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The Relationship Between Self-esteem and Addiction

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The role of self-esteem in addiction

Does using drugs or alcohol lead to self-esteem problems, or is low self-esteem to blame for addiction in the first place? The answer may simply be “yes.” That is, the two issues are extremely hard to separate, and one easily leads to the other. Low self-esteem is a contributing factor for addiction, and the realities of drug or alcohol addiction can also destroy self-worth. While this may seem like the epitome of a chicken-and-egg problem, the growing body of research around addiction and mental health does offer some hints. 

Although there have been a limited number of studies published about self-esteem during (or after) using substances, there is plenty of research about addiction itself. In the last few decades, as the medical and psychiatric fields have shifted to understanding addiction more as a disease and less as a moral failure, many scientists have begun investigating how, when, and why addiction happens.


Self-Esteem and Self-Medication

In more than 20% of cases, those suffering from substance use disorders meet the criteria for a co-occurring “dual” diagnosis. This means that besides substance abuse disorder, these people meet diagnostic guidelines for mental health problems like depression, anxiety, or PTSD. These conditions can lead to deep fissures in self-esteem, which only further worsens sadness, panic, sleeplessness, and other symptoms. In lieu of seeking treatment, people may attempt to minimize the severity of these problems and self-medicate with substance abuse

To make the matter even more confusing, self-medicating may not even be a conscious phenomenon when it first begins. For example, having a glass of wine “to take the edge off” is a common practice that is frequently depicted in TV and movies. Some people can stop at one glass, but others—especially those with underlying mental health conditions—may find themselves “needing to take the edge off” earlier and earlier in the day, or with more and more alcohol.


Low Self-esteem and Drug Abuse

It’s hard to track “self-esteem,” as it’s a fairly subjective rating that addiction specialists don’t often focus on, but the clinical course of addiction and the accompanying negative changes in quality of life provide a sort of roadmap. For example, an at-risk person starts out with a relatively mild issue (like anxiety) that makes substance abuse attractive but is otherwise functional. 

Unfortunately, this person finds that any previously-existing issues are magnified, not solved, by using drugs or alcohol. Increasing anxiety and negative thoughts help turn the substance abuse into full-blown addiction, and the “functionality” of the at-risk person starts to deteriorate rapidly. 

As soon as this person’s addiction starts having negative real-world consequences, the s/he may enter an increasingly-serious mental and emotional spiral. This is because previous barriers to self-destruction like jobs and family will no longer stand in the way of the addict’s behavior.


What is The Relationship Between Self-Perception and Drug Addiction?

The scars of addiction can persist in the form of guilt or shame for years, even if the affected individual gets sober. Most serious addicts have hurt people close to them, ruined future career prospects with an arrest record, and/or do things they would never have thought themselves capable of to support their habit. This doesn’t mean that healing and recovery aren’t possible, but before most addicts can resume “normal” life, they will need a period to put themselves back together again after completely destroying their self-worth during the process of addiction. 

One place to start to rebuild this sense of worth is to help others in need. Programs like Alcoholics Anonymous understand this, which is why sponsoring other recovering addicts is a central tenant of the program. If an addict takes an active and thoughtful role in his/her recovery, the trauma of addiction and the damage to self-esteem that it caused will fade with time.


Mental Health and Addiction Numbers

When we look at the numbers, it becomes obvious that substance abuse not only devastates the addict and his/her loved ones but society as a whole. Just how many people are caught up in this cycle, and what is it costing us as a society? A 2012 meta-review study estimated25 million Americans as having substance abuse problems, while approximately 45 million (or some 20% of the population) are suffering from a diagnosable mental health condition. This same study found that approximately 4-5 million Americans are living with a dual diagnosis. Overall, rates of depression and anxiety continue to climb, and suicide is now a leading cause of death among working-age (and increasingly, retired) people in parts of the US. Based on preliminary data from the opioid epidemic alone, rates of addiction are almost certainly climbing, too.

Perhaps unsurprisingly, the combined effects of these two massive epidemics are having a noticeable impact on the American economy. It’s hard to quantify the effects of low self-esteem, but it’s almost certainly a contributing factor to the tens of billions of dollars in lost wages and productivity that addiction and mental health issues are costing the US economy every year. The issue has gotten so serious, in fact, that employers themselves are looking at ways to provide mental health and addiction services directly to their employees. Don’t hesitate asking for help! Get in touch with us today!


Helping Recovering Addicts Overcome Low Self-esteem

Addiction destroys self-image and takes productive people out of their families, their jobs, and sometimes even their homes. Because of the emotional spiral precipitated by substance abuse, early intervention may be one of the most effective tools to stop the number of addicted Americans from climbing even higher. 

Although problems with self-esteem associated with a higher likelihood of addiction are complex, they can often be treated in the context of other mental health disorders. Strengthening the availability of mental health care and treatment facilities is a good place to start. Telemedicine and other technologies are one way that Americans who live in remote or underserved communities could access providers.


It’s also important that society continues to work on normalizing conversations about mental health and emotional struggle for everyone. This way, people suffering from mental health or self-esteem issues can be intercepted before their lives go off the rails due to addiction if they attempt to self-treat or medicate symptoms. Regardless of whether help comes on the community- state- or federal level, the staggering number of people suffering (and dying) from addiction should speak for itself. Doing nothing is no longer an option.

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Written By: Linda Whiteside

Licensed Clinical Professional Counselor who has been providing mental health services for over 10 years.

Medically reviewed by: Dr. Ryan Peterson

Went to medical school at The George Washington University School of Medicine in Washington, D.C.

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