Exercise addiction is real, and so is denial

One more mile.
One more mile.
Image: Reuters/Sergio Moraes
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I’m not saying that I show up to dates sweaty, but I have been known to wash my face, change my clothes, and douse myself in liberal amounts of deodorant and Febreze in lieu of showering so I can squeeze a run into my day.

For as long as I can remember, staying active has been a huge part of my life. My parents got me playing tennis when I was four, and at nine I joined my school’s JV cross country team (our races were just a mile long). I’ve never actually been competitive or particularly talented, but exercise makes me really happy. It’s my time to zone out and get away from technology.

But then there’s this: I get really anxious if I’m not able to fit in a workout. I take one day off a week to give my joints a break, and find myself itching to go outside and stretch my legs, even if it’s just for 20 or 30 minutes. When I can’t run, I can feel the tension build in my shoulders. Decisions start to feel finite and of the utmost importance; I start to doubt the ones I’ve made, ranging from big ones like going to graduate school to the mundane like whether or not I used the right words in a text to a friend to try to schedule a time to catch up. I feel self-conscious and want to be alone. When I run, though, I feel reassured and happy; I actually want to see the friends I’ve made plans with.

In moments where I really crave a workout more than anything else, I have to wonder if I’m addicted. Rarely do we think of exercise as something that falls in the same category as substances like sugar, drugs, and alcohol. But it turns out,  for at least a small portion of the population, exercise can become a genuine addiction.

“Exercise addiction is an overzealous pursuit of physical activity persisted in despite physical, emotional, and social consequences,” write Katherine Schreiber and Heather Hausenblas in Psychology Today. Hausenblas is a kinesiologist at Jacksonville University in Florida studying the relationship between diet and exercise and quality of life. She’s found that it doesn’t take much to push someone from being able to balance routine exercise with the rest of their lives to exercising compulsively and losing all the pleasure and value working out offers.

According to the American Society of Addiction Medicine, in order for a hobby to evolve into an addiction, it has to meet certain criteria: It must be something that requires larger and larger amounts in order to have the same initial effect, and has to cause symptoms of withdrawal, like insomnia or irritability, when forgone for a day or two.

With exercise addiction, these symptoms can translate into a number of different behavioral choices. “There’s an obsessionality about exercising all the time,” said Aviv Weinstein, a behavioral psychologist and addiction specialist at Ariel University in Israel. For example, some people will still lace up their shoes for a run despite painful injuries (often making them even worse), or isolate themselves from loved ones by spending all their free time at the gym. Often, these situations will cause more stress, leading people to seek out even more exercise, creating a negative feedback cycle.

I can’t say that I haven’t decided to keep pushing myself despite pain I knew was a warning sign of something bigger: In high school, I once I played tennis through pain in my elbow until I was sure I had broken my arm (it turned out to be just a really nasty case of tennis elbow). This winter, I accidentally made myself quite ill because I decided to push through a long run when I had a cold. And just this past weekend, I insisted on getting in my long run, even though I was in the mountains. I forced myself to cover the same distance I normally would, and spent the next three days hobbling (and jogging very slowly) on quads shredded by running up and down huge changes in elevation. In every case, though, I told myself I was just being determined.

Weinstein and his colleagues have found that certain people who exercise compulsively also tend to be the most depressed and anxious. In 2015, he co-authored a small study (paywall) that surveyed 71 amateur and professional athletes, and found a positive link between those who reported compulsive exercising and signs of depression.

That link, though, may not actually tell us much about the overall picture of exercise addiction. It was a small sample size, and participants didn’t report how they felt before they began their compulsive workout regimens; it could be that obsessive exercise may lead to depression or it could mean that depressed people might tend towards obsessive exercise. This study also doesn’t really tell us much about how many people worldwide are actually addicted to exercise, though Weinstein estimates that the number is anywhere from 1% to 3% of the population.

There’s a fairly clear physiological explanation for exercise addiction: the chemicals generated through exercise are known to create neurological addiction in some people. In a 2013 review (paywall), Weinstein and his colleagues outlined the major pathways that have been suspected to cause exercise addiction in animal and clinical models. When we exercise, our bodies produce serotonin, endorphins, dopamine, and adrenaline. It’s possible that the combination of these chemicals in various activities can give the feeling of a high or create a neurological circuit similar to the one created, for example, by gambling.

“Any substance or behavior that repeatedly and reliably activates…dopamine neurons appears to carry some risk of addiction and exercise is no exception,” David Linden, a neuroscientist specializing in addiction at Johns Hopkins University, wrote in the New York Times. But, he argues, although there is that slight risk, unless a person also has an eating disorder, the negative effects of exercise addiction are likely to be minimal, especially when paired with the benefits of physical activity.

“The real crux of the issue is why you’re exercising, not the number of hours you spend,” said Marylin Freimuth, a psychologist in Green Bay, Wisconsin. “For some, working out two hours a day can be a sign of a problem, whereas others can do twice that and be fine.”

We have to stay active, and that makes exercise addiction hard to recognize and treat. Weinstein recommended talking to a therapist if you notice yourself working out more and more without feeling happier or more fulfilled, and making sure you vary the type of exercise you do to avoid overuse injuries. And speaking of balance: the other key is to make sure exercise doesn’t come at the expense of the other important aspects of our lives.

That’s what makes me think what I’ve got is really just a fulfilling hobby: I become anxious when I’m not active, but I also feel down if I don’t make time to catch up with my friends and family. It’s all a balance; sometimes it swings to favor more workouts to less, depending on the week. If I’m actually sick or hurt, I try to make sure to take it easy. And I always shower eventually.