you just ahead on this edition of being well clinical psychologist dr. Jerry Boyd will be here to talk about the connection between self esteem and depression will learn more about the origins of self esteem and ways to develop and maintain good self-esteem throughout our lives that's just ahead so don't go away production of being well is made possible in part by Sarah Bush Lincoln Health System supporting healthy lifestyles eating a heart healthy diet staying active managing stress and regular check-ups are ways of reducing your health risks proper health is important to all at Sarah Bush Lincoln Health System information available at sarahbush.org additional funding by Jazzercise of Charleston thanks for joining us for being well I'm here with dr. Jerry Boyd a clinical psychologist tell us a little before we get into the topic just give us a little background on your practice and where you see patients well good morning Lori it's nice to see you I'm a clinical psychologist in private practice I work at a couple of different settings I have a main office in Charleston that's open basically five days a week two days a week I work in a family practice clinic in Effingham County and so I'm kind of divided up between two places actually ok well the focus of our topic today is the connection between self-esteem and anxiety and depression where does our self-esteem come from and when do we start developing that well self-esteem is widely researched there's been a lot of professional time spent on trying to understand it because there's been a lot of assumptions about how really important it is but the general consensus I think amongst professionals is that there's a critical period for the development of self-esteem it's probably in childhood self esteem is related to things like self-concept it's related to things like self-confidence but those are also separate things but they're interrelated but I think that children learning that their loved children learning that they're good boys are good girls that's probably the foundation of self-esteem getting praised significantly more praise and criticism i might add criticism has its place in the scheme of things but certain kinds of criticism are destructive to self-esteem whereas encouragement support feedback about the person's strengths especially those are some of the building blocks of self-esteem I guess you would say but it really originates in childhood that's probably the best way to put it and I use the term critical phase or a critical period whether it really means is that if you don't get it as a child is much harder to acquire as an adult not impossible but harder to acquire as an adult so when I did the research for this program i typed in self-esteem and depression and lots of things came up and it seems to be and have you addresses it's a chicken-or-egg thing do you have low self-esteem when the primary investigations in the research I was describing meta-analysis of the research on self-esteem I think in my review of the the meta analyses that have been done there been several where they look at all of the studies as a group and try to draw conclusions instead of looking one study in drawing a conclusion they tried to summarize the findings of multiple studies and as is often the case the results are often inconclusive so is depression a cause or an effective low self-esteem the studies I think have consistently shown that most people who are depressed do have low self-esteem but there's not compelling evidence that i am satisfied with it indicates that low self-esteem in and of itself will cause depression the theories of depression are just that they're theories I don't know that we have facts about the origins of depression I think we're fairly well convinced that heredity plays a role in depression in other words that if your parent or your grandparents suffer from depression you have a higher probability of acquiring depression yourself at the same time though if you are raised by a parent who has depression and low self-esteem they'll be modeling depression and low self-esteem kinds of behaviors to children and children we know are very impressionable very receptive to especially multiple repetitions of behaviors they contend to acquire well let's talk about some of those low self-esteem behaviors that you probably have seen in some of your patients I think there are lots of them I think it's difficult to narrow them down to a few the main thing I would want to say about low self-esteem is that it's how you think about yourself people can have a similar experience for example there's a general belief that a failure experience will result in low self-esteem that's not necessarily true it's how you interpret that failure experience there's there least two camps on the subject of self-esteem and adversity there is one camp of people who say that adversity actually strengthens your self-esteem that it makes you not only a stronger more competent person but it also toughens you up that tough exterior gives you the capacity to be adaptable which is a certainly a life skill to be adaptable and that your self-esteem may be enhanced well it's sort of like the idea that if you try out for an athletic team in grade school or high school or whenever it may be and you get cut you don't make it in theory you know being rejected could be something that could result in decreased self-esteem but the camp that believes that adversity enhances your self-esteem would say that will you try again and the next time you you make the team and then you have great self esteem because you've you've learned that you can deal with adversity in your life and be successful the problem with that is that there are some people who are not natural athletes and they're never going to make the team and they end what people need instead of athletic success is something in their life that they feel that they're good at you don't have to be the best at it but you have to have a sense of competence one component of low self-esteem and depression since we start out talking about that thread is a sense of lack of personal control in other words living in your world and you feel like you are a like a cork on the ocean where the whims of others the events of life fate whatever you want to call it is all beyond your control that you are are helpless and sort of hopeless to effect the kind of changes in your life that you want for yourself that type of thinking is very related to low self-esteem and it also is related to depression so you had said we developed these are our self-image our self-esteem as children so if you don't get that as a child how can you develop it later in life well that's that's often a question I don't have too many people who walk in the office saying you know dr. Boyd would you improve my self esteem most people come in saying I've been terribly depressed you know life has been really difficult for me and I have trouble coping from day to day in depression clinical depression especially it's not just a bad day or two it's weeks or months of substantially down mood loss of interest in pleasure difficulties being motivated to deal with the activities of daily living so it's a big difference clinical depression in a bad day or two that all of us have those bad days are two up to five or six percent of the population or more may suffer from clinical depression in any given time so the answer really to your question about how do you acquire it as an adult if you didn't get all of that you need it as a child I think there's several things a person can do one of the things that we talk to people about is sort of developing a list of what it is you're what's good about you I mean make an inventory of what your strengths are and there are some people when we're working on their self-esteem as a part of treating their depression is will actually have them write it out and typically on something like a like a no car doors or half of a note card even pretty small print maybe and then laminate it and when they're feeling down or when they're feeling ineffective or putting themselves down we will will have them pull it out read it to themselves a couple of times to refresh them that refresh themselves with the idea that look there really are some good things about me so being positive with yourself as an important way as an adult not just to acquire some self-esteem but to maintain the self-esteem that you have I think it's easy for people to become self-critical and heaven knows that there's plenty of people who will criticize us you know in various ways and and social media the and the media that we watch every day on in the form of television the models not this show not this show of course I wasn't that this is one of the rare exceptions of course you know and anyway of course I think that we look at for example the the models role models that we have for our adolescents how they should dress and how they should look and how their their hair should be or what their physical prowess should be in the males or females to you know the girls athletics has grown tremendously and it's extremely competitive and still doesn't yet offer the rewards that I think it should for young female athletes but it's come a long way from what it was point being though that the expectations are so far and people never quite reach and get that sense of success and satisfaction and I think being able to reach and attain goals and setting goals reasonably so that they aren't unattainable is an important part of obtaining and preserving self-esteem there are some really basic things about getting self-esteem and preserving self-esteem and it's hard for me to really separate the getting and preserving because I think most people have some it just may not be a lot and most of us don't have too much self-esteem as far as that's concerned with we may on the outside you know seem very confident but most of us have our insecurities that we carry around and tend to try to conceal because we feel vulnerable when they're exposed but I think the basic things I'm talking about I live a basic healthy lifestyle get enough sleep exercise regularly eat reasonable on a reasonable diet associate with other people it's really important to be have a circle of friends in your life that are supportive of you our family isn't always so supportive i think that we're supposed to know that they love us we're supposed to know that they would be there for as if we need them but actually I think very often those assumptions exist but that is also sort of like a green light for people who love us to say things to us that hurt is more deeply than people that we don't really know or don't really care about and so I'm not suggesting people should distance themselves from their family but I'm suggesting that we do need to surround ourselves with people who like us and who treat us respectfully and if there's people in your life who don't treat you respectfully on a consistent basis or who are abusive to you and when we or another than I am an advocate of of talking with that person about the nature of the relationship try to repair it if it's possible but if you make several efforts and it's not possible then I think it's important to know when to say when yeah to move on to move on to other healthy relationships I want to talk about you brought it up earlier social media you know we see in social media what everyone's doing and how great their life is are you finding in some of your patient that that's for people with some self-esteem issues that reading that newsfeed of how wonderful so-and-so's husband is and their kids are great and all these beautiful pictures of their vacation that that's really detrimental or difficult for people it's a two-edged sword i think you know they're there are some people for whom it's very comforting to know that this is a possibility that that they can if other people can be happy maybe I can too that if other people can have a supportive network of friends who care about them then maybe I can too so it on the one hand it could display that this isn't a accomplishable task on the other hand I think sometimes people say you know that the world looks so perfect that my world will never be that perfect and so again as I said earlier in our discussion self-esteem is how you think about what happens and what you perceive that determines how you will feel about it so if you think of it in a positive way then it may be a helpful thing the biggest I guess gripe I have about the combining self-esteem and social media when you those two words in the same sentence would be adolescents adolescents live and die by by Facebook Instagram Twitter and and other relatively immediate forms of communication cell phone too but the social the social media such as Facebook Twitter and Instagram are much less personal you don't have to have a face-to-face to be able to say an impulsive remark that could be very very hurtful or are well thought out remark that's very very hurtful and it goes into the stratosphere and and people don't get to see the reaction or the herd of the respondi but the adolescents are where I tend to see the greatest impact and it can be disastrous so parents need to supervise their their kids social media if you're a parent you don't know what Instagram is I urge you to learn if you if you have a any new ones there's new things all the time all the time but if you're not informed about it then you can't be very good at holding them accountable for their behavior on social media so social media in itself is not evil by any means it's a useful way for people to communicate maintain relationships that sometimes are a long distance but it's abused also so how would you talked about parents how would you address a parent whose child may be struggling with self-esteem that may be the parent themselves is struggling also a self-esteem it's creeping into the next generation how do you go about changing that cycle well the I think change starts with in the home I think it's important for parents to realize that your example will convey and teach much more than your words ever will to your child and when I say child i'm talking about under the age of 20 ok ok i think that if you see in your child evidence of low self-esteem it's worthwhile to ask yourself is that an issue that i have yes exactly is that an issue that i have and i think they're there are a lot of good books on the topic i think that looking at some of the resources that are out there such as the books I I've just described I think there are many highly rated books on various of the internet sites where you can purchase books and I think join with your child to do a study of it together you know and talk about what are your strengths so exactly think makes you a good person and be honest with your child about the fact that it's been a deficit for you talk to your child about how it's held you back in various ways or how it feels just share and I think that getting it out on the table makes it something that it's approachable at that point but when something is so painful to or scary that people can't even talk about it it's hard to address it so what point do you recommend people seek professional help whether it's a parent or an adult seeking help for themselves or maybe a parent seeking help for their child when is it beyond something that you can fix yourself well the simple answer a simple answer to your question is whenever it starts affecting major life areas okay in other words if the symptoms are so pronounced that a child isn't eating mm-hmm or if a child has developed compulsive overeating due to low self esteem for example or contributed to there's never a single causative factor in there's rarely a single causative factor in human behavior but whenever it affects a major life area eating sleeping if sleeping is greatly disturbed if a child is socially avoidant and doesn't have friends or if you see evidence in an adult that you know that they are withdrawing from whatever social network they may have had before missing work personal hygiene deteriorating the basic you know important life areas so whenever it starts to interfere with that then that's an indication to talk to your family doctor my general belief is that people should start by speaking to their family physician family physicians are are no your total health history they often no other family history and they're there the entry point in my opinion for the mental health system they can rule out some things that look like depression for example can be a medical exactly can be a condition like hypothyroidism or certain kinds of other conditions that can mimic or masquerade as a mental health issue and not get addressed because people right at office well it's only depression well depression is a serious thing and I think one of the things that people fail to realize is that in combination with low self-esteem and certain other risk factors there's a mortality rate associated with depression people die of depression really yes they do it so it's it's it's a very serious condition that should not be overlooked now not everybody who's depressed is going to be suicidal that's not my message here but my point is that depression is is very treatable many of the Cardinal studies on depression have indicated that 93% of people with depression will benefit significantly from from treatment and in severe depression combination of appropriate medicines and psychotherapy produces tremendous relief for people that are suffering and not functioning at their full capabilities are you seeing are we seeing more depression and anxiety in our society or is it that people are just more open about it do you think I think on the depression angle that people are more open about it anxiety though we have a lot to be anxious about we live in a world where again like I said earlier communication is instantaneous and so what happens in the Ukraine what happens in Afghanistan what happens in Mexico City or wherever we would be talking about or in Los Angeles where there's a mass shooting again or any major city in the United States we're instantly aware of that and and there was a time of course certainly not in recent history but we were more protected from those kinds of news items not that these things didn't occur but yes I do think that people are more anxious because they have an awareness that there's more to be anxious about let's talk in these last few minutes just give us some last few tips about what we can do to develop and maintain good self-esteem okay and I'll kind of piggyback on the things I talked about earlier it's really important I think to be positive with yourself at the end of the day you're supposed to be your own best friend it just tough some days very tough because we're we're excruciating Lee aware of our faults and shortcomings and most of us are driven to be successful and to be popular and to be well regarded by others and and I think sometimes we operate with very unrealistic beliefs there was a an author and a famous psychologist named dr. albert ellis and he listed as she came up with list of over 120 irrational ideas that that caused people to be not mentally healthy and one of them was it everybody should love me for everything that I do all of the time and he said if you if you really even if subconsciously you believe that that's so you're going to be often disappointed and depressed so being realistic with yourself not everybody's going to love you all the time and if you stand for anything there may be a lot of people who don't like you for it and at the same time you also do need to examine your own behavior because we can slide into negativity ourselves with others and we don't want to be the source of someone else's contributing low self-esteem so in addition to basic self-care I think it's a very very important thing is to do things for other people do nice things for other people volunteer be somebody who is this the supporter of others somebody who tries to say hey I believe in you you know you're really a good person go out of your way to catch people doing something right so often we were quick to judge people on find what's wrong I say try hard to catch somebody doing something right and call their attention to it I think that for people close to you I think holding someone's hand or putting your hand on armor on their shoulder when at a time of discouragement you don't have to go volunteer in a big agency there's lots of ways to give of yourself to others I think as I said earlier spending time with people who are good company do you that's that's a if you don't remember anything else I said today that would be the one to hang on to surround yourself with people that are good to you surround yourself with people where it's a sort of a mutual admiration society where where people are there for each other and that's easier said than done for some people some people especially if they have low self-esteem are pretty shy yeah or gravitate towards other people that are like that I think so because if you feel like a failure you don't want to surround yourself with people who are high six high achievers simply because you're going to feel all the time you're going to feel pretty inadequate but you don't want to do the opposite either where you surround yourself with people who are functioning at a much lower level than you are because the we tend to sometimes gravitate toward a lower common denominator yeah well dr. Boyd thank you so much for stopping by being well and giving us some good information on advice on developing and maintaining good self-esteem it's my pleasure thank you terrorism's shootings international unrest the world is full of turmoil right now and for some that's a lot of pressure to handle but mental health experts say there are ways you can deal with stress so it doesn't become a serious problem here's Holly firfer with today's health minute it's a tough world out there and for some people all this upheaval can be upsetting many become stressed out but psychologists say there are ways you can deal with anxiety that can keep depression away exercise doctors say the best thing to do is to keep busy and get the endorphins pumping which can make anyone feel better watch your salt and sugar lowering both of these in your diet helps your whole body work better including your brain get more vitamin D studies have shown that a lack of vitamin D can add to the Blues best way to get vitamin D from the Sun so get out for short periods of time and enjoy the outdoors hang with friends or loved ones being around people you like can make you a happier person and relax try a yoga class or meditation research shows that even 15 minutes of meditation can cut down on stress and if you find things do not get better seek professional help depression is a serious condition but it can be treated for today's health minute I'm Holly firfer production of being well is made possible in part by Sarah Bush Lincoln Health System supporting healthy lifestyles eating a heart healthy diet staying active managing stress and regular check-ups are ways of reducing your health risks proper health is important to all at Sarah Bush Lincoln Health System information available at sarahbush.org additional funding by Jazzercise of Charleston you