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Most adults who live in the U.S. seem to link their self-worth with their careers. Many also identify with their body image, irrespective of gender. Some pin their self-esteem on high intelligence. People seek advanced college degrees in the expectation that it will allow them to earn more money, and for the purpose of self-worth. Thus, we have Americans who exercise and watch their diet, and who educate themselves and increase their earnings. Many Americans value the accomplishments of their offspring, as extensions of themselves.

Mentally ill people, if we went into a bar and someone approached us to ask, "What do you do?" We might not have a good answer. It would be an awkward moment. And, because psych medications adversely affect metabolism and make it a lot harder to exercise, we may not have a fit physique. Regarding the accomplishments of family, we may have parents or siblings who've done well for themselves, but very few mentally ill people are raising their kids, if they have produced them. Thus, again, when we are approached in a bar or at almost any gathering, when asked about ourselves, we might not have much to say, and this is awkward.

Under these circumstances, it is difficult to have much self-esteem. If we are subject to outpatient institutionalization, and if we don't have a professional job, we may be subject to implied messages telling us that we're subnormal. 

A diagnosis that effectively says there is a major defect in one's brain, by itself, constitutes a substantial blow to self-esteem. The cause of this is cultural. We've learned via osmosis that if we have a supposed defect, we do not deserve to like ourselves. This is why so many Americans are trying so hard to have the perfect bodies, the perfect careers, the finest cars, and so on. In modern times, everyone is measured by material possessions, by wealth, and by tangible achievements. People are in fierce competition with each other on who is the biggest, and the best, in the aforesaid realm. 

People should realize that if they could get to know themselves better on the inside, they could create limitless self-esteem by means of a few simple mental exercises. And this doesn't necessitate being insane; actually, learning about one's insides will make a person saner than they were. 

People with mental illness can value ourselves. It requires that we wholly reject society's shallow material standards of a person's worth. We can replace this with self-talk and self-coaching that builds up our self-acceptance, so that when people try to put us down, the detracting messages don't make it through the invisible shield we've created that protects our self-approval. This is an advantage that we can give to ourselves, and a thing that supposedly successful people do not know how to achieve. 

I'll offer a few examples: "I did not create my brain, so if it has a defect, it is not my fault." "It is not how perfect or powerful my brain is that counts, but what I do with it and how well I use it." "I do not have the perfect six pack of abdominal muscles or the biggest biceps, but I can accept myself as I am." 

The above are positive self-building statements that we can feed ourselves. And, I have news for you, mentally ill people aren't the only ones with self-esteem problems.