title: Exercise treatment for bipolar disorder: potential mechanisms of action mediated through increased neurogenesis and decreased allostatic load.
abstract: Outcomes are frequently suboptimal for patients with bipolar disorder who are treated with pharmacotherapy alone. Adjunct exercise has the potential to substantially improve acute and long-term outcomes, although how exercise would improve the course of bipolar disorder needs to be elucidated. We propose that exercise may improve mood and functioning by increasing neurogenesis and reducing allostatic load. We review data suggesting that exercise increases levels of brain-derived neurotrophic factor, which in turn increases neurogenesis and decreases allostatic load. Exercise as a psychosocial adjunct for bipolar disorder should be assessed with rigorous randomized clinical trials.
authors.affiliation: Massachusetts General Hospital, Harvard Medical School, Boston, Mass., USA. lsylvia2@partners.org
authors.forename: Louisa G
authors.initials: LG
authors.lastname: Sylvia
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Ametrano
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Nierenberg
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology; D000339:Affect / Q000502:physiology; D052636:Allostasis / Q000502:physiology*; D001143:Arousal / Q000502:physiology; D001714:Bipolar Disorder / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*; D001921:Brain / Q000503:physiopathology; D019208:Brain-Derived Neurotrophic Factor / Q000378:metabolism; D003131:Combined Modality Therapy; D015444:Exercise / Q000502:physiology* / Q000523:psychology*; D006801:Humans; D055495:Neurogenesis / Q000502:physiology*
chemical_list: D019208:Brain-Derived Neurotrophic Factor