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Self-Esteem Issues

Self-Esteem Issues

Having a healthy level of self-esteem is a foundational aspect of having a good sense of mental wellbeing. Think of it as how much you like yourself. Do you respect yourself, feel like you have value, and see yourself in a positive light? A good sense of self-esteem can help you live up to your potential in school, at work, in relationships, and in every area of your life. It infuses your being with a belief in your ability to reach your goals and achieve your dreams.

People who have low self-esteem are likely to underachieve, be afraid to go for their dreams, and tend stay in unsatisfying or unhealthy relationships. They are also more vulnerable to feelings of anxiety and depression.

On the other end of the spectrum, those who have an inflated sense of self-esteem often feel they are special and have a sense of entitlement that others may view as arrogant and demanding. At the extreme, these people may have narcissistic personality disorder. It may seem counterintuitive, but people who appear to have excessive self-esteem or who are narcissists may actually suffer from low self-esteem. They may feel insecure or inadequate inside, and they make up for it by exaggerating their accomplishments and seeking praise and validation from others.


Self-esteem typically fluctuates across the lifespan. In general, self-esteem is fairly high during childhood, dips during adolescence (especially in girls), rises steadily throughout adulthood, then tends to fall steeply in old age.

Low self-esteem is common. Research from the Dove Self-Esteem Project shows that 7 in 10 girls saying they don’t measure up or aren’t good enough in some way. And 85% of women and 79% of girls say they choose not to participate in activities when they don’t feel good about the way they look.

Low self-esteem can affect boys and men too. In one study, over 80% of men said they talk about body image and point out flaws and imperfections in ways that promote anxiety.

In terms of inflated self-esteem, males seem to have the upper hand. It is estimated that narcissistic personality disorder affects up to 6.2% of the population, and approximately 50-75% of those with the disorder are male. Symptoms and signs often emerge during a person’s teens or in young adulthood.


Many factors can influence your self-esteem in a negative way, including:

  • Genetics: There may be a genetic component to your level of self-esteem.
  • Exposure to trauma: Negative emotional experiences, turbulent relationships, a chaotic upbringing, being bullied, or enduring excessively harsh criticism from a loved one can damage self-esteem. Similarly, exposure to traumatic events or experiencing abuse, neglect, or abandonment as a child appears to be common among people who display inflated self-esteem.
  • Poor academic performance: Having learning difficulties or other trouble in school can result in a lack of confidence that seeps into other areas of life.
  • Social media: Constantly comparing yourself to others on social media can make you feel like you aren’t good enough.
  • Thinking patterns: Your thoughts have a major impact on how you view yourself. If you tend to focus on your flaws and weaknesses, you’re more likely to have low self-esteem.


Self-esteem problems can manifest in a variety of ways. How can you tell if your level of self-esteem is healthy, or if you may have a problem? Take a look at the following characteristics associated with healthy, low, and inflated self-esteem.

Healthy self-esteem is associated with:

  • Generally liking yourself
  • Confidence in your abilities
  • Positive outlook
  • Ability to handle constructive criticism
  • Awareness and acceptance of your strengths and weaknesses
  • Transient negative situations don’t color your outlook on life
  • Feeling comfortable saying no to things that don’t fit in your best interests
  • Feeling comfortable asking for help or expressing your needs
  • Ability to withstand stress

Low self-esteem is associated with:

  • Feeing unlikable
  • Lack of confidence
  • Negative outlook
  • Trouble accepting criticism or positive feedback
  • Excessive focus on and insecurity about your weaknesses
  • Negative experiences impact your overall outlook on things
  • Feeling a need to say yes to everything to appease others
  • Uncomfortable expressing your needs
  • Excessive fear of failure
  • Preoccupation with how others perceive you
  • Feelings of anxiety, depression, shame, or inadequacy

Inflated self-esteem is associated with:

  • An exaggerated sense of self-importance
  • A desire to be recognized as special
  • A sense of entitlement to special treatment
  • A tendency to exaggerate accomplishments or talents
  • Needs external validation to feel good about self
  • Arrogance


Self-esteem issues that go unchecked can lead to physical, psychological, and social consequences. Research shows that having low self-esteem as an adolescent is associated with a higher incidence of teen pregnancy, school dropout, joblessness, financial problems, and criminal behavior. It often co-exists with mental health disorders.

Low self-esteem is associated with increased risk of:

Inflated self-esteem can lead to narcissistic personality disorder, which is associated with increased risk of:


Self-esteem problems are not considered an official mental health diagnosis, yet they can steal your happiness and keep you from living the life you deserve. And since they are often linked to conditions like anxiety, depression, substance abuse, and others, it’s important to seek help. In traditional psychiatry, however, diagnoses are largely based on symptom clusters and conditions are too frequently misdiagnosed. An inaccurate diagnosis and improper treatment not only won’t help you get well, but it can also make you feel worse about yourself.

Part of the problem is that traditional psychiatry typically takes a one-size-fits-all approach to diagnosis and treatment. But psychological issues aren’t simple or single problems. Giving everybody the same treatment will never work.


Neuroimaging studies are teaching us more about where self-esteem lives in the brain. A 2017 study in eLife pinpointed what happens in the brain when a person’s self-esteem goes up or down. They enlisted 40 people who agreed to have their brain scanned by MRI while they were judged by strangers—either getting a thumbs up or a thumbs down. The researchers found that activity related to self-esteem occurs in the insula and prefrontal cortex, areas of the brain related to valuation and learning. In this study, the people who had the greatest fluctuation in brain activity in these areas during the social evaluation task also had lower self-esteem and were more likely to have anxiety or depression.


Amen Clinics uses brain SPECT imaging as part of a comprehensive evaluation, which can help determine if your self-esteem problems are related to any mental health conditions that also need treatment. At Amen Clinics, we also assess other factors—biological, psychological, social, and spiritual—that can contribute to self-esteem issues. Based on all of this information, we are able to personalize treatment, which may include helpful forms of psychotherapy, simple tools to kill the ANTs (automatic negative thoughts), natural supplements, nutrition, exercise, and medication (when necessary).

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