It would seem you are right a catch 22. Anxiety and depression make it real difficult to find the motivation and to stick to things yet those things can improve self esteem. I think self worth and self love is largely an inside job but it takes a lot of outside help. Kind of a paradox. I would be careful about defining your self worth on outside compentencies like work, or playing the piano or whatever. I think it should be based more on values or attributes. Like are you kind, trustworthy, honest, etc. what do you value most in life and about yourself.

I wouldn't give up on CBT and other forms of therapy. It can just take a long time and a lot of healing. I wonder how you advise clients in your work? How do you treat an addict? 12 step programs are an inside job but we need a lot of help to do the work. I have been clean and sober for many years and have had horrible depression my whole life. I would say don't give up on the inside job with help, as you also focus on those other healthy things you want to pursue.

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