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From the article: An longitudinal study of people who participated in Vasloppet, the world’s largest long-distance ski-race, held in Sweden showed that those participating in the race have lower incidence of bipolar disorder compared to the general population.

However, when performance in the race was considered, high performance women had higher risk of bipolar disorder than slower skiing women. This association was not found in men. The study was published in the International Journal of Bipolar Disorders.

Bipolar disorder is a complicated diagnosis. Its key feature are mood swings ranging from severely depressed to overactive manic episodes. Around 2-4% of the population are estimated to suffer from it.

The disorder typically begins with one or several depressive episodes, but these are later followed with at least one episode of mania or hypomania. Mania is a condition in which a person displays an over-the-top level of activity or energy, mood or behavior. It is characterized by feelings of invincibility, lack of sleep, racing thoughts and ideas, rapid talking and having false beliefs or perceptions.

Recent studies have linked bipolar disorder to around 10-year shorter life expectancy, for both men and women. This has been attributed to poor cardiovascular health and an increased risk of suicide of persons suffering from bipolar depression. Because bipolar disorder affects how energetic a person feels, many researchers have wondered whether exercise could have some bearing on the likelihood of developing bipolar disorder.

A large study in Sweden found people with the lowest fitness levels to have a higher risk of bipolar disorder. But are there any associations with an active lifestyle in general?

“Previous studies suggested that the preventive potential of physical activity for mental health could be substantial,” said study author Martina Svensson, an assistant researcher at Tomas Deierborg’s Experimental Neuroinflammation Laboratory at Lund University. “We were both interested in investigating this at a larger level.”

Exercise is also the best treatment for depression (as effective as SSRIs, though not necessarily for the same groups of people that SSRIs are effective for, and the effects last longer after stopping, than when you quit SSRIs).

But of course, the problem is for depressed people, it's hard to get motivated to exercise. I imagine the same problem happens for bipolar people in the low times.

Lifelong bi-polar II here, anecdotally reporting that my highly active lifestyle was a learned coping mechanism for moderating my hypomania. So while competitive skiers may have a lower incidence of bi-polar, I'd like to see a study of active lifestyle traits of bi-polar vs normal people, there may be more like me who learned that exercise mediates hypo periods.

As another person with such, this isn’t an actual solution, at least one where most people are able to do/take. Don’t try to tell otherwise

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My hypomania makes me exercise... to the point I will injure myself.

Different approaches work differently for different people, I had no medication options in the 60's and 70's outside of Ritalin, learning to cope in any way I could was paramount to my survival.

What I learned from playing sports was the discipline to expend energy without injuring myself, I wasn't always successful and did overdo it sometimes, but it beat the alternative of just sitting there racing and holding on for dear life inside my head.

Outside of diseases like eating disorders, Bipolar disorders are one of the most dangerous mental illnesses for the individual that has it. Based on this study I think I'm only further entrenching my view that school is failing our children by making them sit down so much.

exercise was very good for manic depression, 'for my own good' the shrinks put me on drugs that made me sick every day and gave me muscle aches so i didn't keep it up.

My family member has bipolar so I am very interested in this. My prior understanding is that is is most likely to first appear in late teens, early twenties. This doesn’t appear to have been factored into the reasoning behind this article I am not a scientist so I may be missing something. If someone could shed light on this I would appreciate it. Side note about our experience to help others. Symptoms showed up at 18 but wasn’t diagnosed until 35. Went through many meds but now on cocktail of 3 that have worked for years. Now in their 60s. 2 manic episodes since diagnosis. Cause for one is a mystery. Cause for another was donation of platelets. They knew they were going manic so got to their psychiatrist who gave meds to stop it. It took awhile. None of any of these meds work immediately- they take days or weeks. They were told to take a long walk everyday because the rhythm somehow helps regulate the brain so they have been doing that for 30 years to good effect. Have never been hospitalized. They have held responsible positions in both work and community for decades. They don’t hide their diagnosis but it rarely comes up. When it does people are shocked since this person is so stable and reliable. They have had a good life so a diagnosis is not all gloom and doom. Just wanted to give you some insight from someone who has lived with it.

During my first manic episode, I spent night and day working out with kettle bells in my apartment. I'd switched back to depression by the time I returned to the doc a month later and only realized something had happened when the nurse pointed out I'd lost 30lb.

That being said, I've found that regular exercise (along side my medication and quality sleep) is absolutely vital for preventing mood episodes.

As a bipolar dude, I've found that when it's hard or impossible to do my regular, intense exercise, it's key to just do whatever I can do at all, even if it's absolutely minimal.

Too depressed to lift heavy weights? Try to lift light weights. Too depressed to lift at all? Try to go for a walk. Too depressed to go for a walk? Try to get up and shower.

It may not be much, but doing whatever I can and being proud of myself for doing it helps a ton.

I've got two 20 pound kettlebells next to my desk at all times. Sometimes I just need to get that energy out.

Study notes:

Women only. And not women that did well in the cross country skiing race.

Dats a lot of caveats.

That being said, exercise is good for the brain.

But diet plays a big role. Feel free to buy the Book Brain Power by Chris Palmer. Or watch his YouTube videos

That’s not really true. There are many depressed people who do what they’re supposed to do like exercise, eating right, meditating, etc. but they still are depressed. Or, if your depression is caused by chronic anxiety, OCD, ptsd, etc. SSRIs will help significantly more than exercise ever will. And then obviously you have people who are severely depressed to the point where they can’t get out of bed, let alone exercise.

Getting into the routine of things also helps create structure for navigating the downs of it more easily, I've found.

Bipolar as well and this was my first thought. I am not always active, but I was in my teenage years because I couldn't deal with my bipolar and BPD mother and NPD father. Getting out and doing stuff was the only way to stay safe and keep myself from doing something destructive.

I watch a lot of videos on mountain climbing, scuba diving, etc, and I have said time and time again that so much of that, "call of the wild," is mania. Lots of broken relationships and a drive to do something they know could kill them because it's the only time they feel real peace. That isn't something I would expect of mentally healthy people. It doesn't seem healthy when people throw their life savings and families away to do some of these things. Not that they can't ever be healthy, they absolutely can. Just that none of what I have learned makes me think this study was looking in the right places.

I have small weights and an exercise ball because I have a two connective tissue disorders, but a need to do something to get out the mania.

Just because something is a good or effective treatment, doesn't mean it works for everyone or even most people. I said it's as effective as SSRIs and I'll stand by that.

There's this study and then there's this meta-study that both conclude it's an effective treatment for depression. - "In summary, exercise appears to be an effective treatment for depression, improving depressive symptoms to a comparable extent as pharmacotherapy and psychotherapy. Observational studies suggest that active people are less likely to be depressed, and interventional studies suggest that exercise is beneficial in reducing depression."

But by all means, cite evidence that this is wrong.

Again. SSRIs are reserved for people who do such things and are still depressed or who’re severely depressed to the point where they can’t get outta bed.

And SSRI success rates are mixed for depression due to a variety of different reasons. For anxiety disorders, OCD, ptsd, etc. all of the meta analyses have shown significant improvement with SSRIs compared to placebo. For individuals who’s depression is caused due to any of those disorders, they will see significant improvement in their depression. For those who’s depression is independent from those things, SSRIs work but there are better options like more dopaminergic focused medications.

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May you cite the study indicating that exercise is non-inferior to medications? I have heard of CBT being non-inferior, but not of exercise, so I’m a bit doubtful of the claim although would love to learn more.

Is this cause or effect? I would imagine having any mental disorder e.g. depression would make one less likely to exercise.

So ski, just don’t do it too well.