imposter syndrome

Introduction:

Somewhere between caring for others and forgetting to care for themselves, millions of women carry silent storms. You’d never guess it looking from the outside—the calm smile, the to-do list checked off, the warm laughter echoing through a room. But beneath it all? There’s often an ache, a fatigue, a loneliness no one notices. I know this not just as a doctor, but as a woman, a mother, a daughter who recently lost the pillar of her world—my father.

Grief doesn’t knock; it breaks in.

That loss didn’t just leave an empty chair at the table. It triggered waves of emotional exhaustion, sleepless nights, and a strange heaviness I couldn’t explain. And yet, I still had to show up—at work, for my children, for everyone. That’s what women do, don’t we?

But why must we?

The Invisible Weight Women Carry:

Mental health struggles among women often wear a different mask—one of resilience, multitasking, and smiling through pain. From postpartum depression to burnout, from anxiety in silence to trauma tucked away for decades—women are taught to endure rather than express. And when they do speak up? They’re too often labeled as “too emotional,” “too sensitive,” or “too much.”

We are not too much. We are carrying too much.

A Doctor’s Lens, A Human Heart:

Working in medicine, I’ve seen too many women slip through the cracks. A young mother ashamed to admit she cries in the shower every night. A professional drowning in imposter syndrome. An elder in denial of her depression, having been told her whole life to “stay strong.”

I’ve been in all their shoes. And no textbook prepared me for that.

Barriers Beyond Biology:

Mental health is not just a chemical imbalance—it’s a social imbalance, too. Cultural stigmas, gender roles, financial dependence, lack of access to care, and an internalized guilt for putting oneself first—these are the chains that often keep women from healing. Let’s call them what they are: barriers built by systems, not by weakness.

Breaking the Silence, Together:

We need to change the narrative. And it starts with listening—really listening—to women’s stories without judgment or rushed solutions.

Here are small but powerful steps we can take:

Normalize therapy—it’s strength, not surrender.

Talk openly about grief, anger, guilt—emotions are valid, not shameful.

Create safe spaces for women to share without being “fixed.”

Advocate for workplace mental health support, maternity mental care, and trauma-informed approaches in healthcare.

My Personal Mission:

After my father’s death, I realized I had never truly paused to process life’s traumas. My journey through grief awakened a deeper calling in me—not just to treat symptoms, but to understand suffering. Today, I’m not just healing myself. I’m holding space for other women to heal too.

I’ve started writing, speaking, and showing up more authentically—not just as “Dr. Tamanna Islam Nishat,” but as a fellow woman on a deeply human journey.

Closing Thoughts:

If you’re reading this and carrying a silent storm—know this: you are not alone. You don’t need to have it all together. You don’t need to be everything to everyone. Your mental health matters. You matter.

Let’s rewrite the narrative of women’s mental health—not with shame or silence, but with storytelling, support, and a fierce kind of compassion.

Depression and feelings of low self-worth can have an impact in many areas of your life. Typical daily activities such as getting out of bed or going to work can feel daunting. Socializing and leaving the house can feel overwhelming, motivation can be hard to come by, your relationships may fall out of sync, etc. When feeling depressed, it's common for self-worth to also be compromised (and vice versa, low self-worth can feed depression. A vicious cycle).

Feeling Undeserving of Good

When experiencing low self-worth, it can feel like you're not deserving of the good things that come your way. For example, if your self-worth is low, you may on a deeper level feel like you don't deserve love, care, intimacy, success in career, a supportive relationship, respect from others, even simply good feelings, and more -- even when you crave it. When you're feeling undeserving of the good, it can be very difficult to know how to both see it when it's there, and receive it.

People generally desire good things in life. You likely want things that will make you happy and fulfilled. However, when your self-worth is struggling or you are feeling depressed, it can actually be incredibly tempting to unconsciously fall into patterns of pushing the good away.

The Impact of Trauma and Hurtful Experiences on Self-Worth

Self-sabotage patterns are quite complicated. It's not easy to convince somebody deep down that they deserve intimacy, to be loved, cared for, et al, especially if growing up they experienced bullying, harsh punishments for supposedly being "bad", abuse, neglect, loss, abandonment, trauma, and more.

For one example, it can be really unsettling to be cared for or close with someone else because maybe you're just waiting for them to find out how un-good you are. How long before this other person (or job, etc.) realizes that you're not worthy of their attention or effort? This is part of imposter syndrome. How long before people realize that you're not worth the good they're providing and therefore take it away? How long before you lose the good, whatever it may be?

Another example is if you've been bullied, abused, or neglected. The internal deeper feelings may be reluctant to become too close or vulnerable, to let your guard down, let someone in, or to trust care from others, especially if the people who were supposed to care for you growing up (and/or others) had a hand in making you feel hurt, or afraid, or actually did physically hurt you. It may be hard to trust that you're really ever safe being close to people.

Self-Sabotage and the Shame of Having Needs

The shame of having needs (and having them met) is a significant piece of self-sabotage patterns. The fear of losing something you need, or being hurt by your needs in the past can make it hard to want to need at all now. Why bother trying to have your needs met if you see the greater and intolerable pain coming, often becomes the narrative. When you're anticipating the pain, shame, or other deeply upsetting and maybe intolerable feelings, this is where self-sabotage patterns start to take over. Perhaps a part of you may feel like the shoe is eventually going to drop -- you're going to be hurt (physically, or otherwise), lose the good, be found out, etc. When you've been through deep pain before, it can become almost a form of torture just waiting for it to happen again. The longer in this unknown space of good being offered to you, in one way or another, or the more vulnerable you start to feel, the less in control of that eventual pain you may feel, and it can become scary.

In this space, the fear of the bad starts to take over. These deeper fears can actually show up unconsciously, and you may not realize fully that they are there. But your actions and feelings towards any of the good starts to shift from wanting it to fearing it. It's in this space where the self-sabotage takes over. You may start pushing people away, or repeat dynamics that serve to prevent success, intimacy, supportive relationships, love, anything you feel you emotionally need and would also be too painful to lose, be disappointed or rejected by, or be potentially hurt by.

Making the World Validate Your Worthless Feelings

Essentially, when struggling with low self-worth, it actually can become instinctive to assist the world in validating feelings of worthlessness, rather than taking in when the world is showing you the good that you so desire. Instead, if people are there who are trying to offer you the good, you might reject it or keep it at bay or arm's distance. This is a common pattern in relationships that struggle with intimacy. (I discuss this more in my Grass Is Greener Syndrome book and articles). Avoidance is a common characteristic in sabotage dynamics. Avoiding connection, intimacy (physical and/or emotional), etc.

Opening up to vulnerability, intimacy, care, success, and anything good may feel too scary, overwhelming, and simply too risky. Instead, it's almost an instinct to reject or destroy the good with self-sabotage dynamics and self-fulfilling prophecies (though, in your defense, they don't tend to happen by conscious choice). You may be offered exactly what you need and are seeking, but it's more safe and comfortable in the comfort zone where you can't be hurt, abused, disappointed, or left in pain in any other way.

In this mode, people unknowingly curate the world around them to match their feelings of worthlessness -- people push the care away in this state, and then become even more pained by being alone and feeling that no one really cares. In this particular fear-based state, this can be the comfort zone and where it feels the most safe, even if it means isolation keeping away the good. It's a harsh "damned if you do, damned if you don't" -- and it makes it harder to break out of depression, as well.

Testing Boundaries and Sabotage

It's also worth mentioning that part of these self-sabotage patterns actually shows up in "testing". When in these untrusting and vulnerable emotional states, it is quite common for people to test their partners or others to see where the boundaries are. Almost a sense of, "How much of myself can I be, or how far can I push before they will turn away from me and leave or have enough of me? Where is too far?" While this may be a form of testing for safety, it unfortunately often becomes the self-fulfilling prophecy. Pushing someone far enough away where the other becomes in some way put off in response. This often serves to create the painful arm's distance, or setting up the disappointment, loss, abandonment that is so greatly feared.

Moving Forward From Self-Sabotage and Increasing Self-Worth

Self-sabotage validates and perpetuates low self-worth, and vice versa. It is possible to break out of this cycle and increase your self-worth. It starts with acknowledging the patterns and seeing them starting to play out without having to act on them, and getting to know on a deeper level what is feeding them. It is common in fact for the patterns to be played out in the therapy, which gives us a chance to respond to them in real time. The first step is simply knowing you want to move forward from these patterns.

#Depression #MentalHealth #Selfworth #selfsabotage #Trauma #Anxiety #Abuse #neglect