeling overwhelmed. And on preview: seconding rd45 that finding a GP who really listens to you around your mental health is so worth it.

I hope you don't mind, I had a wee look at your profile to see if I could work out where you are in case it was near me, and watched the beautiful video of you with your daughter. You ask why your wife even likes you. To this internet stranger I'd guess she likes you because you're a lovely guy, a dedicated father who's been right by her side through some super-stressful parenting times, and because you're thoughtful, caring and steadfast. I'm sure you're many other wonderful things too, but those came across to me from that wee snippet.

Oh, and this is really just a throwaway, but hating your cynicism? Welcome to Metafilter! You're among your people! Seriously, I came across the concept right here of my 'inner moron'. We all have one. It thinks things that would shame us if we spoke them aloud. If we're not careful it shames us anyway, we just keep that shame inside of us. But the bit of us that recognises they're a moron is the bit that matters. You matter. I hope you can find help, because you seem awesome, and you deserve to be happy. Best to you.
posted by penguin pie at 3:23 PM on June 17, 2019 [8 favorites]

Your moment to moment awareness is composed of a lot of different elements. You could consider you have trained yourself or habituated yourself to a train of thoughts, reactions and deep level responses that add up to this feeling. You can't cure yourself so much as change the habitual patterns you have. There's no cure for thinking 'I suck' other than thinking something different.
However, you got where you are, whatever circumstances led up to this in your personal history, it's yours to deal with now. You may have trained the deeper parts of your brain to react with this particular set of emotions and now you have to find a way out of that particular mindset/emotional response pattern.
In some way, you have to find a path that lets you get 1% better. A new health routine, a new mental dialogue, a new dietary pattern, a daily walk, anything that gets you to 1% better is a pattern that becomes a new habit. Rinse, repeat throughout your life until you see progress.
You can definitely retrain your brain, but the deeper parts don't really think or conceptualize, they just react. You may have laid down the wiring for this set of reactions and now you have to mindfully watch them at work until you can see how they operate. At their worst, your deeper instincts can crush your spirit by driving your awareness into depression or fight/flight states. Practicing mindfulness, gratefulness and other healthy routines helps retrain that.
When my brain loop gets too weird, I ask "is this true", is the statement I've just made in my head a true thing? Helps to cut my awareness some slack. Good luck.
posted by diode at 8:03 PM on June 17, 2019 [2 favorites]

Your struggle sounds very familiar to me. Champion self loather here, decades of practice, we are talking visceral contempt for myself at times. I also strongly identify with many of your other stated troubles such as envy paralysis and depression.

What has helped lately is deciding that honestly, I just truly don't give a shit about how awful I am. I just really want to enjoy myself a little while I'm still here. So I try to build comforting things into my day. Self-care has kind of been an alien concept to me all these years. I mean I'll do things like eat tasty food or whatever but seldom do I seek out truly enjoyable experiences for myself and allow myself to enjoy them. I've been trying to change that and actually be somewhat selfish in a way. Or if I can't get things done like I feel like I should be able to, I just give myself a huge break. I'm dealing with a lot that isn't visible to other people. As long as things are good enough to get by, that's good enough for me.

In general, lately I've been trying to just be more laid-back about life in general and I find that it also impacts how I think of myself. No longer do I have to be absolutely perfect to deserve my own respect. It definitely doesn't always work for me last week for instance was a bear. But sometimes it has work so I wanted to share that. I hope you can find a good solution, self-loathing is truly toxic.
posted by whistle pig at 9:21 PM on June 17, 2019 [3 favorites]

Just popping over to say that I had very complicated and resistant depression and it turned out that medication for Bipolar disorder actually worked for me and was a total game changer. SSRIs actually made me feel worse. Lamictal/Lithium both were life changing for me. I wish you all the very best.
posted by jeszac at 8:59 AM on June 18, 2019 [1 favorite]

Response by poster: Thank you all for your kind words - I saw my GP today after calling for an appointment and getting a short notice cancellation. After 15 years of this I could have written a script for him before going in and true to form he went over the same stuff again.
He has increased the dosage of Duloxetine to 90mg per day but on a more positive note he has referred me for further counselling.
It was not easy for me to post but the words had been burning me up inside for a few days and it felt good to just spill them onto a page - and receiving such caring feedback has made me feel it was worthwhile
Hard to be positive but I will just keep going
posted by mrbenn at 12:37 PM on June 18, 2019 [6 favorites]

I experience self loathing too, and it’s so awful, I’m sorry you suffer from this too. It’s not your fault. A few things that have incrementally helped me are attending ACA ( Adult Children of Alcoholics (ACA)/Dysfunctional Families) support groups (although these don’t seem to exist in your area, the literature might be helpful, or you could even start your own meeting), listening to podcasts by Tara Brach and reading monthly self compassion newsletters from Lea Seigen Shinraku. Oh and just recently I discovered the concept of Complex PTSD and a good book on the topic that’s been helpful.
posted by lagreen at 7:31 AM on June 19, 2019 [2 favorites]

Response by poster: Just a small update if anyone is still here - the increased dosage has made the self-loathing even worse, constantly feeling like a total waste of air
posted by mrbenn at 1:46 AM on June 29, 2019

Paradoxical effects of antidepressant medication are the one side effect they emphasise to report quickly. If you can't contact a doctor for any reason, and/or you do want to talk about it privately, you can memail me.

You are holding on, and you are reaching out. You need to keep doing the second. You deserve every single piece of help you get, and much more.
posted by howfar at 3:28 AM on June 29, 2019 [1 favorite]

Seconding howfar - it’s definitely “revisit the doctor” time. And if you find yourself completely desperate (especially, but not only, if you feel that you might be a danger to yourself), it is permissible to call 999 and tell them you’re having a mental health crisis.

I say that because it’s something that many people would never think to do - it seems like 999 is for people bleeding to death on the road, right? But I know someone who hung on a long time with unbearable depression symptoms and an unhelpful GP. They eventually told a friend who happened to be a former police officer with a better idea of how these things worked, and she called 999 and reported a mental health crisis. The person ended up being admitted to hospital for a while, which was tough but needed, and the start of their eventual recovery/stabilisation.

So I just wanted to know that you’re allowed to escalate this yourself if you think you need to - your GP doesn’t have to be the sole gatekeeper to higher-level mental health care. Sending you the best.
posted by penguin pie at 6:31 AM on June 29, 2019 [2 favorites]

(And, just in case your depression is telling you otherwise, you do deserve that help, as much as every other person in the world. You’re as valuable as the rest of us, and we need you around here, as do your family and friends.)
posted by penguin pie at 6:36 AM on June 29, 2019 [1 favorite]

Response by poster: I am blown away by the response to this dark period - you guys are awesome! It is amazing to me that a community of strangers are willing to take time to write such kind words to a fellow website member.
Some people have mentioned suicidal ideation - I have in the past (and fleetingly recently) suffered from this but not to such an extent that I have made plans, written notes or hoarded meds - I continue to fight and am very glad I live in a country with hard-to-access firearms.
My rock is my beautiful, amazing daughter - anyone who cares to read through my posts on Mefi will easily find her story - she is the main thing that keeps me going, keeps me getting up in the morning and going to work, even on those days I can't really face it. Her life up until now has been such a challenge but thanks to my wife I have gotten through - and I am telling myself that if I can survive that I can beat this shit! Now she has just finished her first year of playschool and is going to nursery school in September - I need to be here to see her grow up!
Reading this back I feel I sound more positive, I am by no means out of the woods yet but this is a better day

posted by mrbenn at 5:50 AM on June 30, 2019 [4 favorites]

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