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You are worthy of healthy relationships!

Both Mental Health and Teen Self-Esteem Awareness are observed in May and since those are so interconnected, we want to discuss them together. Both of these issues have influence on a person’s physical health, especially in how they take care of themselves, so it all needs to be in a good balance.

Self-esteem is defined as the overall opinion a person has about themselves – including how they perceive their abilities and worth, self-confidence, and sense of security. Self-confidence relates specifically to how well someone feels they can trust their ability to handle situations, which of course provides feedback to their self-esteem.

There are a lot of external reasons one may have low-self-esteem and these can include:

·         Adverse Childhood Experiences (ACEs) – these are traumatic events that occur before the age of 17 and some examples are experiencing, witnessing, or being exposed to violence, substance abuse, household instability including food insecurity, death of a loved one by suicide

·         Societal Pressures/Expectations – comparing oneself to others, especially in media where people usually only present their best selves/lives, this can also come from friends, family, or school, I would add bullying

·         Attacks on identity – as teens are developing their identity, hearing hurtful messages about people to whom they might feel similar, they will need support in taking pride in aspects of their identity such as culture of origin, race/ethnicity, sexuality, gender, socioeconomic situation, or medical/learning/mental health challenges or impairments.

·         Chronic criticism


Mental health or developmental challenges also contribute to low self-esteem, especially if those challenges result in poor grades, being bullied in school, or adults having low expectations.


Effects of low self-esteem can include:

·         Engaging in unhealthy risky behaviors, including unsafe sexual behavior leading to early pregnancy and sexually transmitted infections

·         Avoidance of healthy risk – these are the kinds of risks that allow people to grow and develop skills

·         Fear of rejection, susceptibility to peer pressure

·         Struggling to make decisions

·         Lack of conflict resolution skills, inability to self-advocate, avoidance of conflict

·         Anxiety, depression, loneliness, substance use/misuse

·         Inability to form or maintain positive relationships, withdrawing from peers or family


Another risk from low self-esteem that is related to the inability to develop or maintain positive relationships is being part of a violent dating relationship. What’s known as Teen Dating Violence (TDV) is a serious public health problem disturbingly common among young adults ages 10-24! According to the Children’s Hospital of Philadelphia Center for Violence Prevention, approximately 1 in 3 teens in the U.S. is a victim of some form of teen dating violence.

Teen dating violence IS dating violence, and as the statistics show, it can begin early and extend beyond the “teen” years. Dating violence includes physical, sexual, and/or psychological aggression, and also stalking. Teen dating violence is also considered an Adverse Childhood Experience, which, as we talked about is a contributor to low self-esteem that can lead to engaging in unhealthy risky behavior and mental health challenges. TDV can occur in-person or electronically and posting sexual photos without permission is included.

People who experience TDV are more at risk of experiencing Intimate Partner Violence throughout their lives. Violence is interconnected, whether that be at school, in the home, in the community, child or elder abuse, animal abuse, these are connected and all of these, including teen dating violence, are associated with short and long-term negative outcomes in mental and physical health, substance use disorders, and continued victimization or perpetration of violence.

During the preteen and teen years people are learning skills that help them form positive relationships and it’s a good time to promote healthy dating relationships. So instead of reiterating the negative, let’s jump to how to stop teen dating violence before it begins.

Very simply, a good relationship means everyone involved is safe, respectful, supportive, has equal standing, and is able to communicate without fear. There is open communication, honesty, compromise, the opportunity to express individuality and have boundaries, and trust between partners. An occasional fight or disagreement is not necessarily a sign of a bad relationship but fighting “fair” and being in control of anger need to be observed. There also need to be healthy boundaries and open communication about intimacy and sex and, always, consent. Also, just to note, we have been hearing a lot of “no means no” but consent is an actual YES and needs to be mutually communicated in each situation.

Bad relationships contain the opposite of these things: Lack of communication, mistrust, suspicion, manipulation, gaslighting, control by one partner, isolation of one partner from family and friends by the other, domineering behaviors, constant criticism, threats, violation of boundaries, and of course any kind of violence.

Positive self-esteem and good mental health are protective factors against being in, or staying in, an abusive intimate relationship. Here are some ways adults can help teens develop positive self-esteem:

·         Model positive behavior, compassion, and self-compassion

·         Praise good decisions and talk about poor decisions

·         Encourage pride in their uniqueness

·         Support children developing their interests and skills, competence often increases confidence

·         Make sure if children are experiencing adverse events that they have access to mental health services

·         Be the “trusted adult” that a youth needs to talk to when they are experiencing challenges

·         Encourage connection to community 

·         Encourage commitment to education

·         Promote one-on-one time with health care providers and encourage regular health check-ups including discussion about and access to contraception information and awareness of sexually transmitted infections


NCHD provides reproductive health and family planning services that include physical exams and testing for several sexually transmitted infections for women and men, pregnancy testing, contraception, and abstinence counseling, and our nurses can recommend resources if a client is experiencing mental health challenges or concerns about dating relationships. These services are completely confidential and do not require parental consent. Services are by appointment and the schedule is on the client services reproductive health page. There are additional mental health resources on the behavior/mental health programs page.
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