Bipolar individuals are more likely to lead a sedentary lifestyle [13–15]. They experience higher levels of pain when exercising, have lower exercise capacity, and engage in less overall physical activity because they perceive exercise to be aversive [46]. Low levels of exercise have been linked to poorer quality of life, worse functioning, and more depressive symptoms [28, 47]. Regular physical activity and higher levels of cardiorespiratory fitness in individuals with bipolar disorder are associated with lower risk for premature mortality. Additionally, exercise training has also been demonstrated to improve a number of important risk factors, such as cardiorespiratory fitness, weight, and high-density lipoprotein cholesterol level, which has been implicated as a risk factor for diabetes due to its potential association with insulin insensitivity [48]. Given that individuals with bipolar disorder tend to be physically inactive, they are at greater risk for physical as well as mental health complications. This suggests that exercise may have a dual benefit for individuals with bipolar disorder [15].
