Mental and physical health are closely tied. Many people with bipolar disorder have concurrent physical illnesses like migraines, polycystic ovarian syndrome, metabolic syndrome, type II diabetes and cardiovascular illness. People with bipolar disorder also have higher rates of obesity than the general population. Because of this, it’s important for patients, physicians and psychiatrists to monitor the physical health of a person with bipolar disorder in addition to monitoring mental health. In this realm, a new study has looked at the connection between cardio-respiratory fitness and mental and physical health quality of life.

Quality of life is a broad concept. It consists of positive and negative aspects of life including health, jobs, socioeconomic status, home life, culture and spirituality. Specifically, health quality of life encompasses physical and mental conditions, functional status and support systems.

The new study, led by Davy Vancampfort of KU Leuven Department of Rehabilitation Sciences, explores whether or not there is a link between cardio-respiratory fitness and health quality of life in people with bipolar disorder. They looked at 20 people with bipolar disorder and 20 healthy controls to find out.

The study took place over a 10-month period. During this time, patients underwent physical assessments, stress tests, maximum oxygen consumption (VO2max) tests and surveys of mood and medication use. Physical activity was also monitored over an eight-day period with the use of a Sensewear armband. The health-related quality of life surveys administered included questions regarding physical functioning, role limitations due to physical and/or mental issues, vitality, pain levels and social functioning.

They found that the participants with bipolar disorder had lower physical and mental health quality of life than the control group, meaning they essentially had a lower rate of overall well-being. Low health quality of life can affect all aspects of a person’s life including emotional well-being, relationships, social activities and physical activities.

They also found that people with bipolar disorder were not significantly less active than the healthy controls, but were more sedentary. Previous studies have shown that up to 65% of people with bipolar disorder lead sedentary lifestyles compared to 25% in the general population. A sedentary lifestyle can lead to severe health problems including high blood pressure, type II diabetes, coronary heart disease, cancer, lower cardio-respiratory health and depression.

In the current study, those with bipolar disorder who scored high on the physical quality of life also saw higher VO2max scores (higher cardio-respiratory fitness), lower body mass index, higher activity levels and lower sedentary lifestyle. They also tended to have higher mental health quality of life and lower antipsychotic medication doses.

While this is an important find, it does not dictate the direction of causality. It is probable that higher activity can result in fewer mental health problems, but there is also the question of functionality. It’s possible that those who function at a higher level are more able to stay active and reap the benefits while those who cannot function as well don’t have that luxury, thus perpetuating a negative cycle for them as opposed to a positive cycle for those who have the ability to stay more active.

Cardio-respiratory fitness may also have another link to mood and behavior. Cardio-respiratory fitness measures the capacity to supply oxygen to the body during sustained activity. If that fitness is low or limited, the body does not receive the oxygen needed to sustain activity, which can cause fatigue. Fatigue is one of the main symptoms of depression. Therein may lie another cycle between mood and fitness.

Regardless of the directionality, it’s important for everyone to attempt a healthy lifestyle in order to have a better health quality of life.

 

 

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Image credit: Oregon State University