Guest post by Lisa Dostmann
5 tips for low self-esteem caused by chronic illness
As a therapist living with several chronic conditions myself, I know the toll that low self-worth from bodily and life limitations takes, both from firsthand experience and from working with patients. Goals you'd set for yourself go unmet. Careers become impossible to continue. Dependence creeps in, often in more ways than one. You end up relying on support: physically, financially, or emotionally. All of it wears on your sense of self-worth.
So what can actually help with low self-worth caused by chronic illness?
- Redefine "success"
- Stop comparing yourself to others
- Practice gratitude
- Write down recurring thought loops
- Practice new behavior patterns
Redefine "success": what actually counts as achievement?
Seeing yourself as a productive, contributing member of society matters deeply to most people. But everyone defines achievement and productivity differently, it's a mix of beliefs and attitudes absorbed from family, friends, and work, some adopted consciously, some picked up along the way without much awareness.
When you can no longer meet your own expectations around achievement, success, and participation in society, a spiral of self-devaluation, guilt, and despair often follows. This makes it worth asking yourself some honest questions when dealing with chronic illness: What does success actually mean to me? Has that feeling mostly come from career or financial achievements up to this point? How do I measure success, and does measuring it that way even make sense?
A helpful exercise here: imagine a friend came to you with your exact problem, feeling worthless because they can't work, or can't fulfill their role as the family breadwinner, as a parent, or whatever role feels lost. What would you say to them? We tend to treat friends far more fairly and with much more nuance than we treat ourselves. We'd never tear them down the way we sometimes tear ourselves down.
The point of this exercise is to figure out: how have I been defining success or achievement, and does that definition actually make sense? Would I really hold my best friend to that same standard? From there, it's worth building new, more fitting definitions of these abstract concepts, ones that genuinely account for your current capacity. What matters most is writing these new definitions down and actively working with them. Stepping off familiar mental paths is a process that feels hard at first, but gets easier the more consistently you practice the "new" ones.
Comparison is the end of happiness and the beginning of dissatisfaction. – Søren Kierkegaard
Stop comparing yourself to others
Comparing yourself to other people, or to your life before getting sick, is a major problem. The latter, honestly, still gets me sometimes too. Especially when you have to reimagine your life and keep catching yourself thinking that five years ago, all these tasks and small things, getting dressed, walking, felt effortless. This kind of comparison is a game you simply can't win.
Recognizing the problems this kind of thinking creates is one thing, actually stopping it is another. Just like before, these thought spirals need to be actively unlearned, especially for people who've drawn a large part of their self-worth from these kinds of benchmarks and comparisons.
Keeping a journal can genuinely help here, which brings us to point three.
Practice gratitude
Gratitude research has demonstrated a range of genuine benefits, from improved sleep [1] to protection against depression. [2] That said, researchers also note it isn't entirely clear how much bias may be shaping some of these findings, and results haven't always been reproducible in follow-up studies. [3]
Even if you're skeptical, it's worth giving yourself 4 to 6 weeks to test the effects of writing down, daily, a few things that brought you joy. At the very least, this practice sharpens your ability to notice the good parts of life. From personal experience, this genuinely gets easier with daily practice, you start noticing life's small pleasures more and more.
Write down recurring thought loops
Sometimes our minds get stuck replaying and rehashing the same thoughts over and over. Not only is this exhausting, it can also reinforce feelings of worthlessness, especially when we've just compared ourselves to our past selves for the fifth time that day.
Writing these thoughts down can help, it consciously signals to your mind that it's been heard and can now shift its attention elsewhere. Deliberately redirecting your focus can help too. It's worth having a few go-to "exit options" ready for when your thoughts start spiraling, these will look different for everyone. Mine is usually belting out my favorite songs at the top of my lungs. 😉
Practice new behavior patterns
New behavior patterns don't form overnight. Patience with yourself matters here too. If you manage to catch yourself avoiding the same old thought patterns just 20% of the time, and remember, in another 50% of cases, that you actually wanted to take a different path, that's already a solid start.
Various techniques can help here. Keeping a habit journal is one option. Apps like Daylio (for Android) can help build new habits and track progress. Even a simple checklist, where you mark off at least every other day, can help build new habits gradually, journaling, for example.
If building new behavior patterns feels particularly hard, seeking professional support may help. Tools from behavioral therapy, hypnosis, or other approaches can improve the odds of lasting behavior change. It can also help simply to bring your partner, friends, or family into the process, so they can offer some structure or feedback along the way. And if you can find someone willing to join you in the process, even better, it's a lot easier with company.
What's your experience been, and did I miss anything?
References
[1] Wood AM, Joseph S, Lloyd J, Atkins S. Gratitude influences sleep through the mechanism of pre-sleep cognitions. Journal of Psychosomatic Research. 2009;66(1):43-48. doi:10.1016/j.jpsychores.2008.09.002
[2] Wood AM, Maltby J, Gillett R, Linley PA, Joseph S. The role of gratitude in the development of social support, stress, and depression: Two longitudinal studies. Journal of Research in Personality. 2008;42(4):854-871. doi:10.1016/j.jrp.2007.11.003
[3] Wood AM, Froh JJ, Geraghty AWA. Gratitude and well-being: A review and theoretical integration. Clinical Psychology Review. 2010;30(7):890-905. doi:10.1016/j.cpr.2010.03.005