Health Condition

Bipolar Disorder

Healthy Lifestyle Tips

Exercise influences the production and use of neurotransmitters and hormones in the body, and its antidepressant effect is well known.61 A preliminary study of the effects of vigorous exercise on the body chemistry of patients with bipolar disorder found that exercise increased a specific chemical associated with better mood.62 However, exercise may adversely influence the effectiveness of some medications used for bipolar disorder. Many people with bipolar disorder take lithium, and because lithium is lost in sweat, exercise that involves significant sweating may change blood levels of lithium. Such a change has been reported in one person;63 therefore, people taking lithium who intend to start a vigorous exercise program should be monitored by their doctor.

References

1. Adams PB, Lawson S, Sanigorski A, Sinclair AJ. Arachidonic acid to eicosapentaenoic acid ratio in blood correlates positively with clinical symptoms of depression. Lipids 1996;31:S157-S161.

2. Maes M, Christophe A, Delanghe J, et al. Lowered omega-3 polyunsaturated fatty acids in serum phospholipids and cholesteryl esters of depressed patients. Psychiatry Res 1999;85:275-91.

3. Stoll AL, Severus WE, Freeman MP, et al. Omega 3 fatty acids in bipolar disorder. A preliminary double-blind, placebo-controlled trial. Arch Gen Psychiatr 1999;56:407-12.

4. Wozniak J, Biederman J, Mick E, et al. Omega-3 fatty acid monotherapy for pediatric bipolar disorder: a prospective open-label trial. Eur Neuropsychopharmacol 2007;17:440-7.

5. Young SN. Behavioral effects of dietary neurotransmitter precursors: basic and clinical aspects. Neurosci Biobehav Rev 1996;20:313-23 [review].

6. Riemann D, Vorderholzer U. Treatment of depression and sleep disorders. Significance of serotonin and L-tryptophan in pathophysiology and therapy. Fortschr Med 1998;116:40-2 [review].

7. Chouinard G, Jones BD, Young SN, Annable L. Potentiation of lithium by tryptophan in a patient with bipolar illness. Am J Psychiatry 1979;136:719-20.

8. Hedaya RJ. Pharmacokinetic factors in the clinical use of tryptophan. J Clin Psychopharmacol 1984;4:347-8.

9. Prange AJ, Wilson IC, Lynn CW, et al. L-tryptophan in mania: contribution to a permissive hypothesis of affective disorders. Arch Gen Psychiatry 1974;30:56-62.

10. Chambers CA, Naylor GJ. A controlled trial of L-tryptophan in mania. Br J Psychiatry 1978;132:555-9.

11. Murphy DL, Maker M, Goodwin FK, et al. L-tryptophan in affective disorders: indoleamine changes and differential clinical effects. Psychopharmacologia 1974;34:11-20.

12. van Praag HM, de Haan S. Chemoprophylaxis of depressions. An attempt to compare lithium with 5-hydroxytryptophan. Acta Psychiatr Scand Suppl 1981;290:191-201.

13. Mendlewicz J, Youdim MB. Antidepressant potentiation of 5-hydroxytryptophan by L-deprenil in affective illness. J Affect Disord 1980;2:137-46.

14. BJ, Simpson JSA, Ferre RC, et al. Effective mood stabilization with a chelated mineral supplement: an open-label trial in bipolar disorder. J Clin Psychiatry 2001;62:936-44.

15. Young SN. Behavioral effects of dietary neurotransmitter precursors: basic and clinical aspects. Neurosci Biobehav Rev 1996;20:313-23 [review].

16. Riemann D, Vorderholzer U. Treatment of depression and sleep disorders. Significance of serotonin and L-tryptophan in pathophysiology and therapy. Fortschr Med 1998;116:40-2 [review].

17. Chouinard G, Jones BD, Young SN, Annable L. Potentiation of lithium by tryptophan in a patient with bipolar illness. Am J Psychiatry 1979;136:719-20.

18. Hedaya RJ. Pharmacokinetic factors in the clinical use of tryptophan. J Clin Psychopharmacol 1984;4:347-8.

19. Prange AJ, Wilson IC, Lynn CW, et al. L-tryptophan in mania: contribution to a permissive hypothesis of affective disorders. Arch Gen Psychiatry 1974;30:56-62.

20. Chambers CA, Naylor GJ. A controlled trial of L-tryptophan in mania. Br J Psychiatry 1978;132:555-9.

21. Murphy DL, Maker M, Goodwin FK, et al. L-tryptophan in affective disorders: indoleamine changes and differential clinical effects. Psychopharmacologia 1974;34:11-20.

22. van Praag HM, de Haan S. Chemoprophylaxis of depressions. An attempt to compare lithium with 5-hydroxytryptophan. Acta Psychiatr Scand Suppl 1981;290:191-201.

23. Mendlewicz J, Youdim MB. Antidepressant potentiation of 5-hydroxytryptophan by L-deprenil in affective illness. J Affect Disord 1980;2:137-46.

24. Stoll AL, Sachs GS, Cohen MB, et al. Choline in the treatment of rapid-cycling bipolar disorder: clinical and neurochemical findings in lithium-treated patients. Biol Psychiatry 1996;40:382-8.

25. Botiglieri T. Folate, vitamin B12, and neuropsychiatric disorders. Nutr Rev 1996;54:382-90 [review].

26. Fine EJ, Soria ED. Myths about vitamin B12 deficiency. Southern Med J 1991;84:1475-81.

27. Hasanah CI, Khan UA, Musalmah M, Razali SM. Reduced red-cell folate in mania. J Affect Disord 1997;46:95-9.

28. McKeon P, Shelley R, O'Regan S, O'Broin J. Serum and red cell folate and affective morbidity in lithium prophylaxis. Acta Psychiatr Scand 1991;83:199-201.

29. Lee S, Chow CC, Shek CC, et al. Folate concentration in Chinese psychiatric outpatients on long-term lithium treatment. J Affect Disord 1992;24:265-70.

30. Stern SL, Brandt JT, Hurley RS, et al. Serum and red cell folate concentrations in outpatients receiving lithium carbonate. Int Clin Psychopharmacol 1988;3:49-52.

31. Coppen A, Abou-Saleh MT. Plasma folate and affective morbidity during long-term lithium therapy. Br J Psychiatry 1982;141:87-9.

32. Coppen A, Chaudrhy S, Swade C. Folic acid enhances lithium prophylaxis. J Affect Disord 1986;10:9-13.

33. Shimon H, Agam G, Belmaker RH, et al. Reduced frontal cortex inositol levels in postmortem brain of suicide victims and patients with bipolar disorder. Am J Psychiatry 1997;154:1148-50.

34. Fauroux CM, Freeman S. Inhibitors of inositol monophosphatase. J Enzyme Inhib 1999;14:97-108 [review].

35. Belmaker RH, Agam G, van Calker D, et al. Behavioral reversal of lithium effects by four inositol isomers correlates perfectly with biochemical effects on the PI cycle: depletion by chronic lithium of brain inositol is specific to hypothalamus, and inositol levels may be abnormal in postmortem brain from bipolar patients. Neuropsychopharmacology 1998;19:220-32 [review].

36. Belmaker RH, Bersudsky Y, Agam G, et al. How does lithium work on manic depression? Clinical and psychological correlates of the inositol theory. Annu Rev Med 1996;47:47-56 [review].

37. Levine J, Barak Y, Gonzalves M, et al. Double-blind, controlled trial of inositol treatment of depression. Am J Psychiatry 1995;152:792-4.

38. Levine J, Barak Y, Kofman O, Belmaker RH. Follow-up and relapse analysis of an inositol study of depression. Isr J Psychiatry Relat Sci 1995;32:14-21.

39. Souza FG, Mander AJ, Foggo M, et al. The effects of lithium discontinuation and the non-effect of oral inositol upon thyroid hormones and cortisol in patients with bipolar affective disorder. J Affect Disord 1991;22:165-70.

40. Grisaru N, Belmaker RH. Lithium dosage and inositol levels. Br J Psychiatry 1994;164:133-4 [letter].

41. Levine J, Witztum E, Greenberg BD, Barak Y. Inositol-induced mania? Am J Psychiatry 1996;153:839 [letter].

42. Berk M, Dean O, Cotton SM, et al. The efficacy of N-acetylcysteine as an adjunctive treatment in bipolar depression: an open label trial. J Affect Disord 2011;135:389-94.

43. Rosenbaum JF, Fava M, Faulk WE, et al. The antidepressant potential of oral S-adenosyl-l-methionine. Acta Psychiatr Scand 1990;81:432-6.

44. Friedel HA, Goa KL, Benfield P. S-Adenosyl-l-methionine: A review of its pharmacological properties and therapeutic potential in liver dysfunction and affective disorders in relation to its physiological role in cell metabolism. Drugs 1989;38:389-417 [review].

45. Carney MWP, Chary TKN, Bottiglieri T. The switch mechanism in affective illness and oral S-adenosylmethionine (SAM). Br J Psychiatry 1987;150:724-5.

46. Carney MWP, Chary TKN, Bottiglieri T, Reynolds EH. The switch mechanism and bipolar/unipolar dichotomy. Br J Psychiatry 1989;154:48-51.

47. Wehr TA, Goodwin FK. Can antidepressants cause mania and worsen the course of affective illness? Am J Psychiatry 1987;144:1403-11.

48. Botiglieri T. Folate, vitamin B12, and neuropsychiatric disorders. Nutr Rev 1996;54:382-90 [review].

49. Fine EJ, Soria ED. Myths about vitamin B12 deficiency. Southern Med J 1991;84:1475-81.

50. Hasanah CI, Khan UA, Musalmah M, Razali SM. Reduced red-cell folate in mania. J Affect Disord 1997;46:95-9.

51. McKeon P, Shelley R, O'Regan S, O'Broin J. Serum and red cell folate and affective morbidity in lithium prophylaxis. Acta Psychiatr Scand 1991;83:199-201.

52. Lee S, Chow CC, Shek CC, et al. Folate concentration in Chinese psychiatric outpatients on long-term lithium treatment. J Affect Disord 1992;24:265-70.

53. Stern SL, Brandt JT, Hurley RS, et al. Serum and red cell folate concentrations in outpatients receiving lithium carbonate. Int Clin Psychopharmacol 1988;3:49-52.

54. Coppen A, Abou-Saleh MT. Plasma folate and affective morbidity during long-term lithium therapy. Br J Psychiatry 1982;141:87-9.

55. Coppen A, Chaudrhy S, Swade C. Folic acid enhances lithium prophylaxis. J Affect Disord 1986;10:9-13.

56. Goggans FC. A case of mania secondary to vitamin B12 deficiency. Am J Psychiatry 1984;141:300-1.

57. Verbanck PM, LeBon O. Changing psychiatric symptoms in a patient with vitamin B12 deficiency. J Clin Psychiatry 1991;52:182-3 [letter].

58. Naylor GJ. Vanadium and manic depressive psychosis. Nutr Health 1984;3:79-85 [review].

59. Naylor GJ, Smith AH. Vanadium: a possible aetiological factor in manic depressive illness. Psychol Med 1981;11:249-56.

60. Kay DS, Naylor GJ, Smith AH, Greenwood C. The therapeutic effect of ascorbic acid and EDTA in manic-depressive psychosis: double-blind comparisons with standard treatments. Psychol Med 1984;14:533-9.

61. Ransford CP. A role for amines in the antidepressant effect of exercise: a review. Med Sci Sports Exerc 1982;14:1-10 [review].

62. Lykouras E, Garelis E, Varsou E, Stefanis CN. Physical activity and plasma cyclic adenosine monophosphate levels in manic-depressive patients and healthy adults. Am J Psychiatry 1979;136:540-2.

63. Norman TC, Mathews W, Yohe CD. A case study on the effects of strenuous exercise on serum lithium levels. Nebr Med J 1987;72:224-5.

Copyright © 2025 TraceGains, Inc. All rights reserved.

Learn more about TraceGains, the company.

The information presented by TraceGains is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2025.