Running and Anxiety – When Exercise Is Not Enough

“The day of the Boston Marathon bombings I witnessed a full range of emotion.”

Dr. Jeffrey Brown, Harvard Psychologist and Boston Marathon Staff Psychologist for over 16 years, recently spoke with me about anxiety and running. Specifically about what happened on Patriot’s Day in 2013 and how it affected runners, staff and volunteers, in the moment.

“People were irate, crying, anxious, terrified, thankful and grateful for having survived,” he remembered, “the human experience and cohesion is remarkable. All people, races, origins, ages. All coming together for a common psychological process.”

Dr. Brown pointed out that even amongst the chaos “we had remarkable leadership in terms of what we offered our staff. Which helped them endure and become resilient. Resilience is something that is natural for runners, endurance is something we just do but it’s psychological.”

Running And Anxiety

Endurance and enduring pain, suffering, mileage and mental anguish is indeed something runners seem especially qualified for. But what if the act of running is not sufficient in helping overcome something as traumatic as the Boston Marathon bombing. And in fact, the act of running itself, that once helped ward off anxious behaviors, is now inexplicably linked to them?

A lot of runners suffer from anxiety. In fact, if you have PTSD (post traumatic stress disorder) or a generalized anxiety disorder, one of the best ways to minimize your symptoms is to exercise. We have seen thousands of articles on how running helps with addiction recovery and lessens the effects of trauma.  But what happens when exercise or running alone does not relieve the symptoms?

“We can have trauma for a host of reasons,” explains Dr. Brown “car accidents, major losses or any experience that occurs outside the range of typical human experience, is generally how it’s defined. For people involved in a mass event only about 10% experience a trauma experience diagnostically.

In fact, for the first 30 days you can’t even be qualified as having PTSD since it’s an acute stress disorder. Having strong memories of a traumatic event is not PTSD. It’s when those memories are in combination with emotional disorganization, sleep and appetite are affected or debilitated and you cannot function like you once did.”

Runners are definitely familiar with anxiety. Any runner who has ever stepped up to a start line or had a big race goal and had trouble sleeping the night before can identify. “We all have anxiety,” remarked Dr. Brown, “it’s when it becomes intrusive or debilitating that it becomes a problem.”

Anxiety And PTSD

Unfortunately, Sandra LaFlamme, experienced runner and triathlete, knows all too well the difference between anxiety and PTSD. She was one of the runners affected by the bombings that day.

“Out of nowhere I was a sobbing crying mess and feeling anxious and out of control,” she wrote in March of 2017 as she was preparing to run the storied 26.2 once again in Boston.

“I have been doing very well with PTSD as the years have passed but when you experience an event that causes PTSD things get rewired in your brain. And unexpected triggers can cause as response that is atypical for most people.”

Once the anxiety is identified as more than pre-race jitters is when the problem solving begins. Living in a world of information overload is a blessing and a curse. So Dr. Brown provides a set of guidelines to help navigate a path to appropriate and professional help.

What To Do

According to Dr. Brown, your first step is to Identify expert sources. If you’re serious about tackling your anxiety, this is how do you do it:

  • Know your sources are experts in their field. Do the research.
  • Be specific with what you’re trying to understand and do not follow advice that seems like a good idea because it worked for someone else, i.e. “Oh getting a medical marijuana card worked for you? Ok then, I’ll give it a try.” A one-size-fits-all approach definitely does not apply here.
  • Educate yourself on how to think accurately on things that make you anxious, remembering that your brain should be more of a priority than your feet.
  • Your expert needs to know the research. We know plenty about anxiety so do not try and reinvent the wheel. As Dr. Brown noted “when you hear footsteps, look for horses first, not zebras.”
  • It’s ok to consider medication but educate yourself on the side effects, weight gain, water retention, difficulty sleeping or too much sleep. Since the side effects may not justify the medication, especially for a runner’s lifestyle.

Understand The Root Cause

If you’re certain your anxiety is unique or specific to running you need to understand what the root cause is.

“The bombing in 2013 opened up the stigma of mental health and running,” said Dr. Brown, reflecting on what happened in the days, months and years since. “It was an event that happened to thousands, not just the people and runners who were there that day and, because of that people were talking about it.”

Which Dr. Brown said was the key, explaining “trauma keeps it’s power because we don’t talk about it but this was different. People learned from this and everyone was talking about it so all of a sudden, that type of conversation became the norm.”

LaFlamme is one of those people who now writes openly about her experiences that day on her blog Organic Runner Mom, “These emotions trap me at times but then they can also lift me up and bring me strength. I am still here. I can run again.

But sometimes it seems wrong and unfair. The feelings linger and sometimes I catch my heart racing. I am holding my breath. Stopped in my tracks, and then it passes. The best thing to do now is to tell you about it.”

EMDR – What Is It

There is no telling how many people sought treatment for PTSD and related illnesses because of what happened on April 15, 2013 but a lesser known therapy may have been (and still can be) effective for this specific type of trauma, EMDR therapy.

EMDR or eye movement desensitization and reprocessing is a fairly new, nontraditional type of psychotherapy. It’s growing in popularity, particularly for treating PTSD, often after experiences such as military combat, physical assault, rape, or car accidents.

Unfortunately the events of the bombing and injuries suffered because the types of bombs used were more than once referred to as like that in combat, which is another reason this therapy can be so effective to this particular trauma.

EMDR therapy was discovered by movement which is why it makes even more sense for runners. Francine Shapiro, Ph.D, founder of EMDR, discovered the link between eye movement and simply thinking about a personal traumatic event, as she did so herself in daily walks.

Shapiro noticed that when she recalled a traumatic event and shifted her eyes back and forth, it relieved the symptoms. It sounds almost too good to be true. However the therapy is so popular because of the speed at which it seems to work. More than 88% of the patients who have been treated with EMDR have reported to have all their symptoms relieved.

Does It Work

Gone are the days of months and years of talk therapy. EMDR patients see results as quickly as six weeks.

“Runners are good candidates for EMDR,” Dr. Brown noted “because runners are very willing to try something different.”

EMDR clinicians can be certified and the work is very good for people who have gotten stuck. “They are trying to dislodge something,” says Dr. Brown “so it’s effective for identified trauma but not for generalized anxiety disorders, however, the risk benefit ratio is very reasonable so it may be worth a consultation.”

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