By Nancy Maleki
Even with treatment, some patients with bipolar disorder have symptoms like extreme mood swings. But, in a recent study, some patients said yoga reduced those symptoms.
Some patients who practiced yoga, which includes exercises for both mental and physical health, said it made them feel more calm.
The study was written by Lisa Uebelacker, PhD, of Brown University in Providence, RI, and colleagues.
Bipolar disorder is a mental condition that causes mood swings, ranging from depression to mania (excessive giddiness and energy).
The authors of the study cited past evidence that yoga helped with symptoms, but there was no published data.
For the research, the authors studied people with bipolar disorder who practiced yoga.
They studied 86 people — 11 men and 75 women. The patients answered questions about their lives, their disorder and their experiences with yoga.
Of the 86 people, 70 met the criteria for bipolar disorder, and 74 said a health professional had told them they were bipolar. About 40 percent were taking medicine to control their symptoms.
They all did yoga — and had done it for about six years on average. Of the many types of yoga, the most common among the patients was hatha (17 percent practiced it). Hatha is the most popular type of yoga in the US. It focuses on breathing, physical posture and meditation.
Those in the study took yoga classes about twice a week and practiced at home about three times a week.
Most patients said yoga helped relieve their depression — a common symptom of bipolar disorder. Of the 57 patients who provided comments to the study authors, 15 said yoga was life-changing. Twenty reported increased mindfulness, such as the ability to focus. Twenty-nine patients noted emotional effects like reduced anxiety. Nineteen people said they had positive physical effects, such as weight loss or improved sleep.
But some said that yoga had negative effects on their disorder. These effects included injury, pain and feeling mania when doing fast breathing. Some said hot yoga (yoga performed in hot and humid conditions) was too hot for them. Some people on antipsychotics (used to treat bipolar disorder) have heat intolerance, the study authors noted.
Five people in the study found yoga increased their agitation, and five said yoga increased their lethargy or depression.
Eight patients said yoga had a negative impact on their bipolar disorder symptoms at least once.
Most patients, however, said that yoga helped them focus on the present moment and feel calm, the study authors noted.
Dr. Glen R. Elliott, MD, PhD, a professor in the Stanford University Department of Psychiatry and Behavioral Sciences, said he found the methodology of the study sketchy.
“The way the authors identified these individuals, there is no way to get a sense of how commonly patients use [yoga] and how many have tried to use it and found it unhelpful,” he said.
The study authors said yoga could have positive effects by reducing worry and self-criticism or by reducing inflammation.
The authors noted that the patient-reported diagnosis of bipolar disorder was not confirmed. They noted the need for further research.
"Our results suggest that hatha yoga may be a powerful positive practice for some people with bipolar disorder but that it is not without risks and, like many treatments for bipolar disorder, should be used with care," the authors wrote.
Dr. Elliott noted that “If a patient is interested in trying it to see if yoga helps with mood stabilization, I would not discourage it; but, I would strongly recommend that he or she work with a trained yoga instructor to minimize the likelihood of physical injury."
The study appeared in the Journal of Psychiatric Practice in September.
The authors declared no funding sources or conflicts of interest.