Exercise – how much is too much?

Priory expert Dee Johnson says exercise addiction is often a sign of trauma, low self-worth, unprocessed emotions, eating disorders and body dysmorphia

What are some of the signs that someone might be addicted to exercise?

Priory psychotherapist Dee Johnson, based at the Priory’s Chelmsford Hospital in Essex, says: “As with any addiction, it’s about the behaviour and intent, regardless of the issues it creates, so having an inability to stop, despite logical or emotionally intelligent reasons why. With exercise addiction, it’s when the need for physical exercise and fitness turns into an unhealthy obsession, that increasingly causes harm physically, and mentally, to the detriment of both regular behaviours and other activities such as time spent with family, socialising , finances, your work or education. Keeping fit and strong is obviously a good thing, but not when it causes you harm, loneliness, ultimate unhappiness (because whatever you do will never be enough). Then it’s time to focus on your mental fitness, which starts with asking for help.”

What specifically do you look for in patients?

“When there is no longer balance. Even professional athletes have rest days, as they truly understand the importance of this. The sort of questions we might ask are things like: Do you find yourself exercising for longer than originally intended? Do you stress or get upset if you cannot exercise, or if something stops you or limits your time? Is exercise occupying your thinking more and more? Do you over self-check, and punish yourself for not doing enough? Do you still exercise despite other health issues or injuries, causing risk to yourself and against medical advice? Do you put yourself in vulnerable places just so you can exercise, like running late at night, in bad weather, to unknown places? Are you hiding, minimising, or lying to others about how much and when you do this? Do you get defensive or upset if you are challenged that perhaps you are overdoing it? Are you spending longer and longer time doing it, planning or recovering from it? Is it more about hiding or supressing emotional pain, trauma, anxiety, depression? Are you driven by fear of being too fat, weak, unattractive?”

What sort of treatments can help someone who is addicted to exercise find a more healthy relationship to fitness?

“Physical fitness is essential for our physical and mental health, so  abstinence is not the usual solution. It’s about being honest as to what’s really going on. Some ‘reprogramming’ is needed, after having built up new neural pathways and hardwiring yourself to seek out the hormone flooding of dopamine, endorphins, adrenalin. It’s about recognising and accepting that something that was once for fun or healthy is now causing harm, and it is a lonely place to be. It is best to seek help. However far it may have gone, you are not on your own. Recovery is possible, and reaching out to trusted people and mental health professionals who specialise in addiction, is really important.”

What next?

“Talk to a therapist – what’s really been underpinning this? It’s often an indicator of trauma, low self-worth, unprocessed emotions, a deliberate act of self-harm, habits that have got out of control, body dysmorphia. Try arranging your exercise with one or two friends and stick to that schedule. It will not feel easy at first, and when the obsession is on you, remember it’s just a thought so talk, journal or meditate it out; breathing mindfully can all help that craving pass. Choose a personal trainer who really understands this, like a therapist does, and they can support you into a healthy regime. Get the fun back, make the target or goal the enjoyment part – not the ‘personal best’. Join fitness groups to help feel connected to others.

Keep an honest diary to monitor how much you are really doing (including the ‘little cheats’ such as running up and down stairs all the time, doing squats when cleaning your teeth). It helps break the denial and the minimising of what you are doing. Have a schedule for your whole day that has a balance of what you need to do (again include the fun stuff), as having structure is really important for recovery.”

Is exercise addiction becoming more or less prevalent?

“It is a bit tricky as it can be hidden, or seen as acceptable, and the harm is not always obvious at first. However, the pressure of body image is extremely prevalent, so we are seeing more people have exercise addiction as part of their destructive behaviours and low self-worth. Judgement and the fear of rejection, not being accepted or fitting in, the pressure to share on social media, including when you visit the gym or are doing a workout routine, adds to the compulsive behaviour  - again all fear driven, even if it does not overtly feel like that. It can also be a key sign or symptom of an eating disorder, OCD or other compulsive disorders, and a  primary/’gateway’ addiction, or a cross-addiction (ie, clean from alcohol or pornography addiction but now turning to excess exercise).  OCD and EDs (eating disorders) are the same, a kind of coping strategy, form of control, way to self-anesthetise, self-harm, become overrun with obsessive thoughts - risking heath, relationships, safety, finances. The consequences are all parallel (and can be interwoven).

ENDS

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About Priory and MEDIAN

Priory is the UK’s leading independent provider of mental health services. We treat more than 70 conditions, including depression, anxiety, addictions and eating disorders, as well as children’s mental health, across our nationwide network of sites. We also support autistic adults and adults with a learning disability, Prader-Willi Syndrome and brain injuries, as well as older people, within our specialist residential care and supported living facilities – helping as many people as possible to live their lives.

Priory is part of the MEDIAN Group, one of Europe’s leading providers of high quality mental health and rehabilitation services. The MEDIAN Group comprises 290 facilities with 5,000 beds caring for 28,000 people in the UK, 120 facilities with 20,000 beds caring for around 250,000 patients in Germany, and 15 facilities with 2,000 beds caring for 13,000 people in Spain, with more than 29,000 employees overall.