Research shows that the onset (or susceptibility to onset) of a ‘mental’ disorder happens during adolescence (or earlier) to children who have experienced detachment, exploitation, and or neglect, whether the cause is hereditary, environmental, or the result of some traumatic event. Technically, anything that interferes with your natural human development is detrimental to your emotional health. In any case, it is not your fault. It is likely no one’s fault.
The onset of SAD is a consequence of early psychophysiological disturbance.[i] Perhaps parental behaviors are overprotective or controlling or do not provide emotional validation.[ii] The receptive juvenile might be the product of bullying, abuse, a broken home, abuse, or bullying.[iii] LGBTQ+ youth experience disproportionately high rates of bullying, harassment, and other types of peer victimization.[iv] “Gender minority youth had approximately four-fold higher odds of experiencing any bullying or harassment in the past year.[v]
Childhood/adolescent exploitation or abuse is a generic term to describe a broad spectrum of experiences that interfere with their optimal physical, cognitive, emotional, and social development.[vi] Any number of situations or events can trigger the susceptibility to onset; it could be hereditary, environmental’, or some traumatic experience.[vii] Inheritability is rare and susceptible to other factors, and traumatic experience is environmental’. Statistically, the LGBTQ+ community is at “a higher risk than their heterosexual counterparts for traumatic life experiences such as childhood physical, psychological, and sexual abuse.” [viii]
Despite the implication of intentionality in the words’ abuse.’ and ‘exploitation,’ much can be perceptual. A toddler who senses abandonment when a parent is preoccupied could develop emotional issues.[ix] Onset or susceptibility to onset is never the child/adolescent’s fault and may be no one’s fault. In any case, assigning blame is nonproductive to recovery.
Undoubtedly, this sociological model conflicts with moral models that claim, ‘mental’ illness is onset controllable, and “persons with mental illness are to blame for their symptoms,” [x] or sexual and gender-based orientation is a choice and not a biological determination.
Maslow’s (1943/1954) hierarchy of needs reveals how childhood/adolescent exploitation can disrupt human development.[xi] Healthy evolution requires satisfying fundamental physiological and psychological needs. The child/adolescent experiencing detachment, exploitation, or neglect may be disenabled from satisfying her or his physiological and safety needs and the need to belong and experience love, impacting their acquisition of self-esteem.
The level of self-esteem determines your relation to self, to others, and the world. Self-esteem provides the recognition that you are of value, consequential, and worthy of love. A recent grassroots poll found that 62% of LGBTQ+ persons believe they suffer from low self-esteem.[xii] “LGBT young people who were rejected by their families because of their identity have much lower self-esteem.”[xiii] Exposure to historical and religious disdain and inaccuracy, ambiguous public opinion, adolescent bullying, heterosexualism, and other harmful elements, “in time, will have an impact on how you view yourself.”[xiv]
Persons with anxiety disorders are typified by low self-esteem and high self-criticism.[xv] A study on the relationship between anxiety and self-esteem concluded that persons with anxiety have significantly lower implicit and explicit self-esteem, which manifests in negative self-images, impelling them to avoid social situations.[xvi] Self-imposed social exclusion “is inherently aversive and reduces explicit self-esteem in healthy individuals.” [xvii]
A study published in Cognitive Behaviour Therapy on depression, anxiety, and general distress looked at the effect of positive self-images on self-esteem. The researchers found that positive self-imagery advances positive implicit self-esteem in both high and low socially anxious participants.[xviii]
[i] Mayoclinic. (2017). Social anxiety disorder (social phobia). Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/symptoms-causes/syc-20353561
[ii] Cuncic, A. (2018). How Social Anxiety Affects Dating and Intimate Relationships. verywellmind. https://www.verywellmind.com/adaa-survey-results-romantic-relationships-3024769.
[iii] NIMH. (2019). Major Depression. [Online.] National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/ major-depression.shtml
[iv] Berlan, E. D., Corliss, H. L., Field, A. E., Goodman, E., & Austin, S. B. (2010). SEXUAL ORIENTATION AND BULLYING AMONG ADOLESCENTS IN THE GROWING UP TODAY STUDY. Journal of Adolescent Health, 46(4): 366–371 (2010). doi: 10.1016/j.jadohealth.2009.10.015
[v] Reisner, S. L., Greytak, E. A., Parsons, J. T., & Ybarra, M. (2015). Gender Minority Social Stress in Adolescence: Disparities in Adolescent Bullying and Substance Use by Gender Identity. Journal of Adolescent Health, 56(3): 243-256 (1-60) (2015). doi: 10.1016/j.jadohealth.2014.10.275
[vi] Steele, B.F. (1995). The Psychology of Child Abuse. Family Advocate, 17 (3).
[vii] Mayoclinic. (2017). Social anxiety disorder (social phobia). Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/symptoms-causes/syc-20353561..
[viii] Bandermann, Kyle M., “Exploring Coping Mediators between Heterosexist Oppression and Post-Traumatic Stress Symptoms among Gay, Lesbian, and Bisexual Persons. “PhD diss., University of Tennessee, 2014. https://trace.tennessee.edu/utk_graddiss/3108
[x] Corrigan, P. (2006). Mental Health Stigma as Social Attribution: Implications for Research Methods and Attitude Change. Clinical Psychology Science and Practice, 7(1), 48-67(2006). doi:10.1093/clipsy.7.1.48
[xi] Maslow, A. (1943). A Theory of Human Motivation. Psychological Review, 50 (4), 370–396 (1943); Maslow, A. (1954). Motivations and Personality. New York City: Harper & Brothers; Early edition.
[xii] Unite UK. (2018). What is causing Low Self-Esteem in the LGBTQ+ Community? (Online.). Unite UK. https://uniteuk1.com/2018/06/low-self-esteem-lgbtq-community/.
[xiii] House, Harris. (2018). LGBTQ Addiction Factors: The Importance of Self-Esteem, (Online). Harris House. https://www.harrishousestl.org/LGBTQ-addiction-factors-the-importance-of-self-esteem/ .
[xiv] Unite UK. (2018). What is causing Low Self-Esteem in the LGBTQ+ Community? (Online.). Unite UK. https://uniteuk1.com/2018/06/low-self-esteem-lgbtq-community/
[xv] Stein, M. B., & Stein, D. J. (2008). Social Anxiety Disorder. The Lancet, 371(9618): 1045-1136 (2008). doi.org/10.1016/S0140-6736(08)60488-2.
[xvi] Ritter, V. Ertel, C., Beil, K., Steffens, M. C., Stangier, U. (2013). In the Presence of Social Threat: Implicit and Explicit Self-Esteem in Social Anxiety Disorder. Cognitive Therapy & Research, 37(6): 1101-1109 (2013). doi:10.1007/s10608-013-9553-0.
[xvii] Hulme, N., Hirsch, C., Stopa, L. (2012). Images of the Self and Self-Esteem: Do Positive Self-Images Improve Self-Esteem in Social Anxiety? Cognitive Behaviour Therapy, 41(2): 163–173 (2012). doi.org/10.1080/16506073.2012.664557.