Low-self Esteem and Mental Illness

Low self-esteem doesn’t get talked about enough. We talk about depression. We talk about anxiety. We talk about burnout, panic, trauma, and stress. But underneath so many of these struggles sits something quieter, more persistent, and far more powerful: a deeply held belief about who you are.

Low self-esteem is not just “low confidence”. It’s not just feeling unsure of yourself on a bad day. It is a core sense of self that has been shaped by experiences of harm, neglect, rejection, or chronic invalidation. And in our work, it is one of the most common drivers behind mood disorders such as depression and anxiety. Not because you are broken.But because something happened to you.

Where Low Self-Esteem Really Comes From

Low self-esteem almost always stems from trauma. Sometimes that trauma is obvious and unmistakable. Abuse. Assault. Bullying. Accidents. Violence. Racism. Homophobia. Transphobia. Growing up in unsafe or unpredictable environments.

And sometimes it’s quieter. So quiet it often gets dismissed or minimised. Being compared unfavourably to siblings. Feeling emotionally neglected.Growing up in a household where love felt conditional.Never being praised, only corrected.Having your feelings ignored or mocked.Not feeling seen or valued at school.Being labelled “too sensitive”, “too much”, or “the problem”. These are often referred to as “small t traumas”. But there is nothing small about the impact they can have on how we see ourselves.

Trauma doesn’t have to be dramatic to be damaging. Repeated emotional experiences shape us just as powerfully as single catastrophic events.

How Trauma Turns Into a Negative Sense of Self

Trauma doesn’t just leave memories. It leaves meaning.

When painful experiences happen or happen repeatedly, especially when we are young, dependent, or powerless, we don’t just think “that was bad”. We start to believe “this says something about me”. And so negative core beliefs form.

“I am unloveable.”“I am not good enough.”“I am weak.”“I am a burden.”“I don’t matter.”“I am broken.”

These beliefs are not fleeting thoughts you can simply argue away. They are deeply held truths about the self, shaped over time, often before we had the language to question them.

They are soaked in shame.

Shame Is More Than a Feeling

Shame is often misunderstood.

It’s not just embarrassment or guilt. Shame is a deeply distressing emotional state that includes negative thoughts, body sensations, and memories of “bad things” happening to you or around you.

Shame says: “There is something wrong with me.”

It brings with it images, flashbacks, sensations, and a constant sense of threat. It can sit quietly in the background or erupt suddenly when something triggers it. This is why low self-esteem is so closely linked to depression and anxiety. If you believe you are fundamentally flawed, the world feels dangerous. Every interaction becomes risky. Every mistake feels catastrophic. Every rejection confirms what you already believe about yourself.

Why You Can’t Just “Think Positively”

Many people are told to fix low self-esteem by “changing their thoughts”.

But this misunderstands the problem. These beliefs are not surface-level thoughts. They are emotional truths formed through experience. The brain doesn’t respond to them as opinions. It responds to them as facts.

This is why affirmations often feel hollow or even triggering. You are not failing at positive thinking. The belief simply lives at a deeper level. So instead, people develop coping strategies to manage the pain of the belief.

The Coping Strategies That Keep Low Self-Esteem Alive

In therapy, we commonly see three internal coping strategies that maintain low self-esteem. They make sense. They are understandable. But they don’t change the belief.

Belief avoidance: You avoid anything that might activate the belief. Intimacy. Feedback. Opportunities. Vulnerability. You stay small to stay safe.

Belief overcompensation: You work relentlessly to prove the belief wrong. Perfectionism. People-pleasing. Overachievement. Over-giving. Exhaustion. No matter how much you do, it never feels enough.

Belief surrender: You give in to the belief. You stay in unhealthy relationships. Accept poor treatment. Stop trying. Tell yourself “this is just how I am”. The tragedy is that none of these strategies heal low self-esteem. They simply maintain it and often make it worse.

When the Environment Is the Problem

Low self-esteem is not always an internal issue. Sometimes the environment is actively harmful. On a macro level, this is especially true for people from marginalised communities. LGBTQ+ people. BIPOC people living in the West. People with intersectional identities.

When systems such as education, healthcare, policing, housing, and employment repeatedly disadvantage, invalidate, or punish you, it would be unrealistic not to internalise that. This is why LGBTQ+ affirming psychotherapy and Queer affirming therapy are essential. Low self-esteem does not exist in a vacuum. It exists within social, political, and cultural contexts.

On a micro level, the environment may be closer to home. A toxic relationship. An abusive family. Cruel friendships. A workplace that constantly undermines your worth. In these cases, therapy is not about teaching you to tolerate harm. It’s about helping you minimise it, leave it where possible, and rebuild your sense of self alongside safer relationships.

How Therapy Helps Repair Low Self-Esteem

A large part of therapy involves gently uncovering the core belief. Understanding where it came from. Why it made sense at the time. How it tried to protect you. And then, slowly and compassionately, working to change it.

This may involve trauma-focused approaches such as EMDR, which helps reprocess painful memories and the beliefs attached to them. Cognitive Behavioural Therapy can help identify and shift maintaining patterns. Art Therapy can access emotions that words can’t reach. Acceptance and Commitment Therapy helps reduce the power of shame and build a values-led life.

Often, it’s also about the relationship itself. Being consistently met with curiosity rather than judgement. Care rather than criticism. Respect rather than dismissal.

For many people, this is the first time they experience a relationship where their worth is not conditional.

Intersectional, Queer Affirming Support That Gets It

Many people tell us the same thing: “I don’t want to have to explain myself.”

They don’t want to explain racism. Homophobia. Transphobia. Body shaming. Misogyny. Islamophobia. Anti-Blackness. Or the constant vigilance that comes with living at the intersections.

At Fighting Fear, our Queer affirming therapy understands that low self-esteem often grows in environments that were never safe to begin with. Healing requires understanding, not minimisation.

Our therapists and coaches work from an intersectional lens. We recognise that low self-esteem is often a rational response to oppressive systems, not a personal failure.

Accessible Therapy That Meets You Where You Are

We also know that therapy can be expensive. And cost should never be the reason someone stays stuck. That’s why we offer FREE and Low Cost Therapy through our Inclusive Therapy Programme. These sessions are delivered by trainee therapists who have been deemed safe to practise and are supported through both group and individual supervision. You are not left alone. A senior, highly experienced supervisor has oversight of all work.

We offer online therapy, making support accessible wherever you are. Our therapists are based across the UK including Manchester, London, Birmingham and Scotland, as well as in Spain and Belgium.

We offer sessions in English, Arabic, Urdu, Hindi, Spanish, French, and Portuguese.

Whether you’re seeking counselling, CBT, EMDR, Art Therapy, Acceptance and Commitment Therapy, or coaching, support is available.

You Are Not the Problem

Low self-esteem is not a personality flaw.It is not weakness.It is not a lack of resilience.

It is often the result of surviving environments that taught you to doubt your worth. And the fact that you’re questioning it, seeking support, and wanting something different already tells us something important about you.

With the right support, low self-esteem can change. Shame can soften. Anxiety and depression can begin to ease.

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