Depression & Self-Esteem

Depression and self-esteem

Many people come to therapy seeking help with depression. It stops them from applying for that job they know in their gut would make them happier, or it tells them they’re not good enough to bother going for that audition. Maybe it stops them from addressing the recurring problems in their relationship, because (their minds tell them) this is all they really deserve. What many people discover is that their depression is intimately linked to low self-esteem.

What Are Common Symptoms of Depression?

Often, when we imagine depression, we imagine a sort of stereotype. We might picture someone who appears totally drained of life. They move slower, and their thoughts are similarly lethargic. They might stop taking care of the basics: eating, showering, chores. They stop reaching out to others, and maybe even stop going to work. Life doesn’t just seem bleak, it doesn’t seem at all.

Low energy, slow movement, and lack of motivation are common symptoms of depression. However, not everyone experiences depression in this way. For many of my clients, their depression doesn’t feel the same every day. Often, it’s a feeling brought on after an event that hurts their self-esteem.

When Depression and Self-Esteem Go Together

You might sometimes feel like the low-energy description above. However, your worst days come and go, without any clear pattern. One moment, you might feel supremely confident, restored to life, ready to seize the day.

Then something happens: you get in an argument with your partner, or your boss makes a vague comment that strikes you as critical, or the train is delayed. You feel yourself sinking into a deep, wounded anger. You get frustrated with yourself for feeling this way: you tell yourself you shouldn’t feel so sensitive. You may worry that your anger would be uncontrollable if you ever let it out, and the very thought of letting it out makes you feel guilty, or afraid.

When the anger wears off, you’re left with a depressed feeling that’s hard to shake. You might notice that you feel dissatisfied or frustrated a lot of the time. Even on good days, you worry that any small thing could tip you back over into feeling depressed.

This kind of depression is a little different from what we think of as stereotypical depression. It’s intimately linked with self-esteem in a way that not all depression is. The people I work with almost always have this kind of self esteem-related depression.

What Other Problems are Common with Depression and Low Self-Esteem?

People with depression also often meet the criteria for another mental health diagnosis. For example, they may also suffer from anxiety. Many of my clients who have depression and low self-esteem wonder if they may fit a diagnosis like Bipolar Disorder or Asperger Syndrome, which can also lead to rapidly shifting moods and struggles with self-esteem.

I like to talk about diagnosis with my clients on an individual basis. I believe people are more than just a collection of symptoms, and sometimes receiving a diagnosis can feel like you’re being put in a box. What’s most important to me is taking the time to carefully learn about your personal experience, and to find how therapy can best help you.

How Therapy Can Help Depression and Low Self-Esteem

Every person’s treatment is unique, but, generally speaking, people with the first kind of depression—depression that is deep and felt every day—need therapy that will help them take care of themselves again and feel connected to other people. When your depression is more closely linked to problems with self-esteem, you might need that kind of support on your bad days. However, you’ll also need support in dealing with fluctuating moods, and managing the deeper frustration and fear that is underneath your depressed feelings.

In my therapy approach, I help people put overwhelming feelings into words. I want to help my clients with depression and low self-esteem discover the origins of that frustration and fear. Getting this kind of self-understanding can help you to build up more tolerance for uncertainty and the normal ups-and-downs of life.

Psychoanalytic therapy for depression

I often use a psychoanalytic approach in therapy. According to psychoanalysis, our feelings and behavior have an unconscious basis: it isn’t transparent to us and we can’t just rationally think it through. We can reveal what’s unconscious when we give ourselves the permission to say everything and anything we think and feel, no matter how random, illogical, or weird.

This process is called free association, and it’s as simple as saying the first thing that comes to mind (or describing it, if it’s an image), and then the second, and then the third, and so on. The task is to ‘tune in’ to those words/images, and to then to say them aloud. It’s easy in principle, but challenging in practice. Part of my job is to help you make sense of these thoughts and feelings, typically by connecting them to other areas of your life—for example, to point out that you described two entirely different things exactly the same way.

How will talking about the past help if i’m suffering now?

If you’re suffering right now, we should talk about that right now! Sometimes what’s going on in the present doesn’t have roots all the way back to childhood. But the sort of recurring self-esteem issues I described above almost always do. Ultimately, you are in charge in therapy. You get to decide what to discuss, and when.

Isn’t this what freud did? isn’t this outdated?

Psychoanalysis started with Freud, but it certainly didn’t end with him. It’s changed considerably in the last 100 years. Therapists who practice psychoanalysis today aren’t old-school authority figures who never show emotion. Psychoanalysis still deals with the unconscious, but it’s a lot more flexible. Modern psychoanalysis leaves room for both the therapist and client to be real people. So, for example, when we both think it’s appropriate, I’m willing to share with you my reactions to you and give you feedback to help you progress.

If what you’ve read on this page sounds familiar to you, I invite you to reach out and schedule an appointment. Click the button below to learn more about how therapy can help improve your mood and strengthen your self-esteem.