Low Self-Esteem
Lack of self-esteem is a negative and devalued self-perception that adversely affects physical, emotional, and mental health.
Symptoms and Causes
Self-esteem is the value a person assigns to themselves, a perception that is built over the years and is based on one’s own feelings as well as those conveyed by significant others. Low self-esteem is a devalued self-perception that is often the origin of many mental health disorders.
Individuals with low self-esteem have a negative view of themselves, with a marked sense of incompetence in different areas of their lives. As a result, they tend to develop avoidance behaviors and self-sabotaging patterns. Unlike occasional moments of self-doubt that anyone may experience, patients with low self-esteem maintain this perception consistently over time.
Symptoms
The most characteristic symptoms of low self-esteem include:
- Insecurity.
- Self-deprecation.
- Severe self-criticism and the use of derogatory self-directed language.
- Doubt about one’s own abilities.
- Excessive focus on flaws.
- Undervaluation of achievements.
- Feelings of inferiority, worthlessness, or incompetence.
- Need for external validation.
- Constant comparison with others, often accompanied by envy.
- Fear of failure, taking risks, or facing new challenges.
- Fear of making mistakes.
- Excessive perfectionism.
- Inability to accept compliments.
- Difficulty making decisions or saying "no" leading to prioritization of others’ needs.
- Tolerance of unsatisfactory or abusive relationships due to the belief of not deserving better.
- Fear of rejection or abandonment.
- Feelings of guilt.
- Sadness.
- Loneliness.
- Dependence on others to carry out tasks or daily activities.
- Physical manifestations: hunched posture or defensive body language, difficulty maintaining eye contact, shaky or low voice when speaking.
Causes
Low self-esteem may be caused by a wide range of factors, including:
- Strict and highly demanding parents or teachers who emphasize mistakes and set excessively high expectations.
- Emotionally distant parents.
- Overprotection during childhood.
- Physical or psychological abuse.
- Sexual abuse.
- Learning difficulties.
- Bullying (school harassment).
- Mobbing (workplace harassment).
- Body shaming: ridicule regarding physical appearance.
- Loss of a loved one.
- Illnesses that damage body image or reduce quality of life.
- Social pressure derived from constant comparison with unattainable standards of beauty or success.
Adolescence is a critical stage for the development of self-esteem; therefore, experiences during this period are fundamental, as individuals are more sensitive to external stimuli. Family problems, excessive academic pressure, physical changes, and, more recently, the influence of social media can contribute to the development of pathological low self-esteem.
Risk Factors
Low self-esteem is influenced by the way the environment is interpreted. The most relevant risk factors include:
- Rigid thinking: fixed and deeply rooted beliefs that do not allow flexibility, preventing acceptance of change, unexpected situations, or new experiences.
- Dichotomous thinking: only extremes exist (black or white, all or nothing, good or bad). This cognitive distortion oversimplifies reality, generating anxiety and frustration, and may lead to abandoning tasks before starting them.
- Selective abstraction: drawing general conclusions from a single event, resulting in a biased perception of the world and of oneself.
- Need for control over oneself, one’s emotions, and the environment.
Complications
Low self-esteem negatively affects both physical and mental health. The most common complications include:
- Depression: resulting from a lack of purpose in life and feelings of hopelessness.
- Anxiety: due to negativity, insecurity-related thoughts, and fear of rejection.
- Social isolation: driven by fear of rejection.
- Self-destructive behaviors.
- Suicidal behaviors.
- Alcoholism.
- Anorexia nervosa.
- Bulimia.
Which physician treats low self-esteem?
Low self-esteem is treated within the specialty of Clinical psychology.
Diagnosis
Low self-esteem, although not a clinical diagnosis, is assessed through a series of questionnaires and behavioral and cognitive evaluations of the patient. Typically, psychoanalytic sessions address the following aspects:
- Personal and family history, as well as concerns and self-perception.
- Rosenberg Self-Esteem Scale: a 10-item questionnaire internationally recognized as the standard for assessing self-esteem. The patient rates each statement depending on whether they strongly agree (4) or strongly disagree (1).
- Evaluation of body language and interactions with the therapist.
- Exploration of thought patterns, such as cognitive distortions.
- Assessment of possible associated disorders, usually depression or anxiety.
- Exploration of childhood experiences and family relationships.
Treatment
The goal of low self-esteem treatment is to help the patient challenge their negative self-perception and develop a more balanced view of themselves. Therapy requires a combination of different approaches tailored to each patient’s needs:
- Psychotherapy: dialogue between therapist and patient to address the underlying causes of low self-esteem.
- Cognitive behavioral therapy to challenge negative beliefs.
- Self-compassion practices to treat oneself with kindness, and assertiveness training to learn how to set boundaries.
- Positive affirmations to reinforce self-worth.
- Meditation, as it often helps increase self-awareness.
Participation in support groups is recommended from time to time to gain insight from others with the same condition. Knowing that one is not alone helps increase receptiveness to treatment.
In addition to psychological care, physical exercise helps improve mood and increase self-confidence.
