In multiple studies, exercise has been shown to improve unipolar depression, but can exercise really help bipolar depression? Some doctors think so but this is mostly because they are generalizing the data from that on unipolar depression. Evidence for the usefulness of exercise in bipolar depression is scant.
Bipolar Disorder and Exercise
Multiple studies have shown that people with bipolar disorder lead more sedentary lifestyles than others. In one study of 60 bipolar outpatients, 78% of their days was considered to be sedentary and no participant met the 150 minutes/week of moderate/vigorous exercise recommended by the United Kingdom national guidelines. The data is limited, but it appears that even people with bipolar who are euthymic (neither depressed nor manic/hypomanic) lead more sedentary lifestyles.
I, personally, am completely guilty of a sedentary lifestyle. I know it. I know it’s not good for me. But here the thing: I’m exhausted – all the time. I’m tired from the time I wake up in the morning until the time I go to bed. And if I exercise? That just makes me more tired. I know it’s not supposed to. I know you’re supposed to get energy from exercise but I have never found this to be the case.
Evidence for the Usefulness of Exercise in Bipolar Depression
While there isn’t much evidence, there is some that says that physical activity is useful in bipolar disorder treatment. One small study with a walking group for people with bipolar showed improvements in depression, anxiety and stress while another small study showed that overall wellbeing was improved after 20 minutes of aerobic activity on a treadmill.
Psychosocial interventions which attempt to alter both the physical activity level of the person with bipolar along with his or her diet also appear to be helpful for some with bipolar depression.
It’s worth noting that programs that try to change diet and/or increase exercise in people with bipolar disorder experience very high attrition rates (in other words, lots of people drop out and just won‘t do it).
Again, I have never found an improvement in mood from exercise, but that’s me. It was obviously different for some of the people in the above studies.
(In what comes as no surprise to me, people in mania or hypomania do tend to exercise more and report that some exercise can actually elevate the mania or hypomania further while other types of exercise (those with a rhythm) may actually be helpful in moderating mood.)
Recommendations for Exercise in Bipolar Depression
People with bipolar disorder are at higher risk for obesity, cardiovascular disease, diabetes and metabolic syndrome than the general population so encouraging exercise for those with bipolar disorder is natural and, undoubtedly, healthy. At the moment, there is no research that indicates what type of exercise, what duration or what intensity of exercise works best for people with bipolar depression but some feel it’s individual.
But, the problem is, people with bipolar depression have trouble getting out of bed so I think telling them to exercise is a bit like telling a person with only one arm to clap three times a day. I think exercise would help some people with bipolar depression but it’s extremely tricky getting anyone to do it, particularly aerobic activity, which likely has the best results (generalizing from unipolar depression studies).
However, I will leave you with this one, very helpful, note. The Harvard Bipolar Program leader, Dr. Sachs, says, “here’s your exercise program: go to the door, look at your watch. Walk 7.5 minutes in any direction, then turn around and walk home. Do that 5 days a week at least.”
I can’t promise you it will improve your mood but, apparently, the average sedentary American would actually lose five pounds by doing this over the course of a year rather than gaining five pounds; and if it’s good enough for Harvard, then it’s probably good enough for me.
Thomson et al, Frontiers of Psychology, A Brief Review of Exercise, Bipolar Disorder, and Mechanistic Pathways
Phelps, PsychEducation.org, Accessed March 25, 2015, Exercise and Mood: Not the Usual Rap