I assume when you write "most difficult" that you mean "hardest to tolerate"? Or do you mean "most problematic"? For me, the hardest to tolerate isn't always most problematic, and vice versa.

I guess my hardest to tolerate symptoms have been delusions of persecution. They get really bad and usually land me in the hospital, or almost in the hospital. People definitely know that something is terribly wrong with me. There's usually no hiding them. Some have been so painful that they left me scarred (traumatized) to various degrees.

As for most problematic, I would say the great decrease in my stress tolerance. This has worsened over the course of my life. It is what disables me. It is what brings about all other problematic symptoms, the list of which is quite long and includes the delusions. I try to thicken my figurative skin, strengthen my constitution, etc, but it is difficult. I try to avoid old flawed crutches, like alcohol, which eventually backfired and exacerbated my situation. My goal is to extend the length of time between serious episodes, to avoid the kindling effect.

Strengthening my constitution isn't an easy feat, for sure. And I know that it involves many things (therapeutic work, healthful diet, exercise, mindfulness, my medications, improved insight, action plans, just to name a few). Fern46 is, to me, a great example of someone who takes many of these quite seriously. I try not to be too hard on myself about not being perfect at doing these. Expectations of perfection are, themselves, barriers for me. Self-imposed. Not of others.