24 Aug How exercise can help those with bipolar disorder

Bipolar disorder is a serious, lifelong mental health condition that affects about one in 50 Australians. Women are more likely to experience the condition than men. Symptoms usually start during the teenage or young adult years.

There are two main types of bipolar disorder:

Bipolar I involves extreme, long-lasting highs along with depressive episodes. This type may also involve psychosis.
Bipolar II is characterised by episodes of less extreme highs that last hours or days, more frequent, longer lasting lows, and periods of normal mood.

People with bipolar disorder experience changing moods that range from extreme highs to extreme lows. The highs usually involve feelings of euphoria, high energy, excessive activity, less need for sleep, and grand ideas. The lows are characterised by depressive symptoms like poor concentration, low energy and motivation, feelings of sadness and hopelessness, and sleep and appetite changes.

WHY IS EXERCISE IMPORTANT FOR PEOPLE WITH BIPOLAR DISORDER?

People with bipolar disorder have a higher risk of developing a range of health problems, including obesity, diabetes and cardiovascular disease. Additionally, some medications used to treat bipolar disorder can lead to weight gain, adding to the risk of health problems.

Regular exercise has been proven to support healthy heart and circulatory function. It is also known to reduce the risk of developing metabolic disorders such as type 2 diabetes and heart disease. Given people with bipolar disorder are prone to developing these problems, exercise is particularly important for maintaining good physical health and reducing disease risk.

EXERCISE AND MENTAL HEALTH

Exercise also has proven benefits for mental health. It triggers the release of chemicals that boost mood and reduce symptoms of anxiety and depression. Because bipolar disorder is a mood condition, exercise can form an important part of symptom management. Bipolar disorder can also adversely affect your sleep, and exercise can help to enhance sleep quality and quantity.

Research into exercise for people with bipolar disorder also indicates it can help with managing symptoms and improving quality of life. A 2016 review of 31 studies covering 15,587 people with bipolar disorder found that physical activity was linked with less depressive symptoms and better quality of life and function.

A 2019 study explored the effects of exercise on 80 people with bipolar disorder who were interviewed during a period of stable mood and reassessed over 18 months. Researchers found the participants who were physically active had lower body mass index, waist circumference, anxiety levels and less insomnia. Sedentary participants had poorer overall function and more mood episodes and hospitalisations.

However, research also shows people with bipolar disorder often don’t get enough physical activity. They may need support to overcome issues like lack of motivation and access to appropriate facilities to engage in exercise.

WHAT TYPE OF EXERCISE IS BEST?

People with bipolar disorder can benefit from two main types of exercise to support their physical and mental health.

Aerobic exercise

Any activity that raises your heart and breathing rate helps to build healthy heart, circulatory and  metabolic function and assists with achieving or maintaining a healthy weight. It also releases mood enhancing chemicals. Aerobic activities include walking, swimming, cycling, dancing, rowing, boxing, and most team sports. The key is finding something you enjoy to help you stick with it. Mix them up if you like variety.

Resistance exercise

These build or maintain muscle strength, which helps with metabolism, weight maintenance and function. Examples include activities using your body weight (like squats and push-ups), resistance bands, free weights or gym machines to challenge and strengthen muscles.

Training support people

If you need support to exercise, training your support people can help ensure you get enough physical activity to improve or maintain your health and quality of life. You might need support for motivation, for example, or to get to exercise classes or sports training.

GUIDANCE FROM AN ACCREDITED EXERCISE PHYSIOLOGIST

People living with bipolar disorder often experience issues that impact their ability to exercise. For example, physical things like cardiovascular risk factors and medication side effects need to be considered.

Lack of motivation or cognitive difficulties (such as problems with memory or concentration) can make it difficult to start or maintain an exercise routine. During highs, hyperactivity and altered thinking may lead to excessive exercise.

People with bipolar disorder are also at higher risk of alcohol and substance misuse, psychosis symptoms and suicide. Support from healthcare professionals can help to manage these risks and ensure you have the best chance of achieving a good quality of life.

As experts in exercise for people with health conditions, accredited exercise physiologists (AEPs) are aware of all these things. Your AEP will create a program tailored to your needs, goals and preferences, and give you the support to help make exercise an enjoyable part of your lifestyle.

Click here to find an exercise physiologist near you.

Written by Amanda Semaan and Kara Foscholo. Amanda and Kara are Accredited Exercise Physiologists and Co-Directors of Active Ability, whose mission is to support people with disability to achieve optimal independence, health and quality of life.