Rapid cycling to cycling rapidly – how exercise can prevent and reverse mental illness

After years of ineffective psychiatric treatment where I took over 20 mind altering drugs with little  or no positive effect, my go to drug today is my bicycle. I can honestly say it’s the best thing I’ve ever purchased, and I use it every day both for my daily commute and for fun. Once I’d begun my journey to healing my rapid cycling bipolar illness by obtaining optimal nutrition and cutting all inflammatory triggers on the Autoimmune Protocol (AIP), I looked to exercise to both help heal my body and keep my mind sharp, and sharp is exactly what my mind has become thanks to my bike!

So why does exercise help heal mental illness? Well it’s all to do with our old friend - inflammation. A substantial body of evidence supports the role of exercise to help people treat their mental illness (1). Studies frequently show that even the most severe mental illness can be improved through exercise and that exercise can contribute to improvements in symptoms, including mood, alertness, concentration, sleep patterns and psychotic symptoms (2) (3) (4). Multiple current studies show that neuroinflammation (inflammation in the cerebral spinal fluid and brain) may contribute to mental illnesses such as depression, anxiety, and mood disorders (5). When I asked researchers at Oxford about the role of the immune system in psychiatric disorders I was told that it likely accounts for 9% of mental illness where anti-neuronal antibodies are a factor (6), however the proportion of mental illness attributable to inflammatory markers without anti-neuronal antibodies could well be significantly higher, however I’ve not found any specific data on this.

So, let’s look at the science. Chronic inflammation in peripheral tissues is indicated by the increase of inflammatory markers such as cytokine Interleukin (IL)-6, TNF-alpha, and IL-1β (5). It is now well understood that pro-inflammatory cytokines in peripheral tissues can cross the blood brain barrier and reach the brain causing neuroinflammation (7) by activating the microglial cells (8). The role of the microglial cells has been associated in a whole range of mental illnesses, from depression all the way to Parkinsons and Alzheimers (9). This neuroinflammation can also promote changes in neurotransmitter metabolism, such as serotonin, dopamine, and glutamate (what people incorrectly call a neurochemical imbalance) and this can directly affect brain function and leads to mental illness (10) (11).

How does exercise reverse this? When muscles contract each muscle produces IL-6, IL-1ra, and IL-10 (12) and a higher volume of regular physical activity was associated with decreased IL-6 levels and increased IL-10 (13). IL-10 and IL-1ra are anti-inflammatory and effectively reverse the inflammatory pathways by inhibiting the production of the inflammatory cytokines such as TNF-alpha (14) and this decrease of pro-inflammatory cytokines prevents the activation of microglia in the brain that are associated with mental illness. In other words, exercise stops inflammation which stops the activation of the microglia thus preventing the onset of illness! Add to that the reduction in weight, increased energy levels, improved sleep, a sense of well-being and even a better social life and exercise is a powerful mechanism to improve mental health and overall wellbeing.

Sadly, exercise is seldom recognized by mainstream mental health services as an effective intervention in the care and treatment of mental health problems (15), however anyone with a mental illness would do well to look to exercise as an central element in reversing their illness.

My process for healing myself started with a very healthy diet with optimal nutrition to switch off the inflammation that was making me ill, and as soon as I felt well enough exercise followed. For more details as to how I healed myself take a look at my Brain Health Protocol.

1. Exercise for mental illness: A systematic review of inpatient studies. Robert Stanton & Brenda Happell. International Journal of Mental Health Nursing. 30 September 2013. https://onlinelibrary.wiley.com/doi/full/10.1111/inm.12045
2. The Impact of Exercise on the Mental Health and Quality of Life of People with Severe Mental Illness: A Critical Review. Kristy Alexandratos, Fiona Barnett, and Yvonne Thomas. British Journal of Occupational Therapy Vol 75, Issue 2, pp. 48 – 60. First Published February 1, 2012 http://journals.sagepub.com/doi/abs/10.4276/030802212X13286281650956
3. The influence of physical activity on mental well-being. The influence of physical activity on mental well-being. Kenneth R Fox. The Nutrition Society. Cambridge University Press. Volume 2, Issue 3a. March 1999 , pp. 411-418. https://www.cambridge.org/core/journals/public-health-nutrition/article/influence-of-physical-activity-on-mental-wellbeing/3C363AEECE5C8CAC490A585BA29E6BF8 
4. Effects of exercise on mental and physical health parameters of persons with schizophrenia. Lora Humphrey Beebe, Lili Tian, Nancy Morris, Ann Goodwin, Staccie Swant Allen & John Kuldau 2009, Issues in Mental Health Nursing, 26:6, 661-676. https://www.tandfonline.com/doi/abs/10.1080/01612840590959551
5. Exercise Prevents Mental Illness, K I Purnomo and M Doewes and M K W Giri and K H Setiawan and I P A Wibowo. 2017. IOP Conference Series: Materials Science and Engineering. http://iopscience.iop.org/article/10.1088/1757-899X/180/1/012167/meta
6. https://www.glutenmad.com/2017/08/lets-talk-brains.html 
7. Yarlagadda A, Alfson E, Clayton AH. The Blood Brain Barrier and the Role of Cytokines in Neuropsychiatry. Psychiatry (Edgmont). 2009;6(11):18-22. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2801483/
8. Microglial Activation and its Implications in the Brain Diseases. S. Thameem Dheen, Charanjit Kaur, Eng-Ang Ling. Current Medicinal Chemistry Volume 14 , Issue 11 , 2007 https://www.ncbi.nlm.nih.gov/pubmed/17504139 
9. Neuroinflammation in the pathogenesis of Alzheimer’s disease. A rational framework for the search of novel therapeutic approaches. Inelia Morales, Leonardo Guzmán-Martínez, Cristóbal Cerda-Troncoso, Gonzalo A. Farías and Ricardo B. Maccioni. Front. Cell. Neurosci., 22 April 2014. https://www.frontiersin.org/articles/10.3389/fncel.2014.00112/full
10. Neurotransmitters and microglial-mediated neuroinflammation. Moonhee Lee. Current Protein & Peptide Science. Volume 14 , Issue 1 , 2013. https://www.ncbi.nlm.nih.gov/pubmed/23441898
11. Miller, Andrew H. et al. “Cytokine Targets in the Brain: Impact on Neurotransmitters and Neurocircuits.” Depression and anxiety 30.4 (2013): 297–306. PMC. Web. 17 June 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4141874/
12. IL-6 enhances plasma IL-1ra, IL-10, and cortisol in humans. Adam Steensberg, Christian P. Fischer, Charlotte Keller, Kirsten Møller, and Bente Klarlund Pedersen. The Copenhagen Muscle Research Centre and 2 The Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark Submitted 19 February 2003; accepted in final form 20 April 2003. https://www.ncbi.nlm.nih.gov/pubmed/12857678
13. Influence of physical activity on serum IL-6 and IL-10 levels in healthy older men. Jankord R , Jemiolo B .  Medicine and Science in Sports and Exercise 01 Jun 2004, 36(6):960-964. http://europepmc.org/abstract/med/15179165
14. Petersen, Anne and Bente Klarlund Pedersen. “The anti-inflammatory effect of exercise.” Journal of applied physiology 98 4 (2005): 1154-62. https://www.semanticscholar.org/paper/The-anti-inflammatory-effect-of-exercise.-Petersen-Pedersen/13c88cb9323c66f0255643d087873fc1248ae631
15. CALLAGHAN, P. (2004), Exercise: a neglected intervention in mental health care?. Journal of Psychiatric and Mental Health Nursing, 11: 476-483. https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2850.2004.00751.x