Issues with self-esteem occur on a continuum from a lack of confidence in social situations to having no sense of who one is, or how one is viewed by others. The latter is called having no "sense of self." A lack of self-esteem can manifest variously as:

• chronic interpersonal insecurity
• shyness or social avoidance
• chameleon-like behavior that changes from interaction to interaction
• vulnerability to peer pressure
• lack of direction and/or inability to make decisions
• interpersonal jealousy
• excessive (compensatory) arrogance or conceit
• competitiveness
• in severe cases, addiction to cosmetic surgery

Issues with self-esteem often underlie difficulties at school, work, or in intimate relationships, and often co-occur with mood disorders such as depression and/or anxiety. Additionally, issues with self-esteem can be caused or complicated by other conditions such as ADD, ADHD, weight issues, handicaps, or other conditions that cause one to feel "different" or conspicuous. Self-esteem is often easily developed or improved through targeted psychotherapy.