Results from open trials of exercise as an adjunctive intervention for bipolar disorder show that it may benefit the physical and mental health of individuals with bipolar disorder. However, to date, no controlled randomized trials have been conducted. For example, these open trials have found that more engagement in exercise was associated with less depressive symptoms, better quality of life, increased functioning as well as less psychiatric comorbidity [22, 49, 50]. Furthermore, dehydroepiandrosterone sulfate (DHEAS), a physiological biomarker, which along with cortisol is implicated in the positive effects of exercise on mood and perceptions of well-being, increased following a bout of 20 minutes of acute exercise in 26 bipolar patients [51].
