Exercise and Mental Health: Do You Have an Exercise Addiction?

In today’s world, we are exposed to a lot of public dialogue regarding the necessity of healthy eating and exercise. Fitness is a good thing, and if you see someone out for a jog, you’ll probably assume that they are engaging in a healthy and positive activity. But when does a love of exercise cross the line into exercise addiction?

Let’s face it, obesity-related health conditions are an issue in our modern society. Living a healthy lifestyle that includes exercise can reduce the risk of many dangerous health problems. Living a sedentary lifestyle is detrimental to one’s health. “Sitting is the new smoking” has even been used as a catch phrase to underscore the dangers of living an inactive lifestyle.

And let’s set aside the health benefits of exercise for a minute because cultural messages about fitness aren’t always about health. They’re about appearance. We praise people who have achieved a certain look. We glorify thinness and even skinniness.

If you exercise, the implication is that you’re engaging in a virtuous activity, and there’s a sense in which fitness is seen as morally superior to being sedentary or unhealthy, based on appearance and social status more than health and well-being.

The question we might ask is, “How much exercise is too much?” How do you know if you have an exercise addiction? When it comes to exercise, you can definitely have too much of a good thing.

Exercise addiction is relatively rare, but it is a real and dangerous behavioral addiction. It is not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) as a standalone condition, but many experts agree that it is a mental health condition and/or a behavioral addiction. (Exercise addiction does appear in the DSM-V as a symptom of the eating disorder bulimia nervosa. It is a form of purging.)

The website Eating Disorder Hope emphasizes that for someone with an exercise addiction, working out is not a balanced part of a healthy lifestyle – it becomes an all-consuming pursuit, a rigid and obsessive routine, the most important thing in life. Working out replaces important events and social activities. It’s a priority regardless of whether the person is sick or injured.

The exercise addict follows their routine compulsively, unable to deviate from it without experiencing extreme distress and anxiety.

Diagnosing Exercise Addiction

Although the DSM-V does not offer diagnostic criteria for this condition, there are two tools that have been developed for professionals to use to screen for the condition. These tools are the exercise dependence scale and the exercise addiction inventory.

Using the exercise dependence scale, a therapist can screen the level of tolerance a person has for exercise (how much do they need to achieve a “high?”), the lack of control over trying to stop the behavior, and the experience of withdrawal symptoms if exercise is temporarily stopped, along with other symptoms of addiction.

The exercise addiction inventory, or EAI, offers six statements for assessing the possibility of addiction:

1. Exercise is the most important thing in my life.
2. Conflicts have arisen between me and my partner about the amount of exercise I do.
3. I use exercise as a way of changing my mood (e.g., to get a buzz/to escape).
4. Over time I have increased the amount of exercise I do in a day.
5. If I have to miss an exercise session, I feel moody and irritable.
6. If I cut down the amount of exercise I do and then start again, I always end up exercising as often as I did before.

If these statements ring true for you or someone you love, it may be time to seek help for dealing with this issue. Agreement with these statements signals that exercise is no longer a balanced part of a healthy lifestyle, but an unhealthy and compulsive behavior.

Types of Exercise Addiction

According to The Recovery Village, experts have classified exercise addiction into two categories: primary and secondary.

• Primary exercise addiction occurs in response to the endorphins and dopamine produced by exercise. This is a behavioral addiction.
• Secondary exercise addiction is when the exercise addiction is a symptom of another condition, such as an eating disorder or another mental disorder.

Signs and Symptoms of Over-Exercising

Psych Central offers nine warning signs for this condition:

1. Irritability, anxiety, or depression when missing a planned workout
2. Exercising even when sick, injured, or exhausted
3. Using exercise as an escape
4. Exercise affects relationships
5. Other important life priorities take a backseat
6. Happiness and mood are dictated by workouts/fitness level
7. Constantly adding more length to workouts
8. Adding excessive workouts without a specific training goal
9. It’s no longer fun

Like the other tools mentioned in this section, this list of symptoms can be used to assess whether exercise has taken on an unhealthy role in a person’s life, possibly signaling a behavioral addiction or eating disorder.

Exercise and Mental Health

According to Good Therapy, the defining characteristics of exercise addiction are:

1. It causes problems in other areas of one’s life. These problems may be physical and/or mental. Instead of improving the quality of life, it makes things worse. This is known as a maladaptive pattern.
2. Exercise addiction is a pattern of excessive exercise without adequate rest, and as seen in the inventories above, it is characterized by withdrawal symptoms such as depression, anxiety, guilt, or irritability when unable to work out according to the desired level.

As with other behavioral addictions, exercise addiction means that working out has become a coping mechanism to deal with stress. It provides a sense of control and safety within structured routines, but it takes on a life of its own, causing an imbalance in other areas of life.

Risks of Over-Exercising

Over-exercising to an addictive level can quickly become the cause of health problems, despite the illusion of health. There are associated mental health risks, including anxiety, depression, and the risk for co-occurring disorders.

Exercise addiction is also associated with a number of physical risks, including (but not limited to):

• Overtraining syndrome
• Stress fractures
• Arthritis
• Chronic joint pain
• Reproductive problems such as amenorrhea
• Heart problems, even cardiac arrest

The physical and mental risks underscore the importance of seeking treatment for this condition. It is a dangerous condition, despite the fact that the addict achieves a sense of control by engaging in over-exercising.

What Causes Exercise Addiction?

As with any behavioral addiction, over-exercising is a complex issue, and it’s impossible to point to a one-size-fits-all cause. However, there are certain recognized risk factors that may lead to the development of an exercise addiction:

• Having another mental disorder (e.g. body dysmorphic disorder), eating disorder, or behavioral addiction (according to Addiction.com, 25% of people with exercise addiction have another behavioral addiction as well).
• Dependence on the endorphins and dopamine produced by exercise.
• A fixation on physical fitness and/or appearance.
• Certain personalities. According to Addiction.com, Heather A. Hausenblas, an exercise addiction specialist, has identified specific types of personalities that are more prone to developing an addiction: obsessive-compulsive, neurotic, anxious, high-energy extroverts, perfectionists, and egocentrics.

Recovery Options

While recovering from any eating disorder or behavioral addiction is difficult, it is possible. If you are struggling with exercise addiction, it’s not too late to get help to live a more balanced life. Recognizing that you have a problem and that your coping mechanism is destructive can help you take the first steps toward healing.

Therapy

When seeking counseling for too much exercise, it’s important to know that a professional therapist can be very helpful in identifying the anxiety triggers underlying the addiction. Which specific triggers lead to using exercise as a coping mechanism? A counselor can offer support throughout the recovery process.

Finding Balance

Northwestern University notes that an essential part of recovery can be patients learning to embrace movement without engaging in compulsive workouts. The website Recovery Warriors notes three components of recovery that must be addressed in order to heal: anxiety, body dysmorphia, and the addiction itself. Regardless of the way your particular addiction presents, Christian counseling can help you recover.

As you develop new coping mechanisms for healthy movement, you can create guidelines for yourself (recommended by Recovery Warriors), including developing new habits to enjoy being active without following a rigid regimen of exercise.

You might choose to avoid exercising alone, just like people with other behavioral addictions might avoid engaging in other addictive activities alone. Maintaining recovery over the long haul will be a challenge, and long-term counseling may be needed to help you be consistent with coping mechanisms instead of relapsing into the addiction.

If you think you or someone you love may struggle with this issue, contact a professional counselor today.