Winter Blues, Part 3: How friendship and self-esteem affect SAD

Seasonal Affective Disorder (SAD), sometimes called seasonal depression, is a major concern, with some statistics suggesting that it affects anywhere between 3 and 12% of the population - that's over 9 million people in the U.S. alone. Dr. G wrote yesterday about some of the differences between SAD and non-seasonal depression. Certain symptoms are considered to be "hallmarks" of SAD: physical symptoms such as increased appetite, increased need for sleep, and fatigue. But even if SAD (which some call the winter blues) is biological, is it possible that social factors or negative beliefs affect its course? Researchers at the University of Manchester investigated whether social support and low self-esteem influenced the experience of depression in people suffering from SAD in a study published in a 2002 issue of the journal, Psychological Medicine.

Everyone included in the study had previously experienced seasonal depression; anxiety and depressive symptoms were measured every two weeks from the beginning of September until the end of March. They found that depression increased through the fall; on average, a mild depression could have been diagnosed at about 6.5 weeks. It was most severe from mid-January to mid-February. As expected, the physical symptoms tended to occur earlier than the cognitive ones (which included self-dislike, feelings of worthlessness, and self-criticism).

Self-esteem and social support affected the onset of depression. People who reported low self-esteem or limited social support experienced a faster onset of depression. The researchers thought that increases in appetite and sleepiness might draw attention to negative beliefs about themselves, making the depression worse. This might set up a negative cycle, in which physical symptoms lead to negative thoughts, which increase sad feelings, making the physical symptoms worse and possibly leading to avoidance and withdrawal.

The researchers also surmised that people with limited social support would have fewer opportunities for their negative beliefs to be challenged through social interactions. On the other hand, positive relationships might delay depression by reducing withdrawal and disconfirming feelings of worthlessness. Overall, the results suggest that people with chronic low self-esteem and few friendships become more depressed at a faster rate than those with more friends and a positive self-image.

So what can you do if you suffer from the winter blues? Talking your doctor is always an option. Also, if increasing social support can have a positive impact on symptoms, then planning ahead in the summer becomes essential! People who anticipate depressive symptoms in the winter might benefit becoming involved in activities that encourage social connections - this will probably be hard to do once the depressive symptoms begin, but might be easier in the summer. The expansion of the social network might provide more opportunities for negative beliefs to be disconfirmed, and might also reduce opportunities to withdrawal socially when the winter blues come along.

You can find the Psychological Medicine study here.

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Note: Posts on Family Anatomy are for education only. If you need to talk to someone about family or mental health issues, you can get a referral from your family doctor.