Dear Shirley:
How can exercise and/or outdoor recreation be used in treatment of severe bipolar in young adults? What type is recommended and how can it be integrated with ongoing talk therapy and psychotropic drug therapy?
CJ
Dear CJ:
Not everyone is familiar with Bipolar, however, most of us have heard of Manic Depression. There are no differences, just the name. In Bipolar Disorder periods of high moods are called manic episodes, and times of low moods are called depressive episodes. These are usually separated by “normal” moods, but in some individual's depression and mania may alternate rapidly. Without treatment, most individuals will have episodes more often. Treatment including medication and therapy is essential to manage one's life effectively.
Late adolescence and early adulthood are peak years for the onset of bipolar disorder. These are critical periods in a young adult's social and emotional development. There is a suggested genetic component, a chromosomal link that passes from offspring to offspring. More likely than individual genes are the influences of environmental factors (life events and interpersonal relationships) affecting the onset of Bipolar Disorder.
Regular daily activities provide stability. This would be developing basic routines such as going to sleep and waking up at the same time each day; being active by walking, swimming, or dancing and eating a healthy nutritious diet. It is important to “know your body.” Journaling will help the bipolar to know their individual cycles. If in a depressed mood they can be prepared with particular ways of coping (i.e. “allow oneself to lie on the couch”). When in a manic episode they might outline coping strategies to productively focus the energy (i.e. “intense activity be it creative or physically challenging”). Granted, life doesn't always go the way we plan it, but foresight and preparation does give us something to fall back on and provides us support when we need it
CJ, you can be supportive and encourage exercise and outdoor recreation as a healthy opportunity the bipolar would benefit from. Any activity that involves “movement” is the answer. More specifically individual sports like cycling and skiing that can transpire alone or with one or two other people. The key is for the activity to reduce stimulus stress rather than increase it. For this reason, individualized sport or outdoor activities are more conducive as well as easier to fit into one's lifestyle. I would also recommend yoga or a pilates class.
Medication for the bipolar is necessary, individually specific and beyond the scope of this column. Consistent monitoring by a medical professional is crucial to minimize symptom flair ups and prevent radical relapses.
There are plenty of people with bipolar disorder who work and live normal lives. Many productive contributors to the arts, entertainment, and political world have successfully lived with Bipolar. These include the likes of Jim Carey, Winston Churchill, and Ted Turner.
“Ask Shirley” questions can be focused on any topics involving sports, competition, health, fitness, personal issues, addictions, or clinical questions.Please, email your questions to Askshirl@gmail.com. All inquiries will remain anonymous.
Shirley K. Durtschi, Ph.D is an Applied Consultant in Sport Psychology (CC-AASP), a Licensed Professional Counselor (LPC), and National Addictions Specialist (NCACII)
