Mood Disorders: Bipolar Disorder, Clinical Depression

Why Physical Activity is Important to People with Mood Disorders

Physical activity can have a positive effect on person’s mood. With exercise, your body releases endorphins which can make you feel better.  Consequently, exercise is often recommended for people with depression and other mood disorders.

Physical Activity Tips and Modifications for People with Mood Disorders

  • Involve the person in physical activity goal setting - make sure goals are realistic. It may be helpful to provide some options for goals that they can choose from.
  • Educate about the importance of physical activity to the individual and their family.
  • Know the individual's strengths and limitations - remember that these may vary from day to day.
  • Be patient.
  • Provide positive encouragement and support at all times.
  • Listen to the person and encourage them to communicate their needs to you - they are the experts at what they need, not you!

Teaching and Communication Techniques for Physical Activity Leaders

The following are ideas for ensuring maximum participation for people with mood disorders, depending on their abilities. You can use these strategies in combination:

  • Memory - write instructions down clearly and fully.
  • Limited concentration - minimize distractions during the activity, and try to keep things consistent. Be willing to change things up more frequently to maximize attention. Provide frequent breaks and opportunity for rest.
  • Physical limitations and fatigue - modify aspects of the activity to match with the person's physical abilities to promote success (i.e. lighter equipment, change size of activity area).
  • Emotional - encourage success and mastery during physical activity in order to boost self-esteem, no matter what level (low or high) they may reach. It is important that they do not feel they have failed in any way.
  • Social behaviour - use smaller groups, modeling a supportive approach and patience. Provide a structured environment, with frequent milestones as determined by the individual.

Modifying Leisure, Sport and Recreation Activities

Mood disorders can be unpredictable and change frequently, so make sure you are always aware of the person's present strengths and limitations - concentrate on their abilities in order to promote success and confidence. Keep it simple - especially for people who have challenges with memory and concentration. For example, decrease the number of steps in an activity and limit distractions. Be aware of an individual’s limitations and shorten workouts if the participant is unable to recognize they are working too hard for their usual limitations.

More About Mood Disorders

This tip sheet is designed to provide some general information about mood disorders such as bipolar disorder and clinical depression. Concepts outlined in this tip sheet should not be used as strict definitions or rules applicable to all those effected, but merely as guidelines. Every person is different. Remember, participants themselves are your number one resource when trying to ensure the inclusiveness of your physical activity programs.

In the mental health field, we practice the recovery model. According to 'Toward Recovery and Mental Health: A Framework for a Mental Health Strategy for Canada', "Recovery is understood as a process in which people living with a mental illness are empowered and supported to be actively engaged in their own journey of wellbeing." The recovery process builds on individual, family, cultural and community strengths and enables people to enjoy a meaningful life in their community while striving to achieve their full potential. Recovery doesn’t mean “cure” although cure is possible for some people.

What are Mood Disorders?

Mood disorders are a group of mental conditions that affect how we feel and think about ourselves, other people and life in general. There are a few different types of mood disorders: depression, persistent depressive disorder and bipolar disorder. Depression leaves you feeling sad or depressed.

Impact of Mood Disorders

Mood disorders may affect individuals of all ages. Depression is much more complex than simply calling it severe sadness. It can be very overwhelming and unlike normal sadness. It can be sadness for no apparent reason. An individual may clearly understand that their sadness is unrealistic but is powerless against it. Some people respond well to the treatments and medications available and may appear to be functioning quite normally on many days but may show signs and symptoms on other days. In some cases, the side-effects of the medications used to manage symptoms can cause unique problems.

A person with a mood disorder may present with a combination of issues. People may have low self esteem and an inability to bounce back from disappointments. They may have difficulty maintaining a regular schedule and lack consistency. During times of abnormally high moods, they may overestimate their abilities and overdo it. During lows, they may lack motivation and experience fatigue with little exertion.

People with mood disorders may be irritable or sad for no apparent reason. They are usually very aware that their feelings are inappropriate for the situation but have no control over the feelings. Often, they are told to “Snap out of it”, even though they have absolutely no ability to do so. Their emotions may be very close to the surface and they may burst into tears suddenly with little understanding of why they are crying. Pushing them to work harder is of little help and will simply drive them away for good. You must be understanding and supportive of them. Celebrate the small victories.

People with mental health conditions such as schizophrenia and bipolar disorder have an increased prevalence of metabolic syndrome and its components, risk factors for cardiovascular disease and type 2 diabetes. Metabolic syndrome may result in uncontrolled weight gain regardless of healthy eating and lifestyle habits. Other side effects can be slurring of speech, uncontrolled movements such as twitches, and a peculiar foot-dragging shuffle. There are a whole range of other treatments such as counseling and lifestyle changes and stress management tools.

Some individuals may appear well but are secretly coping and wish not to share their personal health status. You must respect their right to privacy should they choose not to disclose their condition or give current status. The causes of mood disorders may vary greatly from one individual to another but the key feature is moods that do not match what one would expect in a given circumstance. Moods can change quickly and the illness may be episodic in nature. With depression, people may be very sad or may have a flat affect and show little or no emotion. They may have little sense of humor and an inability to focus. They may be easily frustrated or quick-tempered. With bipolar disorder, people may experience drastic mood swings with extremely high periods and extremely low periods. During low times, they may be severely depressed. At other times, they may be visibly agitated or appear as if “high”. During these times they may be very animated and impulsive.

People's ability to cope with the daily stressors of life may be greatly affected by mood disorders and they may experience challenges in the following areas:

  • Cognitive (problems with memory, concentration, organization, and comprehension);
  • Behavioural (depression, irritability, inability to sit still);
  • Lack of motivation, i.e. an inability to even get out of bed in the morning;
  • Lack of impulse control and poor decision-making;
  • Some individuals may also experience psychosis or delusions as a result of a mood disorder (See Tip Sheet on Psychosis and Dissociative Disorders).

Useful Information About Mood Disorders

  • In 2013, an estimated 3 million Canadians (11.6%) aged 18 years or older reported that they had a mood and/or anxiety disorder.
  • More than a quarter (27%) reported that their disorder(s) affected their life "quite a bit" or "extremely" in the previous 12 months. Basic activities and the ability to work are challenging for many.

Resources

National Network for Mental Health - www.nnmh.ca
Mood Disorders Society of Canada - www.mdsc.ca
Canadian Mental Health Association - www.cmha.ca
Toward Recovery and Mental Health: A Framework for a Mental Health Strategy for Canada - www.mentalhealthcommission.ca/sites/default/files/FNIM_Toward_Recovery_and_Well_Being_ENG_0_1.pdf

Helping Canadians with Disability/Chronic Disease Get Physically Active

For Canadians with a disability, regular physical activity may be even more important than it is for the rest of the population. For a person with a disability, an active lifestyle can open doors to increased health, social inclusion and self-empowerment - doors which might otherwise remain closed. Access to physical activity can eliminate the likelihood of acquiring secondary health conditions like diabetes, high blood pressure or heart disease. Being active builds resiliency and can provide an all-important outlet for a person with a disability.

 

This project would not have been possible without the expertise of our partners. ALACD would like to sincerely thank these organizations for working with us to develop this resource: the Ontario Blind Sports Association, Variety Village, the National Network for Mental Health, and the Learning Disabilities Association of Canada.