Depression or low self esteem can ironically make the affected person selfish. Unable to stop feeling down on yourself uses up time that would be better and more productively be spent on other things and people. A vicious cycle results when you beat yourself up about this very selfishness. I try to remind myself of this fact whenever I feel my anxiety pulling me too far away from reality. This selfishness does not arise from my ego- as a person with low self esteem I nearly *lack* an ego, and furthermore struggle just to see myself as worthy of others’ caring at all.