Are you addicted to exercise?
I am all for exercise! There is nothing better at treating and preventing so many health problems and it has always been a key part of my life. But how do you know when it's gone too far? It's a hard one to spot but once you know the signs there may be some things to consider to break that negative cycle.
A quick test
This research validated questionnaire is a simple set of questions to see how at risk you are of exercise addiction:
Those most at risk of exercise addiction would score 24 or more out of 30, a potential risk 13 to 23, and very unlikely risk zero to 12.
Exercise addiction can be primary or secondary depending on the goal. If the goal is weight loss that there will normally be an eating disorder at the heart of it. If the goal is to stay in shape there may be an underlying body dysmorphia. With primary exercise addiction there is an absence of another psychological disorder with regular exercise being the primary objective.
It was originally classified as a 'positive' addiction by Glasser (1977) due to the health benefits that can occur, however this was challenged because psychiatric case studies had shown that exaggerated exercise could lead not only to physical injury but also to the negligence of everyday responsibilities such as work and family life.
There are six classic signs of addiction that can indicate the behaviour is no longer positive:
You experience anxiety, fatigue and other similar symptoms if you don’t exercise. Or will have to exercise to relieve these.
The amount of exercise or length of exercise sessions is longer than originally intended (meaning you need more of a stimulus to get the same response).
Loss of control
A persistent desire to train or make unsuccessful attempts to reduce the amount of exercise.
Large amounts of time are spent exercising and conflict with other areas of your life.
You will continue to exercise even with persistent physical or psychological issues that are made worse from exercising, such as a recurring injury.
It is hard to quantify but based on the questions above you'll get an idea of if you might need to relook at what exercise means to you.
So why does it happen?
There are proposed theories based on physiology and psychology.
From a physiological perspective the presence of a post exercise 'high' is thought to be caused by an increase in endorphins (the happy hormone). Endorphins come from a similar family as morphine therefore can lead to dependence. This increase has been seen in the blood but you can't see it in the brain without dissecting it so it remains a theory! The need to get a greater 'hit' can lead to needing a bigger amount of exercise than when you first started, which can take over more and more of your life.
From a psychological and behavioural perspective, exercise becomes a coping strategy to alter your mood and respond to stress. Therefore if you cannot exercise for some reason that coping/control mechanism is lost and you can experience withdrawal symptoms such as irritability, guilt and anxiousness. This can then have an impact on work and family life if you start prioritising exercise over these aspects of life leading to a negative spiral.
Sadly it is often only when something starts to go wrong such as an injury or illness that it will get picked up.
From the outside exercise addiction may look like someone is 'super healthy' and would be applauded for their efforts (reinforcing the problem). Often exercise addiction is hard to isolate but it is something I see within my patients who have got injured as a result of too much exercise with little recovery. Whilst in their injured state they often can't exercise (or at least to the level they're used to) so they become restless, agitated and their pain is more pronounced. This is not a good state to heal and there is often something else going on in their life that they need to address in order to recover.
Whilst I will always bang my exercise drum as it has awesome health benefits, I realise there is a darker side to it that can occur with excess. With the fitness explosion and glamourised exercise on social media we need to make sure we are promoting recovery as well as exercise to ensure a healthy balance.
Berczik, K., Szabó, A., Griffiths, M. D., Kurimay, T., Kun, B., Urbán, R., & Demetrovics, Z. (2012). Exercise addiction: symptoms, diagnosis, epidemiology, and etiology. Substance use & misuse, 47(4), 403-417
Glasser, W. (1976). Positive addiction. New York, NY: Harper & Row.
Griffiths MD, Szabo A, Terry A (2005) The exercise addiction inventory: a quick and easy screening tool for health practitioners British Journal of Sports Medicine; 39:e30.
Griffiths, M. (1997). Exercise addiction: A case study. Addiction Research, 5(2), 161-168.
Terry, A., Szabo, A., & Griffiths, M. (2004). The exercise addiction inventory: A new brief screening tool. Addiction research and theory, 12(5), 489-499.