About self-esteem
Low self-esteem affects how we see ourselves, our relationships and our decisions. Therapy helps identify self-critical thoughts, recognise strengths and build a more realistic and kind relationship with yourself.
Therapist is the everyday word for a professional who offers talking therapy: depending on the country it can be a psychologist, a psychotherapist, a licensed counsellor, a marriage and family therapist or a clinical social worker. Profiles show each therapist’s actual title, training and registration.
Getting mental health care in San Marino
Public health system · Istituto per la Sicurezza Sociale (ISS), UOC Salute Mentale
The public Istituto per la Sicurezza Sociale runs a Mental Health Unit (UOC Salute Mentale) covering prevention, diagnosis, treatment and rehabilitation for people with mental health problems or psychological distress.
How to check that a professional is licensed
- Ordine degli Psicologi della Repubblica di San Marino. San Marino has its own psychologists' statute: practising requires registration in the San Marino Albo. Psychotherapists must also hold a psychotherapy specialisation and be registered with the San Marino Ordine; Italian registration alone does not apply.
Urgent help in San Marino
If your life or someone else's is in danger, call the emergency number now. These services can help at any time:
- 118 · Ambulancia (emergenza sanitaria)
Information reviewed in November 2026 · Sources: iss.sm, consigliograndeegenerale.sm
Signs to look out for
Everyone doubts themselves sometimes. Low self-esteem may be holding you back when you are constantly self-critical, feel you are not good enough whatever you achieve, compare yourself unfavourably with others, struggle to accept compliments, avoid challenges for fear of failing, find it hard to say no, or feel that others’ opinions define your worth. It often accompanies anxiety or low mood.
What helps: treatments and professionals
Psychologists and psychotherapists can help you identify where your harsh inner voice comes from and develop a kinder, more realistic view of yourself. Cognitive-behavioural therapy (CBT), compassion-focused therapy, acceptance and commitment therapy (ACT) and schema therapy are commonly used. Work on assertiveness and boundaries is often included. If low self-esteem relates to body image or eating, specialised support may be needed.
When to seek urgent help
Low self-esteem alone is rarely an emergency, but it can come with depression. If feelings of worthlessness lead to thoughts of harming yourself or ending your life, contact your local emergency services or go to the nearest emergency department immediately. Seek prompt help too if you are being bullied, harassed or abused, or if you are restricting food or self-harming.
What you can do in the meantime
Notice your inner critic and ask whether you would speak to a friend that way. Write down small achievements and qualities others appreciate in you. Spend time with people who treat you well and reduce exposure to content that makes you compare yourself. Try small challenges, practise saying no in low-stakes situations, and look after your body with rest and movement.
What does a therapist do?
A therapist helps you talk through what is worrying you and find practical ways to feel and cope better. In sessions they listen, ask questions, help you notice patterns in your thoughts, emotions and relationships, and agree goals with you. Depending on their training they may use cognitive-behavioural, humanistic, systemic, psychodynamic or other evidence-based approaches, with individuals, couples, families or groups.
When to see a therapist
It makes sense to look for a therapist when stress, anxiety, low mood, grief, relationship problems, a difficult change or the effects of past experiences start to weigh on your daily life, or when you simply want space to understand yourself better. If symptoms are severe, you may need medication or there are signs of a medical cause, involve your doctor or a psychiatrist as well.
How to choose
When choosing, check the licence and training, the approach they use and whether they have experience with what you need. Consider practical aspects too: language, price, location or online sessions and availability. The relationship with the professional matters a great deal; if after a few sessions it does not feel right, it is fine to change.
Frequently asked questions
Does the public health system in San Marino cover psychological care?
The public Istituto per la Sicurezza Sociale runs a Mental Health Unit (UOC Salute Mentale) covering prevention, diagnosis, treatment and rehabilitation for people with mental health problems or psychological distress.
How do I check that a therapist is licensed in San Marino?
Ordine degli Psicologi della Repubblica di San Marino: San Marino has its own psychologists' statute: practising requires registration in the San Marino Albo. Psychotherapists must also hold a psychotherapy specialisation and be registered with the San Marino Ordine; Italian registration alone does not apply.