Following #MENTALHEALTHAWARENESSWEEK it’s an ideal time to share some of my own thoughts and experiences. Mental health is an all-encompassing term that takes account of several issues that can either help or hinder the quality of our psychological well-being and, for many, can manifest physically. Having worked within the fitness sector for what feels like forever, negative body image is one of the most common themes that leads to psychological distress and is one that I'm personally familiar with.
Being a self-confessed over-achiever and perfectionist, I have battled periods of anxiety and depression for most of my life. I‘ve always been involved in fitness and used exercise to support this. Indeed, physical activity is often used as an alternative and/or standalone treatment for depression and is proven to reduce anxiety. I will always be a strong advocate for this despite the experience I'm going to share with you.
The desire for physical fitness is a driving factor for a lot of people, and a healthy one at that! According to the ACSM (2018), health-related physical fitness is "a set of attributes that people have or achieve that relates to the ability to perform physical activity". For a long time I obsessed over this ability to physically perform (if you know me, I guess I still do). If I was able to run 10k in the morning, teach 5 PT sessions, take a spin class at night and throw a lifting session in there somewhere, then I must be 'fit', right? I was truly addicted to the physical results and the amazing boost of endorphins that supported my mental state. Sadly, this was not a healthy level and I soon found myself gripped by an exercise addiction and eating disorder.
Bulimia made a sinister appearance in my life slightly earlier, during my teens. Juggling school commitments with training as a gymnast and trying to have a social life somehow became too much. I started to lose control of managing the various demands and my pursuit for perfection in all areas of my life (including my physique) manifested as an eating disorder. Ironically, it seems like the most out of control thing you could do to your body, yet it gave me a feeling of inner control and satisfaction during a time where everything on the outside seemed so hectic.
With support from my family, I retired as a gymnast around 18 to allow me to concentrate on academic pursuits and start to focus on my health. This was a soul destroying experience which left me with crazy levels of anxiety about how I would stay ‘fit’ and wondering if I would ever excel at anything again. When you plough an inordinate amount of effort into something for so many years then have to give it up, I think there can be a sense of loss of identity and confidence! Gymnastics defined me, or at least I thought it did. I know many professional athletes who experience these types of feelings post injury or retirement and can certainly sympathise (to a lesser degree). I talk later about techniques I’ve used to become comfortable in my own skin, confident in my abilities and able to value my self-worth.
I stormed through my early 20s, staying ‘fit’ through running and training at the gym. I successfully gained a First class Honours degree in Business and Marketing, got a job in an advertising agency and purchased my first flat. On paper, I was doing swell! Behind closed doors, my relationship with my body image was fractured at best. When I was made redundant, I decided that it would make me happy again if I worked in fitness. If only I could have instilled some of the wisdom and understanding from yogic philosophy in my younger self. I might have realised the limitations associated with using external things to ‘find happiness’. I understand now that when everything is stripped back, happiness is our essential nature, our default if you will. Clinging to material objects or people to bring us joy or even blaming others for our unhappiness does not serve any positive or constructive purpose. Although working in fitness has ultimately been a great path for me, my initial motivation to pursue this was never going to solve any of my problems. The answer was, and always is within.
Fast forward through years of retraining to work as a freelance Personal Trainer and class instructor as well as managing the marketing function and helping with teaching support for a vocational fitness training company. I was certainly more satisfied in the work I was doing and couldn’t think of anything better than being paid to help people get fit, whilst staying fit myself! You’re probably as frustrated as me reading this and thinking ‘that’s the worst thing someone with an exercise addiction could do’. Strangely, the development of anatomical and nutritional knowledge supported my understanding of how damaging my lifestyle was. Still, I didn’t change, I didn’t want to! It wasn’t until a number of years later when my weight plummeted to below 45kg, I began to experience heart palpitations, tested positive for low bone density and hadn’t experienced a period for over a year that alarm bells began to sound. I couldn’t even shave my legs properly because my veins protruded so prominently that I constantly cut myself. It was grim!
It was around this time that I met David (my future husband). The combination of his influence and the immense relentless support of my family led me to embark on a journey of using counselling, alternative therapies such as EFT (Emotional Freedom Technique) and almost complete abstinence from intense exercise. This process lasted a number of years and fortunately empowered me enough to turn things around. It wasn’t easy or pleasant for me or for the people around me!
At 32, I’m now married to David, expecting a baby (despite my poor odds), work as a full time lecturer in Fitness Health and Exercise, teach yoga and specialise in pre and post-natal exercise/yoga. Pre-pregnancy my weight was around 62kg and I had sustained that for a number of years. I rarely weigh myself as I don’t believe it to be a very positive measurement of ‘health’ or particularly accurate (if you really want to track something, measuring body fat is far more accurate, but still unnecessary for most in my opinion). I will always have an eating disorder in so far as having to manage the psychological demons that celebrate negative self-talk about my fitness and body. Physically though, I’m confident that I won’t return to a pattern of making myself sick, but have to be honest that the inordinate amount of sickness during my pregnancy has been extremely mentally demanding given my history. Using EFT and other strategies mentioned ahead have supported massively. Most importantly, the motivation to nurture our growing baby is overwhelming.
So what has changed now (other than the obvious)? One of the most interesting things is my interpretation of what fitness is. I no longer view it as a static term, but as one that evolves and changes depending on situation, lifestyle etc. Becoming comfortable and respecting this has been immensely challenging but pretty evolutionary at the same time. Take for example the comparison between my 22 year old and current self. One could run a half marathon a few times per week, lift weights to a decent level, take spin classes virtually every day, and exist on less than 6 hours sleep. I was ‘fit’ for purpose (i.e. I could facilitate the demands of my very physically demanding job to an excellent level). The other version has (thus far) supported the healthy growth of a baby; since the pregnancy sickness has reduced slightly, has been able to go for a number of short low intensity runs, perform a few body weight circuits and do short yoga flows each week. In terms of “perform(ing) physical activity” (ACSM, 2018), both certainly demonstrate that but at opposite ends of the intensity scale.
Even pre-pregnancy my attitude to exercise and fitness had changed. I focus largely on what my mind and body need, what feels right and what I enjoy, opting for more yoga and favouring more rest when I can get it. I still love intense exercise and value the incredible physical and psychological benefits it offers but now respect my body a little more and moderate this type of activity. Perhaps this is more akin to ‘wellbeing’, "a positive physical, social and mental state" (The Department of Health, 2010). The significance of looking after our mental health is all too often overlooked, particularly the bearing it has on our physical health. For this reason, I believe that one of the most important practices to include in our daily routine to stay ‘fit’ is meditation. Not necessarily the stereotypical sitting cross-legged in a quiet, darkened room (although this can be pretty awesome), but simply finding space to still the mind every day. I tend to do this for around 10 minutes each morning when I wake, sitting upright, focussing on a full yogic breath (sign up via the website to receive full instructions on how to do this), counting rounds of breath and finally repeating positive affirmations/intentions for that day. It sounds a little cheesy but it works and can be truly transformational. Try it! If I’m short on time, I meditate while I'm running when I find I can zone out completely, counting my steps and becoming acutely aware of every sensation in my body as I move. There are also several excellent apps that can be used to perform short guided meditations.
So ask yourself, ‘what does fitness mean to me?’ Is it purely aesthetic without regard for your psychological fitness? Often we exercise as punishment for eating too much, for having a few days off, for drinking more than normal etc. Make it your mission to find a physical and mental fitness routine that you enjoy and that serves you at this current time in your life. Accept that you will and should rest, and that perhaps more intuitive eating would support you positively. I recently listened to an incredibly insightful Deliciously Ella podcast with nutritionist and intuitive eating expert Pandora Paloma. I would advise a listen!
Closely linked is our internal chatter and the importance of acknowledging and dealing with negative self-talk. If that ‘chatter’ were a person sitting on your sofa, would you listen to them? In most cases you would probably think they are slightly unhinged and make it your mission to get away from them! Don’t beat yourself up for having negative thoughts, instead give them less power by allowing them to pass. You have created those thoughts but those thoughts are not you! Try replacing them with the positive affirmations mentioned before and be kind to yourself. This is not easy and will take time! It will undoubtedly support physical fitness pursuits if you can create a more comfortable and positive mental state within.
How to identify/support recovery from an exercise addiction?
An inability to take a rest/recovery day with irrational thoughts and anxiety about the effects of this. Support by staying active on those days e.g. going for a light walk in fresh air; trying something new like a meditation or yin yoga class; catch up with friends or family to stay busy; read something educational and learn something new. Set a regular bed time routine like turning off phones, computers etc. before bed, having a bath, reading a book. Enjoy the experience!
Low immune system, regularly catching colds, bugs etc. as well as regularly picking up injuries. Support by RESTING (as above). A little bit of basic science to help rationalize this...exercise puts the body into a catabolic state (basically breaking down), which is perfectly normal provided that it is built back up (put in an anabolic state). The only way to do this is to allow the body to recover through good quality nutrition and rest. This is when your body makes the changes that you are trying to achieve through exercise. If you continuously ignore this, not only will you not make the gains/achieve the weight-loss you are aiming for but you also risk having dangerously high levels of the stress hormone, cortisol in your body. This will keep you in a constant state of 'fight or flight', increase blood pressure, and ultimately be detrimental to your nervous system and overall health.
Obsessive tracking of calories, time spent moving etc. Support by reducing/stopping usage of fitness tracker watches, apps etc. (these certainly have a place but, be honest with yourself, are they simply fuelling your obsessive behaviour?)
Irrational behaviour, mood swings, feeling like crying for no particular reason. Generally a bit miserable and lethargic. Support by RESTING (as above)...notice a pattern?
Inability to moderate intensity of exercise. Support by applying the RPE scale (rate of perceived exertion) during exercise. Simply put, this is a scale of 1-10 which is used to monitor exercise intensity. During cardio vascular activity when applied accurately (i.e. when you are being honest with yourself), the numbers correlate well with %max heart rate e.g 5/10 would mean you are likely to be working at around 50% of your maximum heart rate. I would recommend to work no higher than 4-6/10. If you feel yourself tipping toward the top end, simply pull back slightly! Another simple tool is to limit exercise sessions to 30 minutes max (that doesn’t mean up the intensity).
This is by no means an exhaustive list and many of these signs can be linked to other issues so approach with caution.
How to support recovery from an eating disorder?
I'm not a trained expert in this so can only speak from personal experience. Note that if you have an eating disorder or suspect that a friend or loved one has then they must seek medical advice. Your GP is a good first point of contact. Please also bear in mind that although eating disorders are often physically obvious, they are a psychological issue that must be treated accordingly. Ultimately, no amount of changes in exercise or diet routine will fix the underlying reasons for this manifestation. In my situation, the best support came from:
EFT (Emotional Freedom Technique). A close family friend is trained in this fascinating technique and has worked with me over a number of years to help me through a variety of difficult times. I still use it every day!
CBT (cognitive behavioural therapy). I was referred through my GP to a CBT practitioner who guided me through a year of intensive treatment. This is not an easy or pleasant process. I describe it as opening pandoras box i.e. having to acknowledge and accept stuff that you have packed away deep into your subconscious that you didn't really want to deal with (sometimes seemingly unrelated to the original issue).
Yoga! Breathe, bend, move! I have always championed yoga, particularly during the height of my recovery. It supported my ability to relax, escape the internal chatter and provide a low impact way to move. Now, as a qualified seasonal yoga teacher I would credit the practice as being life changing for me. Seasonal yoga in particular helps to educate the mind and body to work more harmoniously with the changing energies, foods, active organs etc. associated with each season. It's pretty cool and provides for a much more sustainable way to live.
Being open with family/friends. This can be very challenging whether you have a close family/friend network or not. I am lucky in having a very close family and supportive friends who were able to help me without judgement and challenge me when necessary. In my experience, I avoided offloading too much to friends and was/still am very choosy about who I talk to. A problem shared can certainly be a problem halved but only with the right people who are in a position in their own lives to offer the necessary support. Charities like Beat offer a free helpline to discuss your feelings/experiences where you might not want to talk to someone closer to you. Another excellent resource is Mind.
Rest...hopefully you've grasped this one by now :)
Move daily, stay healthy and be happy, Sarah x
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