Negative Self-View Predicts Both Depression and Mania

Negative self-views and self-appraisals are commonly associated with depressive symptoms. Individuals with major depression, as well as those with depression related to bipolar, often experience low self-esteem, feelings of worthlessness, and overall negative self-concept while in their depressive states. In contrast to these feelings, high levels of self-esteem, goal attainment, and motivation are often evident preceding or during manic episodes.

But according to the results of a new study led by Hana Pavlickova of the School of Psychology at the University of Wales Bangor, negative self-beliefs can also predict manic episodes in people with bipolar. Pavlickova theorized that the comorbidity of both positive and negative affect might exist during periods of no symptoms and also during periods when symptoms were present. Understanding how this overlap affects each mood state could help determine when manic or depressive episodes might occur and also could provide opportunities for intervention prior to those episodes.

For her study, Pavlickova evaluated 253 participants with bipolar several times over the course of 18 months. She looked at depressive and manic symptoms and how self-esteem, self-appraisals, internalization, externalization, and other behaviors influenced the symptoms.

The results revealed that self-esteem was most strongly associated with both mood states. In particular, low self-esteem was linked to depression and high self-esteem to mania. However, negative self-esteem, although highly predictive of depressive symptoms, also indirectly predicted manic episodes. Pavlickova discovered that although cross-sectional data indicated a direct association between negative self-esteem and depression, longitudinally, negative self-esteem was weakly but clearly associated with mania.

She explains this finding by suggesting that individuals with bipolar may overcompensate for feelings of negative self-worth by actively avoiding any depressive emotions and engaging in high levels of externalizing, which could provoke manic behaviors and symptoms. These results are novel in that they demonstrate the overlapping relationship of negative self-evaluations in bipolar. Pavlickova added, “In terms of clinical implications, the findings accentuate the importance of the therapeutic management of negative self-concept shared by both depression and mania in bipolar disorder.”

Pavlickova, H., et al. (2013). Symptom-specific self-referential cognitive processes in bipolar disorder: A longitudinal analysis. Psychological Medicine 43.9 (2013): 1895-907. ProQuest. Web.

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  • Deanna

    September 11th, 2013 at 11:03 AM

    Looks like it is the pretty common that is=f someone either thinks too little or tto much of themselves then they could be having some internal issues that someone should be concerned about. We often only look at those people with low self esteem and think of those as being the ones with the issues; but now we see that even people who seem to have very high self esteem, and in many cases too high, that they could also be experiencing some issues that we may not have thought about previosly. I think that this is probably due to the fact that they are trying to over compenstae for how they really feel about themselves and this tends to come across as very egocentric. In reality they probably feel terrible about themselves but don’t know how to express that.

  • josie r

    September 12th, 2013 at 3:48 AM

    weird since these are seemingly total opposites

  • Bruce

    September 13th, 2013 at 3:54 AM

    I have actually watched people on both ends of the spectrum struggle with both depression and manic attacks and in the end much of it has boiled down to the same old issues. Feeling bad about oneself, their lives, the lives of their kids, genetics, it’s all there, all the same.
    It just happens that in certain people that it will manifest itself in different ways.

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