Monday, February 2, 2009

Sport/Therapy: Thoughts on Depression & Runner's High

Runner's high is just what the name suggests: a sense of euphoria.

I feel this on a really good day, when I run for more than an hour. Once you hit it, you feel like you can run forever. If that wind catches my sail at 60 minutes, I'll run another 40. I started logging way more miles after I first got a taste of it. Euphoria is a great motivator.

Recent medical studies have shown that the biochemistry of this state is real, and that it looks just like the euphoria of "new love" - and, interestingly, the deep pleasure of listening to music that blows your mind (see "Yes, Running Can Make You High"). I sometimes feel this intense pleasure when playing soccer - I love pick-up games that last for hours. The pacing is different, but the payoff is similar - on a good day, I feel in love with the pitch and everyone on it. (The high in soccer is distinctly social - I am sure the nature of this high is why so much soccer literature is so outrageously romantic.)

Anyway, journalism on "runner's high" suggests that running has a natural anti-depressent effect. I don't know if that's accurate - but it sure is true that "runner's high" feels good when you are feeling it, and, too, if you are in the habit of running that long and that far, you are at least able to get yourself out of bed and out of the house.

But it turns out that athletes can have their own form of athletic depression: "overtraining syndrome." According to this 2002 article in Peak Performance, it looks just like major depression - but is signaled in the athlete by "decreased physcial performance." That drop in performance compounds the difficulty of depression's symptoms (difficulty sleeping, loss of interest/motivation, weight loss/disordered eating, irritability, restlessness, etc.). [Image: Yrsa Roca Fannberg's "Falling" (2009).]

According to Laurence Armstrong and Jaci VanHeest (authors of the study on which the Peak Performance article is based), disappointing performance leads to more and harder training as the athlete tries to grapple with feelings of failure and is driven by the sense that "harder" work will somehow get them back on top. The syndrome produces a vicious cycle and can be hard to notice because athletes are so good at doing the very thing that "traditional" depressives seem to struggle with. An athlete tends, by definition, to be very active - and often lives in a world reluctant to acknowledge the reality of psychological struggle. (Laurence Armstrong and Jaci VanHeest's study can be foud in Sports Medicine, 32(3) 2002, pp 185-209.)

I have been wondering if, in all these new conversations about treating depression in athletes, people have explored the impact of antidepressants (increasingly prescribed to everyone) on "runner's high." As happy as I was when an anti-depressant relieved me of the disabling cycles of panic and anxiety which tormented me in my 20s, I was sad to find that experiences of euphoria became muted - I distinctly remember, in fact, that I couldn't "feel" music the way I used to. (I also didn't cry at the movies like I do normally. Or sink into spirals of complete despair.) I didn't run much back then. No more than 30 minutes a couple times a week. So I have no personal experience with the impact of an anti-depressant on runner's high.

Some anti-depressants lift the "floor" of your lows, while also dropping the ceiling of your highs. Surely, they must have an impact on how athletes experience the pleasures (and anxieties) of their sport. And I wonder how that kind of chemical shift in feeling impacts people in competition.

Armstrong and Vaneest's study recommends that atheletes suffering from depression work closely with their therapist, coach, and (ideally) nutrionist - the only way to track the effectiveness of any treatment is to keep very close track of what one is doing, and how one is feeling. This of course means bringing the darker side of the athlete's emotional life into the open - to acknowledge experiences of depression as an aspect of the self - as one of the things that make us unique, and even uniquely driven.

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