Low self-esteem

Self-esteem is the opinion we have of ourselves. When we have healthy self-esteem, we tend to feel positive about ourselves and about life in general. It makes us able to deal with life’s ups and downs better [1].

When our self-esteem is low, we tend to see ourselves and our life in a more negative and critical light. We also feel less able to take on the challenges life throws at us [1].

Low self-esteem often begins in childhood. Teachers, friends, siblings, parents, and even the media send us messages about ourselves, both positive and negative. For some reason, negative messages are the ones more likely to stay with us. Stress and difficult life events, such as serious illness or a bereavement, can also have a negative impact on self-esteem [1].

Common signs of low self-esteem [2];

  • Self- criticism- “I’m not good enough
  • Self-blame- “It’s my fault that they cheated on me
  • Self-doubt- “If my friends really knew who I was, they wouldn’t like me
  • Ignoring, or discounting praise, successes, and strengths- “I only won because the others weren’t very good today
  • Focusing on criticisms, mistakes, or weaknesses- “That guy said I should smile more when accepting a prize

Feelings/symptoms; sadness, anxiety, guilt, shame, frustration, anger, fatigue, tension, nausea, or insomnia

Behaviours; self-consciousness, shyness, difficulty making decisions, perfectionism, difficulty being assertive, not looking after yourself, worrying about what other people think of you, trying too hard to please others, or social withdrawal

Some people find that their self-esteem varies during their menstrual cycle [3]. If you tend to feel particularly tearful, irritable, or low (depressed) on a cyclical basis, it can be an indication that you have low self-esteem…

The great news is that low self-esteem is highly responsive to esteem-building activities- either as an individual, or with the help of a friend, or therapist [2]. This is because all of these negative thoughts/ behaviours are based on ‘opinions’, and not ‘facts’ about ourselves [2]. This means that it is possible to change these opinions- and happily, it is surprisingly easy to do so! Please see the tips & tricks section for more details…

Managing hormone-related low self-esteem:

Try a hormone-balancing diet– As outlined in this blog, a vegetable-based ‘anti-inflammatory’ diet can significantly improve all hormone-related symptoms. We highlight a few of the key steps that are especially relevant for those suffering from low mood/ self-esteem, below;

Try nutritional supplements– A 2016 clinical research review [4], shows that various minerals are associated with low mood/ self-esteem, especially; Co- enzyme Q10 [5]; omega 3 fatty acids (found in fish and some seed oils)[6] [7]; Magnesium [8] [9]; and B-vitamins [10].

Research also shows that Vitex Agnus Castus (200-500 mg of extract daily) [11] can be beneficial for hormone-related low mood/ self-esteem. NoteVitex Agnus Castus is not suitable for those who are under 18; using hormonal medication (or devices); are pregnant, trying to conceive, or breast-feeding; or have a pituitary problem.

– Avoid alcohol– As a depressant, alcohol can only make a low mood worse- and excessive use can cause depression, and make suicidal thoughts more likely [12].

– Eat oily foods (unsaturated fats)– A type of oil found in fish (try linseed/flax-seed oil if you are vegetarian) contains omega 3 oils, which have been found to reduce the risk of low mood/ self-esteem in some clinical research studies, (although research on this relationship is limited and mixed) [13] [14]. We think it’s worth trying to see if this improves your mood – after all, eating some fish or flax-seed oil is not likely to harm your health and wellbeing. Please let us know how it goes…

Exercise regularly– Regular exercise, particularly aerobic exercise, may help you combat stress and release tension. It also encourages your brain to release serotonin, which can improve your mood [1].

Research has shown that regular exercise, (more specifically cardio-respiratory fitness), and a healthy BMI (Body Mass Index), significantly reduces the risk of menstrual cycle-related health issues, including low mood/ self-esteem [15].

Boosting self-esteem- Cognitive behavioural therapy (CBT) is one of the most effective treatments for building self-esteem, and is often available on the NHS.

CBT helps you to understand how your problems, thoughts, feelings and behaviour affect each other. It can also help you to question your negative and anxious thoughts, to improve the way you see yourself, and reduce damaging internal thought processes. CBT usually involves meeting with a specially trained and accredited therapist for a one-hour session every week for 10-12 weeks [1].

NoteThe Oxford Cognitive Therapy Centre produces a highly effective (and cheap!) booklet on ‘Building self-esteem’

In the UK, help is available if you feel you need support to start seeing yourself in a more positive light [1]:

Reduce stress hormones- Research shows that Mindfulness-based Cognitive Behavioural Therapy (MCBT) is highly effective in reducing menstrual cycle-related low mood, self-esteem, anxiety, and other symptoms [16] [17].

Mindfulness works by focusing your awareness on the present moment and by acknowledging and accepting certain feelings. Being mindful can teach you how to overcome negative thoughts – for example, being able to challenge hopeless feelings.

You may find relaxation and breathing exercises helpful, or you may prefer activities such as yoga or pilates to help you unwind- recent research found that, in adults with mild-to-moderate major depression, an 8-week hatha yoga intervention resulted in statistically and clinically significant reductions in depression severity [18].

Further information:

Page last reviewed and updated: June 2018


1. NHS. (2017) Raising low self-esteem. [ONLINE] Available at: http://www.nhs.uk/Livewell/mentalhealth/Pages/Dealingwithlowself-esteem.aspx. [Accessed 26 July 2017].

2. Jenkins, H & Fennell, M. (2004) Building Self-Esteem Oxford Cognitive Therapy Centre (available for £2.75 here- https://www.octc.co.uk/product/booklets/building-self-esteem)

3. Brock R, Rowse G, Slade P. (2016) Relationships between paranoid thinking, self-esteem and the menstrual cycle. Arch Womens Ment Health Apr;19(2):271-9. doi: 10.1007/s00737-015-0558-4

4. Du J, Zhu M, Bao H, Li B, Dong Y, Xiao C, Zhang GY, Henter I, Rudorfer M, Vitiello B. (2016) The Role of Nutrients in Protecting Mitochondrial Function and Neurotransmitter Signaling: Implications for the Treatment of Depression, PTSD, and Suicidal Behaviors. Crit Rev Food Sci Nutr Nov 17;56(15):2560-2578. Review. PubMed PMID: 25365455; PubMed Central PMCID: PMC4417658

5. Maes M, Mihaylova I, Kubera M, Uytterhoeven M, Vrydags N, Bosmans E. (2009) ‘Lower plasma Coenzyme Q10 in depression: a marker for treatment resistance and chronic fatigue in depression and a risk factor to cardiovascular disorder in that illness’. Neuro Endocrinol Lett. 2009a;30:462–469

6. Sublette ME, Hibbeln JR, Galfalvy H, Oquendo MA, Mann JJ. (2006) ‘Omega-3 polyunsaturated essential fatty acid status as a predictor of future suicide risk’ Am J Psychiatry. 163:1100–1102

7. Sinclair AJ, Begg D, Mathai M, Weisinger RS. (2007) ‘Omega 3 fatty acids and the brain: review of studies in depression’ Asia Pac J Clin Nutr 16(Suppl 1):391–397

8. Cheungpasitporn W, Thongprayoon C, Mao MA, Srivali N, Ungprasert P, Varothai N, Sanguankeo A, Kittanamongkolchai W, Erickson SB. (2015) Hypomagnesaemia linked to depression: a systematic review and meta-analysis. Intern Med J. Apr;45(4):436-40. doi: 10.1111/imj.12682. Review. PubMed PMID: 25827510

9. Rajizadeh A, Mozaffari-Khosravi H, Yassini-Ardakani M, Dehghani A. (2017) ‘Effect of magnesium supplementation on depression status in depressed patients with magnesium deficiency: A randomized, double-blind, placebo-controlled trial’. Nutrition  Mar;35:56-60. doi: 10.1016/j.nut.2016.10.014. Epub 2016 Nov 9. PubMed PMID: 28241991.

10. Sánchez-Villegas A, Doreste J, Schlatter J, Pla J, Bes-Rastrollo M, Martínez-González MA. (2009) ‘Association between folate, vitamin B(6) and vitamin B(12) intake and depression in the SUN cohort study’. J Hum Nutr Diet Apr;22(2):122-33. doi: 10.1111/j.1365-277X.2008.00931.x. Epub 2009 Jan 16. PubMed PMID: 19175490

11. Atmaca, M., Kumru, S., & Tezcan, E. (2003) ‘Fluoxetine versus Vitex Agnus Castus extract in the treatment of Premenstrual Dysphoric Disorder’ Human Psychopharmacology 18(3): 191-5. PubMed PMID 12672170

12. Boden JM, Fergusson DM. (2011) ‘Alcohol and depression’ Addiction May;106(5):906-14. doi: 10.1111/j.1360-0443.2010.03351.x. Epub 2011 Mar 7. Review. PubMed PMID: 21382111

13. Grosso G, Galvano F, Marventano S, Malaguarnera M, Bucolo C, Drago F, Caraci F. (2014) Omega-3 fatty acids and depression: scientific evidence and biological mechanisms. Oxid Med Cell Longev. 313570. doi: 10.1155/2014/313570. Epub 2014 Mar 18. Review. PubMed PMID: 24757497; PubMed Central PMCID: PMC3976923

14. Appleton KM, Sallis HM, Perry R, Ness AR, Churchill R. (2015) ‘Omega-3 fatty acids for depression in adult’ Cochrane Database Syst Rev Nov 5;(11):CD004692. doi: 10.1002/14651858.CD004692.pub4. Review. PubMed PMID: 26537796; PubMed Central PMCID: PMC5321518

15. Haghighi ES, Jahromi MK, Daryano Osh F. (2015) ‘Relationship between cardiorespiratory fitness, habitual physical activity, body mass index and premenstrual symptoms in collegiate students’ J Sports Med Phys Fitness Jun;55(6):663-7. PubMed PMID: 26205766

16. Panahi F, Faramarzi M. (2016) ‘The Effects of Mindfulness-Based Cognitive Therapy on Depression and Anxiety in Women with Premenstrual Syndrome’ Depress Res Treat. 9816481. doi: 10.1155/2016/9816481. Epub 2016 Nov 29. PubMed PMID: 28025621; PubMed Central PMCID: PMC5153465

17. Gotink, R. A., Chu, P., Busschbach, J. J. V., Benson, H., Fricchione, G. L., & Hunink, M. G. M. (2015). Standardised Mindfulness-Based Interventions in Healthcare: An Overview of Systematic Reviews and Meta-Analyses of RCTs. PLoS ONE, 10(4), e0124344. http://doi.org/10.1371/journal.pone.0124344

18. Prathikanti, S., Rivera, R., Cochran, A., Tungol, J. G., Fayazmanesh, N., & Weinmann, E. (2017). Treating major depression with yoga: A prospective, randomized, controlled pilot trial. PLoS ONE12(3), e0173869. http://doi.org/10.1371/journal.pone.0173869