Exercise Has Always Made Me Feel Worse...
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Q:  Exercise Has Always Made Me Feel Worse...

I can not take any anti-depressants even with mood stabilizers on board.  Very sensitive to them and other meds such as steroid nasal spray. I began to exercise on a Wii Fit a month ago. I do some yoga, strength, aerobic and balance exercises. I started out with half an hour and I became very sleepy and just yawned and wanted to go to bed. I increased the time to an hour (sweat) and now I am raging. Exercise has always made me feel worse either immediately  or over a period of time. Even a 15 minute walk outdoors can worsen my mood. I don't know what people are talking about when they say how exercise has helped them.  I have been in mental chaos since exercising for the last month. I have read where levels of serotonin and dopamine and a number of other chemicals are increased during exercise. My fight or flight is at a all time high. If that is true and I can't take anti-depressants wouldn't that mean that exercise is causing me to cycle and have problems just as anti-depressants do.  If so, how do I lose this weight.

Dear Anne --
I have one other patient who has something rather like bipolar disorder, although he is not very typical.  And he had the same kind of experience with exercise: it made him worse, almost immediately. I will tell you his experience just in case it might have some value for you, although I do not intend by this to raise your hopes very much, because I have no way to know if you are really like him or not.

When he finally got really good symptom control, pretty much perfect, no symptoms at all, all of a sudden he was able to exercise.  And surprisingly, as he continued to exercise, he was able to taper down the medications. His medication was divalproex (Depakote), but that medication has some significant risks for women that it does not have for men ("polycystic ovarian syndrome"). Nevertheless, based on his experience -- which is the only time I have ever seen this "exercise makes me worse" reaction -- it seems plausible that if you found a treatment regimen that worked really well for you, this might make exercise possible.

Now that I think about it, as I recall he also had very negative reactions to antidepressants rather like you describe.  But again, I do not know if his experience means anything for you.

How do you lose weight, without significant exercise?  As you may know, it is fairly difficult to lose weight just by increasing one's exercise.  That will work in the long run, but it is not very fast.  On the other hand, most diets are not effective in the long run.  Most people, even those who lose a significant amount of weight, gain it back.  So in the long run, the only way that really works is to change one's eating habits (that is, making it a lifestyle change more than a "diet"). Good luck with the process.

Dr. Phelps 


Published April, 2010


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