How Exercise Can Help You Manage Bipolar Disorder

"Research has shown that physical activity can reduce symptoms of depression and anxiety, help stabilize moods over time, improve sleep, and help overall daily functioning," says Yelena Zack, MD, the director of psychiatry at Northwell Health’s Phelps Hospital in Sleepy Hollow, New York. "For those with bipolar disorder, this can lower the frequency of mood episodes and hospitalizations over time."

Here's a look at why exercise is helpful, along with considerations to keep in mind when adding more physical activity to your everyday routine.

Physical activity boosts feel-good neurotransmitters (brain chemicals) like serotonin and dopamine while also supporting brain cell growth and repair, says Dr. Zack.

"This can improve sleep quality and act as a natural mood stabilizer for those with bipolar disorder," says Dr. Dimitriu. "It can also be an excellent tool for countering metabolic side effects such as weight gain, which is often associated with mood stabilizers and antipsychotics."

The general recommendation for physical activity is 150 minutes per week of moderate activity such as brisk walking, swimming, or cycling, says Zack. Or you can do 75 minutes per week of vigorous activity like jogging or fitness classes.

"This amount of physical activity should be spread across several sessions per week, with each session being about 30 to 60 minutes," Zack says.

Certain forms of vigorous exercise may require deeper consideration before trying them, says Deborah Vinall, PsyD, a psychologist specializing in trauma and abuse recovery and the chief psychological consultant at Recovered, an organization in New York City that provides mental health resources and treatment. "High-intensity interval training (HIIT) and marathon training should be approached cautiously, as the extremes of these forms of exercise have been known to trigger feelings of mania in some," she says.

That doesn't mean you can't do these workouts if you have bipolar disorder, but you should monitor mood changes more closely if you're taking on HIIT or endurance training to see if they may be negatively affecting you.

Several factors come into play when creating a regular workout routine, says Rocky Snyder, CSCS, a personal trainer and conditioning coach in Santa Cruz, California, and the author of strength-training guide Return to Center. Here are several questions that can help guide you toward the exercise that's a good fit for you.

What Do You Enjoy?

Enjoyment is a top factor for maintaining motivation. "If you look forward to a certain kind of workout, that will help you stick to it in the long term," Snyder says. "Forcing yourself to work out often leads to abandoning that form of exercise and getting off track with your physical activity."

Keep in mind that it may take some trial and error to find what's enjoyable for you, says Snyder. For example, you might not know if you like yoga or strength training if you've never tried it before. Doing several sessions of each activity can be a good way to discover the routine you like best, he says.

Do You Want to Work Out Solo or With Others?

Part of experimenting with different types of exercise is finding out whether you feel better in a group setting or doing workouts on your own. For many people, taking a group fitness class or doing personal training in a small group can help them feel more supported and connected, says Snyder. Others may prefer to hike trails or do a Pilates mat routine as a solitary activity.

What Is Your Schedule Like?

Even if you're excited to start seeing benefits from an exercise routine, it's crucial to progress gradually, says Snyder. Not only can that help prevent injury but it can also help you stay motivated, versus doing too much and burning out quickly as a result.

Developing a realistic schedule is crucial. "When you're just getting started, the most important goal is to establish consistency," he says. "For that, creating a schedule that you plan in advance is useful, and it also gives you a sense of predictability."

Are You Already Motivated or Do You Need Help Getting Started?

One of the biggest sticking points when it comes to establishing a regular workout routine is the overabundance of information about fitness, says Snyder. Even a cursory internet search on "how to start working out" can quickly get overwhelming, with advice from trainers, influencers, gym goers, and others. But if you have the means, finding a local trainer and making an in-person appointment can help you avoid overwhelm and learn how to work out safely.

"If you're unsure how to get started, it's helpful to talk with a personal trainer who has experience with clients who have your specific condition," Snyder says. That might mean someone who understands mental health challenges but who also has familiarity with any coexisting conditions or issues like type 2 diabetes, excess weight, or cardiovascular disease.

Not sure where to find that type of expertise? Dimitriu recommends asking your healthcare team; they may be able to refer you to a physical therapist who will help you develop a sustainable plan to become more active.

Sticking to a routine is helpful even on days when you're not feeling particularly motivated, but it's also okay to skip a day if the lack of motivation is affecting your mood, says Dr. Vinall. Or you can modify your routine if you're more tired than usual — for example, if you struggled to get enough quality sleep the night before. It's important to listen to your body and assess your emotional health to determine when to challenge yourself and when to take a break.

• Injuries
• Muscle or joint pain
• Muscle stiffness
• Unexpected weight gain or loss
• Anxiety
• Catching colds more often
• Generally feeling fatigued

• Exercise doesn't replace medication and psychotherapy for bipolar disorder, but physical activity can be a meaningful complement to your treatment plan.
• Working out can reduce symptoms of depression and anxiety, and improve sleep, which may help reduce the frequency of mood episodes in people with bipolar disorder.
• It's helpful to experiment with different types of exercise to find out what you enjoy; doing something you look forward to will make you more likely to stick to a consistent workout schedule.