By: Carrie Elizabeth Lin

This is the seventh in a series of 26 posts covering a variety of stress management tools and techniques, starting with the letter A. For some background information on stress and bipolar disorder, the blogger recommends reading her three-part series, “Getting a Handle on Stress When You Have Bipolar Disorder,” starting with the first one.

Welcome to the A to Z Guide to Stress Management for People with Bipolar Disorder. In this series I will give you a wide variety of stress management tools and techniques to try. Some go hand and hand, and some may appear contradictory—for example, changing your thoughts and accepting your thoughts can both work. Everyone is different. There will probably be some methods you like and some that don’t work for you. Also, a particular tool or technique may work better in some situations than in others. Keep an open mind, experiment, and discover what helps most.

And now for “G”: Get Moving

Exercise is one of the best ways to combat stress, reduce mental health symptoms, and improve your general health. Exercise can:

• Serve as an outlet for frustration (I talked about the relationship between frustration and stress in a previous article)
• Improve cognitive functioning
• Improve quality of sleep
• Reduce depression (exercise has been shown to be as effective as antidepressants for mild to moderate depressive episodes—that’s good news for people with bipolar disorder, since many of us have adverse reactions to antidepressant medications)
• Boost immunity
• Improve cardiovascular health and lower blood pressure
• Build confidence, self-esteem, and a sense of mastery and control in your life.

While the benefits of exercise are clear, finding an appropriate program and sustaining it can be tough for those of us with bipolar disorder. Here are some tips for motivating yourself to exercise, remaining safe, and maintaining an exercise program for the long term:

• Find something you enjoy, at least somewhat. Exercise is more effective for stress reduction if you enjoy it. You’re also more likely to stick with it. Find the right kind and amount of exercise. You might not like to walk alone but love walking with a friend—or vice versa. You might really enjoy swimming—but only for 30 minutes at a time. Also, aim for variety. Doing the same thing every day is likely to lead to boredom and burnout.
• Exercise even if you don’t feel like it. It isn’t something you can wait to be inspired to do. One way to motivate yourself is to determine why you are exercising. What are your top values in life? Personal wellbeing? Service to others? Creative expression? Figure out how the benefits of exercise support your values. Then, to find motivation to exercise, remind yourself why exercise is important to you.
• Exercise with deep attention. Exercising with attention has been shown to be more beneficial than exercising mindlessly. It can also help prevent injuries. Pay attention to posture, movement, breath, and the position of your body in space. I know some people like to exercise while doing something else like reading or watching videos. But if these activities distract you from body awareness, it may be more effective to put your full attention on what you are doing.
• Aim for moderation. People with bipolar disorder may overdo exercise for a number of reasons (for example, perfectionism or the high levels of goal-directed activity that come with mania/hypomania). Overzealousness can lead to injuries, exhaustion, or worsening of mental health symptoms. Additionally, while moderate exercise increases immunity, extremely intense exercise can lower it.
• Be careful if you’re on medication. Exercise can impact the action of drugs in your body, meaning you may need to adjust your medication dosages (this is especially true for meds that require a specific blood level, such as lithium). Talk to your prescriber if you start exercising after being sedentary, increase or decrease how much you exercise, or exercise inconsistently.
• Avoid vigorous exercise too close to bedtime. It can interfere with sleep. However, mild exercise, such as a slow walk or some gentle stretching, may help you sleep better.
• Remain aware of your moods. The jury is still out on how exercise affects bipolar disorder symptoms, but it likely has different effects on different people at different times. For example, yoga can make some people feel either too agitated or too relaxed. Ultimately, it’s up to each individual to determine how exercise affects their mood—for example, by using mindfulness, keeping mood charts, or consulting with health care providers. Try out different types of exercise and notice how it impacts you. What happens when you do cardio? Yoga or stretching? Strength training? Balance training? Do they affect you differently at different times?

Tips for Sustainability

• Stay safe. People with bipolar disorder may have problems with balance and posture control and may be more prone to accidents (tripping, bumping into things, and so on). This is another good reason to maintain body awareness. Also, be mindful of urges to do impulsive things like going for a walk or run alone late at night.
• Check with your doctor. Even though exercise is generally good for the heart, check with your doctor about your individual case. People with bipolar disorder are prone to heart problems. If possible, get ongoing care from a cardiologist. And if you experience things like dizziness or faintness when you exercise, be sure to check with your doctor.
• Warm up and stretch before exercising. This is standard exercise advice, but it may be even more important for people with bipolar disorder. I’m not aware of any research on this, but I’ve noticed that people with mental health issues seem to be prone to muscle injuries like strains and sprains. This may be due to the balance and posture problems I mentioned above, medication side effects, or other factors. In any case, warming up and stretching will help you prevent injuries and sustain an exercise program for the long-term.
• Be aware of heat and sunlight. Be aware of any tendencies to become overheated. Some meds can cause heat or sun sensitivity. Try to exercise when it’s not too hot or sunny. Drink plenty of water before, during, and after exercise. And use sun protection such as sunscreen and a hat if you’re exercising outdoors. Activities such as “hot yoga” may not be a good match for people with bipolar disorder.
• Aim for integrative fitness. This is a new trend in the fitness industry, and I think it’s a great thing for many people with bipolar disorder. Integrative fitness focuses on the whole person—physical, mental, and emotional. It involves being mindful, intentional, and flexible with fitness. Rather than going to the gym and doing the same rote exercise every day, you have a “menu” of exercises to choose from depending on your current mood and circumstances. For example, let’s say you had planned to go to the gym on Tuesday for an intense sweat session. But Monday night you didn’t get much sleep. Rather than forcing yourself to go through with your plans, think through the pros and cons. What would be the best option, given how you’re feeling now: Going to the gym but working out at a lower intensity? Taking a short walking and doing a little yoga at home instead? Taking a rest day?

My personal experience: For me, exercise is a vital part of my wellbeing. It helps greatly with stress, anxiety, and depression. However, the reason I can offer these tips is that I’ve learned about its potential pitfalls the hard way. I’ve experienced injuries, accidents, dehydration, overheating, and lying awake at night after exercising too late in the evening. I’ve had to learn to pay attention and respond to what is going on in my body and in my surroundings. I’ve had to work on perfectionistic tendencies that have caused me to keep pushing through exercise when I’m in pain or not feeling well. And I’ve had to come to terms with having limitations others might not have (like not being able to exercise outdoors when it’s hot).

How to start: If you’ve been sedentary, walking can be one of the best ways to get moving. You can also check out gyms in your area, buy a fitness video, or explore an online yoga or dance program. It’s also a good idea to start a mood chart such as this one from Depression and Bipolar Support Alliance to track how exercise affects you. Keep experimenting until you find what works for you.

Additional resources: The YMCA is a great place to find a variety of exercise classes, gym equipment, and other fitness programs. They have locations all over the world and offer financial assistance based on individual circumstances.

You can find the rest of Carrie’s IBPF posts here or read additional articles on her Addiction.com blog. You can also visit the website for Counseling and More, her private practice, or Bipolar Beast, a company designed to empower people with bipolar disorder.