Anxiety is it just a lack of confidence?

The problem with the world is that intelligent people are full of doubts , and the stupid ones are full of confidence ….Charles Bukowski .

This might be controversial…..

Self-Esteem = belief and confidence in your own ability and value

Anxiety = a feeling of worry , or unease about something with an uncertain outcome .

On the face of it ,the two descriptions from the Oxford dictionary seem absolute opposites , so if someone has high self-esteem or confidence , It seems to follow that they cannot be suffering from anxiety , is this true ? is anxiety just a lack of confidence or self esteem ? …..

The National Alliance on Mental Health ( NAMI) describes someone with high self-esteem or confidence as someone who can recognise their good qualities and will generally strive for a happy and successful life. In contrast someone with low confidence or self esteem believe they are not worthy of love , happiness or success. Low self-esteem they go on to show can lead to poor relationships and a propensity to addiction . This all sounds very familiar to trauma or anxiety sufferers, building on our idea that low confidence goes hand in hand with anxiety or even trauma.

In fact NAMI goest further, they point out that low self-esteem and confidence ” Tends to work in a vicious cycle with other mental health conditions like depression and anxiety”, although they say its hard to say which one comes first .

So Anxiety and Self-esteem does have a link?

I think we might be getting somewhere with this idea , its not like we have invented gravity , as an anxiety sufferer you already know your self confidence is low , but what if that came before the anxiety? What would it mean if they were inseparable , one couldn’t exist without the other?

In 2019 a Vietnamese and Netherlands study ( Dat Tan Nguyen ,Wright, Dedding Pham, Bunders 2019) looked into low self-esteem and its association with anxiety ,depression and suicidal intentions amongst secondary school students. Their conclusion was that self-esteem was indeed associated with anxiety and depression , it significantly affects the students quality of life. Low self-esteem or confidence leads to negative outcomes for young peoples behavioural and mental health problems, the study points out.

This topic is surprisingly current , A paper published in February 2023 ( Wenyan Li et al ) looked at reciprocal relationships between self-esteem , coping styles and anxiety symptoms among adolescents . This longitudinal study ( a study with repeated observations over long periods of time)was conducted in 10 public schools in the Guangdong province of China. I can’t help getting excited about their findings , (little things ..I know ) but they found that …Low self esteem and anxiety symptoms bidirectionally predict each other . Before I move on to other findings , let’s just go over this important point . Anxiety and low self-esteem seem to predict each other , thats huge . Children with low self-esteem may develop anxiety and children with anxiety may develop low self-esteem . The study also found that interventions promoting self-esteem and cultivating a positive coping style may reduce adolescent anxiety.

The Terror Management Theory ( TMT) ( Worm at the Core , Greenberg,Solomon,Pyszczynski ) indicates that positive self-esteem is associated with an increased feeling of safety and security and is a buffer against anxiety ( in the book they talk about anxiety against human mortality), so it could be argued that the reverse is true and that is that low self-esteem gives no protection against anxiety.

Ive just found an article on Psychology Today ( always a good webpage to visit www.psychologytoday.org ) they posted in march 2019 asking the question ” Is low self-esteem making you anxious?). Written by Jill Weber PhD she discusses her experiences with her patients who she had noticed when treating the symptoms of anxiety that they also suffered from low self-esteem. She developed four signs others can use to see if the cause of their own anxiety is in fact low self-esteem. These are….. 1) Getting stuck on rejection , sufferers constantly scan their surroundings for signs of possible rejection. 2) Not taking chances , sufferers avoid taking risks, missing out on the positive sense of achievement and are content to remain in their comfort zone. 3) Perfectionism , feeling that there is always a problem ? always feeling that things need fixing ? 4) Internal focus , sufferers ruminate about the past and possible future mistakes. Webber has answers to the four points above. In order are. 1) Accept yourself as you are learning to love yourself. 2) Put the anxiety aside and recognise that taking those risks is exactly what you need . 3) The idea that we can have all our ducks in a row at all times is a delusion , accept this and free up your reserves. 4) Believe in yourself , your abilities ,and your capacity to mange whatever comes your way . ( she has a published book Be calm: proven Techniques to Stop Anxiety Now ).

I don’t know if its just me , I don’t know if its been too long since my last large Latte but anxiety and self-esteem seems to be best friends. It also seems to me that trauma is a close cousin to them both as is depression .

Palmer ( homeforchildren.org) states that trauma and low self-esteem are closely related , trauma can have a significant impact on sense of self, they point out. Further to this a paper in the European Journal of Psychotraumatology in 2020 ( Lanius et al ) shows us the importance of our old friend the Default Mode Network ..DMN ( see previous posts for explanation ) , in the impact of trauma on self-esteem . The DMN it seems is altered by trauma and this can lead to an altered sense of self , this might effect the autobiographical memory process and the theory of mind ( the capacity to understand other people , judging, analysing and inferring ) .

Let’s take stock of where we are so far at least , our question was,… is anxiety just a lack of confidence (self-esteem ) . We haven’t answered this yet , but we’re getting closer . It does seem that anxiety and low esteem are coexisting , as for whether the chicken comes before the egg , did the anxiety come first? I suspect that just as fatigue has many causes , some of them undiagnosed , so anxiety can be caused by multiple causes one of which seems to be low self-esteem . We must also acknowledge the anxiety can also precede low self-esteem , as we have seen it appears to be bidirectional.

One thing we also need to consider is the influence of Avoidant Personality Disorder ( AVPD) . This disorder is a mental health condition that involves chronic feelings of inadequacy . Part of the Cluster C personality disorders , these behaviours are not part of the accepted norms expected in society . Typically sufferers have very low self-esteem rather than being directly caused by anxiety ( although panic disorder is common in individuals with AVPD especially in social settings or relationships). This might be caused as a result of Early Childhood Experiences , attachment style or perhaps even genetics. Disorders in cluster C have seen little or no research into treatment although CBT is thought to be helpful .

Well , Im a little bit wiser about self-esteem , but not totally happy . It’s clear to me that if you draw four circles , write ….Depression , Anxiety , Low self-esteem and Trauma in each and look at the commonalities. Then place all the circles so they overlap in areas they have in common and we could see the large areas of common symptoms and causes . As for how they interact , in what direction those relationships play out I have no idea , I suspect its multi-directional , anxiety is caused by Low self-esteem , Low self esteem is caused by Anxiety . Low self- esteem is caused by Trauma , depression is caused by Trauma , low self esteem is caused by depression . Let’s face it we are complicated.

I really hope that further research into the interactions can be funded . I realise that this is a very simplistic look at the interplay and I’m going to go out on a limb here and answer my own question with a NO .

Anxiety is not just low confidence or esteem its often caused by a complicated interplay and as we have seen in multiple posts there are many factors not at least ACEs , personality disorders , attachment types , background , genetics , relationships and many more causes. To say anxiety is just lack of confidence appears to be on the face of it simplistic.

Oh I’m off to get myself another coffee before the shop closes , I hope Ive found you in good place , thanks for spending time with me , I know I don’t get everything right , Im on a journey of discovery about my own anxiety and looking for answers , I hope you will join me on my discoveries.

Added the next day , after a long sleepless night ..

So , we have an old Border Collie , occasionally he has a bad night , last night was one of those , my wife is a Medical Specialist and is back at the Hospital so she needs her sleep , I am not back at school for a few days so my turn to have sleepless night . What’s this got to do with you I hear you ask ? Well apart from me seeking some sympathy …none ? really ?…..I had some more thoughts about this last post .

I just don’t think I finished it properly , really I should have looked into what would happen to anxiety if we raised our self-esteem , would it help?.

Well Hope Therapy Services in Virginia seem to think it does, (www.hopetheryandwellness.com) , they c claim you can destroy your anxiety by building up your confidence and they are not alone. A paper in Child Adolescent Psychiatry Mental Health ( Dec 29 2017 11:68, Henriksen et al ) looked at 201 adolescents who had been referred to Adolescent Psychiatry in Trondheim Norway , Longitudinal data was used ( fancy way of saying data was looked at over a long period) . They found that most research previously had concentrated on self-esteem and its effects on internalising problems . This study also found that externalised problems such as ADHD could also be affected by self-esteem .

Self esteem can be graded using the Rosenberg Self-esteem Scale , once the adolescents in the above trial were graded and data recorded at certain time frames a number of interesting conclusions were observed ( ok , interesting to me , but I watch Shameless, US version so what do I know ) . Anyway they found that those with higher baseline self-esteem at the first data recording had a dampening effect on future anxiety and also depression, even after medication and therapy intervention had been taken into consideration . For any of you suffering with ADHD , they also noted that positive self-esteem had a protective effect .

The researchers think that positive self -esteem may in some way acts as a buffer to stress , thus reducing the harmful effects of stress on mental health. Another important point , I think its really relevant to us with anxiety problems , Im going to make a big deal of this point so take a deep breath …………the paper suggests that avoidant strategies ( we all know about these !) are adopted by those of us with low self-esteem . We are back to an area we looked at in a previous post ( Resilience is Futile , my sad play on the Borg , Star-trek story) yes! resilience , those of us who have developed resilience ,avoid long term internalising of problems leading to anxiety and depression . Those lucky enough to have positive self-esteem have problem focused coping strategies, that do not lead to anxiety or depression .

This is huge , low self-esteem , can have big effect on anxiety , it appears that in a clinical setting when self-esteem is addressed it can have a protecting effect on future anxiety . As ever , we should note this study limitations , the adolescents involved were already displaying symptoms , they were already having treatment and the baseline assessment used a shorter measuring scale for self-esteem .

However it raises some interesting questions , if we work on our own self esteem , can we improve our anxiety , even by a small amount. How should we do this?

The CPD online college ( UK) says we should practice self acceptance , be more assertive , look after yourself physically , practice mindfulness ( this keeps coming up) , celebrate your achievements , spend time with people who make you feel good. They say you should identify goals that challenge you ,speak and think of yourself as you would a good friend and lastly get to know your own thought patterns .

I checked out the self-esteem app for iOS , I have no connection with them , they start off with a short test to measure self esteem , mine was 23% which it describes as low . It offered me a plan over three months to raise my level to 85% . I gave them my email address for them to send me the plan , personalised to me , however a fault on the site seemed to prevent me from entering my email , so I guess ill never know , www.selfesteem.app if you want to have a try. There is a great description of how to improve your self esteem on the Mind Uk website , mainly like the above website it surrounds ideas of being kind ti to yourself , recognising positives , talking therapies , build a positive support network.

Look , I think by now we can see that having a strong positive self-esteem is like a shield possibly protecting us from the effects of some mental illnesses such as anxiety. We as anxiety sufferers and victims of trauma are our own worst critics . We wonder what others think , why we are less than others , why no-one would want to spend time with us . We don’t want to make a fool of ourselves in public , we are unlikely to try new things or experiences , ninety nine people could say our work is wonderful , but you know that we will remember the one that says its trash…. It seems the key here is to be the opposite , be kind to yourself , don’t dwell on the thoughts of others , get out more , make friends .

For a long time now I have thought that we sufferers should have our own chat room , but only for support , no negative comments allowed , only those who want to make friends , support growth , support recovery , be encouraging and laugh about our very strange predicament and all free, with no one trying to make money , I think if we all realise we are not alone , not strange and not weak that would be a start to boost our self-esteem .

If you are in a bad place at the moment , please seek out a professional medical specialist in Anxiety or Trauma , it their job to help and most have dedicated their lives to help. Importantly , you are not alone .