NHS Choices

Raising low self-esteem

NHS Choices - Live Well - Tue, 23/09/2014 - 11:02
Raising low self-esteem

We all have times when we lack confidence and don’t feel good about ourselves.

But when low self-esteem becomes a long-term problem, it can have a harmful effect on our mental health and our lives.

Self-esteem is the opinion we have of ourselves. When we have healthy self-esteem, we tend to feel positive about ourselves and about life in general. It makes us able to deal with life’s ups and downs better.

When our self-esteem is low, we tend to see ourselves and our life in a more negative and critical light. We also feel less able to take on the challenges life throws at us.

What causes low self-esteem?

Low self-esteem often begins in childhood. Teachers, friends, siblings, parents, and even the media give us lots of messages – both positive and negative. But for some reason, the message that you are not good enough sticks.

You may have found it difficult to live up to other people’s expectations of you, or to your own expectations.

Stress and difficult life events, such as serious illness or a bereavement, can have a negative effect on self-esteem. Personality can also play a part. Some of us are simply more prone to negative thinking, while others set impossibly high standards for themselves.

How does low self-esteem affect us?

The problem with thinking we’re no good is that we start to behave as if it’s true. “Low self-esteem often changes people’s behaviour in ways that act to confirm the person isn’t able to do things or isn’t very good,” says Chris Williams, Professor of Psychosocial Psychiatry at the University of Glasgow. 

If you have low self-esteem or confidence, you may hide yourself away from social situations, stop trying new things and avoid things you find challenging.

“In the short term, avoiding challenging and difficult situations makes you feel a lot safer,” says Professor Williams. “In the longer term, this avoidance can actually backfire because it reinforces your underlying doubts and fears. It teaches you the unhelpful rule that the only way to cope is by avoiding things.”

Living with low self-esteem can harm your mental health, leading to problems such as depression and anxiety. You may also develop unhelpful habits, such as smoking and drinking too much, as a way of coping.

How to have healthy self-esteem

In order to boost self-esteem, you need to identify and challenge the negative beliefs you have about yourself.

“You need to look at your beliefs, how you learned them and why you believe them,” says Professor Williams. “Then actively begin to gather and write down evidence that disconfirms them.”

Learn to spot the negative thoughts you have about yourself. You may tell yourself you are "too stupid" to apply for a new job, for example, or that "nobody cares" about you. Start to note these negative thoughts and write them down on a piece of paper or in a diary, suggests Professor Williams. Ask yourself when you first started to think these thoughts.

Next, start to write down evidence that challenges these negative beliefs: "I am really good at cryptic crosswords" or "My sister calls for a chat every week". Write down other positive things you know to be true about yourself, such as "I am thoughtful" or "I am a great cook" or "I am someone that others trust". Also write down good things that other people say about you.

Aim to have at least five things on your list and add to it regularly. Then put your list somewhere you can see it. That way, you can keep reminding yourself that you are OK.

“It’s about helping people recognise they have strengths as well as weaknesses, like everyone else, and begin to recognise those strengths in themselves,” says Professor Williams.

“You might have low confidence now because of what happened when you were growing up,” he says. “But we can grow and develop new ways of seeing ourselves at any age.”

Other ways to improve low self-esteem

Here are some other simple techniques that may help you feel better about yourself.

Recognise what you are good at 

We are all good at something, whether it’s cooking, singing, doing puzzles or being a friend. We also tend to enjoy doing the things we are good at, which can help to boost your mood.

Build positive relationships

If you find certain people tend to bring you down, try to spend less time with them, or tell them how you feel about their words or actions. Seek out relationships with people who are positive and who appreciate you.

Be kind to yourself

Professor Williams advises: “Be compassionate to yourself. That means being gentle to yourself at times when you feel like being self-critical. Think what you’d say to encourage a friend in a similar situation. We often give far better advice to others than we do to ourselves.”

Learn to be assertive

Being assertive is about respecting other people’s opinions and needs, and expecting the same from them.

One trick is to look at other people who act assertively and copy what they do. “It’s not about pretending you’re someone you’re not,” says Professor Williams. “It’s picking up hints and tips from people you admire and letting the real you come out. There’s no point suddenly saying, ‘I’m going to be Chris Hoy’, but you might be able to get your bike out and do a bit of cycling for the first time in ages.”

Start saying 'no'

People with low self-esteem often feel they have to say yes to other people, even when they don’t really want to. The risk is that you become overburdened, resentful, angry and depressed.

“For the most part, saying no doesn’t upset relationships,” says Professor Williams. “It can be helpful to take a scratched-record approach. Keep saying no in different ways until they get the message.”

Give yourself a challenge

We all feel nervous or afraid to do things at times. People with healthy self-esteem don’t let these feelings stop them from trying new things or taking on challenges.

Set yourself a goal, such as joining an exercise class or going to a social occasion. Achieving your goals will help to increase your self-esteem. 

Where to find help for low self-esteem

You may feel you need some help to start seeing yourself in a more positive light. Talking therapies, such as counselling or cognitive behavioural therapy, can help. Your GP can explain the different types and tell you what’s available in your area.

Read more about the different types of therapy.

You can also refer yourself for counselling or therapy. Use the NHS Choices Services Directory or visit the British Association for Counselling & Psychotherapy website to find a registered counsellor and therapist near you.

Hear Dr Williams' podcast about tackling unhelpful thinking.

 

 

Categories: NHS Choices

Raising low self-esteem

NHS Choices - Live Well - Tue, 23/09/2014 - 11:02
Raising low self-esteem

We all have times when we lack confidence and don’t feel good about ourselves.

But when low self-esteem becomes a long-term problem, it can have a harmful effect on our mental health and our lives.

Self-esteem is the opinion we have of ourselves. When we have healthy self-esteem, we tend to feel positive about ourselves and about life in general. It makes us able to deal with life’s ups and downs better.

When our self-esteem is low, we tend to see ourselves and our life in a more negative and critical light. We also feel less able to take on the challenges life throws at us.

What causes low self-esteem?

Low self-esteem often begins in childhood. Teachers, friends, siblings, parents, and even the media give us lots of messages – both positive and negative. But for some reason, the message that you are not good enough sticks.

You may have found it difficult to live up to other people’s expectations of you, or to your own expectations.

Stress and difficult life events, such as serious illness or a bereavement, can have a negative effect on self-esteem. Personality can also play a part. Some of us are simply more prone to negative thinking, while others set impossibly high standards for themselves.

How does low self-esteem affect us?

The problem with thinking we’re no good is that we start to behave as if it’s true. “Low self-esteem often changes people’s behaviour in ways that act to confirm the person isn’t able to do things or isn’t very good,” says Chris Williams, Professor of Psychosocial Psychiatry at the University of Glasgow. 

If you have low self-esteem or confidence, you may hide yourself away from social situations, stop trying new things and avoid things you find challenging.

“In the short term, avoiding challenging and difficult situations makes you feel a lot safer,” says Professor Williams. “In the longer term, this avoidance can actually backfire because it reinforces your underlying doubts and fears. It teaches you the unhelpful rule that the only way to cope is by avoiding things.”

Living with low self-esteem can harm your mental health, leading to problems such as depression and anxiety. You may also develop unhelpful habits, such as smoking and drinking too much, as a way of coping.

How to have healthy self-esteem

In order to boost self-esteem, you need to identify and challenge the negative beliefs you have about yourself.

“You need to look at your beliefs, how you learned them and why you believe them,” says Professor Williams. “Then actively begin to gather and write down evidence that disconfirms them.”

Learn to spot the negative thoughts you have about yourself. You may tell yourself you are "too stupid" to apply for a new job, for example, or that "nobody cares" about you. Start to note these negative thoughts and write them down on a piece of paper or in a diary, suggests Professor Williams. Ask yourself when you first started to think these thoughts.

Next, start to write down evidence that challenges these negative beliefs: "I am really good at cryptic crosswords" or "My sister calls for a chat every week". Write down other positive things you know to be true about yourself, such as "I am thoughtful" or "I am a great cook" or "I am someone that others trust". Also write down good things that other people say about you.

Aim to have at least five things on your list and add to it regularly. Then put your list somewhere you can see it. That way, you can keep reminding yourself that you are OK.

“It’s about helping people recognise they have strengths as well as weaknesses, like everyone else, and begin to recognise those strengths in themselves,” says Professor Williams.

“You might have low confidence now because of what happened when you were growing up,” he says. “But we can grow and develop new ways of seeing ourselves at any age.”

Other ways to improve low self-esteem

Here are some other simple techniques that may help you feel better about yourself.

Recognise what you are good at 

We are all good at something, whether it’s cooking, singing, doing puzzles or being a friend. We also tend to enjoy doing the things we are good at, which can help to boost your mood.

Build positive relationships

If you find certain people tend to bring you down, try to spend less time with them, or tell them how you feel about their words or actions. Seek out relationships with people who are positive and who appreciate you.

Be kind to yourself

Professor Williams advises: “Be compassionate to yourself. That means being gentle to yourself at times when you feel like being self-critical. Think what you’d say to encourage a friend in a similar situation. We often give far better advice to others than we do to ourselves.”

Learn to be assertive

Being assertive is about respecting other people’s opinions and needs, and expecting the same from them.

One trick is to look at other people who act assertively and copy what they do. “It’s not about pretending you’re someone you’re not,” says Professor Williams. “It’s picking up hints and tips from people you admire and letting the real you come out. There’s no point suddenly saying, ‘I’m going to be Chris Hoy’, but you might be able to get your bike out and do a bit of cycling for the first time in ages.”

Start saying 'no'

People with low self-esteem often feel they have to say yes to other people, even when they don’t really want to. The risk is that you become overburdened, resentful, angry and depressed.

“For the most part, saying no doesn’t upset relationships,” says Professor Williams. “It can be helpful to take a scratched-record approach. Keep saying no in different ways until they get the message.”

Give yourself a challenge

We all feel nervous or afraid to do things at times. People with healthy self-esteem don’t let these feelings stop them from trying new things or taking on challenges.

Set yourself a goal, such as joining an exercise class or going to a social occasion. Achieving your goals will help to increase your self-esteem. 

Where to find help for low self-esteem

You may feel you need some help to start seeing yourself in a more positive light. Talking therapies, such as counselling or cognitive behavioural therapy, can help. Your GP can explain the different types and tell you what’s available in your area.

Read more about the different types of therapy.

You can also refer yourself for counselling or therapy. Use the NHS Choices Services Directory or visit the British Association for Counselling & Psychotherapy website to find a registered counsellor and therapist near you.

Hear Dr Williams' podcast about tackling unhelpful thinking.

 

 

Categories: NHS Choices

Late cancer diagnosis 'costing lives and money'

NHS Choices - Behind the Headlines - Mon, 22/09/2014 - 12:30

"Almost half of cancer patients diagnosed too late," says The Guardian, citing a new report that explored both the financial and health impact of late cancer diagnosis.

The late diagnosis of almost all types of cancer usually means the disease has already spread within the body, making it less treatable, reducing a patient's chances of survival, and potentially increasing the cost of effective treatments.

This means an enduring aim of cancer treatment is to pick up the disease as soon as possible, so treatment is more likely to be effective.

The report predicted around 52,000 cases of four common cancers (colon, rectallung and ovarian) may be spotted too late every year, costing the NHS around an extra £150 million to treat.

Various theories have been put forward to explain why this is the case, including "patients put[ting] their heads in the sand when they feared cancer", and how "doctors are struggling to get patients seen quickly".

 

Who produced this report on late cancer diagnoses?

The report was produced by Incisive Health, a specialist health policy and communications consultancy, in collaboration with experts at Cancer Research UK, a leading cancer charity. It was funded by Cancer Research UK.

The report – titled "Saving lives, averting costs: an analysis of the financial implications of achieving earlier diagnosis of colorectal, lung and ovarian cancer" – presumed that early diagnosis is crucial, and aimed to uncover the financial implications of achieving earlier diagnosis for colon, rectal, non-small cell lung (the most common type of lung cancer) and ovarian cancers.

The report estimated the number of people currently diagnosed with cancer using national guidance and data sources. This included data on the stage of the cancer when it was diagnosed (where available), and the authors calculated the cost of treatment. They then modelled what would happen if the cancers had been diagnosed earlier.

 

Links To The Headlines

Almost half of cancer patients diagnosed too late. The Guardian, September 22 2014

50,000 lives cut short by cancer diagnosis failings. The Daily Telegraph, September 22 2014

52,000 cancer cases a year are spotted too late: Delays blamed on 'stiff upper lip' mentality and pressure on GPs not to refer patents for costly tests. Mail Online, September 22 2014

Almost half of cancers 'caught too late'. ITV News, September 22 2014

Links To Science

Cancer Research UK. Half of cancers diagnosed at late stage as report shows early diagnosis saves lives and could save the NHS money. September 22 2014

Categories: NHS Choices

Dry-roasted peanuts may be worst for nut allergies

NHS Choices - Behind the Headlines - Mon, 22/09/2014 - 01:00

“Dry-roasted peanuts 'worst for allergies',” the Mail Online reports. New research involving mice suggests that the roasting process increases the "allergic power" of peanuts.

Researchers exposed mice to small amounts of proteins derived from either "raw" peanuts or dry-roasted peanuts, to “prime” their immune systems for an allergic reaction. They later gave them larger doses of the proteins and found that the intensity of the allergic reaction was much larger after priming with the dry-roasted protein, compared with the raw.

The researchers speculated that the roasting process may change the chemical composition of nuts, making them more likely to provoke an allergic reaction.

The research team thought this might partially explain why there is a much higher prevalence of peanut allergies in Western countries – where dry roasting is more common – compared with Eastern countries.

Importantly, the findings were based on mice, so are not directly applicable to humans. Studies involving humans would be needed to better explore these issues. There may be ethical considerations, however, due to the possible risk of anaphylaxis – a severe allergic reaction.

This research alone does not warrant the avoidance of dry-roasted peanuts out of fear of developing a nut allergy. Similarly, if you have a history of nut allergies, you shouldn’t assume that raw, boiled or fried nuts will be safe to eat. Those with an existing allergy should continue to take their normal action to prevent triggering their own allergy, which will vary from person to person.

 

Where did the story come from?

The study was carried out by researchers from Universities in Oxford (UK) and Philadelphia (US), and was funded by the National Institute for Health Research Oxford Biomedical Research Centre (UK), the National Institutes of Health (US) and the Swiss National Science Foundation Prospective and Advanced Research Fellowships.

The study was published in The Journal of Allergy and Clinical Immunology, a peer-reviewed science journal. 

The UK media’s reporting was generally accurate, with some warning against over-extrapolating the results to humans, and that new treatments or allergy-prevention strategies may take a long time to develop, if at all.

 

What kind of research was this?

This was an animal study, using mice to research allergic reactions to peanuts.

Peanut allergies are relatively common and can be serious, sometimes fatal. The researchers highlight how, despite similar peanut consumption, the Western world has a much higher prevalence of peanut allergy than the Eastern world. The research team suggested that this might be due to the way nuts are prepared. Eastern countries tend to eat their nuts raw, boiled or fried, whereas Western countries consume more dry-roasted nuts.

Researchers often use mice for research purposes because, as mammals, they are biologically similar to humans. Hence, conducting research on mice can tell us what might happen to humans without directly experimenting on them. The caveat is that there is no guarantee the results seen in mice will be applicable to humans; while similar, the biology of the two organisms is not identical, and the differences can sometimes be crucial.

 

What did the research involve?

The researchers studied the immune response of mice to various peanut products: peanut protein extracted from raw nuts; peanut protein extracted from dry-roasted nuts; raw peanut kernels (grain or seed); and dry-roasted peanut kernels. 

The team studied how immune cells reacted to the peanut products and the biochemistry involved in the response.

They studied three main routes of exposure to the peanut products:

  • peanut protein extracts were injected into the mice under the skin (subcutaneous route)
  • peanut kernels were fed to the mice for them to eat as they normally would (gastrointestinal route)
  • extracts were applied to sores in the skin (epicutaneous route)

The main analysis looked at the immune reactions of the mice, comparing raw with dry-roasted peanuts and peanut proteins.

 

What were the basic results?

The main finding was that the dry-roasted peanut protein extracts and whole peanut kernel elicited a much stronger immune response in the mice than the equivalent raw peanuts and extracts. This occurred consistently across all three exposure routes – on skin, in the stomach and under the skin.

Interestingly, when the mice were “primed” with low levels of dry-roasted peanut proteins to give a low-level reaction, they gave a much larger subsequent reaction to both raw and dry-roasted products. This suggested that exposure to dry-roasted nuts influenced subsequent reaction to raw nuts, possibly sensitising an individual for a strong reaction in the future.

 

How did the researchers interpret the results?

The researchers indicated that this is the first experiment to show a larger immune response elicited by dry-roasted peanuts compared with raw peanuts in a living mammal.

They suggest that: “A better understanding of how high-temperature antigen modification, such as peanut dry roasting, leads to allergic sensitisation should inform future preventive strategies, including those concerning early-age exposure, and therapeutic measures, such as the choice and route of antigen delivery in desensitisation strategies.”

 

Conclusion

This small animal study indicates that dry-roasted nuts and nut proteins cause a larger immune reaction than raw nuts. The team hypothesise that this might explain the difference between the prevalence of nut allergies in Western countries – where dry roasting is more common – and Eastern countries – where raw nuts are more typically consumed. While this study lends some weight to this idea, it does not directly prove it.

The study was consistent in its findings, giving them some validity, but we should consider that this was a small study involving mice. The findings are not directly applicable to humans, so we cannot say for sure that dry-roasted peanuts cause more allergic reactions or are the cause of the higher prevalence in the West – studies involving people would be needed to better explore this.

As the researchers acknowledge, further research confirming the findings of this study are required, which could include exploring ways to prevent allergies to nuts through desensitisation (immunotherapy). After these methods are developed in mice models, they might be investigated in humans. The path to a treatment or preventative strategy from this very early-stage research might be long and complex, so readers should not expect any immediate or short-term impact. 

This research alone does not warrant the avoidance of dry-roasted nuts out of fear of developing a nut allergy. Similarly, if you have a history of nut allergies, you shouldn’t assume that raw, boiled or fried nuts will be safe to eat.

Those with an existing allergy should continue to take their normal action to prevent triggering their own allergy. Allergies can be very different in different people, so this might vary between individuals.

Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter. Join the Healthy Evidence forum.

Links To The Headlines

Dry-roasted peanuts 'worst for allergies': Findings will help scientists develop nuts that prevent reactions. Mail Online, September 22 2014

Peanut allergies: 'Roasted worse than raw nuts'. BBC News, September 22 2014

Peanut allergy: Roasted worse than raw for sufferers. The Independent, September 22 2014

Links To Science

Moghaddam AE, Hilson WR, Noti M, et al. Dry roasting enhances peanut-induced allergic sensitization across mucosal and cutaneous routes in mice. The Journal of Allergy and Clinical Immunology. Published online September 22 2014

Categories: NHS Choices

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