Grant Proposal- Peer Review

Bipolar Disorder and the Effects of Yoga

06

University

Professor

May 14, 2018

Bipolar Disorder and the Effects of Yoga

Specific Aims

Bipolar disorder is a brain disorder that affects how a person feels. It causes shifts between depression and mania. This disorder can be very difficult to live with. Bipolar Disorder is a mood disorder that negatively affects people’s lives. It causes strains on relationships, employment, school, and everyday tasks. The idea that proper exercise and meditating that one can get through yoga, can set the path for better recovery and treatment needs further research. There are still aspects of bipolar disorder we do not understand. The increase in information regarding this disorder will increase the likelihood of a better recovery. While bipolar disorder is not curable, it is treatable. Du et al. (2017) looks at how anxiety disorders can affect the diagnosis of bipolar disorder. Yoga has been known to help with anxiety disorders. Those with a diagnosis need to be treated with the proper care team, as well as a support system within their personal lives (Veseth, Binder, & Stige, 2017). The proper care can be a life and death difference to many people who are involved in this mood disorder. Yoga can help be a lifeline that assists keeping people on track to healthier mind.

The specific aim of this proposal is to look at how yoga can help to manage the symptoms of the disorder. Through research and studies, the link between the calming aspects of yoga and decreasing the swings between mania and depression will be found. Finding ways to increase exercise, such as bipolar disorder along with the increase of healthy hormones can help to stabilize the symptoms of bipolar disorder.

Background

Bipolar disorder affects over five million people each year. This disorder can negatively affect those millions who have the symptoms of this brain disorder. Symptoms can include aspects of depression. Depression symptoms can include feeling tired, hopeless, sad, thoughts of suicide or self-harm, rage, outbursts both physical and verbal and lose interest in things that once interested them. Signs of mania include, feeling unstoppable, too much energy, feeling the need to go shopping, racing thoughts, inflated ego, and unrealistic thoughts or expectations. Many people who have bipolar disorder are medicated but still have episodes or outbursts. Many of those who experience these outbursts are looking for ways to help decrease or eliminate the symptoms they still may be experiencing. “Mindfulness aspects of yoga may reduce negative ruminations in depression leading to reduced feelings of distress” according to Kinser Et. Al. Yoga also teaches breathing techniques, and relaxation techniques that can be beneficial to those experiencing either mania or depression. There have been studies that look at how exercise helps to decrease the symptoms of depression in those who exercise thirty minutes at a time at least three days a week (Cooney et al. 2013). The symptoms of depression were reported to decrease. The decrease of symptoms were found to be directly related to the increase of exercise in the patients. Many physicians are starting to refer patients with depression to start an exercise routine to work with medication and therapy (Stanton, 2015).

A literature review of this article shows the importance of including exercise in the treatment of those with a mental disorder. The article shows the correlation between treatments of mental disorders with exercise. It explores the results of the using exercise built into a treatment plan. The study proves the theory that exercise with proper medication can be a great way to help treat mental disorders, with higher levels of coping with symptoms. Strengths of the study are that there is plenty of information that supports the thesis. Exercise can be used to improve the neurobiological impairments and behavioral symptoms associated with mood disorders such as bipolar disorder (Philips, 2017). Pemberton and Tyszkiewicz, 2016, discuss how exercise can help with connecting brain synapses that can decrease symptoms of mood disorders and bipolar disorders. The connecting of the brain synapses causes the miscommunication in the brain to stop. It allows the brain to function normally and not create imbalances that cause mood swings. Kucyi, Alsuwaidan, Liauw, and McIntyre, 2010, look at those who have high functioning bipolar disorder also have an exercise routine that they follow to increase their manageability of symptoms. Ng, Dodd, and Berk in 2007, also looked at how exercise helped to make symptoms of bipolar disorder more manageable. It decreased the severity and length of the symptoms in those who had exercise routines that were followed.

Significance

The proposed research will use a setting were those with bipolar disorder are being monitored. They will be in charge of monitoring their symptoms related to their disorder. The group of subjects will be involved in yoga classes. The subjects will see counselors in a group and individual setting during their month long observation. The subjects will participate in yoga classes and will be taught breathing techniques, relaxation techniques and will participate in three hour long sessions a week. They will see a decrease in symptoms related to mania and depression. They will also have more coping mechanisms to help to decrease the side effects of the disorder overall.

Decreasing the symptoms of the disorder and giving better coping mechanism will create a better world for those with bipolar disorder. They will see an increase in positive mechanisms in dealing with their mood differences. They will also be able to see a decrease in the frequency and severity of mood changes. Being able to achieve relaxation, as well as increase the endorphins released from the exercising will help to stabilize the severity of the mood swings experienced. Having breathing techniques to help calm the body can help to decrease the amount of verbal and physical outbursts experienced by the individuals who partake in the yoga. This will be shown in their questionnaires.

Proposed Study

Twenty individuals who have been diagnosed with bipolar disorder and who are in long term care in a rehabilitation home will participate in this study. They must only have a bipolar diagnosis. The individuals will fill out forms rating their symptoms of mania and depression on a scale from 1-5. One being not bad to five being the worst. They will also be asked to give a number of verbal and physical outbursts they have had in the last month. They will also have group and individual therapy to discuss how they are feeling and monitor symptoms of Bipolar disorder. The subjects will participate in three, hour long sessions of yoga a week. After each week, the participants will fill out another questionnaire.

Some risks to consider is the overall health of the individuals participating. Their health will be monitored through the nurse on site through the rehabilitation facility. They will undergo a health exam prior to starting yoga. Only those that pose no risk of injury or health complications will be allowed to participate in the yoga. The facility’s nurse will be available during the workout sessions.

Budget Justification

Funding is requested for the lead investigator at 50% to conduct subject recruitment, data collection, conducting data analysis and publication of the results. 150 dollars per participant (20 participants) is also requested. Travel expenses to and from facility are requested. Payment for the yoga instructor is also requested.

Appendix A: Budget

SUMMARY PROPOSAL BUDGET	FOR INSTITUTION USE ONLY
ORGANIZATION	PROPOSAL NO.	DURATION (MONTHS)
PRINCIPAL INVESTIGATOR (PI)/PROJECT DIRECTOR Hannah Sherwood	AWARD NO.
A. PERSONNEL: PI/PD, Co-PIs, Faculty, Graduate Assistants, etc.	Funds
List each separately with name and title.	Requested By
	Proposer
1., ($70,000/year) - 50% effort for 1 month	$2917
TOTAL SALARIES		2917
B. EQUIPMENT (LIST ITEM AND DOLLAR AMOUNT FOR EACH ITEM EXCEEDING $5,000.)
None
TOTAL EQUIPMENT	$0
C. TRAVEL	1. DOMESTIC - PI attendance at national meeting	$900
TOTALTRAVEL		$900
D. PARTICIPANT SUPPORT	$3,000
1. STIPENDS	$	150
2. TRAVEL
3. SUBSISTENCE
4. OTHER
TOTAL NUMBER OF PARTICIPANTS (20) TOTAL PARTICIPANT COSTS	$3,000
E. OTHER DIRECT COSTS
1. MATERIALS AND SUPPLIES-, data collection and analysis	$200
2. Yoga Instructor	$900
3 OTHER Office supplies	$530
4. OTHER
TOTAL OTHER DIRECT COSTS	$1630
F. TOTAL DIRECT COSTS (A THROUGH E)	$8447
G. TOTAL INDIRECT COSTS (F&A) (Rate = 37.5%)	$225
H. TOTAL DIRECT AND INDIRECT COSTS (F + G)	$8672

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Cooney GM, Dwan K, Greig CA, Lawlor DA, Rimer J ,Waugh FR, McMurdo M, Mead GE (2013) Exercise for depression. Cochrane Database of Systematic Reviews 9,

Du, N., Zhou, Y., Zhang, X., Gou, J., & Sun, X. (2017, October 24). Do some anxiety disorders belong to the prodrome of bipolar disorder? A clinical study combining retrospective and prospective methods to analyze the relationship between anxiety disorder and bipolar. BMC Psychiatry, 17(351), 1-16

Gliddon, E., Barnes, S. J., Murray, G., & Michalak, E. E. (2017, September). . Online and mobile technologies for self-management in bipolar disorder: A systematic rev BIPOLAR DISORDER

Jones, S. H., & Burrell-Hodgson, G. (2008, November 1). Cognitive-behavioural treatment of first diagnosis bipolar disorder. Clinical Psychology and Psychotherapy, 15, 367-377.

. Kinser P.A, Bourguignon C, Whaley D, Hauenstein E, Taylor AG. Feasibility, acceptability, and effects of gentle Hatha yoga for women with major depression: findings from a randomized controlled mixedmethods study. Arch Psychiatr Nurs. 2013; 27: 137–147

Mneimne, M., Fleeson, W., Furr, R. M., & Arnold, E. M. (2018, March 1). Differentiating the everyday emotion dynamics of borderline personality disorder from major depressive disorder and bipolar disorder. Personality Disorders: Theory, Research, and Treatment, 9(2), 192-196.

Ng, F. Dodd, S. and Berk, M. “The effects of physical activity in the acute treatment of bipolar disorder: a pilot study,”Journal of Affective Disorders, vol. 101, no. 1–3, pp. 259–262, 2007

Parens, E., & Johnston, J. (2010, March). Controversies concerning the diagnosis and treatment of bipolar disorder in children. Child and Adolescent Psychiatry and Mental Health, 4(9), 1-14

R. Pemberton and M. D. Fuller Tyszkiewicz, “Factors contributing to depressive mood states in everyday life: a systematic review,” Journal of Affective Disorders, vol. 200, pp. 103–110, 2016.

Philips, C. (2017, January 1). Physical activity modulates common neuroplasticity substrates in major depressive and bipolar disorder. Neural Plasticity, 2017, 1-37.

Rask, O., Suneson2, K., Holmström, E., Backstrom, B., & Johansson, B. A. (2017, December 12). Electroconvulsive therapy for manic state with mixed and psychotic features in a teenager with bipolar disorder and comorbid episodic obsessive–compulsive disorder: a case report. Journal of Medical Case Reports, 11(345), 1-6

Schaffer, C. B., Schaffer, L. C., & Howe, J. (2017, November). Treatment resistant bipolar disorder. Psychiatric Times, 34(11), 33-35. Veseth, M., Binder, P., & Stige, S. H. (2017, September 20). “If there’s no stability around them”: experienced therapists’ view on the role of patients’ social world in recovery in bipolar disorder. International Journal of Mental Health Systems, 11(55), 1-8. ist easier and more worthwhile. This article is from the view of the therapists.

Stanton, R., Rosenbaum, S., Kalucy, M., Reaburn, P., & Happell, B. (2015, June 1). A call to action: exercise as treatment for patients with mental illness. Australian Journal of Primary Health, 21, 120-125.

Youngstrom, E. A., Egerton, G. A., Genzlinger, J., Freeman, L., Meter,A.V & Rizvi, S. R. (2018, March 1). Improving the global identification of bipolar spectrum disorders: Metaanalysis of the diagnostic accuracy of checklists. Psychological Bulletin, 144(3), 315- 342