The role of running in the treatment of depression and anxiety disorders and addiction

Female athlete suffering overtrainingThe role of running in the treatment of depression and anxiety disorders and addiction

By Alice Morrison

Moroccan-based journalist, winner of Best Africa Blog, writer for RunUltra, author of “Dodging Elephants: 8000 Miles Across Africa by Bike” and Special Correspondent for IRUN4ULTRA.

DAVID’S STORY

Although I was never formally diagnosed (because I never sought help) four years ago I almost certainly had depression and was working very hard on giving myself a drink problem. I would certainly tick Yes on most of the questions on those ‘Spot if you have a drink problem’ medical leaflets. I was living away for work reasons and would travel by train at the weekends. One weekend I was very close to stepping off the platform in front of a high speed train. I would run a little bit with the military but not a lot. I knew I needed to dig myself out of the hole I was in but not how. On a holiday someone mentioned the Lakeland 50 race. Knowing nothing about ultra running and running maybe five miles once a fortnight I signed up. Then I started training. I read a few things on how to train for these types of events and then started training properly. On the New Years Eve I stopped drinking – partly to help me train but mainly because I knew what it was still doing to me. Nine months after starting to train I completed the Lakeland 50. Running, and ultra running in particular, has helped me get myself out of the hole I was in. The black dog still comes to visit sometimes but I’m now better equipped to deal with him.”

THE NUMBERS

Mental health issues such as depression and anxiety disorders and addictions to alcohol, drugs and nicotine affect a huge number of families worldwide. According to The National Institute of Mental Health in the U.S. (NIMH) In 2014, there were an estimated 43.6 million adults aged 18 or older in the United States with mental health Issues. This number represented 18.1% of all U.S. adults.

This number does not include the statistics for addiction. The National Institute on Alcohol Abuse and Alcoholism found that 16.3 million adults ages 18 and older (6.8 percent of this age group) had an Alcohol Use Disorder (AUD) in 2014. This includes 10.6 million men (9.2 percent of men in this age group) and 5.7 million women (4.6 percent of women in this age group).

The figures from the National Institute of Drug Abuse (NIDA) make equally somber reading: NIDA estimates that the use of illegal drugs costs the U.S. €11 billion per year in health care and $193 billion in loss to the economy.

ROLE OF RUNNING

In the face of this epidemic, can something as simple as running really help?  Well, yes, is the answer. There has been a great deal of clinical research carried out over the past couple of decades in the use of exercise for treating depression and anxiety and also addictions. The Royal College of Psychiatrists in the UK says on its website. “Why does exercise work? We are not yet exactly sure. There are several possibilities.  

  • Most people in the world have always had to keep active to get food, water and shelter. This involves a moderate level of activity and seems to make us feel good. We may be built – or “hard wired” – to enjoy a certain amount of exercise. Harder exercise (perhaps needed to fight or flight from danger) seems to be linked to feelings of stress, perhaps because it is needed for escaping from danger.     
  • Exercise seems to have an effect on certain chemicals in the brain, like dopamine and serotonin. Brain cells use these chemicals to communicate with each other, so they affect your mood and thinking.
  • Exercise can stimulate other chemicals in the brain called “brain derived neurotrophic factors”. These help new brain cells to grow and develop. Moderate exercise seems to work better than vigorous exercise.
  • Exercise seems to reduce harmful changes in the brain caused by stress. “

 

JASON’S STORY

 

“I’ve always been against using any form of drugs that I absolutely don’t need (alcohol being the notable exception in the past few years.) When I went through a tough divorce, a counselor was suggesting the use of anti-depression medication and I skipped it with the understanding that I ran to accomplish similar goals. Running continued to be a great form of stress management and social interaction and eventually I did my first impromptu marathon plus a little more while checking a course I was RD’ing the next day. This was eventually followed by a more official 50km. I’ve always known that I have an addictive personality and I realize running is now my addiction but I’m mostly OK with that. Someday, I may be forced to find another form of addiction but until then, running is my drug.

It was a very conscious decision not to add anti-depressants to my world and the counselor I was seeing asked, “why not?” I said I would rather deal with the root of the issue than treat the symptoms. In the year leading up to my divorce, I was isolated in a small apartment in Pittsburgh that was noisy and my ex-wife was hardly ever around; She basically came home to shower and sleep while working on her PhD. The social isolation did a number on me and about halfway through that year, I started cycling again because I had gained a lot of weight. At the time of my separation, I moved back to Tucson, AZ (where my job was) and started cycling a lot. I was riding up the local mountain several times a week and it wasn’t enough to deal with my grief. My body was often exhausted but I still had more to deal with mentally. It was at this point that my boss (an ultra runner) said, “Ya, know… you should run.” He told me about a group that met every Tues/Thurs for speedwork and I started going. I found myself surrounded by people who made healthy decisions and good life choices and made a very conscious decision to let myself feel peer pressure from them in order to improve my own life. So … for me running was about rebuilding the social part of my brain which had atrophied in isolation for a year, rebuilding my body and managing stress. I lost over 100lbs, gained friends and healthy habits.”

EXPERT VIEW

We asked Tanya Woolf, Consultant Counseling Psychologist, Efficacy, if this chimed with her experience of treating Depression.

“Typically with Depression, you get in to a vicious cycle. You feel low on motivation, so you don’t do anything and then low levels of activity make you feel more depressed.  One of the first treatments for depression is behavioral activation – doing something that gives you a sense of achievement and pleasure.”

“Exercise helps in two ways: on the psychological level it gives you that sense of achievement and – hopefully – pleasure, and physically it releases endorphins.”

THE OUTDOORS

For almost all of us who run, one of the great joys of it, is that you have time in nature. Research has shown that this can add to the benefits. In a study called “Acute effects of outdoor physical activity on affect and psychological well-being in depressed patients” the researchers found:

“A single outdoor exercise bout showed greater affective improvements compared to indoor and sedentary equivalents for self-reported excitement and activation. As patients felt more active, an outdoor setting might be useful in overcoming listlessness during depression treatment. “

ADDICTION

Krasse Gueorguiev is a keen ultra runner but also studied Psychology and worked in Victim Support. He used running as one of his tools to help clients.

“I used to work at Victim support in London for quite a few years and dealt with domestic violence rape etc…. and also had some private clients that would come to me with addictions from drugs to smoking and eating. So I would get them to concentrate on doing sports that can be by themselves for a period of time like a running for few hours where I would ask them to think of solving mechanisms while running. Nothing in particular just think of their daily lives and see how they see it on the go.”

Tanya Woolf, adds, One of the things that is often observed in addiction is that people pursue their goal (be it drugs, drink or anything else) at the expense of all previously valued goals. So, having a new, valued goal such as a race, can help displace the old, unhealthy one. Also in addiction, people very often get the notion that they don’t have control, that their addiction controls them. Any goal-oriented exercise, and ultra running is a fantastic example, gives the person a sense of control. Instead of your addiction controlling you, you are controlling your body.”

EVIDENCE

Research and expert opinion shows that running really does have a role to play in combating a range of mental health problems.  According to the study, “The Benefits of Exercise for the Clinically Depressed”:

Many studies have examined the efficacy of exercise to reduce symptoms of depression, and the overwhelming majority of these studies have described a positive benefit associated with exercise involvement.

Additionally, exercise compares quite favorably with standard care approaches to depression in the few studies that have evaluated their relative efficacy. For example, running has been compared with psychotherapy in the treatment of depression, with results indicating that running is just as effective as psychotherapy in alleviating symptoms of depression “

Compelling as the scientific research is, inspiration is at the human level so let us leave you with a final story from the ultra running community.

JANE’S STORY

“How (ultra) running helped me. Being a victim of a heinous crime… kidnap victim of a aggravated sexual assault by four men, running in general has played a big part in my therapy. I’m training for my first 50km in October and utra running helps me cope. It reminds me to overcome and conquer my fears. I was destroyed and I learned to rebuild my life again. I was also an addict for over almost 12 years which I don’t share openly. I quit cold turkey and never looked back. Running and living a healthy life has been my “addiction”. Not losing my sanity after the sexual assault on Christmas Eve and Christmas day is also on my priority list. It’s been a long road but running besides God and family is most important in my life.”

Many thanks to all who shared their stories with us and congratulations on your recovery and transformation

USEFUL LINKS/FURTHER READING

https://www.nimh.nih.gov/index.shtml

https://www.niaaa.nih.gov

https://www.drugabuse.gov/

http://www.samhsa.gov/data/population-data-nsduh

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC474733/

http://nymag.com/scienceofus/2016/03/how-running-and-meditation-change-the-brains-of-the-depressed.html

http://www.theglobeandmail.com/life/health-and-fitness/fitness/outrunning-depression-exploring-the-link-between-body-and-mind/article21294111/

http://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-12-50

http://link.springer.com/article/10.2165%2F00007256-200939060-00004

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3276339/

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