Abundant evidence shows that exercise is helpful in depression and anxiety, in fact, some specialists suggest that exercise should be the first intervention attempted in cases of mild to moderate depression. However, research into the relationship of exercise and bipolar has been spotty, at best.
The available studies have used very small study groups, and have not considered different types of exercise, or compared an exercise program, such as a gym or group with physical activity in daily life, such as walking or stair-climbing. Also the studies have been weak in considering confounding factors, like race and socioeconomic status.
Nonetheless, there is reason to believe that exercise regimes and recommendations should take a larger part in treatment of bipolar. For one thing, people with bipolar often have physical comorbidities, particularly cardiovascular disease and diabetes. These physical problems are well known to cause lower life expectancies and ill health. They are also, of course, known to be improved by increased physical activity, even just 30 minutes of walking, three times a week can make a big difference to health and longevity.
One study followed participants diagnosed with bipolar and other serious mental illnesses as well as obesity, who joined a program of group exercise combined with individual weight loss counseling. The intervention group showed significant weight loss over an 18-month program, demonstrating that people struggling with serious mental health issues can also make and maintain important commitments to physical health and wellness.
Another program working with people with serious mental illness, including bipolar, used a wellness manual to initiate lifestyle change. Over a 9-month period working with an individual health mentor, participants achieved increased exercise, vigorous activity and leisure walking. In addition to measurable reduction in waste circumference, participants also reported significantly improved mental health functioning.
Exercise and Mania
There is some preliminary evidence that exercise may be a “double-edged sword” for people with manic symptoms. Some people have reported a “spiraling” effect of exercise on mania, but it is not clear if exercise heightens mania, or if mania induces excessive exercise. Also, some people do report a calming effect of some types of rhythmic exercise, such as walking, running or swimming, so the type of exercise is clearly important as well, and may be specific to each individual.
For some, exercise could represent a “goal striving” activity, leading them to over exercise in addiction-like patterns, but on the other hand, physical activity is often associated with improved sleep quality, which is also beneficial in bipolar disorder, especially immediately before and during a manic episode.
The one major takeaway from all of this is that exercise is important and any possible “double-edged sword” effects should not be taken as a reason to limit physical movement and activity. Mood charting may be important to incorporate into an exercise program, but exercise should not be neglected.
Thomson D, Turner A, Lauder S, Gigler ME, Berk L, Singh AB, Pasco JA, Berk M, Sylvia L. A brief review of exercise, bipolar disorder, and mechanistic pathways. Front Psychol. 2015 Mar 4;6:147. doi: 10.3389/fpsyg.2015.00147. PMID: 25788889; PMCID: PMC4349127.