Q: My 27 years old daughter-in-law is suffering from a very poor self esteem and lack of confidence. She feels that she can’t do anything and goes into a shell when she is amongst friends and outsiders. She stays in America, so that there is no interference of any kind but she has not been able to do anything in the last five years. She only broods the whole day and is constantly becoming irritable. I want to assure you that there is no interference from our family. She has the freedom to do anything she wants. My son loves her unconditionally and lets her do anything she likes. The only thing we have felt is that she is confused as she is only getting negative advice from her family. We also remain distressed as we want our only daughter-in-law to be happy. How can her poor self esteem and lack of confidence be improved?

A:According to the description in your letter, the most likely possibilities are that she is depressed, or that she is suffering from personality problems. The first step toward helping her, if she will accept it, would be for her to be evaluated by a psychologist or a social worker. If the diagnosis of depression she might benefit from psychotherapy by the psychologist or social worker, and that might be combined with medication by a psychiatrist or other medical doctor. If, on the other hand, she is not clinically depressed but is only confused and lacking in self-confidence, she might receive help from continuing psychotherapy with the same or another psychologist or social worker.

Depending on her attitude toward accepting help, it might be necessary for her husband to be involved in treatment. For example, if she is reluctant to go on her own, perhaps he could suggest that they go for marital counseling as a way of getting started.