Low Self Esteem
Dear Mrs. Radcliffe,
I think my 16 year old daughter is suffering from low self-esteem. She is socially withdrawn and she does nothing to enhance her appearance. She doesn’t eat properly and seems just not to care about herself. Lately, she just lies around in her free time doing very little of anything. I have other children who are much more enthused, take care to present themselves well and who obviously hold themselves in higher regard. What can I do to help?
Mrs. L.
Dear Mrs. L.
You are guessing, from your daughter’s outward appearance and conduct, that she is suffering from low self-esteem. Although she may indeed have this problem, it is also possible from your description that something else entirely is going on. For example, young people who are socially withdrawn may be introverted by nature (not socially interested), or they may have social anxiety (discomfort around groups of people) or they may be suffering from depression (which has social isolation as one of its possible symptoms). Similarly, children who don’t “put themselves together” well may have low self-esteem, but they may also have poor body image, poor taste, depression, insecurity or deficient “know-how.” Kids who don’t eat well may be normal teenagers or they can be experiencing physical or mental health symptoms. Those who lie around may lack motivation, be bored, be underachieving or be depressed. In order to make the right “diagnosis” we really need to have more information. The “treatment” will then depend on the diagnosis.
To help decide whether this might be a mental health issue as opposed to a personality issue (like laziness, insecurity or low self-esteem), consider the following questions. Is your daughter performing well in school or has she experienced a recent downhill slide? Is she eating and sleeping the same as always, or have there been recent changes in these habits? Has she lost or gained a significant amount of weight? Is she having more trouble than usual making decisions? Does she obviously enjoy other aspects of life – is she generally happy at home, in a good mood and involved with things that interest her?
The reason we look at these areas of functioning is to help rule out teenage depression. Although a doctor or mental health professional must be consulted for an actual diagnosis, parents can be aware that depression is likely to be diagnosed when a teen exhibits at least 5 of the following criteria most of the time during a two week period:
1. depressed or irritable mood
2. diminished interest or pleasure in most activities
3. significant weight change without dieting
4. insufficient or excessive sleep
5. physical lethargy or agitation
6. exhaustion
7. feelings of guilt or worthlessness
8. trouble concentrating
9. thoughts of (threats of or plans for) dying
A high load of these factors can indicate a depressive episode and warrant a visit to the doctor. Treatment may involve therapy, alternative medicine and/or psychotropic medication. Another diagnosis – dysthymic disorder – is a milder form of depression that lasts at least 2 years and is often so chronic as to be confused with personality. It is characterized by a fairly consistent experience of at least 2 of the following symptoms:
1. excessive or undereating
2. too much or too little sleeping
3. low energy or fatigue
4. low self-esteem
5. difficulty with decisions or concentration
6. feelings of hopelessness
Dysthmia, like major depression, may respond well to psychotherapy, alternative medicine and sometimes to psychotropic medication. Again, a check-up with a medical or psychological professional may be in order.
If you’ve ruled out the likelihood of depression, you can consider the common personality concerns that may be affecting your teen. If your daughter is otherwise happy, high functioning and well-adjusted, she may just need some “fine-tuning” to improve her self-concept and social skills. Again, a mental health professional may be very helpful for this or for self-concept and self-esteem issues.
As a parent, the most positive thing you can do is be in a good mood yourself and be very warm with her. Criticism will only worsen her condition, so refrain from it as much as possible. On the contrary, be sure to let you know you like her and approve of her in as many ways as possible. Loving encouragement, acceptance of her feelings and her individual way of being can be therapeutic. Find and praise her unique realms of successful functioning, since people tend to go from success to success. And keep in mind too, that people grow up at different rates and it is possible that this child just needs more time to come into herself. Your patience and acceptance can help enormously whether she is having a bit of a developmental lag or whether there are more complex factors affecting her behavior.
