Addicted To Exercise

by Irene Rubaum-Keller, MA, MFT

"Ouch!" said Gayle as she tried pathetically to run following a serious ankle sprain.  "I sprained it in aerobics two days ago.  The doctor told me to rest it completely for two weeks and then gradually return to running.  I thought I'd just try two easy miles today."

Is Gayle crazy?  No.  She's an exercise addict who runs four to six miles seven days a week and then lifts weights for two hours every other day.  She does this rain, shine, sleet or hail.  The thought of even taking one day off is enough to make her feel panicked or depressed.  The thought of taking two weeks off to let her injury heal was more than she could bear.

Serious Injuries

Gayle is not alone.  Although the  number of exercise addicts is not known, we do know that addiction effects both men and women.  Men tend to be trying to stay young  and women use over-exercising as a purging technique in conjunction with an eating/body image disorder.  Exercise addicts tend to be driven, high achievers from upper-middle class families.  They also tend to be introverted and have difficulty expressing anger.  They come to the attention of doctors and personal trainers due to injuries that don't heal.

According to Peter Alexakis, MD, noted orthopedic surgeon and assistant clinical professor at UCLA, stress fractures of the hip, foot and shin are the most common injuries he sees in exercise addicts.  "I've seen people with stress fractures of the hip who had a rough time letting them heal because they were over-eager to return to exercise."  When I ask him what he does for these people, he laments, "All you can do is explain the risks of continuing."

Gayle knew the physical risks of continuing - including chronic injury, amenorrhea and osteoporosis - but logic is weak in the face of an addiction.  Even with the knowledge that she could cause herself permanent harm, she still wanted to try running the two miles. 

If his clients come in with an injury that's not completely healed and want him to train them, Jim Bolden, certified personal trainer who works with celebrities, sends them home.  In his many years as a personal trainer, Bolden has seen his share of addicts.  He believes that the maximum weekly workout should be five hard exercise days and two very light, or no exercise days.  More than that, according to Bolden, is excessive and potentially harmful.

Becoming An Addict

Why we become addicted to exercise is complex.  There is research to support the link between beta-endorphins and addiction.  Beta-endorphins, released by the pituitary gland, are the body's own morphine.  They are produced during vigorous physical activity and create feelings of euphoria and relaxation.  Serotonin activity is also increased in the brain with exercise.  Serotonin is released by the hypothalamus and can suppress appetite, improve sleep, relieve depression and create an overall feeling of well being. There is also evidence that the tendency toward addiction, or an addictive personality, runs in families.  The latest research suggests that there may be a gene that predisposes one to addiction.

Although there may be some physical causes, it's my bias as a psychotherapist and recovered exercise addict that people who are addicted are running from something internal.  Generally, it is disturbing memories, feelings, thoughts and/or fears.  In order to really heal an addiction, one must get at the psychological cause.  In Gayle's case, her father was an abusive alcoholic and treated her cruelly.  This created strong feelings that she was inadequate and unloved.  She felt that she wasn't thin, pretty, smart or successful enough.  She feared getting close to people, especially men, and used the isolation of running and weight lifting to avoid intimacy.  She'd cancel dates so that she could go exercise.  Gayle was also using the "high" from exercise to mask her emotional pain and was willing to cause herself physical pain in order to continue doing that.

"So how do we cure my exercise addiction?" asked Gayle.

"Let's go for manage versus cure," I explained to Gayle. "You aren't going to have to give up exercise completely. After all, exercise is good for us." She looked like someone had told her she'd just won ten million dollars.  "You will, however, have to cut down while we work on what it is you're running from," I added.

Recovery Is Possible

Here is what I recommended for Gayle - and what I recommend in general - to help her recover from this addiction:

Go for five days a week of vigorous exercise and two light days of stretching or yoga only.

Start a journal and use it to write about your feelings, especially on the light exercise days.  This should begin to help you understand what it is you're running from.

When you become comfortable with five hard and two easy exercise days, try taking one day completely off.  Pay close attention to your feelings on your day off.

Learn some stress and anger management techniques. These can be learned in individual therapy. However, since exercise addicts often use exercise to isolate themselves, taking assertiveness training workshops or anger or stress management classes is a good was to be around people and learn new coping skills.

If weight gain is a fear, educate yourself about calories and portion sizes. Use that knowledge to decrease your calories slightly to compensate for the decrease in physical activity.

Make a list of the benefits you'll receive once you've conquered your exercise addiction.

Get support.  Changing is difficult and the help of friends, family and qualified professionals can make all the difference.

Believe you can get better.  It is possible.  I've done it and so have many others.  If we can do it, so can you.