Low self-esteem or a disrupted or disjointed sense of self is one of the hallmarks of addiction. If a person’s self-image is negative, they may struggle with feeling motivated, capable, and worthy – feelings that lead to depressive episodes and often unhealthy coping mechanisms, such as substance use. While the two are not mutually exclusive concepts, in one study 41.5% of respondents that suffered from substance use reported having very low self-esteem. From a young age, many with a substance use disorder cannot ever remember having a high opinion of themselves.

The Child with a Thinking Problem

In recovery and 12-Step programs, you’ll often hear members claim that they were prone to substance use behaviors long before they ever used them. Many with long-term recovery believe that they displayed behaviors and thinking, such as low self-esteem, poor emotional regulation, a sense of feeling disconnected from the world around them, even as children. This is echoed by members that had both seemingly good and seemingly bad childhoods. People are raised by imperfect and flawed caregivers, doing their best to provide for the needs of their child but often falling short in one way or another. In some cases, those missed needs led to the development of a negative sense of self. 

Causes and Conditions

There are a number of experiences in childhood that can create conditions for low self-esteem, and that can later relate to a substance use disorder.

• Trauma – Suffering physical or emotional abuse as a child is one of the most observable causes of low self-esteem. Feeling unsafe as a child leads to an inability to trust oneself or others, a feeling of victimhood, and if the trauma is not properly processed, one can believe they are at fault or to blame. All of these lead to a low image of oneself and, therefore, low self-esteem. As adults, one might turn to substance use as a means to cope with these negative feelings. Disassociation can occur as a result of an inability to cope with negative or triggering emotions, leading to a sense of emptiness that is relieved by the regular use of substances. 
• Being bullied – If someone experiences bullying as a child, they may absorb their victimizer’s view of them. Being harmed emotionally in this way leads to feelings of fear and worthlessness and a sense that others feel pity for them. These feelings lead to low self-esteem and isolating behaviors, often common among those with substance use disorder. A lack of connection to others by isolation and mistrust is a hallmark among those that turn to substances to fill that void. 
• Uninvolved or disapproving caregivers – When someone’s parents are uninvolved in their lives at a deep level as a child, it leads to feelings that they are not important or worth time or attention. If their parents were disapproving or harsh and critical, it forms the idea that they are not capable or worthy. These are markers of low self-esteem, a sense that one will never be good enough, or they are not worth love and kindness. As adults, those who have had these experiences might be prone to a substance use disorder. When they have the core belief that their existence is unimportant or unnoticed, or that they add no value to the lives of those around them, some turn to substances to cope.
• Caregivers in conflict – Children absorb the feelings within their family home. If their parents are in constant conflict, either arguing between each other or individually visibly emotionally distraught, they absorb feelings of negativity and fear which can manifest into self-blame and being “at-fault.” Self-esteem is difficult to build when one feels as if they are personally responsible for the negative emotions of others and responsible for chaos. As an adult, substances help a person allay negative feelings about themselves in order to interact with the world around them. 

Build Me Up

The challenge of low self-esteem is that it is often created and broken down in childhood, reaffirmed in the youth, and difficult to combat as adults. Even when one recognizes the challenges their self-image creates for them, moving towards a better sense of self is a lifelong journey that, at times, has very little measurable gain. For those with a substance use disorder, the decision to seek help and treatment is often the first esteem-building act they can take for themselves, as it is deciding that they want and deserve a better life. This can be why it takes some so long to reach the point of recovery; they may feel they are not worthy of wellness. Once someone begins and continues the process of recovery, they must continually attempt to build upon the foundation, examining the things that harmed their self-esteem in the first place, healing those wounds, and then going forwards to seek better in the future. The best way to build esteem is to perform acts worthy of esteem:  being of service to others, behaving in a way one believes is worthy of esteem, and taking actions for oneself that build the belief that they are worthy of the life they desire. 

Ashley Addiction Treatment is an innovative treatment program located on Maryland’s Chesapeake Bay. Ashley provides support for professionals seeking help with addiction. We are able to help people with co-occurring disorders and offer confidential treatment programs to meet your needs. Please reach out to us today at 800-799-4673.