Study launched to engage teens with bipolar disease in exercise

You can’t bottle it, but it might be one of the most effective medicines out there—exercise. Dr. Ben Goldstein thinks it might be especially effective for teens with bipolar disease. Now, Brain Canada and Health Canada have awarded Goldstein and his team $779,000 to see if he might be on to something.

Bipolar disease affects between 2% and 5% of teenagers. Even with treatment, these youth experience mood symptoms that negatively affect their day-to-day lives. Moreover, teens with bipolar disease are at higher risk for early heart disease.

Although there is evidence that exercise is beneficial in other areas of mental health, surprisingly little is known about its effect on teens with bipolar disorder, says Goldstein, a psychiatrist and senior scientist at Sunnybrook Research Institute in the Hurvitz Brain Sciences Research Program. “In the world’s literature, there is not a single exercise intervention study published for which improvements in cardiorespiratory fitness [in bipolar disorder] are the main outcome measure,” he says.

This is the first exercise intervention study for teens with bipolar disorder. Goldstein has assembled a multidisciplinary team that includes Dr. Brad MacIntosh, a senior scientist in Physical Sciences at SRI, other scientists and clinician-scientists, social workers and a mental health advocacy leader. Rounding out the team are people not typically seen on research grants: an adolescent with bipolar disease and a parent of a teen with the illness.

“When we surveyed teens in our clinic, we found that there was no one-size-fits-all [approach],” says Goldstein. “What appealed greatly to some didn’t appeal to others. Including a teen and a parent ensures that we are approaching this challenge collaboratively, brainstorming together with those who have first-hand experience.”

The team will enrol 40 teenagers with bipolar disease, seeking to engage them in exercise in a way that is personalized and flexible. Over 12 weeks, the teens will learn about exercise, and receive in-person and phone counselling about exercise beliefs, problem solving, motivation and progress. They can also choose to be coached by an exercise trainer, receive family-focused counselling and tap into peer support.

This initial three-year study seeks to get answers that will help the researchers design a bigger study. There are two overarching questions, says Goldstein. “First, will teens with bipolar disorder be willing to actively participate in this intervention? Second, will their aerobic fitness improve? Lessons learned from this study will help us refine and improve our intervention approach, which we would then test on a larger scale.”

The grant was one of six awarded through the Improving Health Outcomes and Quality of Life Team Grant competition, funded by the Canada Brain Research Fund, a federal partnership between Brain Canada and Health Canada.

In addition to Sunnybrook-based investigators, the team includes collaborators from the Mood Disorders Association of Ontario, Sick Kids and the University of British Columbia. Sunnybrook Foundation is also supporting the study, notably through the generosity of the Great Gulf Foundation and the Michael Albert Garron Foundation.