Low Self-Esteem: Why It Persists and What the Research Says Actually Helps

Low self-esteem can significantly impact your life. Usually, the first step to overcoming a challenge like this is to know you have it – but too often we find ourselves well aware of low self-esteem but feeling unable to do anything about it.

We’ve already talked about what exactly self-esteem is, and how it can be thought of as a combination of self-liking and self-confidence per the Rosenberg Self-Esteem Scale. It makes sense that, if you don’t feel worthy or competent, you might have a hard time making changes to improve your life.

In this article, we’ll talk about the effects and signs of low self-esteem, the maintenance cycles that keep self-esteem low, and how to overcome low self-esteem.

What Keeps Low Self-Esteem Going?

Difficulties like low self-esteem generally stick around because our behavior confirms our beliefs. According to cognitive-behavioral models, our thoughts, feelings, and actions are all connected, and they continue to feed into each other until we break the cycle.

In 1997, psychologist Melanie Fennell suggested a cognitive model of self-esteem [1]. According to Fennell’s cognitive model, low self-esteem starts with early experiences that form negative core beliefs about the self. For example, being constantly critisized at home might lead you to feel like you’re not good enough for other people.

These negative beliefs about yourself can lead to further negative beliefs about the world and others. If you believe that you’re not good enough, you might believe that you need to measure your worth in other people’s approval and admiration. When you come across events where you can’t or might not meet those standards, your negative core beliefs are triggered, and you make assumptions based on these core beliefs and act in accordance with them.

In the current example, if you encounter a situation where you don’t think you’ll be accepted – maybe you’re the odd one out, or you’re the only stranger – you might avoid making conversation with others, stick to the sidelines, and leave without making any meaningful connections.

Having left the event without connecting with anyone, you’ve confirmed your negative core beliefs that you’re not good enough. This can lead you to ruminate on what happened and engage in self-critical thinking, leading to negative emotions like shame and sadness, which can continuously re-activate those negative beliefs.

The Mental Health Impact of Low Self-Esteem

Longitudinal, or long-term studies, enable us to see how one thing might predict another over time. An analysis of longitudinal studies on low self-esteem found that self-esteem was better at predicting depression than depression predicting low self esteem, suggesting that low self-esteem might be a precursor to depression [2]. Low self-esteem was also found to be associated with anxiety, although in anxiety’s case, each predicted the other – low self-esteem to begin with was associated with later anxiety, but anxiety to begin with was also related to later low self-esteem.

In one study, students with low self-esteem had nearly 5x the odds of having depression, and 2x the odds of anxiety symptoms [3].

It can still be difficult to untangle how psychological factors impact one another. For example, a third variable like academic stress or an unsafe home environment could impact both self-esteem and depression or anxiety (or indeed both) at the same time, leading both to increase. Low self-esteem itself may not be the ultimate cause of mental health difficulties, but it can certainly make someone more vulnerable to feeling low.

How Self-Esteem Changes Across Your Life

Most of us have experienced periods of low self-esteem, especially in adolescence and perhaps early adulthood. This can be a difficult time, where social comparison seems like the be-all-end-all and we’re still finding out who we want to be. It may be no surprise, then, that self-esteem tends to change across our lifespan.

According to another analysis of longitudinal data, based on 164,868 participants from age 4 to 94, self-esteem shows the following pattern [4]:

• Age 4-11: Self-esteem increases
• Age 11-15: Self-esteem stays the same
• Age 15-30: Self-esteem increases strongly
• Age 30-60: Self-esteem continues to increase at a slower rate
• Age 60-70: Self-esteem stays the same
• Age 70-90: Self-esteem decreases slightly
• Age 90-94: Self-esteem decreases strongly

This makes sense when we consider how important self-efficacy and competence is to self-esteem: as children, we have to rely on others to do things for us (which is why we develop such strong attachments to caregivers), but we quickly build skills and confidence. As adolescents, self-esteem can stagnate; perhaps because, while we are still building mental skills, we’re also figuring out how we fit into it and measuring ourselves up.

Self-esteem then increases throughout our lives as we learn more about ourselves and the world, increasing more sharply during our most formative years. Sometimes, in older age, we find it difficult to do things for ourselves again – which might explain why self-esteem can dip later on, especially after the age of 90.

Low Self-Esteem and Narcissism

Narcissism has been thought of as excessive or defensive self-esteem, but some psychologists have argued that narcissism and self-esteem are actually two very different concepts [5]. The “mask” model of narcissism suggests that narcissistic grandiosity is actually a mask for low self-esteem [6].

However, researching narcissism and self-esteem has proven to be complicated – narcissism has been associated with different kinds of self-esteem (e.g. high self-esteem when it comes to intellectual skills but not morality), and studies don’t always consider this or different kinds of narcissism.

Grandiose narcissism is the way we typically think of narcissism – a sense of superiority, arrogance, and high self-image. However, there’s also vulnerable narcissism, which describes the same sense of entitlement and self-importance but from a place of low self-esteem and victimhood.

The relationship between narcissism and self-esteem can therefore be complicated. Although we sometimes think of narcissism as excessively high self-esteem, it might actually be better represented by high self-importance.

Low Self-Esteem and ADHD

Attention deficit hyperactivity disorder, or ADHD, has been associated with low self-esteem. The more intense the ADHD symptoms, the lower the scores on Rosenberg’s Self-Esteem Scale [7]. Treatment for ADHD is associated with better self-esteem scores [8].

So, why are ADHD symptoms associated with low self-esteem? We can look at this through Fennell’s cycle: ADHD symptoms often lead to negative social experiences like bullying and exclusion.

These experiences can shape your core beliefs about yourself, such as: “I am too much”, “I can’t do anything right”, “I’m not likeable”. When we have these beliefs, we make dysfunctional assumptions (“If I stay quiet then people will like me”, “I shouldn’t try to do things I’m not good at”), which trigger those negative beliefs, hence low self-esteem, when challenged.

Treating ADHD might support improving self-esteem in two ways:

1. Reducing symptoms reduces negative experiences;
2. Supporting emotion regulation helps us to view ourselves and our experiences from other, less self-critical or negative perspectives.

Low Self-Esteem in Attachment and Relationships

Your self-esteem is interwoven with your attachment style, both in infancy and in adulthood. So, if you have low self-esteem, part of this manifestation might be in insecure attachment behaviors like anxiety or avoidance. People-pleasing, protest behaviors, and emotional dysregulation can all show up in relationships when we’re dealing with low self-esteem.

High self-esteem has been shown to benefit relationships, likely explained by its association with attachment security [9]. Notably, how we see ourselves influences how we think our partners see us – if we see ourselves negatively, we believe our partners do too. This can lead to conflict and mistrust, eroding intimacy in relationships.

These are interesting relationships, but they don’t show directionality: existing studies suggest that high self-esteem supports healthy relationships, but it could also be that healthy relationships support high self-esteem.

Dating and the early stages of building intimacy are sensitive times in a relationship, and they can easily lead to critical incidents in the self-esteem cycle. If you experience low self-esteem specifically when dating or in a relationship, it’s important to consider where this is coming from. The following reflective questions might be helpful:

• Is my partner doing anything that makes me feel bad about myself?
• When do I feel bad about myself? Is it during or around the times I talk to my partner?
• Do I feel safe and comfortable bringing up the concerns I have about how I feel in this relationship?

If you can tie your negative feelings to specific things your partner has said or done, or you don’t feel able to bring up your concerns, it might be important to think about how your relationship is affecting you. However, if you think your self-esteem is coming from deeper rooted difficulties, you might be wondering whether therapy can help.

Therapies for Low Self-Esteem: Which is Best?

Certain kinds of therapy have been found to be very effective at managing low self-esteem. Cognitive-behavioral therapy can be particularly helpful, by intercepting the low self-esteem loop and breaking the cycle [10].

Cognitive-behavioral therapy, or CBT, targets negative thought patterns and how we act on them. This can help us to reduce our negative self-beliefs and our maladaptive behaviors, preventing the rest of the cascade and the continuing cycle.

Eye Movement Desensitization and Reprocessing (EMDR) therapy has also been found to be effective in improving self-esteem [11]. There are lots of different therapies you can try, and the best therapy might be different for everyone – it’s okay to shop around different therapists and types of therapy until you find one that feels right. Group therapies can also be very validating, even though they can be daunting at first.

Self-Compassion

Another kind of therapy that could be beneficial is compassion-focused therapy, or CFT. CFT targets shame and self-criticism to build feelings of safety, and could be useful for anyone dealing with these difficulties [12].

If therapy isn’t accessible to you, the good news is that you can practice self-compassion in your own time. Online resources like Dr. Kristin Neff’s online guided practices and exercises can help you to practice self-compassion at home, or any time you have a short, 10 minute break.

Since self-criticism can be prevalent in low self-esteem, self-compassion helps us to see ourselves through a kinder, more positive lens, reducing those negative beliefs.

Conclusion

Low self-esteem can impact any and every part of your life, from work, to relationships, even leisure activities. The cycle of low self-esteem keeps negative thoughts and behaviors on a loop, but it can be broken with changes in cognition or behavior.

Self-esteem changes over a lifetime are normal, and you might find that greater self-esteem comes with time and experience. Nevertheless, if you’re struggling with low self-esteem, self-compassion and cognitive-behavioral therapies can help you to rebuild your sense of self.

Low self-esteem also has a significant impact on our relationships, and is heavily implicated in our attachment styles. Find out your scores on the Rosenberg Self-Esteem Scale and get personalized insights with our free self-esteem test.

FAQs

How long does it take to build self-esteem?

There’s no set timeline for building self-esteem, and self-esteem can fluctuate easily depending on how we feel and what we’re experiencing. It’s normal for self-esteem to be at its lowest when we’re younger, increasing rapidly between age 15 and 30, and increasing still from 30 to 60.

Can ADHD cause low self-esteem?

ADHD is linked with low self-esteem. This is likely because the symptoms of ADHD lead to negative experiences, which lead us to develop negative beliefs about ourselves and begin the low self-esteem cycle.

What are signs of low self-esteem?

Low self-esteem is characterized by negative self-beliefs, whether through a lack of self-liking, self-confidence, or both. When we have low self-esteem we might avoid trying new things, avoid meeting or getting close to new people, and feel bad about ourselves and our achievements.

What age does low self-esteem start?

Low self-esteem can start at any age. It typically stagnates from age 11-15, during a time when social comparison and pressure are notably high, so adolescence could be a risky time for low self-esteem.

References

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9. Erol RY, Orth U. Self-esteem and the quality of romantic relationships. European Psychologist. 2017 Jan 16.
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12. Gilbert P. Introducing compassion-focused therapy. Advances in psychiatric treatment. 2009 May;15(3):199-208.