Many suggest that exercise can help with bipolar disorder. For those of us with severe bipolar disorder, this is a bit frustrating. After all, if you can’t get out of bed, taking a brisk jog is right out of the question. And I’m a stellar example of someone who has always hated exercise — before bipolar and now with bipolar disorder. I’m also someone who has tried to exercise over and over again with great failure as a result. So today I want to talk about the evidence of exercise in bipolar disorder and my past year-and-a-half attempt to exercise.

The Evidence of Exercise in Bipolar Disorder

I can quite simply tell you the scientific consensus as told by the evidence: the jury is out on the helpfulness of exercise in bipolar disorder. In spite of everyone telling you to get to the gym, there is no real evidence to back that up.

However.

I’m not suggesting you not exercise.

Here is the conclusion of a systematic review done in 2016 (appears to be the most up-to-date review):

Generally, exercise was associated with improved health measures including depressive symptoms, functioning and quality of life. Evidence was insufficient to establish a cause-effect relationship between mood and physical exercise.

While some may say that doesn’t sound promising, what it really is is a lack of evidence. So we can’t say that exercise does nothing useful, of course, and it looks like it might be good, but we can’t really say.

And evidence suggests that it likely is helpful with depression. We know this because there is lots of evidence for exercise in unipolar (non-bipolar) depression. A meta-analysis from 2016 that looked at 23 randomized controlled trials concluded:

Physical exercise is an effective intervention for depression. It also could be a viable adjunct treatment in combination with antidepressants.

It does stand to reason that a similar positive effect would be seen in bipolar depression as it is in unipolar depression. (For those of you who aren’t aware, those with major depressive disorder have the same diagnostic symptoms as those experiencing bipolar depression.)

Exercise in Bipolar Disorder and Depression — Limitations to the Evidence

So simply said, it’s likely that exercise will help depression in bipolar disorder but we don’t have the evidence yet — although people are looking.

The limitations you need to be aware of, and they’re important, are:

  • There is some evidence that exercise can make mania worse. Evidence on this is limited, too, but it’s definitely worth watching out for.
  • In the case of bipolar disorder studies, they haven’t been randomized so it’s likely that those who experience improvements with exercise have self-selected. In other words, they were well enough to exercise so they might have experienced improvements anyway.
  • Lots of the evidence in unipolar depression (but not all) is for those with mild-to-moderate depression. Depression in bipolar disorder tends to be more severe.
  • Lots of the evidence in unipolar depression (again, not all) is for more vigorous exercise — something we’re even less likely to do.
  • There are many other health benefits to exercise outside of mood improvement and these are important for those with bipolar disorder as we tend to be at risk for blood sugar and heart disorders (yes, often due to bipolar medications).

My Experience with Exercise and Bipolar Disorder

Like I said above, when it comes to me, bipolar disorder and exercise, I’m a pretty big failure. For years and years, I tried and failed or just did nothing at all. If this is you, you’re not alone. Statistically, most people with bipolar disorder live a sedentary lifestyle.

That said, I’ve changed things a bit over the last year-and-a-half. But I’ve done it the most simple, possible way: I’ve started walking.

When I started, I didn’t think I would be able to do it and I especially didn’t think I could do it long term. So far, I’ve been proven wrong on both parts, much to my surprise.

Watch this video to hear a little about what I’m doing and how I got here:

What Kind of Exercise Program Works in Bipolar Disorder?

Of course, the kind of exercise that will work for any individual with bipolar disorder varies but let me share with you my favorite quote on exercising with bipolar disorder. 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 five days a week at least.

Apparently, the average American would lose five pounds a year doing that, rather than gain five pounds a year for those who are sedentary.

This one quote gave me hope. I thought I could do that.

One of the big problems for me, though, was that involved leaving the house. I don’t that if I don’t have to. It’s too much effort to put on clothes and a face and the like. So I figured, I could take that advice but do it by doing laps of my apartment. Yes, I know it sounds silly and looks silly, but it worked for me. And as I say to people with bipolar disorder all the time: you can often get to your endpoint, but you may have to take an unusual route to get there.

And to help keep me honest, I bought the cheapest Fitbit you can buy. It tracks time and steps.

I sort of thought tracking things was dangerous because I might just beat myself up over lack of completion of my goals — but oddly, it did the opposite. It actually encouraged me. Weird, I know. I never thought I would be influenced by a piece of plastic and metal. Like, ever. But I was wrong.

Exercise is suggested for those with bipolar disorder, but why? Does exercise even work to treat bipolar disorder? Here is the evidence and my experience.

Now I’ve actually been walking for a year-and-a-half. I’ve also worked up (very slowly) to walking longer distances. I still can’t walk very far but I can walk a bit more. What I do now is I walk at least between 15-40 minutes three times a week. That’s outside my apartment. On the days in between, I try to consistently walk throughout the day in my apartment, understanding that some days, I can’t do any of that.

The motivation for me is to make different goals à la Fitbit and work to meet them. When I walk outside, my motivation is to get to breakfast. I walk to breakfast, work for two hours, and then walk back. It forces me out of the house in a good way and in a way I can handle.

Results of Exercising in Bipolar Disorder

Now, honestly, I haven’t seen a change in mood. My mood is bad. It’s always bad. It only reacts to medication changes. I’ve always been that way.

I also haven’t seen any changes in my weight, in case you were curious. The medications affect that so dramatically it seems like walking can’t really fight that.

The good results from exercise in my bipolar disorder, though, is this: I have a bit more energy. No, I haven’t turned into the Energizer Bunny, but I find I can do a bit more during the day. This is a huge win for me as energy is a huge problem for me.

I’ve also found that I’m actually able to pat myself on the back when I meet my steps/distance, whatever. I never thought that would happen, but I’m actually finding it quite positive.

I can’t say what will happen to anyone else — maybe it’ll be even better for you — but that’s what I have found.

So basically, if you can find an exercise you can do — any exercise — I think you will see something positive from it. Maybe it’s as simple as seeing your ability to congratulate yourself for doing something that day as opposed to only sitting on the couch that day. That’s a positive thing that’s worth it.

(I have to say that you should always check with your doctor before starting any exercise. You don’t want to do something that would injure yourself, after all.)