Exercise and bipolar disorder

Exercise and Bipolar Disorder

By Aaron Greenup, Jul 1, 2021

What is bipolar disorder?

Bipolar disorder refers to a group of mental health conditions that are characterised by periods of high (manic or hypomanic) and low (depressive) moods. It is a serious mental health condition that affects approximately 1.3% of all Australians1.

The two most common types of bipolar disorder are bipolar 1 disorder and bipolar 2 disorder. The difference between bipolar I and bipolar II is that those with bipolar I experience greater episodes of mania as well as psychotic symptoms, whereas those with bipolar II have less severe and shorter experiences of mania and are referred to as hypomanic, they also do not experience psychotic symptoms. However, people with bipolar II often experience more frequent and longer lasting depressive episodes1.

How can exercise help?

People living with bipolar have an increased risk of developing Metabolic syndrome, which places them at greater risk of developing conditions such as type 2 diabetes and cardiovascular disease2. Furthermore, there is evidence to suggest that the pathophysiology of bipolar disorder and type 2 diabetes may be linked3.

Exercise is essential for the prevention and effective management of type 2 diabetes and conditions such as cardiovascular disease and metabolic syndrome4,5. Additionally, exercise has been shown to have a range of other beneficial effects for people living with mental health conditions, such as:

  • improvements to social functioning6;
  • reduced risk of weight gain due to medications7;
  • reduced symptoms of depression and anxiety8-9 and increased self-esteem10;
  • improved sleep quality11.

While the benefits of exercise are numerous, like any treatment there are some risks and it’s important to consider these before commencing an exercise program. Some research has suggested that while exercise has many benefits, it can have some deleterious effects for those experiencing manic or hypomanic episodes12.  Therefore, it’s important to work closely with an accredited exercise physiologist who can help develop an appropriate plan for exercising while living with bipolar disorder.

 

how exercise has helped one of AXM’s clients with bipolar disorder:

“”When I first began exercising more seriously with an Exercise Physiologist, it was suggested as one of my goals as getting “jacked”, but later when I got more fit I thought my wife would approve of my new look. However, one day she saw me in the mirror and said I looked like a gorilla. Subsequently, I had to re-evaluate for what reasons I did exercise and how it helped my life. There seemed to be so much more than getting “jacked.”

 

 

The interaction with my exercise physiologist has provided much encouragement to exercise and talk about the benefits of exercise that left me feeling positive to do exercise. Having a good exercise physiologist is just as important as rehabilitation itself because they are a sounding board for what you want to do and get out of it, as the best exercise physiologists listen carefully to you, help find the motivation in you (the cornerstone to doing exercise) and partner with you to reach your goals.

For my bipolar condition I can get quite depressed and exercising is one activity for something simply to do (where just doing something/anything can be difficult) and know I get some health benefits out of it, plus knowing I’m doing something positive, as opposed to say lying in bed depressed.

 

Doing a variety of exercises can be interesting and challenging. I didn’t know that there could be so many exercises around the core exercises. My bipolar condition could be one reason why I like the novel and creative. So performing new different exercises is quite interesting to me and gives me some motivation to try them out.

 

Reaching measurable goals or just setting personal bests can be motivating and encouraging, if I don’t care about them (the goals), which sounds paradoxical. This is because they are incidental and when they are mentioned they give me some confidence along the way, but to keep going seeing what you can do in terms of pushing yourself is a bigger motivator.

Pushing yourself as your own motivator helps my depression which I can apply to other tasks in life. My exercise physiologist helped initially to push myself. But eventually, you can learn to push your own self to do exercise, and then try to transfer this ability to do other things in life on your own initiative with enough confidence, which is very helpful for depression. In the end, even though I feel a bit fitter, I like trying new things out and seeing where you can go or go all the way.

After learning the above as my journey, I then asked my wife later: “what’s wrong with looking like a gorilla?” She said, “looking like a gorilla is fine.” I sighed. But I realised my journey of learning wasn’t in vain, as I had experienced the real benefits of exercise (other than being “jacked”)”

 

– George, AXM Exercise Physiology Client.

References:
  1. Bipolar Disorder [Internet]. Australian Psychological Society 2021 [cited 22 June 2021]. Available from: https://www.psychology.org.au/for-the-public/Psychology-topics/Bipolar-disorder
  2.  McIntyre RS, Danilewitz M, Liauw SS, Kemp DE, Nguyen HT, Kahn LS, Kucyi A, Soczynska JK, Woldeyohannes HO, Lachowski A, Kim B. Bipolar disorder and metabolic syndrome: an international perspective. Journal of affective disorders. 2010 Nov 1;126(3):366-87.
  3. Calkin, C. V., Gardner, D. M., Ransom, T., & Alda, M. (2013). The relationship between bipolar disorder and type 2 diabetes: more than just co-morbid disorders. Annals of medicine45(2), 171-181.
  4. Hordern, M. D., Dunstan, D. W., Prins, J. B., Baker, M. K., Singh, M. A. F., & Coombes, J. S. (2012). Exercise prescription for patients with type 2 diabetes and pre-diabetes: a position statement from Exercise and Sport Science Australia. Journal of Science and Medicine in Sport15(1), 25-31.
  5. Stubbs, B., Rosenbaum, S., Vancampfort, D., Ward, P. B., & Schuch, F. B. (2016). Exercise improves cardiorespiratory fitness in people with depression: a meta-analysis of randomized control trials. Journal of affective disorders190, 249-253.
  6. Lederman, O., Grainger, K., Stanton, R., Douglas, A., Gould, K., Perram, A., … & Rosenbaum, S. (2016). Consensus statement on the role of Accredited Exercise Physiologists within the treatment of mental disorders: a guide for mental health professionals. Australasian Psychiatry24(4), 347-351.
  7. Curtis, J., A. Watkins, and S. Rosenbaum, Keeping the body in mind: an individualised lifestyle and life skills intervention to prevent antipsychotic-induced weigh gain in first episode psychosis. Early Interv Psychiatry 2015.
  8. Rebar, A., et al., A meta-meta-analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations. Health Psychol Rev, 2015. 9(3): p. 366-378.
  9. Stanton, R. and P. Reaburn, Exercise and the treatment of depression: a review of the exercise program variables. Journal of Science and Medicine in Sport, 2014. 17(2): p. 177-182.
  10. Krogh, J., et al., The effect of exercise in clinically depressed adults: systematic review and meta-analysis of randomized controlled trials. J Clin Psychiatry, 2011. 72(4): p. 529-538.
  11. Rethorst, C., P. Sunderajan, and T. Greer, Does exercise improve selfreported sleep quality in non-remitted major depressive disorder? Psychol Med, 2013. 43: p. 699-709.
  12. Malhi, G. S., & Byrow, Y. (2016). Exercising control over bipolar disorder. Evidence-based mental health19(4), 103-105.

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