Lido Wellness Center Blog

Building Self-Esteem in Mental Health

February is International Boost your Self-Esteem Month

What Is Self-Esteem

How we view ourselves in terms of our own subjective sense of personal worth or value is typically referred to as self-esteem, self-worth, self-regard, or self-respect. It’s basically the way we perceive ourselves and our own value, regardless of the current circumstances in our lives. Our self-esteem can be defined by our own feelings of security, our sense of self-confidence, a sense of belonging or our feelings of being capable and confident. It is many times the foundation of our identity. Building self-esteem is valuable for anyone looking for mental health.

Poor self-esteem can come from a variety of places. Some of us are born with it as part of our genetic make-up. For others, they can feel “less than” due to their socioeconomic status, physical or mental disabilities; or perhaps low self-esteem is due to a mental health struggle. Sadly, children raised in a negative environment where they didn’t feel valued, or perhaps they were abused or neglected, may grow up with feelings of worthlessness, and consequently, continually struggle with self-esteem as an adult.

The Poor Self-esteem Bias

Regardless of what the source of self-worth struggles are, low self-esteem is a biased view that reflects a harsh and unfair judgment about ourselves. We then act according to those self-taught beliefs. For example, you may know somebody who is chronically indecisive, never seeming to trust their own decisions or perhaps easily swayed by the opinion of others.

For others low self-esteem manifests as negative self-talk or going to extreme lengths to please others. If you have low confidence or know of someone who lacks self-confidence they also tend to suffer from low self-esteem. All in all, it can result in feeling a lack of control in many or all aspects of life without the ability to create the change needed to feel more confident and in charge of their own destiny.

Social Media and Self-Esteem

Increasingly, the role of social media is being questioned in the role of individuals’ self-esteem, especially when it comes to young adults. While both men and women of any age can suffer from low self-esteem, social media plays a heightened role particularly in young girls questioning their own self-worth.

Social media creates a platform where it becomes easy to compare yourself to someone else. Individuals post “versions of themselves” which are typically not accurate of their day-to-day lives. This can prompt comparisons that foster body image issues and create self-esteem gaps and questions around a person’s looks, their lifestyle and their quality of life – and whether they are “good enough.” It becomes easy to see how constantly viewing the joy of others through a filter of their “perfect life” as portrayed on social media can create insecurities.

Beauty Filters and Mental Health

A 2021 survey of 200 teens ages 13 to 21 revealed that young people who use beauty filters regularly in their posts on platforms like Snapchat and Instagram are more likely to have a desire to want to get cosmetic surgery and/or to alter their skin color. The survey also revealed a correlation between the amount of time a teen spends on social media and their dissatisfaction with their appearance. As one would expect, the more time spent on social media, the higher their feelings of dissatisfaction with themselves. Social media is setting a disingenuous and unrealistic bar for what people feel they should look like, how they should act, and what their lives should look like.

“It makes very intuitive sense that when you don’t have a strong sense of self or don’t have strong attachments or modeling behaviors from family that it can sometimes lead to developing poor self-esteem and even poor body image, which translates to anxiety, depression, and isolation. It also contributes to developing traumatic attachment, trauma, and codependency. Poor self-esteem can be a symptom of underlying mental health issues.”

Eric Chaghouri, MD
Psychiatrist/Medical Director,
Lido Wellness Center

The Risks of Low Self Esteem

Leading a healthy, full life can be difficult when you suffer from low self-esteem. It affects your ability to connect with others and have a meaningful relationship with a significant other. There is a possibility of becoming codependent. It can contribute to loneliness and propagate isolation. Social anxiety can result, which may create stress around interactions with others – even casual conversation can be affected, wondering if you are saying the right things or worrying that you are dull or don’t have anything of value to contribute to the conversation. Individuals with low self-esteem can also have trouble setting boundaries with others and allow themselves to be taken advantage of or find themselves in uncomfortable, or even sometimes, dangerous situations.

From a total health perspective, low self-esteem contributes to high levels of stress and can lead to unhealthy coping activities if individuals turn to substances such as alcohol or drugs. Having poor self-esteem can manifest into serious mental health disorders such as anxiety and depression, and even suicidal ideation.

Several studies have been done that connect the feeling of positive self-esteem with the ability to experience more joy and optimism daily. There’s also evidence that those who enter treatment regimens for treating disease with positive feelings of high self esteem get through treatment faster and have better outcomes, and even have a stronger immune system.

Tips for Improving your Self-Esteem

One of the first things to remember for anyone struggling with their sense of self-worth is to reject that your negative self-talk is true. Believing the inaccuracies, we tell ourselves plunges us further into a hole where we risk sinking so far that we can no longer see the truth about ourselves. Instead, we believe the lies through the poor self-esteem filter that we have created. Here are a few ideas on how to consciously tackle feelings of low self-esteem:

• Challenge some of the automatic thoughts that you have about yourself. Don’t just accept what comes into your head about yourself as true.
• Don’t compare yourself to others.
• Remember your achievements – small or large. Keep a list handy to refer to.
• Talk to yourself as you would talk to a friend. You wouldn’t constantly criticize a friend or find fault with everything they do. Give yourself the same grace. Learn how to practice self-compassion.
• Pay attention to good health habits – engage in regular exercise and eat healthy.
• Select those around you carefully – stay away from individuals who are constantly critical and who aren’t positive.
• Seek professional help and explore the source of your self-esteem issues to address it at its core.

Building Self-Esteem and the Lido Model of Care

At Lido Wellness, our mental health approach is driven by a Person-Centered Treatment Philosophy that is based on respecting and understanding each individuals’ unique life experiences. Self-esteem struggles can develop as a result of those life experiences. Low self-esteem is commonly found in people with trauma and stress related disorders, anxiety, depression, substance use disorders and eating disorders. It’s no wonder that a driving force behind development of these types of mental illnesses can be low self-esteem.

In recent outcome surveys conducted by Lido Wellness Center, individuals who completed a patient health questionnaire noted improvements to many areas of their lives, including ability to notice or regulate emotions, ability to tolerate distressing experiences/emotions, and readiness to transition back to a regular routine of their lives, including work, school, etc. Many noted feeling listened to and heard during their time at Lido Wellness Center, which is important in being open to treatment and plays a vital role in the success of individuals seeking care.

At Lido Wellness Center, our Person-Centered Treatment Philosophy goes hand in hand with helping individuals build self-esteem. This is vital to being open to receiving mental health treatment that eventually helps individuals:

• Feel valued
• Believe they are cared for
• Increased confidence in their abilities to improve their lives and live their best life
• Enhance motivation to continue to improve
• Build better health and resilience for an improved quality of life

For many individuals, being heard translates to feeling respected and important – which are crucial components to self-worth. The feeling of being heard also adds to the idea that our experiences are legitimate, and our concerns are real. It can also add to the feeling of empowerment and the idea that we can accomplish what we set out to do.

References

Eric Chaghouri, MD, Psychiatrist/Medical Director Lido Wellness Center

11 Signs of Low Self-Esteem (verywellmind.com)

https://www.teenvogue.com/story/social-media-filters-how-young-people-see-themselves

https://www.manageyourlifenow.com/low-self-esteem-is-dangerous-for-your-health/

Lido Wellness Center Blog

Distress Tolerance and Emotional Regulation

Stress. We all feel it. We all have it. While it may have been cyclical in the past, stress has become a 24/7 problem. With our electronic devices we have access to “anything and everything” and that means 24×7 news and information, social media posts, non-stop emails at the touch of a button – all of it disrupting our here-and-now and keeping us “always on.” As the stressors in the world are increasing so are the number of individuals who are being negatively affected by them. As a result, our nervous system is more readily activated, and depending upon our distress tolerance and emotional regulation, some of us are more affected than others.

What Is Distress Tolerance?

Distress tolerance refers to the ability of an individual to manage emotional distress – whether it is an actual stressful situation or one that is perceived to be. Distress tolerance also refers to the ability of someone to navigate through an emotional incident without making it worse on themselves – such as reliance on an addictive substance, becoming severely withdrawn or even becoming violent. Individuals with low tolerance are easily overwhelmed by situations and turn to unhealthy ways of coping or reacting. A low tolerance for stress is also known as a narrow “window of tolerance.” 

For some individuals, daily life provides a vast range of annoyances that are outside their window of tolerance — some may be as minor as uncontrolled impatience with computer issues in the office, to facing major events such as the serious illness of a loved one, or a job change or loss. Learning how to manage stressors first starts with understanding that stressful events will not go away. We’re always going to face stress, so understanding how to increase our stress tolerance and widen the window of tolerance to emotionally regulate our nervous system is important to decrease our stress and live a more peaceful, balanced life. 

The Window of Tolerance

The window of tolerance is a concept that describes the range within our psychological and physiological optimal state that allows us to manage stressors. How to Help Your Clients Understand Their Window of Tolerance (nicabm.com)

First described in 1999 by psychiatrist Dr. Dan Siegel, the model’s middle zone (window of tolerance) is when individuals are neither hyper vigilant/hyper-aroused or the opposite – hypo-aroused. That middle ground is where individuals are able to emotionally self-regulate and tolerate emotions and tap into coping skills when life presents challenges. This zone is where we are alert, present and engaged without being anxious, and relaxed without being fatigued or numb. Being in that optimal range allows individuals to manage the ups and downs of emotions in a balanced and tolerable way. While experiences, pain, anxiety, or disappointment may bring us close to the edges of the window at times, having the ability to stay within the window allows us to have the capability to optimally solve problems. 

The Window of Emotional Regulation

Individuals who have experienced trauma in their lives may have a narrower window of tolerance and find themselves in a place where they can’t find peace and calm, or on the other end of the spectrum, they may shut down completely and disengage to the point of being stoic, frozen, and dissociated from life. For example, when an individual is hyper-aroused and flies off the handle easily, or conversely, they are “checked out” and dissociate as a coping mechanism – both techniques are outside the window of tolerance. They are likely techniques that individuals may have relied on in the past to manage and protect themselves from whatever stressors they’ve been subjected or traumatized by in their lifetime. While trauma and stress can narrow the window, therapy can widen it.

Hypervigilance/hyper-arousal

Individuals who are hypervigilant or hyper-aroused experience their nervous system kicking into high gear. They find themselves in a state of increased alertness, making them hyper-focused on their surroundings and perhaps even on the lookout for hidden dangers that may not exist around them. When individuals are in a state of hyper-vigilance, they’re extremely sensitive to their surroundings and exhibit emotional, physical, and mental symptom such as:

• Severe anxiety
• Fear
• Panic
• Persistent worrying
• Racing thoughts
• Feeling on edge
• Accelerated heart rate
• Rapid, shallow breathing
• Sweating
• Tense muscles
• Clenched jaw
• Overly sensitive to sounds
• Heightened awareness of your surroundings

Hypo-arousal 

In a hypo-arousal state, individuals feel drained and out of it – feeling almost passive and numb to the world around them. They likely feel frozen in their thoughts, responses, and actions, and tend to dissociate from their surroundings. They may exhibit symptoms such as:

• Emptiness
• Irritability
• Anger
• Social withdrawal
• Decreased energy
• Loss of appetite
• Fatigue 
• Poor memory
• Depersonalization
• Depression symptoms 

When individuals experience either hypervigilance or hypo-arousal, the area of the brain responsible for  more advanced cognitive function (the prefrontal cortex), slips into a passive hibernation mode which results in impaired problem-solving and decision-making. 

Effects of Stress

There are innumerable factors that cause stress. Lifestyle choices – everything from where and how we live, to how demanding or stressful our careers are – all can play a part; family struggles, health issues and most recently pandemic fears, and the resulting isolation, are also factors. Everyday stressors can also build – things like traffic congestion and demands from others; in addition holidays and the expectations that accompany them along with time pressures, also challenge our ability to tolerate distress. 

Stress has been with us for generations and will continue to be with us well into the future. And while the source of stress changes with the times, what is most worrisome about distress and our ability to tolerate it is that its effects aren’t just limited to mental health challenges. While the World Health Organization has called stress the health epidemic of the 21st century, it is a constant, and how we face it determines our physical, mental, and emotional wellbeing.  

What is the result of having a low distress tolerance? Negative effects on health and well-being include: 

Holistic Healing at Lido 

When the effects of stress are negatively impacting your ability to manage and enjoy everyday life, it may be time to proactively take control to widen your window of tolerance. Doing so can bring healing to your body, your mood, and your behavior.

Lido Wellness helps individuals find and expand their window of distress tolerance. Since everyone’s window is not the same, the Holistic Healing program at Lido Wellness was created to understand where each patient is coming from. Individuals who struggle with mental health issues or who have had trauma in their lives may find that their window of tolerance is small. As life happens, they may bounce in and out of their window – from being hypervigilant to feeling depressed and hypo-aroused. Living always hypervigilant or hypo-aroused is not only an unhealthy lifestyle but an unsustainable way to live. 

Lido’s Holistic Healing program teaches grounding, resourcing, and orienting techniques to help individuals be more present and in the moment, as well as helping them raise their awareness to recognize within their body when they are feeling distressed or dysregulated. Working with professionals at Lido, individuals find that their window of tolerance begins to open a little bit at a time as they become more present to their everyday life. Lido Wellness patients who complete the program notice that they begin to see life in a different light; they see things that they never noticed before, and most importantly, they find that they’re able to deal with frustrations and everyday annoyances that once used to create high levels of distress. 

Other Mental Health Approaches in Orange County

Treatment plans may use other combined and complemented therapies in an integrative mind/body/spirit holistic therapeutic model guided by Lido Wellness Center’s multidisciplinary team using clinical theoretical approaches to help patients increase their distress tolerance including:  

• Cognitive-Behavioral Therapy (CBT)
• Dialectical Behavioral Therapy (DBT)
• Somatic Experiencing (SE)
• Eye-movement desensitization and reprocessing (EMDR)
• Acceptance and Commitment Therapy (ACT)
• Integrative Dance-Movement based therapy
• Neuro and Biofeedback

References

Hypervigilance: Symptoms, Causes, and Treatment (healthline.com)

Hyperarousal: Symptoms, Causes, Treatments (healthline.com)

What Is… the Window of Tolerance – Mental Health @ Home (mentalhealthathome.org)

Hypo- and Hyper-arousal – C-PTSD Survival Guide (wordpress.com)

Understanding and Working with the Window of Tolerance – ATTACHMENT AND TRAUMA TREATMENT CENTRE FOR HEALING (ATTCH) (attachment-and-trauma-treatment-centre-for-healing.com)

What Is Distress Tolerance? (verywellmind.com)

Stress: The Health Epidemic of the 21st Century | SciTech Connect (elsevier.com)

DeAnna Holloway, LMFT

Somatic Trauma Psychotherapist