Social support and self-esteem predict changes in bipolar depression but not mania

Introduction: Our own and other research has suggested that social support predicts course of bipolar disorder, with particularly strong effects on depressive symptoms. Within this paper, we examine which components of social support appear most powerful. Methods: Thirty-one individuals with Bipolar I disorder were followed longitudinally for 9 months. Participants completed a standardized symptom severity interview monthly, and at a 2-month follow-up, they completed the Interpersonal Support Evaluation List. At a 6-month follow-up, they completed the Rosenberg Self-Esteem Inventory. Results: Self-esteem support appeared to the most important predictor of change in depression across a 6-month follow-up, and multiple regression analyses suggested that social support effects were mediated through self-esteem. Limitations and implications: Although the small sample size suggests a need for replication, current results highlight the importance of psychosocial variables in the course of bipolar depression. Self-esteem may be a particularly important target for clinical interventions.