Very few people with bipolar disorder get much physical activity. 78% are reported to lead sedentary lives.
For those who do exercise, little is known about the effect of exercise on this mood disorder. And yet, some people maintain that vigorous exercise can bring on manic episodes.
Could this be true? Well, yes and no.
The ways exercise can help those with depression are well-researched and overwhelmingly positive. Regular physical activity can lift a person’s mood from despair to upbeat, and many of the physical symptoms of depression can be improved by exercise.
Results of research into the effects of activity on depression lead many to believe that exercise should be considered a primary therapy when treating depression.
For people with bipolar disorder that tends toward mania, the results are a little murkier.
No one is advocating for a sedentary lifestyle. No one thinks inactivity is good for those with bipolar disorder. The level of activity is what’s in question.
Moderate physical activity can help regulate moods and improve sleep, thus it helps a person avoid the onset of manic episodes. Exercise can also positively impact all of the physical conditions that are co-morbid with bipolar disorder.
Regular, moderate exercise can help anyone live better and live longer. This is crucial in bipolar disorder, where lifespan is shortened so severely by the effects of co-morbidity. Exercise can help ameliorate the effects of co-morbid, physical diseases.
But can exercise cause mania?
A study made the rounds a while ago and caused many headlines. It inferred that vigorous exercise can bring on a manic episode, or at least hypomania, in many with bipolar disorder.
No one will deny that vigorous activity is stimulating. Runners speak of the “runner’s high,” and exercise addiction, for a small group of people, seems to be a real thing.
I remember a manic episode I had a few years ago. I began running. I ran far and fast, every day. As with many things I have undertaken during episodes, I overdid it. I ended up with a stress fracture in my femur, the strongest bone in the body, and I could barely walk. But it’s unclear if the manic episode fueled my running, or if the running fired the manic episode.
Studies on exercise and bipolar disorder have reached the same chicken and egg dilemma. Researchers can’t be sure which came first, the intense activity or the mania, or if they’re just bidirectional.
The studies that imply that exercise causes mania are also limited because they’re qualitative (not statistically measured or controlled) and result from small sample sizes.
What these and other studies on bipolar disorder and exercise do conclude is that the type of exercise undertaken by the subject is key. Regular, moderate exercise seems to have no detrimental effect on mood, and can even improve it.
While vigorous exercise may lift mood into a phase a bit too exuberant for safe mental health in those with bipolar disorder, the type and frequency of exercise can change outcomes.
It seems rhythmic exercises like walking, running, or swimming can have a calming effect, while more multi-directional intense activity may lift the mood too high and lead the exerciser into hypomania, or mania, over time.
The point is to experiment. Many different types of exercise are available, and the person with bipolar disorder needs to get up, raise their pulse rate, and find a type of exercise that works for them.
It amazes me how headlines stir behavior. The implication of a link between exercise and mania can lead many with bipolar disorder and sedentary lives to say, “why bother?” No, you don’t have to run to a cross fit gym, and maybe you shouldn’t. But you do have to move around.
The physical and mental health benefits of exercise far outweigh any risk. Just don’t overdo it.
My book Resilience: Handling Anxiety in a Time of Crisis is available wherever books are sold.