George Carlin once said, "Most people with low self-esteem have earned it." What does that mean? Do you agree?

I keep thinking about this quote because I feel as if I have low self-esteem. I'm a 36 year old man who is bipolar and schizoaffective and I feel as if low self-esteem has been dogging me my whole life. One thing I can say for sure is that I do believe we get what we deserve. In other words, we are where we are in life because of our actions in the past. So if we are down and out, we must've done some things to get there. Some people believe in victimhood. They believe they are merely victims. And to a certain extent, people are victims of circumstance. People cannot control their genetic make up. And, in some cases, mentally ill people have a chemical imbalance that causes them to be mentally unstable. So I guess you could say I am where I am because of a combination of the two things- not only has my chemical imbalance been responsible for my place in life but also the decisions I made in life have determined my outcome. What do you think about all of this?