Low Self-Esteem and Depression by Dr Peter Mack
All the passages below are taken from Dr Peter Mack book, “You are not Alone”
The link between depression and low self-esteem has been established in many studies. Commonly, with low self-esteem the child tends to experience fluctuations in their emotions and perceive other people in his life as rejecting him. In general, too little self-esteem makes people feel defeated and lead them to make had choices. It is as if they are driving through life with hand-brakes on their vehicles. They can fail to live up to their full potential or fall into destructive relationships.
The concept of self-esteem is closely connected with the idea of personal value. It is a complex combination of beliefs about the self that develops in early childhood and reflects a person's subjective emotional evaluation of his self-worth as he matures into adulthood. It involves his ability to handle life's challenges and to feel accepted and liked. It also paves the way for him to interact competently in his circle of friends, identify his values, live up to his life potential, give love to others and be loved.
Self-esteem is built on a foundation of trust, security and unconditional love in the early stages of one's life. As the child grows, positive evaluations will enhance his self-esteem whereas negative evaluations will destroy it. Likewise, self-esteem is enhanced when the child is able to make favourable comparisons with other people or with an ideal self when he is able to perform effectively in his social and physical environment.
A good opinion and respect for oneself generates a sense of well-being. This is largely determined by the person's previous successes, aspirations and family hopes on him. A lot depends on what he perceives as his value to the world and how valuable he thinks he is to other people. This lies at the core of his self-concept and affects his trust in others and his relationships.
Our self-concept is the overall view of the unconscious belief' we have of ourselves, our attributes, who we are and what the self is all about. The essence of self-concept is the sense of being distinct from other people and the awareness that one possesses unique qualities, including appearance, skills, temperament and attitudes. This view is heavily influenced by the way in which a person interprets the feedback he receives from other people and the way he perceives their reactions to what he does and says.
As a rule, most of us try to behave in a manner that fits in with our self-concept. The gap between one's perceived self and one's ideal self gives an indication of his self-esteem. If a person's view of himself is close to how he would like to be, then he can be said to have healthy self-esteem.
JENNY ON SELF-ESTEEM, SOCIAL COMPARISONS AND RELATIONSHIPS
Jenny, a thirty-year-old who has been suffering from chronic anxiety since her college days, shares with me how her concept of what she wanted to achieve academically pushed her into depression with multiple suicidal attempts. During the interview, Jenny gives an account of the extent to which she has been affected by her perception of how the world judged her: This happened even after getting into university and her anxiety worsened as she continued to make comparisons between herself and others.
I have attempted suicide twice before. Actually in secondary school I have already thought of jumping down and killing myself should I fail to score the points I wanted. In my second year of college, I didn't do well. Apart from cutting myself, l took an overdose of Panadol one day after my exam results came out. I took twenty tablets. It was embarrassing. How can I as a top student drop to the bottom few? But I didn't die, just bad stomach aches and persistent vomiting from the overdose.
My 'A' Level results were worse than what I expected. In subjects that I used to score either an A or a B, I got C's.
In university 1 did even worse. I kept cutting my wrist because of the pressure to score well. Also, there was pressure from my ex-boyfriend in university. He would compete with me for results, to see who scored higher. After every test we compared answers to find out who was right and who was wrong, and it was very stressful while we were waiting for results. He would keep analysing my performance to tell me why I couldn't score adequately for First Class Honours. He also had a violent and bad temper. I was so stressed that my hair kept dropping. Finally I got my First Class Honours and 1 felt better. I always carried a penknife in my bag and 1 would use it to cut myself whenever my boyfriend gave me stress.
After graduation I found a job as a research assistant. I didn't really like myself in work life. Despite physical abuse from my boyfriend, I still stuck on with him because I wouldn't know how to be with any other guy. I stayed on with him simply because I needed a boyfriend. I just accepted him because I didn't have anyone else.
I do not know how I acquired this mentality of feeling shameful about being single. I still have this feeling today. Last weekend at a wedding lunch, my ex-colleague asked me about my marital status and commented that if I still did not get married by 31, it would be too late because a girl's shelf life was short.
To me it is very embarrassing if I don't have a boyfriend. I couldn't stand my ex-boyfriend anymore. We broke off eventually and he got married to someone else. So, all those guys that I was with have all got married, while I am still single. I ask myself: "What's wrong with me?"
The quality of esteem development in the adolescent's early growth phase largely determines the extent to which he develops trust and warmth or become suspicious and hostile towards others in later life. From the moment a baby is born, self-esteem develops as part of his blossoming identity. Parents respond lovingly to his smiles and cries as he feels loved and cherished. At school age, the child relies a lot on his parents and teachers to affirm that he is being loved and approved of. A child whose early life experiences have been favourable to the building of healthy self-esteem is able to internalise the feelings of self-worth and gradually become less dependent on others for approval. Otherwise, if he still has to rely on external sources for his self-esteem, he will find it tough to handle life challenges. A child with low self-esteem is prone to anxiety. He often says that he is unhappy, hates himself and concerned about how other people perceive him. On the other hand a child with high self-esteem speaks confidently of himself and with pride.
With adolescent growth, there is a transition from being dependent on parents to a state in which he starts to figure out how he fits into the greater scheme of his social environment. This is a period of uncertainty in his life and he is likely to face significant emotional and mental upheaval. The loss of his original identity may lead to a feeling of vulnerability. In the meanwhile, he struggles to rediscover who he is as an independent individual. During this period of development, he may want to conform to social expectations in order to receive the approval of his peers. Otherwise he may want to take on responsibilities and tasks in which he is likely to succeed so that he feels efficacious. Both approaches will help to enhance his self-esteem.
We all require some sense of belonging to a group. After all, this is a primal human need, just like the need for food, clothing and shelter. Belonging means being accepted as a member. There are some people who seek belonging through excluding others based on the reasoning that there must be people who don't belong in order for there to be those who do. Unfortunately, this approach works against esteem building. A single instance of a child being excluded from a sports team can undermine his self-confidence and well-being and create pain and conflict.
Our society and culture place great emphasis on evaluation of individual merit and tend to be unforgiving of mistakes made. Children are graded in their academic performance and athletic achievements or co-curricular activities in schools. In turn, the schools are ranked according to their students' overall performance standards. Parents often compare their children's school achievements with those of other families as they try to keep up with the social standing of their friends and neighbours. Such social comparisons plant the seed for anxiety in the child. He will start asking: "How am I in comparison with my classmates? Which group membership will make my school life happier?" To him, peer acceptance is uncertain and his personal worth is not assured. He is mentally occupied with comparing himself with others and doubting his efficacy. Under such circumstances more questions surface. He wonders if he has found a place to which he can comfortably belong and if others will respect him in this new group. He will also question whether he has managed to accomplish what he should be doing.
Low esteem leads to anxiety and a distorted view of oneself and others. A characteristic of children with low self-esteem is their difficulty in forming close attachments. This is simply because they find it difficult to believe that they are worthy of a fulfilling relationship with someone else. They have difficulty setting goals and solving problems. They tend to deny their successes while placing little value on their own abilities. With a lowered level of self-confidence they fear failure of attaining their academic potential, expect the worst in life and are handicapped by self-limiting beliefs.
Hazel On Effects of Low Self-Esteem
Hazel shared with me her experience of growing up with low self-esteem and how it took a toll on her mental well-being.
I grew up with low self-esteem and the people around me made me feel like my presence was never significant. I felt like my feelings didn't matter and was taken for granted all the time. I remember I wanted to end my life when I was about 14 or 15 years old. I just couldn't stand being around people as 1 felt useless and unwanted.
As I grew older, the repressed feelings of uselessness would still linger more than it should, causing waves of anxiety, sleepless nights and much tears. With this negativity constantly at the back of my head, I short-changed my expectations. The yearning to have someone like me was profound, especially when 1 started dating.
I dated someone who was very emotionally abusive and yet I stayed with him for almost two years. Subsequently I had another relationship but it ended abruptly just because his mother didn't like me. He didn't tell me why at first despite my begging to know the reason. It was so painful when I got to know about it eventually because I felt it was very unfair that he just concluded that he didn't like me without even getting to know me. Subsequently I found out he had also been cheating on me. He made a girl pregnant and the discovery broke my heart. I couldn't focus on whatever I was doing and it took a toll on me. I lost so much weight and was so depressed that I had to see a counsellor because I really needed help. It took me more than two years to overcome my depression but I am blessed that I am now emotionally stronger than I was before.
One way to understand the emotion behind self-esteem is to understand the concept of mood. Many people feel that low self-esteem has been a key contributor to their low mood and depression to start with. Some of them have been bullied because they are shy or reserved. In turn, experiencing depression wears their self-confidence down further. Some also feel that depression has changed the way they see themselves.
Like emotions, moods fluctuate over time. It is a mental disposition that is elated at one extreme in which a person is aroused and ready to act, and at the other extreme he feels fearful, listless and anxious and is reluctant to take action. Mood influences thoughts and actions but it is also influenced by the events and experiences in the world of the maturing adolescent. A positive mood encourages him to perceive the world in benign terms and fosters the perception of a self at ease and accepted by other people around him. It produces momentary positive self-evaluation which creates certainty about his self-worth.
In contrast, a negative mood encourages him to perceive the social world as hostile. He sees a self that is at risk living within and this leads him to wonder about how others will respond to his actions and his chances of success in his endeavours. He adopts self-limiting beliefs because he sees obstacles with unfriendly people in his life path and limited chances for achievement.
Mood is related to how successfully the person has attained his goals in his social world. If a school child falls short of the expectations of his parents or teachers, he feels disappointed, ashamed and depressed. In the mental state of shame, the mood is influenced by the emphasis on the individual responsibility for his performance and outcome. Feeling that he has failed, he has now to endure the shame of facing a world of judging people before him.
On the other hand, a person who believes in himself and is self-reliant is more likely to be able to cope with his failure. He will be able to weather the occasional storm and regain his equilibrium more readily. With increased resilience he is more likely to enjoy life and form more successful, fulfilling relationships than someone with low self-esteem.
Foundations for Healthy Self-Esteem
It is of utmost importance to know the natural ground for building healthy self-esteem in our children. To start with, we will have to fully accept our child as he is. Guiding him into the educational and social world at his own pace and respecting his unique qualities is fundamental. He must understand how his character is different from those of other people.
Next, we need to listen to the child's feelings and refrain from criticising him as he struggles with his life problems. Instead, we should use realistic praise for the efforts he puts in and for his accomplishments. Allowing him to discover his way of coping with new situations and encouraging him to keep trying when he is challenged are important. Within the home it helps to delegate responsibilities to him that are appropriate for his age and skills.
The maturing adolescent needs the adult to shine light on his path towards independence. To this end it helps if we show interest in what captivates him in his schoolwork and make it explicit that we are proud of his uniqueness. Along the way, we need to spend time to teach him how to handle disappointments. There is much value in taking a walk with him together and listening to his account of his social experiences. Playing games with him or planning family outings together are also of help because we are showing him that we experience joy in being with him.
As parents, we need to be conscious of the fact that we are the child's most powerful mirror in which he can use to see his reflected self. Hence, we need to evaluate our own level of security and esteem and model to our child our capability of handling challenging situations. The child's earliest perceptions of himself stem from his internalisation of parent's attitudes. If the parent-child relationship is positive in the pre-school years, he experiences himself as a worthwhile, successful, and loved individual. As the child grows we will need to help him to develop a strong sense of self and understand how he fits into the social world around him. Doing so would require him to have a clear awareness of his personal values and guiding principles in life.
There will be times when the child's insecurities interfere with his ability to accept who he is and his social functioning. When this happens we need to address his issues head on. As parents, we may want to explore those areas of his life that shape his self-worth and self-confidence. Contrary to popular belief, self-esteem does not come by simply telling the child that he is wonderful and great. Instead, it comes from cumulative experiences that have made him feel capable, effective and accepted.
When the child learns to do things for himself and feels proud of what he can do, he starts feeling capable. So, we should help our child to develop an understanding of who he is and where he can fit into his own social environment. He may also need help to identify what he values in his life and what qualities he admires in others. If he admires someone who is kind, loving and charitable, he too may like to develop the same qualities in himself. We may then want to guide him into reflecting over what he needs to do to live in accordance with those values, and furthermore, how to use his personal values to build his guiding principles in life.
For instance, if a child values charity and kindness he may want to join a social group and participate in volunteer work. Along the way he may want to set goals that are in accordance with his values. The moment he realises how he can attain his set goals, he will feel capable and ready to embark on his journey of esteem building. He will also feel the effectiveness in himself when he sees that positive results are coming out of his efforts.
Next, we need to be aware that the child's self-esteem has a deep connection with parenting styles, a topic that is discussed in greater depth in the next chapter.
Let us take the example of the authoritarian style in which parents are strict and controlling. In this style, the family rules are clear but rigid and inflexible. The parents are aloof and unresponsive to the child's emotional needs. They do not allow room for the discussion of his problems. Bad behaviours in their eyes are punished. Hence children with authoritarian parents develop low self-esteem because they are not allowed to have choices, make decisions or express their opinions. While they may perform well in schoolwork, they tend to become followers rather than leaders. They have a hard time relating to peers and playing with others. In general, those children who have been abused verbally, emotionally, physically or traumatised in some way when they were young would tend to have difficulty in developing high self-worth and coping with life challenges.
It is useful therefore to help the child discover his strengths and weaknesses and accept the fact that making mistakes is a natural and effective way of learning. An important source of positive self-esteem comes from the drive for achievement and the joy of seeking, learning, creating and competing. Interactions with other people form the basis of self-concept and a solid self-concept is associated with self-mastery and effective coping abilities.
Keep in mind that the child's failure to conform to self-imposed standards of performance in the academic or sports arena can also injure his self-esteem. Do help him to learn what he is capable of and set realistic and challenging goals. If necessary, compile a list of all his strengths and post it on his bedroom wall to remind him of his qualities. Accumulate all his accomplishments such as trophies, awards and certificates and put them on a shelf and let him spend some time looking at his accomplishments regularly. At the same time it is crucial that you do not let him dwell on his weaknesses.
It is also important to help the child develop creativity in self-expression and recognise the unique ways in which he can express himself. Some children use artistic means such as drawing, painting, colouring and writing to provide an outlet for the strong emotions that they deal with. Others may prefer to express themselves through playful expression with interactive games, sports or through the building of objects like dollhouses or model cars.
How Parents Can Help
Impress on the child that he has the right to be himself and that he can make a difference to the world. Sometimes even the mere act of talking about earning self-esteem can motivate the child. Assist him to imagine a future self so that he can focus on attaining his goals. Help the child to learn how to take care of himself. While life can be difficult he has to be reminded that there are ways and things he can do to smoothen the path for himself. Teach him to ask himself each day what is he is grateful for. Even when things are going tough, so long as he can identify one thing each day for which he can be thankful, such as good weather, he can help himself to feel good.
It is often upsetting for parents to hear their child speaking about his suffering and hopelessness. One common reaction from parents is to point out the good things the child already has in life and remind him how fortunate he already is, and that he should be contented. This is a mistake. Such an approach makes him feel that he is not understood and discourages him from confiding in his parents thereafter. Rather, the parents should comment on what the child considers as his suffering in such a way that the child feels that there is interest in his well-being and that the parent is making an effort to understand.
Whether or not a child appears to care, he needs plenty of encouragement from the parent. Simple words of praise and paying attention to the good things he does or says every day makes a big difference in his life. One example is to tell him that you notice that he is making a greater effort at schoolwork or he is playing the piano livelier than before. You may like to thank the child for helping to clear the table and wash the cutlery after dinner. Commenting on any small signs of progress in his daily life is a good way to help him get back on track.
Spending enjoyable and relaxed time with a teenager is often helpful when he is depressed. This can be difficult because the depressed child may be caught up with his own life and want to remain alone. However it is a worthwhile effort to think of creative ways to spend one-on-one time with the child. Shopping together in a mall or watching a movie together can help. Remember that it is often the informal time spent together that is more valuable. A good time to chat is when you are picking him up in a car from school.
Sometimes parents are worried that listening to the teenager's upsets will encourage him to get more stuck in his negative thoughts and push him further towards suicidal tendencies. The truth is that the child needs the parent not only to listen and accept their concerns but also to reassure him that help is available should he need somebody to cheer him up. It is when a child is allowed or left to ruminate over his sufferings and blame himself for his difficulties will he tend to spiral down into depression.
Let us not forget that it is emotionally exhausting to handle anxious children. Concerned parents feel that they cannot leave their depressed children alone. They need to remember to recharge their own batteries, such as regular exercise, spending time with their own social circle or even joining a support group for people with depressed family members. Caring for one depressed child puts strain on the whole family and the other children may feel overlooked and start to resent. As a parent you need to explain to them your perspective of the depressed child's difficulties. Giving time to the other children may help them to understand and cope better with the situation. Do not abandon your family holidays because the depressed child may also want to participate and enjoy a break. All families have problems. A healthy family would acknowledge the existence of a problem, discuss them together and take steps to solve them. [92-107]