It is a chronic condition of behavioral compulsions, delusions, and of emotional denial and repression resulting in a lifestyle of low self-esteem, and a feeling of powerlessness that can lead to medical complications. This is denial that the condition exists. This can lead to a chronic state of delusion. Including smoking, eating, working, spending, alcohol, drugs, gambling, sex, relationships. Problems result from the chronic state of repression of feelings.
Safety is survival.
Feel rotten inside, but never let others know how you feel. People with low self-esteem feel insecure. They are not sure what normal is, and they are not comfortable with themselves or with others. They are experiencing behavior over which they have no control, just as a person with cancer has no control over the cancer. Commonality and predictability of the symptom behavior make it an illness and a condition to be treated as such.