61A - Fit and Well Column for Feb 29th, 2004

TITLE: " Exercise: Habit or Addiction?”

Dear David and Trish,

I have been exercising regularly for years now. I have made progress, and feel good about my commitment. However, some of my friends are skeptical, and have even accused me of being “addicted” to exercise. This really disturbs me, and has me wondering. What would you say indicates an “addiction” to exercise”, versus just a positive habit. Can you assist?

Confused in Crofton

Dear Confused,

Our “layman’s” definition of addiction: “A behavior that results in negative consequences, and still cannot be stopped”. This, of course, is quite simplistic, but will serve as a handy benchmark for this us.

There are three elements or benefits of exercise that I believe are significant in the continued enjoyment of the activity. Unfortunately, these same elements often are the motivation or basis that goes towards developing a self-destructive addiction to the same activity. There IS a fine line between a life-supporting healthy habit, and a life-threatening compulsion.

Sounds like a great thing… to feel better, and LOOK better! And it is. But, many of us are burdened with what is called “distorted body image” and unrealistic expectations (often stemming from media representation).

As most of you know, I was overweight for many years. I lost one hundred pounds about twenty years ago (and, fortunately, have kept it off). I was delighted, and have been known to periodically throw kisses at myself at the gym! But, at the same time, I often look at myself and STILL see that obese person that I left behind! It sounds unreasonable, if not absolutely crazy, but it’s true. It is difficult, and sometimes impossible, to truly change what one’s mind has come to accept.

This naturally leads to a compulsive attempt to work harder and harder… and leaves no room for feelings of accomplishment and satisfaction. Like a mouse stuck in a revolving wheel… never getting to the cheese, but trying all the time!

It is tremendously exciting when one suddenly learns that they CAN change the composition, and even overall function, of their body through proper nutrition and exercise. It is empowering to discover that they are not “victims” of a genetic conspiracy. Regardless of what limitations and characteristics they are born with, they can engage in lifestyle changes that will significantly improve their help and well being.

This, of course, is wonderful. However, after discovering the “control” that one has in the gym, and the LACK of control one has in life, people often use the gym as a “retreat”. This is not necessarily harmful, but when it goes to excess it becomes truly life threatening. Imagine if the only place you find peace and serenity is at the gym or running on the track. More time there, less time in the real world.

Some go so far as to compare a good workout to a spiritual experience, like meditation. An avid runner we know put it this way:

"It means much more than just keeping my body in shape. Running is the major focus of my life. It is the one thing I have complete control over. Every day I can count on my run for a quiet time alone when I can be outside moving, breathing hard. It fills me with a sense of power and confidence as I move quickly through the streets. After the run, I feel very relaxed, confident, satisfied, and in my own world."

Along with the physical benefits, most people experience a definite and persistent psychological bonus -- an improved sense of well-being following their physical activity. Studies consistently show that exercise can lower anxiety and improve mood in healthy, as well as clinically depressed individuals. Why this is so is not clear. But the theories are interesting.

Researchers have shown that during exercise a morphine-like substance, beta-endorphin, is released by the pituitary gland. Some scientists speculate that this release of beta-endorphin may be responsible for the feeling of euphoria following physical activity.

Lately, researchers have been investigating the relationship between exercise and serotonin. Serotonin is found in high concentrations in the hypothalamus (a gland that sits at the top of the brain stem) and helps to transmit messages across nerve cells in the brain. This chemical can suppress appetite and affect a wide range of conditions, including migraine headaches, depression, aggression, sleep disturbances, mood shifts, and anxiety. A recent report suggests, for instance, that exercise may have an effect similar to that of the prescription drug Prozac. That is, exercise may increase the activity of serotonin in the brain, thus benefiting mood and well-being.

Even without validating the actual physiological benefits, The “distraction” provided by many forms of exercise gives us a relief, a good feeling. It is a release from our normal activities and concerns. It is a way to help liberate pent-up frustrations, anger and hostility. In addition, the ability to eat more freely without gaining weight also increases pleasure, satisfaction and sense of self-control.

Let me relate a personal story about exercise addiction.

About eighteen years ago, when I was working in Pennsylvania as a psychotherapist, a colleague of mine was presented with a dilemma.

He was a dedicated runner. Really enjoyed the sport! Ran early morning and late evening on a daily basis. This was truly the center of his lifestyle.

Then, without warning, he developed a lower back problem. He experienced chronic and often excruciating pain. He kept this to himself, and continued to run.

Finally, the pain was just too intense to keep it a secret. His wife found out, and insisted that he see a doctor. He did, and discovered that he had a form of spinal degeneration that was progressing quite rapidly. It was imperative that he discontinue his running immediately. He agreed to do so.

What happened then was totally unexpected. He became a “sneak runner”! He would sneak out of the house, in the middle of the night, to run. He did this for weeks without being discovered.

Finally, one early morning, he collapsed. And, sadly, he was subsequently confined to a wheel chair.

His area of specialty as a therapist? He treated chemical and behavioral addictions!

Avoiding the trap of exercise addiction is easier said than done. The most important principle to remember is “Everything in Balance”. Exercise is a wonderful thing, and absolutely necessary for continued good health, vitality, and wellness. However, we must take responsibility to take frequent self-assessments to assure that we stay balanced. Exercise, as important as it is, should never be the focus of our lives.

Take this quiz to see if you are developing the qualities of an exercise addict.

If you recognize three or more of these symptoms, it would be advisable to discuss the situation with your trusted health-care professional. Don’t go it alone!