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When I first started running nearly two decades ago, my only goal was to lose weight. As an overweight teenager, I spent most of my high school years on a never-ending search for the next best nutrition and exercise program that would take the pounds off quickly. After several failed attempts at crash dieting and countless hours of over-exercising, I turned to running.

And instantly, I was hooked.

Running became my “go-to” activity of choice. The freedom to exercise anywhere at any time, allowed me to maintain my weight loss. And the sense of camaraderie I experienced from being part of a running community, helped facilitate friendships and a sense of belonging that I so desperately needed.

But over time, running became more than just a method of weight loss or social stimulation. When my lifelong battle with anxiety took a turn for the worse, it was the time spent outside—feet to the pavement—which helped me to see that the mental and emotional benefits of exercise, far outweighed any of the physical benefits.

What the research says about exercise and mental health

Yes, stress and anxiety are a normal part of life. But when you consider that 40 million adults ages 18 or over are affected by anxiety disorders, and around 16.1 million adults aged 18 years or older in the U.S. experienced at least one major depressive episode in the last year, it’s no wonder scientists, researchers, and the mental health providers are looking for alternative ways, like exercise, to treat these debilitating conditions.

Running and other types of exercise, including walking, weight lifting and yoga, all have the effect of decreasing the risk for depression and anxiety, as well a being an effective treatment agent for both mental health conditions.

“We have lots of research showing that exercise lifts mood, decreases anxiety and improves the body’s ability to withstand and recover from stress,” explains Karen Cassiday, Ph.D., President, Anxiety and Depression Association of America, and owner of the Anxiety Treatment Center of Greater Chicago. “It is so effective that people can decrease or eliminate their need for medication and it can help people who have failed multiple attempts at different medications for depression,” she adds.

For years, “scientists have been studying the reasons why exercise has such a powerful effect on our mental well-being,” explains Cassiday, and now, studies are showing that exercise accomplishes several things that influence our mood and mind including:

  • Exercise helps to clear the bloodstream of stress-related chemicals and mechanically relaxes our muscles;
  • It decreases the inflammatory markers that are associated with poor mental health and helps to regulate and release chemicals in our brains that are associated with feeling good;
  • Exercise, specifically running, tends to expose us to sunshine which helps to increase our vitamin D3 levels, which we need in order to feel good and avoid depression and anxiety;
  • It also tends to regulate sleep and improve sleep quality, which has a positive impact on depression and anxiety symptoms;

Cassiday says these good effects start occurring after about 20 minutes of exercise and can last for hours afterward. “Exercise is one of those things that is a guaranteed win for anyone who wants to feel better emotionally.”

Running and mental health

It’s well known that running promotes the production and release of endorphins—your body’s natural pain and stress fighting chemicals. In fact, anyone who has experienced “runner’s high” can tell you how powerful this rush of chemicals can be.

But did you know the time spent pounding the pavement may also reduce the symptoms of anxiety and depression and make you feel better?

According to a paper published in the US National Library of Medicine — National Institutes of Health, involvement in structured exercise has shown promise in alleviating symptoms of clinical depression, that may be long-lasting.

And the best part: you don’t have to go all out and train for a marathon, in order to reap the mental benefits of participating in your favorite sport. In fact, an average of five days a week for about fifty minutes each session is what is recommended for enhanced mental wellness.

Running as part of a treatment plan

By now, you should be asking yourself: “How did I did feel after my last run?” And if you’re dealing with any type of stress, chances are, you felt better in the hours after you finished exercising.

That’s because the mood-enhancing benefits that come from exercise, usually kick in about five to ten minutes after moderate exercise. While impressive on its own, this natural stress relief also extends well beyond the immediate benefits you feel during your cool-down—which makes running (and other forms of exercise) a powerful addition to any treatment plan.

Multiple studies have shown that regular aerobic exercise—and primarily jogging—reduces the symptoms of clinical depression. And according to studies cited by the Anxiety and Depression Association of America, running and other forms of vigorous exercise can reduce anxiety symptoms and help you relax.

One of the most well-known researcher in the field of exercise and mental health, Dr. Michael Otto, explains in a Psychology Today article, that in addition to cognitive behavioral therapy and medication for the treatment of anxiety, there is increasing evidence for the value of exercise for treating both clinical anxiety disorders as well as more general difficulties with anxiety.

And since there is a myriad of health benefits resulting from participation in regular exercise including improved sleep, stress relief, and improvement in mood, mental health service providers can safely provide evidenced-based physical activity interventions for individuals suffering from moderate to serious mental illness.

The bottom line

Anyone can experience the mental and emotional benefits from running. In fact, “the mental health benefits of exercise are the same for all age groups and even for people who have severe mental health disorders,” says Cassiday.

As for my story……running has evolved from a form of weight loss to a place of clarity and inner peace. Now when I run, I look up and out, rather than down and forward. I focus on my breath—and how my body feels—when it is connected to my mind. And I wake each day feeling thankful to have a powerful form of therapy that involves a pair of running shoes and a long stretch of highway.

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Can Running Help to Reduce Anxiety?

You already know running can help you lose weight and prevent disease—but it can also serve as a healthy way to manage stress and maybe even anxiety.

With each run, your body releases feel-good endorphins, improves your mood, and boosts self-confidence.

It also distracts your mind from any spiraling negative thoughts, allows you to confront difficult emotions. Plus, running simply gives you something to feel good about.

Here are five reasons why adding running to your Aaptiv workout routine may help reduce anxiety.

Note: If you suffer from anxiety, consult with your doctor or a mental health professional before starting any exercise regime.

Running helps you relax.

Negative thoughts involve two areas of your brain: the prefrontal cortex, which controls attention and focus, and the hippocampus, which promotes learning and memory.

Physical activity has been shown to encourage the growth of new brain cells. And the simultaneous release of endorphins can help ease anxious feelings, too.

“Running can help to reduce the feelings of anxiety and clear space in your head,” says Aaptiv trainer Jaime McFaden. “I have clients with anxiety who have felt a great sense of calm through running.”

The physical stress of exercise blocks pain signals in the body, prompts an influx of neurotransmitters, such as dopamine and serotonin, and basically reorganizes your brain.

“I find running to be an uninterrupted way to clear your head and sort through your thoughts,” says Aaptiv trainer Jennifer Giamo. “Sometimes just expending nervous energy can also make you feel more relaxed, and many of my running clients says it helps them reduce stress or manage it better.”

Running can be a healthy coping mechanism.

When stress hits, most people reach for unhealthy fixes: a stiff drink, comfort food, or hours of television. Of course, those choices aren’t inherently bad at all.

Running, though, can lift your mood in a similar way, while also giving you a mental and physical escape from stressful situations.

“I personally run to calm my own stress more than for the typical reasons of exercise,” says McFaden. “Before becoming a personal trainer, I battled with depression after my father passed away. Exercise became the best solution for me. That was 12 years ago. I have never felt depressed or anxious since then, and I attribute that to a healthy lifestyle.”

Getting outside might provide the most bang for your buck. One study of outdoor walkers reported a decrease in anxious, ruminating thoughts. Their brain scans also showed decreased neural activity in the part of the brain associated with mental illness.

That said, be sure to also find other ways to manage your anxiety, too. Too much running could potentially lead to overexercising. “Anxiety can also make you feel compelled to work out, or work out for longer than normal,” says psychotherapist Greta Angert, M.S., LMFT.

It’s entirely possible your anxiety symptoms will persist despite regular exercise. Talk to your doctor or mental health professional to find the best options and outlets for you.

Your “fight-or-flight” skills improve.

People who experience anxiety often talk about common symptoms, such as sweating and increased heart rate. These are similar to the types of physical reactions produced by the body during exercise. Some researchers view working out as a form of “exposure treatment,” where individuals prone to anxiety can practice reacting to fight-or-flight sensations. In other words, running can help biologically “toughen up” your brain.

Another study suggests runners are simply less susceptible to stress. Runners can better observe negative feelings that pop up, and then find a way to quell them.

You can practice intentional breathing.

Meditation is known to make exercise more effective, and intentional breathing plays a critical role. No surprise, then, that running can also help lower stress levels because of its emphasis on proper breathwork. Mcfaden says breathing is the most fundamental element to running, and also to calming an anxious mind.

“Running can help with anxiety, which can include symptoms like difficulty sleeping, racing intrusive thoughts, and uncomfortable body sensations, such as stomach problems, headaches, or issues with focus,” says Angert. “Focusing on one’s breath is very effective, and I work with clients who utilize exercise in general as a supplement to therapy and/or medication.”

You’re part of the running community.

Anxiety can cause some people to feel alone. As a runner, though, you’re already part of a big community – especially if you’re part of the Aaptiv community.

Making connections with other runners can equip you with like-minded individuals willing to support you with each run or race. Find a local running buddy, join a running group, or check out the Aaptiv Facebook page for more motivation—and a sense of togetherness.

Again, running is not a substitute for therapy, medication, or medical advice. But it can certainly function as a great way to ease symptoms of stress and/or anxiety. It’s a good place to start.

How Running Can Help With Anxiety Disorders

As if you needed another good reason to take up recreational running…But if you do, consider jogging because it can really calm your anxiety.

Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the U.S., or 18% of the population, according to the National Institute of Mental Health. The Anxiety and Depression Association of America (ADAA) says that they are highly treatable, but only a third of patients actually receive treatment.

People with anxiety disorders are three to five times more likely to go to the doctor. Why spend the money when you can prevent the problem from getting worse by simply running. You don’t need to do it for hours every day.

Brain cells

Studies have found that exercise creates vibrant new brain cells. Physical activity reorganizes the brain so that its response to stress is reduced and anxiety is less likely to interfere with normal brain function. In experiments, when mice that were allowed to exercise regularly experienced a stressor – such as exposure to cold water — their brains displayed a spike in the activity of neurons that shut off excitement in the ventral hippocampus, which is the region in the brain that regulates anxiety.

Hormones

Other studies suggest that exercise improves brain function almost immediately and the positive effects can make a big difference in the long-run. Exercise helps release endorphins, also known as the feel-good chemicals in the brain. Endorphins and endocannabinoids, known for relieving pain and promoting positive feelings (among other things), are chemicals naturally produced in the brain during exercise, research shows.

Stress

People feel under stress all the time; sometimes they don’t even realize it. It’s important to handle the pressure before it becomes chronic. The Mental Health Foundation recommends exercise as a way to relieve tension, stress and mental fatigue. Doctors often recommend running. They believe that the chemicals that boost your mood after a run also help relieve stress. One study even found that exercise can help reduce the ill-effects of stress internally.

Body temperature

Running, and aerobic activities in general, will increase your body temperature. “It’s also common for episodes of increased stress and anxiety to cause a person to feel cold or chilly because of the restricted blood flow to the skin due to the constriction of blood vessels caused by the stress response,” according to Anxiety Center. When the body feels cold or chilly, it wants to increase its temperature and go back to normal. Warm body temperature, not fever, of course, will calm the body.

Socializing

Running connects people. Whether you are training for a marathon, work with a coach, run with friends for motivation and accountability, you are socializing. This takes away feelings of loneliness, which is a common problem for those with anxiety.

More readings:

6 Things That Make Anxiety Worse

NEVER Say These Things to a Person Suffering From Anxiety

12 Surprising Health Benefits of Exercise

I once heard a story about a couple in a restaurant who ate in total silence for over an hour. When coffee came, the husband whispered something to the wife, who hissed back: “It’s not the coffee, it’s the last 25 years.” A slow crumbling like that would be pretty appalling. But when you’re given the surprise approach, the moment of impact feels brutally physical. Someone stands across from you, looks directly into your eyes and tells you they are leaving you, they no longer love you, they have found someone else, you are not enough, and you think: “Oh, so this is the moment I am going to die. I can’t possibly get through this.”

As I lay on the floor of my own sitting room, watching my husband’s feet walking quickly towards the door, I knew that the end of my marriage, after less than a year, would bring unbearable sadness, awkward questions, terrible embarrassment. I even knew that, with the right coping skills, it might be OK in the end. But I also knew something else: at 29, unlike most adults, I had no coping skills.

Anxious even as a very small child, I had let my worries fester, take control, and dominate my life. Mental health problems had stunted my own growth, leaving me too scared to take on challenges. I quit things when they got hard. I turned down opportunities that would push me, or give me independence. I preferred being small.

From a young age, I had been agoraphobic, prone to panic attacks, intrusive thoughts, hysteria and depression. By the time my husband walked out on me, I’d had years of this. Often I couldn’t make it to the supermarket on my own (honestly), much less navigate my way through a breakup of this magnitude. I knew I had to get off the floor, but I didn’t know what to do next. Everything was draped in fear.

If ever there is a trigger to make you try to change something, it’s the shock of your marriage collapsing. Given that people who get divorced in the UK have usually managed about 11 and a half years before they pull the plug, tanking your vows as spectacularly as I did felt like quite the feat. Any longer and it might just have been seen as sad, unavoidable, or chalked up to “young people not sticking at anything any more”; but eight months? It would be unwise not to question your life just a little bit after that.

I went back to work, alternately crying in the toilets (my husband worked for the same company; that was fun) and sitting mute at my desk, listening to bagpipe music on my headphones in a strange attempt to find some mettle whenever I saw him walk by. (As an aside, this was strangely effective and I would recommend it to anyone needing to feel strong. Start with Highland Laddie.)

I felt stagnant, aware that I had to endure these painful emotions, but also worried I might never feel truly better. Life continues around you, no matter how much your own world has been shattered. I could see normality heave into view and I didn’t want it. I suspected that, within a few months, I might be over the breakup but still locked in my small space, anxiety and depression my only bedfellows.

It’s easy to behave as if nothing is wrong, even when you have a mental illness. I was good at holding down my job, cracking jokes, going out just enough that I wasn’t seen as a hermit. I could probably have gone on like this for ever, living half a life, pretending I was OK with it. But something had broken, and I couldn’t do it any more.

I saw myself exposed as a fraud – a cowardly kid play-acting as an adult, with no business being there. JK Rowling has said that when her own short-lived marriage imploded, leaving her an unemployed single parent, rock bottom became the foundation upon which she built her life: because her worst fears had been realised, she had nowhere to go but up. As it’s her, I can allow the cliche and even grudgingly admit it fits. In Rowling’s case, she went on to create a magical world of wizards that helped her become one of the richest women in the world. In mine, rock bottom spurred me on to go for a jog.

I still don’t know why running was the tool I opted for in the midst of misery. I’d never done strenuous exercise before. But I had spent a lifetime holding at bay the need to run away – from my mind, from my negative thoughts; from the worries that built up and calcified, layer upon layer, until they were too strong to chip away at. Maybe the sudden urge to run was a physical manifestation of this desire to escape my own brain. I guess I just wanted to do it for real.

I was about to turn 30, and terrified I would use the breakup as an excuse to retreat, to be scared of life itself. I was not ready to run across a playing field. So I put on some old leggings and a T-shirt and walked to a dark alleyway 30 seconds from my flat. It fitted two important criteria: near enough to the safety of home, and quiet enough that nobody would laugh at me. I felt absurd and slightly ashamed – as if I was doing something perverse that shouldn’t be seen.

With my headphones in, I settled on a song called She Fucking Hates Me by a band called Puddle Of Mudd. Not to my usual taste, but the lyrics were suitably angry and I didn’t want anything that might make me cry (everything was making me cry). I managed 30 seconds of jogging before I had to stop, calves screaming and lungs burning. I rested for a minute, and then started again. I somehow managed to keep time with the shouting singer, mouthing the words as I screwed up my face and lumbered down the path. I ran an incredible three minutes, in stages, before I gave up and went home. Did I feel better? No. Did I enjoy it? Also no, but I hadn’t cried for at least 15 minutes and that was good enough for me.

To my surprise, I didn’t leave it there. I went back to that same alley the next day. And the day after that. Those first few attempts were all pathetic, really. A few seconds, shuffle, stop. Wait. Go again. Freeze if a person emerged from the shadows. Feel ridiculous. Carry on anyway. Always in the dark, always in secret, as if I was somehow transgressing.

I got shin splints, which hurt like hell. I ran too fast and had to stop after wheezing uncontrollably. Photograph: Thomas Butler/The Guardian

I got shin splints, which hurt like hell. I ran too fast and had to stop after wheezing uncontrollably. I tried to go up a hill and had to admit defeat and get on a bus; I had a panic attack in a dark part of the local park when I mistimed sunset and realised I was all alone. I fell over and cried like a child. Running felt like a language I couldn’t speak, and not only because I was hugely unfit. It seemed to be something only happy, healthy, bouncy people did – not neurotic smokers who were scared of everything.

Throughout my life, if I couldn’t do something well on the first attempt, I was prone to quit. It was embarrassingly clear to me that I was not running well, or getting better at it. And yet, much to my own quiet disbelief, I carried on. For the first couple of months, I stuck to the roads closest to my flat, looping around quiet streets. I was slow, sad and angry. But two things were becoming clear. The first was that when I ran I didn’t feel quite so sad. My mind would quieten down; some part of my brain seemed to switch off, or at least cede control for a few minutes. I wouldn’t think about my marriage, or my part in its failure. I wouldn’t wonder if my husband was happy, or out on a great date, or just not thinking about me at all. The relief this gave me was immense.

The second thing, which was even more valuable, was that I noticed I wasn’t feeling so anxious. Soon enough, I was reaching parts of the city I hadn’t been able to visit in years, especially alone. Within a month I was able to run through the markets of Camden without feeling I would faint or break down. When your brain has denied you the chance to take the mundane excursions most people do every day, being able to pass through stalls selling “Nobody knows I’m a lesbian” T-shirts suddenly feels like a red-letter day. By concentrating on the rhythm of my feet striking the pavement, I wasn’t obsessing over my breathing, or the crowds, or how far I was from home. It was miraculous to me.

When you run, your body takes your brain along for the ride. Your mind is no longer in the driving seat. You’re concentrating on the burn in your legs, the swing of your arms. You notice your heartbeat, the sweat dripping into your ears, the way your torso twists as you stride. Once you’re in a rhythm, you start to notice obstacles in your way, or people to avoid. You see details on buildings you’d never noticed before. You anticipate the weather ahead of you. Your brain has a role in all of this, but not the role it is used to. My mind, accustomed to frightening me with endless “what if” thoughts, or happy to torment me with repeated flashbacks to my worst experiences, simply could not compete with the need to concentrate while moving fast. I’d tricked it, or exhausted it, or just given it something new to deal with.

Anxiety has been with me for as long as I can remember, but it’s ebbed and flowed over the years. At 11, I went to secondary school and the change sent me into a tailspin. I cried every day, like many other kids who hate moving to a new place and making new friends; but I didn’t stop there. I developed OCD tics – swallowing whenever I had a bad or negative thought, blinking, even more disgustingly, spitting – as if to rid bad feelings from my body as quickly as possible. I had no idea what this meant – I just knew I “had” to do them. I remember missing my bus stop in the mornings many times because I hadn’t blinked in the correct way. There was no winning; the goalposts would shift all the time. If it wasn’t blinking, it was avoiding cracks in the pavement – small things that paralysed me.

These routines would take up hours of my time, partly in the doing and partly in the concealing; those around me must not know. I also found myself disassociating for the first time – detaching from my surroundings when it all got too much. This remains my most terrifying anxiety symptom, and the one I can’t totally shake; though it’s believed that your brain does this in an attempt to protect you, it only makes me feel much worse, as though I’m drowning but my legs don’t work. Colour gets too bright, sounds are jarring and it feels like I’m cocooned in bubblewrap, unable to get back to reality.

At worst, I’ve looked in the mirror at my own face and not recognised it to be me, and not just because I had terrible hair and bad skin that morning. It’s a strange and awful experience. When I was trapped in a fug of anxiety and depression in my early 20s, disassociation made it feel as though the people around me were actors in a bad reality show. I couldn’t connect with loved ones; everything felt fake and staged.

What else? Well, I would scratch and pick at my skin, until it bled and scarred, pull out hairs (a mild form of trichotillomania, where sufferers have an intense urge to pull their hair out and feel a strong sense of relief when they do). I’d chew my lips until they bled. All fun scars to have as an adult: “Why do you have scars all up your legs, Bella?” “Oh just because I pull and pluck my leg hair until I bleed when I feel like I’m losing control – who wants another drink?”

Having managed to leave school with most of my childish worries fairly dormant, I was knocked off my feet one day at university, when, out of the blue, I had a terrible panic attack. The clever (not a compliment) thing about anxiety is that the moment you’ve got a handle on one thing (night sweats, panic attacks, dizziness, nausea, headaches), it’ll throw you another one, and you better believe it’ll be worse.

Running is not a cure-all for severe mental illness, or anything else for that matter. But I often think of the girl I was in my 20s and wish I could go back and try putting on some trainers. Instead, I dropped out of uni, went to a psychiatrist and took the antidepressants that I was swiftly prescribed. What else could I do? At this point, suicidal thoughts were creeping in.

Despite all of this, I was extremely fortunate. I had a family who, while not fully understanding why their daughter was crying hysterically all the time and refusing to go out, had the resources to pay for me to see a professional. (My NHS GP was kind, but could only put me on the waiting list for therapy.) The pills helped, and I was able to look at myself in a mirror again without wondering who was looking back at me. After quitting my degree, I got a job, was able to go out again, and managed a few relationships. I was patched up, in the most basic sense.

After a decade of settling for merely ‘managing’, I’d found the thing that broke me out of it: I’d found running. Photograph: Thomas Butler/The Guardian

I say all this, not to give you a small insight into my not-particularly-special mind, but to show how easy it is to accept the most pallid imitations of existence when you’ve got a mental illness. To paint on a small canvas, and to pretend that you’re happy with the narrow perimeters you’re able to move within. Not a life wasted by any means, but a life limited. So to find something that breaks you free of this can feel miraculous. For some that may mean medication, for others meditation. My mother does yoga whenever she feels low. A colleague lifts weights, and one friend boxes because he feels far too angry and it helps keep those thoughts under control. Somehow, in the wreckage of my marriage, after a decade of settling for merely “managing”, I’d found the thing that broke me out of it: I’d found running.

Weeks after my marriage collapsed, I was still sick with it all. At work, I would regularly go into the toilets and cry quietly. At home, I would put on my pyjamas the moment I got in and mindlessly watch TV. When I went out, I drank too much and would cry again. While I was running, nobody could give me the dreaded sympathy head tilt or an excruciating hug. Nobody even looked at me.

I soon found I was setting myself little challenges: go two minutes farther today, run down that busy road you’ve avoided for years. I discovered old railway lines that ran like arteries through built-up estates, hidden from plain sight. I ran along the canal and found an expanse of brambles, wild flowers and ducklings swimming along next to me. The panic attacks were fading away.

One day, I decided to go farther. I ran into the heart of the city, towards one of the bridges that traverse the Thames and beckon you over with the promise of light and air, and I headed across without a backwards glance. I crossed another bridge, intoxicated by the sunshine on my skin, and I ran into Parliament Square, thronging with tourists and vendors and honking cars. I passed through Soho, marvelling at the noise and rickshaws and sex shops. I kept going, like a neurotic Forrest Gump, until I physically couldn’t go any farther. And when I stopped, I wandered around. The pit in my stomach wasn’t raw, I wasn’t checking my breathing – I didn’t notice my body. I was able to take in my surroundings and enjoy them. I felt triumphant. I felt… happy.

Running is not magic beans. Life is tricky and gets diverted constantly, and we all stumble. There have been crappy times. There have been brilliant times. But the main difference between my life before I ran and my life since is that I have hope. And I have a life that is not always dictated by worry, panic, doom and depression. You can do so much more when those things don’t sit on your chest and slowly squash you.

Some people might take my (small) achievements as proof that I simply grew out of my anxiety, or that I was never affected by it too much in the first place. I assure you neither is true. Anxiety rarely “leaves” you. Some people might be lucky and feel it float away one day; but for most of us it’s a lifelong companion we must learn to live with. That doesn’t mean enduring it, or giving in to it. It means finding ways to negate it, to push it back.

Since that first short and sad run I took over four years ago, I have lived alone, travelled, changed jobs and begun a new relationship. Knowing I could do a 10K meant I knew I could fly to New York for a job interview, and that I could step outside my door alone without hyperventilating. It’s a measure of how over the whole “starter marriage” I am that I sat across from my boyfriend at dinner last year and proposed to him (he said yes, thank the lord). Running has given me a new identity, one that no longer sees danger and fear first. I ran myself out of misery.

Six tips for anxious runners

Take water Most experts say you don’t need to, on short runs, but it might help if you get panicky and need to stop. Take sips, wait for your breathing to get back to normal. I have a bottle that moulds to my hand and makes me feel I’m carrying a neon weapon.

Podcasts and music help They distract me when I get bored, or tired. More importantly, at the beginning, they made my brain concentrate on something other than worry.

Start small If leaving your safe places makes you feel vulnerable, do a loop of your road. Run that road until you feel confident you can go to the next one. It all counts, and it’s important you don’t push yourself too fast. Listen to your body.

Nobody is looking at you Running feels incredibly exposing, overwhelming and scary to begin with. I assumed people would mock me, honk from vans. But nobody batted an eyelid. I fell over at the feet of a man on the canal path and he carried on eating his sandwich.

Enjoy the beauty around you Your anxiety can make you introverted, forcing your brain to see negative, scary things instead of your surroundings. Nearly every time I go for a run, I stop to take a longer look at a building, a poster, a sunset. My phone is full of photos of weird street names, beautiful views, and dogs I see along the way.

Be kind to yourself Buy an ice-cream after a run; have a glass of wine. Never berate yourself if you have a panic attack and need to go home abruptly. Running is not always a straight line (that would be boring).

• Jog On, by Bella Mackie, is published by Harper Collins, priced £12.99. To order a copy for £11.43, go to guardianbookshop.com or call 0330 333 6846.

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Depression and anxiety: how running helped me

My anxiety started back in 2009, when the home that I lived in with my husband and children was damaged by the floods. I began to notice myself overthinking everything and analysing every little irrelevant thing; worrying became a daily habit, even about things that hadn’t happened yet. At the time I didn’t realise this was anxiety – I just put it down to the daily stresses of being a mum.

Later that year I became very restless and distracted, not always concentrating on what I was doing. This ended up putting me in danger – when cutting my parent’s lawn one day, I wasn’t paying attention and ran over the lawn mower cable, which electrocuted me badly. 240volts of electricity threw me from the lawn to the path and cut my head open, and I woke up later in hospital.

Returning home I felt weak, silly and pathetic in some ways. For months I couldn’t turn on a light switch or boil a kettle – anything electric terrified me. This made me feel very low and worthless – some days I didn’t see the point of getting out of bed, since I couldn’t do anything.

“For months I couldn’t turn on a light switch or boil a kettle – I didn’t see the point of getting out of bed, since I couldn’t do anything.”

I decided it was time to talk to my GP, who diagnosed me with an underactive thyroid. For three years I went back and forth, saying that surely this couldn’t just be down to my thyroid. Eventually he diagnosed me with depression and put me on medication.

However, the medication made me feel more anxious and paranoid than ever, and I ended up having a panic attack on a flight. I felt like I was going to die, I couldn’t breathe and felt trapped – luckily the flight crew were very understanding and helped me take control again. I visited my GP again, but he just increased my medication.

I think this was the point when I was at my lowest. I was heading in a downward spiral and drinking alcohol every night, which did me no favours. It just kept me in a dark hole, depressed and anxious.

In 2014 I decided that enough was enough. I put my foot down with my doctor and said no to medication, no more alcohol and no more blaming my thyroid for how I felt. After a lot of talking, he diagnosed me with anxiety and depression and referred me to a wellbeing clinic. The people there were absolutely fantastic – they never judged me, always listened and understood my feelings and after many sessions I began to feel like me again.

We talked for many hours over these sessions, and at one point I was asked what I liked doing when I was a child. For me, this was an easy answer: running. They suggested that I give this a go as an adult and see how I felt.

“My chest felt tight, I started to wheeze, I had tears flowing, but I was determined not to let this beat me.”

So the next day, I did just that. At first it was horrible – I cried, I panicked, I couldn’t breathe. Luckily I called a friend who soon snapped me out it. A week passed and I gave it another go. This time my chest felt tight, I started to wheeze, I had tears flowing, but I was determined not to let this beat me.

I pushed myself to run every day, and every time it got easier. The more I ran, the more I loved myself again – not because I’m perfect, but because every mile I ran it proved to me that I am capable of more than I ever thought possible.

It’s now got to the point that when I run, it’s nearly impossible to be sad. There are endorphins, the sense of accomplishment, time to think, time with friends and the feeling of my heart pounding inside my chest, reminding me that I’m alive with an amazing body that allows me to accomplish incredible things!

In 2016 I decided to run a Tough Mudder for Mind as I wanted to give something back for all the support I’ve received with my own battles and the support they’ve given my friends and family.

“Every mile I ran proved to me that I am capable of more than I ever thought possible.”

Me and a team of friends took on the 10mile race which included over 20 obstacles. My team made sure I conquered some of my fears through tackling these gruelling obstacles head on, and through our sponsors we raised nearly £3000.

This year I took on the Tough Mudder challenge again with a team of 13, aiming to beat our fundraising total from last year. We got all of our friends and family involved organising sponsored bike rides, the Hull 10k, and an auction with prizes donated by my local rugby teams Hull FC and Hull KR, and my favourite football team Manchester United.

“With the support of my family and friends I dug my heels in, and with pure determination and lots of tears I battled on to cross that finish line.”

I also took on my biggest challenge yet, pushing my limits to run a marathon. I did this in my home town of Hull and completed it in 5hours 21mins which I was immensely proud of. It was a very hard challenge and every mile was a battle. My anxiety kicked in and I questioned myself all the way round, but with the support of my family and friends cheering me on along the route I dug my heels in, and with pure determination and lots of tears I battled on to cross that finish line.

All of these fundraisers took our total to a staggering £4219 which is fantastic and I can’t thank my team mates, friends and family enough for all the support they’ve given me.

If you’d like to give Tough Mudder a go, you can find out how to sign up here.

Or, if running’s not your thing, there are loads of ways to fundraise for us – get some inspiration here.

How I “Cured” My Anxiety and Night Terrors to Live a Life Worth Living

I should be my first line of defense. I should be responsible for my own health through my behaviors.

This is why the healthcare system is fucked.

People are conditioned not to be responsible for their own health. It’s only those that experience chronic illness and fight through the long road to recovery that then understand how important a healthy lifestyle really is.

Disclaimer: I’m not knocking doctors by any means. They save lives, and if you think you need to see a doctor, then you absolutely should. Some people see great results taking medicine for anxiety and depression. I’m only sharing my story and saying what didn’t work for me.

The moment I took accountability for my own health is when I realized how shitty my lifestyle had been:

  • I sat playing video games all day long.
  • I frequently pulled all-nighters — again playing video games — only to finish my college assignment 1 hour before the 7 AM deadline.
  • I ate like crap.
  • I drank 4–5 nights per week, blacking out 2 of those on average.
  • I barely exercised except basketball once per week, if that.

The next few months, I made some simple lifestyle changes that drastically improved my situation.

With my health on the line, the tiny shifts in my daily behaviors were rather easy to make. Sure, I had to read and learn a few things about healthier living, but in comparison to what I had endured the last several years, that was nothing.

Two Important Weapons in the Battle Versus Anxiety

Looking back at my battle with anxiety, there were two crucial things that I learned:

1. Anxiety, in my experience, wasn’t a disease. It was a feeling that I had never been equipped to manage.

That’s exactly what I tell people these days when asked about my anxiety.

I never “cured” it. I’ve simply learned how to “manage” it.

There wasn’t actually anything wrong with me, at least not in the “I have cancer and I’m slowly fading with each day that passes” kind of sense.

I was just experiencing elevated levels of anxiety for the first time and I had no idea how to manage.

For most of my life, I had been living in a reactive state. If something felt off, I went to the doctor and blasted it away with the best that modern medicine had to offer.

To manage anxiety I had to become proactive.

Looking at my lifestyle, I could see why I felt like an anxious, nervous wreck. The daily activities of my life had been filling up my anxiety bucket and I had been doing nothing to drain it.

That’s how I view managing my anxiety these days — like a bucket.

If I spend a few days eating like shit and neglecting exercise, I literally feel my bucket overflow with anxiety. When I spend a few days practicing healthy behaviors, I return to a balanced state.

My bucket becomes half full, so-to-speak. Right where it belongs.

2. Stop fighting the feeling.

When you feel angry or sad, what do you do? Do you try to fight the feeling with all your might, or do you recognize it for what it is — a feeling — and allow it to slowly fade?

The problem with anxiety is that it’s a feeling no one enjoys experiencing.

The nervousness.

The on-edge-ness.

The worry.

The fear.

The impending doom.

I don’t blame you for not wanting to feel like that, but that doesn’t mean you should fight it. It took me a painfully long time to learn this.

Anxiety, isolated from other issues, isn’t anything to worry about. It’s actually a good thing to have it. It spikes your adrenaline when you need it most — think running from bears, hunting for food, and other things of the sorts.

In today’s world, you don’t have much of a need for that feeling. Outside of fighting and war, the majority of people could do without it. So when you experience it, you struggle. You fight back. You resist.

The resistance to anxiety is what makes it stronger. It allows your anxiety to grow. It adds to your bucket.

I remember days lying in my bed, waking up from a decent night’s sleep and actually feeling normal. My first thoughts were “please God, don’t let me start feeling anxious.”

And without fail, I’d start feeling anxious. It was the resistance that brought on the very thing I feared.

But if you let go, you allow yourself to be free.

Feel the feeling of anxiety. Recognize it’s just a feeling. Learn to accept the uncomfortableness. Then move on.

“Oh, I’m feeling anxious. I don’t like it, but it’s not going to hurt me.”

This is what I practiced doing for several months, even after making all the lifestyle changes I talked about earlier. Eventually, I got to a point where a month had gone by and I hadn’t felt overly anxious.

No more panic attacks. No more night terrors. No more dragging ass.

I remember saying to myself, “Hm, that’s weird. I can’t believe I haven’t felt like that in a while.”

Then I continued on with my day.

Several years later…

Pure happiness.

…and I’ve never cheesed so hard in my life.

I rose from the pit of despair and conquered my fears. Today, I happily and healthily “manage” my anxiety, but I sure as hell haven’t “cured” it.

Before you go…

I’m Jason Gutierrez. Anxiety’s a bitch, but mindfulness can make it better. If you enjoyed this article, you might love my free 7-day mindfulness email course to reduce stress, improve happiness, and learn the foundation for creating change. Get started here.

October 10 is World Mental Health Day, a chance for raising awareness of mental health issues around the world and mobilizing efforts in support of the effort.

Most Tuesdays, I run early in the morning with a woman named Meredith. For such close friends, we’re quite different. Meredith is a voluble social worker who draws energy from crowds. I’m an introverted editor who works from home. Meredith runs her best in large races and loves training with big groups. I’ve set PRs in solo time trials and tend to bail when a run’s head count gets above five. Meredith is a worrier, beset by regrets and anticipated outcomes, who has sought treatment for anxiety. I have dysthymia, or chronic low-grade depression. We like to joke that Meredith stays up late as a way of avoiding the next day, whereas I go to bed early to speed the arrival of a better tomorrow.

We do have one key thing in common: Meredith and I run primarily to bolster our mental health. Like all runners, we relish the short-term experience of finishing our run feeling like we’ve hit reset and can better handle the rest of the day. What’s not universal is our recognition that, without regular running, the underlying fabric of our lives—our friendships, our marriages, our careers, our odds of being something other than miserable most of the time—will fray. For those of us with depression or anxiety, we need running like a diabetic needs insulin.

Running Is My Therapy: Relieve Stress and Anxiety, Fight Depression, Ditch Bad Habits, and Live Happier amazon.com $19.06

Meredith and I discovered this decades ago, and now researchers and practitioners are starting to catch up. Studies show that aerobic exercise can be as effective as anti-depressants in treating mild to moderate depression (and with side effects like improved health and weight management rather than bloating and sexual dysfunction). In countries such as Australia, United Kingdom, and the Netherlands, official guidelines include exercise as a first-line treatment for depression. Although U.S. guidelines have yet to change, at least one psychotherapist, Sepideh Saremi in Los Angeles, California, conducts on-the-run sessions with willing patients.

How does moving the body change the mind? A growing body of work—both in the lab and with patients—shows that there’s more to it than endorphins, the well-known opioid the body produces during certain activities, including exercise. The emerging, more sophisticated view of running to improve mental health also takes into account long-term structural changes in the brain as well as subjective states like mood and cognition. Science continues working to explain the theory behind what we runners already know from practice.

Think Different

Unlike many with the condition, I’ve never been majorly incapacitated by depression. Most people would consider me productive, accomplished, perhaps even energetic, given that my lifetime running odometer is past 110,000 miles. My dysthymia has two main components: weltschmerz, a German word meaning sadness about how reality doesn’t live up to one’s hopes, and anhedonia, a diminished ability to experience pleasure. Life often feels like waiting out a series of not-horrible, not-fun obligations. Things sometimes seem so pointless that I watch myself not caring that I don’t care. For example, I once received a group email that a book I’d coauthored had made The New York Times best seller list. That’s a big deal in publishing. As if from outside, I observed myself writing an exclamation-point-filled reply-all response thanking and congratulating those of us who worked on the book. As I typed I thought, “Yeah, fine, whatever. Is this really going to lift life above 2 p.m. on a gray Tuesday in March?”

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That it’s possible to be outwardly active but internally askew can mask just how common depression and anxiety are. In any one year, about 10 percent of the U.S. population would meet the diagnostic criteria for depression, and about 20 percent for anxiety. (The two often coexist.) The incidence of those conditions in the running population is probably similar; a 2017 review of research published in the British Journal of Sports Medicine found no difference in depressive symptoms between what the researchers called “high-performance athletes” and nonathletes. All levels of runners are affected, with elites such as Olympian Adam Goucher and Western States 100-mile champions Rob Krar and Nikki Kimball having spoken publicly about their depression.

Of course, everybody gets sad and worried at times. What distinguishes those feelings from clinical depression and anxiety? In the short term, therapists often look for significant changes in emotions, behavior, and psychological functioning. They also focus on how symptoms such as feeling agitated, threatened, and uncomfortable (for anxiety) or joyless, lethargic, and apathetic (for depression) interfere with people’s everyday functioning. “I look at how these things affect activities of daily living, like sleeping, going to work, interpersonal relationships,” says Franklin Brooks, Ph.D., a clinical social worker in Portland, Maine. “There’s a profound difference between ‘I’m having a bad day at work’ and ‘I’m having a bad day at work and I’m not going to get out of bed tomorrow because of it.’”

That classic depiction of depression sounds like what Amelia Gapin, 34, a software engineer and marathoner from Jersey City, New Jersey, has experienced. “I’ve had episodes where, for six weeks, two months, I couldn’t even get myself out of bed,” she says. “During the weekends it was wake up and take a couple hours to move myself to the couch.”

Ian Kellogg, 22, a 14:43 PR 5K college runner at Otterbein University in Westerville, Ohio, says, “When I fall into depression, I more often than not don’t run. I can’t find the energy or willpower to get out the door, even though I know my training is suffering and that just half an hour will make me feel better.”

Pati Haaz, 42, also knows this form of depression but was able to use running to overcome it. In June 2015, the finance professional from Kendall Park, New Jersey, had a miscarriage while two months pregnant. She became severely depressed and started missing work. “I didn’t want to get out of bed, I didn’t want to go out of my house,” she says. “It was that feeling that there’s no point in continuing. I had no motivation to do anything other than take care of my kids, which was more an automatic duty.” Guilt over being depressed—“feeling like I’m the worst mother in the world”—compounded the situation.

Haaz started seeing a therapist who asked about Haaz’s pre-depression hobbies. Haaz said that she was a runner who, before becoming pregnant, had planned to run her first marathon that fall in New York City. The therapist encouraged her to resume running. Haaz decided she needed the goal of finishing a marathon to overcome the inertia that depression had introduced to her life.

She found that marathon training helped in two key ways. “If I was running for the sake of running, I would have stopped with my normal six-mile run,” Haaz says. “But I was doing 16, 18, 20 miles, things I’d never done before. I was able to carry this sense of accomplishment into other areas.”

Even her shortest runs helped Haaz think differently. “If I was driving or working or waking up in the middle of the night and thinking about the things that were making me sad, it would just make things worse—it would become like a spiral, and there was no end to it. But when I was running, I would think about those same things, and somehow I was able to process them differently. I would start my run with all these negative thoughts, and after a mile or two, they were gone.” Five months after her miscarriage, Haaz finished New York City in 6:38.

Reframing ruminations—thinking differently about hashed-over topics—is one of the main appeals of running for those of us with mental health issues. Cecilia Bidwell, 42, an attorney from Tampa, Florida, who has anxiety, puts it this way: “When I’m running, the thoughts come in and out, and I’m not worried,” she says. “I can think about things objectively. I realize that things that I’m thinking are a huge deal aren’t a big deal in the scheme of things.” The effect carries through Bidwell’s stressful work days. “When I’ve gone for a good run in the morning, if things are going haywire at 2 p.m. I’m handling them a lot better. I’m not creating crises and wondering, ‘Why am I here?’”

The more-immediate cognitive focus of a typical run also contributes to its efficacy. “When we’re overwhelmed with anxiety and depression, shifting from the big picture—all the frustrations, worst-case scenario thinking—to the small, in-the-moment task of doing something that approaches a goal, like running a four-mile loop with two hills, will kick off a positive feedback loop that continues throughout the run and takes our thinking and emotions out of the trench of negativity,” says Laura Fredendall, Psy.D.

These changes in mood and thinking are more accessible for runners. In a 2008 study published in the Archives of Physical Medicine and Rehabilitation, ultramarathoners, moderate regular exercisers, and non-exercisers walked or ran for 30 minutes at a self-selected pace that felt somewhat hard. After the workout, everyone’s mood had improved, but that of the ultramarathoners and moderate exercisers did so about twice as much as that of the sedentary people. Also, the ultrarunners and regular exercisers reported greater vigor and less fatigue after the workout than before, while the non-exercisers felt the same.

The reason is that runners can hold a good pace for a long time without going anaerobic, and that allows the physiological processes that lead to improved mood, according to Panteleimon Ekkekakis, Ph.D., a professor at Iowa State University who is a leading figure in the field of exercise psychology. “In sedentary folks, their ventilatory threshold—the point where exercise is no longer purely aerobic—is very low,” he says. “So they get up off the couch, they take a few steps, they’re already above their ventilatory threshold. If you’re a regular runner, you have the cardiorespiratory fitness to sustain an exercise intensity that’s associated with a feel-better effect.”

Pati Haaz overcame post-miscarriage depression by training for the New York City Marathon. Amelia Gapin’s daily runs provide reprieve from depressive rumination. Marathonfoto / James Farrell

My Chemical Romance

What causes that feel-better effect? Although the quick answer is usually endorphins, they’re not the only relevant aspect of brain chemistry. What’s more, focusing on the nebulous “runner’s high” ignores crucial changes in brain structure and thinking patterns that running can induce.

Endorphins entered the runner’s lexicon in the 1970s. That’s when it became known that these chemicals, which bind to neuron receptors in the brain, are released at higher levels during a run. Several studies found that higher blood levels of postrun endorphins correlated to improved mood. In terms of the brain, however, a strong correlation between endorphin levels and improved mood wasn’t demonstrated until 2008. German researchers used PET scans, an imaging study often used to check for cancer, on triathletes’ brains while the athletes ran for two hours. They found high levels of endorphins in the prefrontal cortex and other parts of the brain associated with mood, and that these levels aligned with the athletes’ reports of euphoria.

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But endorphins aren’t everything. As part of his research into human evolution, David Raichlen, Ph.D., a professor of anthropology at the University of Arizona, has measured pre- and postrun endocannabinoid levels in runners, dogs, and ferrets. Endocannabinoids are substances that bind to the same receptors in the brain as THC, the primary substance responsible for a marijuana high.

Raichlen says there are two leading theories on why running causes increased levels of endorphins and endocannabinoids. First, when humans became hunter/gatherers close to 2 million years ago, they became more active; the release of these chemicals, which act as pain relievers, may have evolved to allow longer, faster movement. In this scenario, the feel-good aspect is a byproduct. Second, higher levels of these chemicals while active could have motivated continued movement, which would lead to getting more food and ultimately higher survival rates. Raichlen says the two mechanisms might have worked in tandem.

Whatever the original mechanism for these evolutionary adaptations, they’re especially helpful for modern runners with mental-health issues. It’s nice to run for an hour and go from being in a good-enough mood to a better one. It’s a fundamental shift to go from being miserable to content, thanks to an infusion of feel-good substances. “I’ll finish a run and be like, ‘Wow, this is how most people feel all the time,’” Bidwell says.

A short-term mood boost thanks to endorphins and endocannibinoids is one thing. (Granted, one much-appreciated thing.) But where running really helps with mental health is over time, thanks to a change in brain structure. A review of research published in Clinical Psychology Review concluded “exercise training recruits a process which confers enduring resilience to stress.” This appears to occur because regular running produces the same two changes that are thought to be responsible for the effectiveness of anti-depressants: increased levels of the neurotransmitters serotonin and norepinephrine, and neurogenesis, or the creation of new neurons.

Neurogenesis occurs primarily due to a protein called brain-derived neurotrophic factor, which has been been called the Miracle-Gro of the brain. “It helps neurons fire and wire together,” Fredendall says. Much of this happens in the hippocampus, an area of the brain that’s often shrunken in people with depression. “MRI scans have shown that even after a six-month exercise intervention, there’s a visible increase in the size of the hippocampus,” Ekkekakis says.

As Ekkekakis notes, you have to be fit to really get the daily benefits that can lead to structural changes. Of course, you also have to get yourself out the door, which can be especially difficult if you’re depressed. But success in running on an especially tough day makes it easier to get out the next time. And it can spur another key mental health benefit of running.

I Think I Can, I Think I Can

Levels of chemicals in the brain are only part of your mental state. There’s also cognition, or mental processes. Cognition includes not just straightforward thinking (“I should run long today because a blizzard is coming tomorrow”) but also more involved phenomena, such as how you think about your thoughts.

A few times a month, usually while cruising along a wooded trail speckled with morning light, I’m overcome with a sensation best articulated as simply “yes.” Yes to the moment, yes to whatever is in store the rest of the day, yes to life itself.

A hallmark of depression is self-defeating, absolutist thinking—“everything is harder than it should be,” “there’s no pleasure in my life,” “it’s always going to be like this.” I’ve learned that lacing up and hitting the roads is my best way to break free from such thoughts. On a daily basis, running reminds me that I can overcome apathy and torpor. Seeing that small victory, I can convince myself that progress is possible on meeting professional goals, or not feeling lonely so often, or figuring out how to afford retirement. “The subjective experience of seeing yourself do something can make you feel better,” Fredendall says.

Ekkekakis says cognition is key to understanding another aspect of running’s effectiveness. “If you take anti-depressants and they make you feel better, the psychological attribution is external—the patients believe that the reason they get better is because of the drug they take,” he says. “With exercise, the attribution is internal—the reason I get better is that I’m doing this thing, I’m putting in the effort. That’s where perhaps the additional benefit of exercise compared to anti-depressants lies—that sense of empowerment, that sense that I’m taking control of my situation.”

Even elite runners like two-time Western States 100-mile winner Rob Krar use running to manage their mental health. Alex Aristei

You Don’t Hear About the Golfer’s High

Is there something uniquely effective about running for managing mental health? Or can any form of exercise provide similar relief?

The short answer is nobody knows for sure, and definitive research comparing the mood-boosting properties of various ways of working out is unlikely. “Such a study would have multiple arms—optimal intensity, duration, or frequency of different forms of exercise—so you go from a study costing $1 million to $3 million,” Ekkekakis says. “The pharmaceutical companies fund their own studies, but who is going to fund the exercise studies? The amount of government funding available is simply not at that level.” (According to the World Health Organization, depression is the leading cause of disability and poor health worldwide, but on average only 3 percent of government health budgets is spent on mental-health issues.)

Staff Runner’s High Tee shop.runnersworld.com $25.00

It is safe to say that purposeful exercise is better than incidental physical activity. A study published in Medicine & Science in Sports & Exercise found improved mood in people after they worked out, but not after daily-living activities such as climbing stairs. Aerobic exercise seems more effective than something like lifting weights. In fact, a review of research published in Preventive Medicine found that people with low levels of cardiovascular fitness were at greater risk of developing depression.

When I asked Raichlen about running compared to other activities, he began by citing more studies on endocannabinoids and talking about “mechanical pain” and “analgesic triggers.” Then the practical runner in him took over.

“It’s much easier to get yourself into a reasonable intensity compared to a lot of other sports,” he says. “It’s not too difficult to get in the right zone and stay there. You have a lot more control over your speed than even in something like cycling, where your effort level is more dictated by the topography or even stop lights.”

“I’ve dabbled with triathlons a little,” says Rich Harfst, 54, a federal government employee and marathoner from Annandale, Virginia, who was diagnosed with depression as a teenager. “I’ve done yoga, I’ve done cycling. Nothing is the same as running.” Ultrarunner Krar, who also mountain bikes and competes in ski mountaineering, says, “Running is that perfect balance where you can push yourself as hard as you like and more easily get in that flow state.” Bidwell says that when she doesn’t run, her anxiety puts her basic state at a 4 out of 10. “Running normally gets me to an 8,” she says. “When I’m hurt and swim instead, I’m at 6.”

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That’s been my experience over the last nearly four decades. When I’ve been injured and switch to cycling or pool running, the workouts themselves are like proverbial castor oil—I do them because I know I need them, not because they’re enjoyable in themselves. The net that keeps me from plummeting starts to fray and sag.

But when running is going well, the net is taut and strong. A few times a month, usually while cruising along a wooded trail speckled with morning light, I’m overcome with a sensation best articulated as simply “yes.” Yes to the moment, yes to whatever is in store the rest of the day, yes to life itself. If I could bottle that feeling, I’d eventually forget what it’s like to be depressed.

This article was adapted from Running Is My Therapy by Scott Douglas, released in 2018.

Scott Douglas Scott is a veteran running, fitness, and health journalist who has held senior editorial positions at Runner’s World and Running Times.

Running for Myself

A lot of things scare me. Right now, those things include my first 20-mile run of marathon training that I have this weekend and sharing this post. That’s the thing with fears, though. Embracing them usually makes you stronger.

Childhood Worries

I grew up with an easy life in the sense that I had a family that loved me and was always taken care of at any expense from my parents. But it definitely wasn’t average and at times wasn’t easy. I was a typical child who loved to roller skate and sing and watch musicals, but I always felt a bit different. I’ve been told that the adults in my life expected me to develop ulcers in third grade because of my constant worry and anxiety. I spent a lot of time in the nurse’s room, lying on a cot with stomachaches. It wasn’t until I was older that I understood why.

Feeling Foolish, Then Finding Help

My first real panic attack was in college, though I didn’t know what it was at the time. I was in a movie theater and I suddenly got the shakes and felt like I couldn’t breathe. That landed me in urgent care, getting chest X-rays, an EKG, and every other test for chest issues. I thought I was crazy when doctors told me they couldn’t find anything wrong. I felt foolish the second time it happened and different doctors told me I was fine. I felt hopeless the third and final time I went in and they said the same thing.
Luckily for me, I was attending the University of California, San Diego, which offers great services for students. I began seeing a psychologist and learned I was suffering from generalized anxiety disorder (GAD). Though sometimes I had to leave classes during panic attacks, my psychologist gave me some advice: “Run.” She said that running helps people learn to control breathing, which is very useful in the midst of a panic attack.
Up until a few months ago, my panic attacks mostly happened at night, and I would wake suddenly with one. I had uncontrollable worries — some more dramatic than others — and was constantly tense and high-strung due to constant worrying. They can be different for everyone, but my panic attacks involved my heart racing, the feeling that I couldn’t breathe and my throat was swollen, dizziness, and intense anxiety that often lead to shaking or shivering. They lasted from 5 to 40 minutes.

Under Control

Now at age 26, I can say that my anxiety disorder is under control, with the help and support of friends and family, running, medication, and health insurance. A lot of people who suffer from an anxiety disorder and depression aren’t as lucky.
I am sharing this story so that you understand what someone with GAD has gone through. In the case of my running, my anxiety has actually proved to be a strength, especially when it comes to controlling my breathing. In other aspects of my life, it was just a giant weight that kept me from living my best life.
People need help. And asking for it isn’t a weakness. Admitting you need help and asking for it? That is acknowledging fear and gaining strength from it. Actually getting the help you need? That is something that not everyone gets. I am running for them just as much – if not more – as I am running for myself.
When I decided to run my first 26.2 miles at the 2013 Los Angeles Marathon, I knew it would be empowering. Trust me, running 18 miles a few weeks ago definitely empowered me. But it is also empowering to be able to use my marathon to raise money for ADAA.

photo credit: AzulOx Photography

Ashley Erickson, a freelance fitness writer and PR Account Manager in Austin, Texas, graduated from the University of California, San Diego in 2008. She trains with Rogue Running and runs for Oiselle.

Depression, anxiety, OCD – running helped us beat them

When documentary photographer Martin Eberlen was diagnosed with ADHD in his early 30s, he turned to running to help manage his condition.

Martin, pictured below, describes being in a “long-term relationship with running”.

“Running helps me control my thoughts, it slows me down, and gives me the opportunity to focus on the things I need to focus on,” he says.

Image copyright Martin Eberlen

The photographer wanted to hear stories from other runners, to find out how they had discovered their passion for running, and how the sport relates to previous experiences and their mental health.

After travelling the country to interview and photograph fellow runners, Martin created the photo series Those Who Run.

Michelle Bavin

Image copyright Martin Eberlen

Michelle Bavin started running in November 2016, beginning slowly with a couch-to-5km programme. At first she couldn’t run for more than a minute, but she stuck with it and now loves the freedom it gives her from her thoughts.

Before running, Michelle had struggled with a “very bad relationship with food” and mental health problems. She weighed just over 20 stone in January 2016.

With the help of a local support group, she lost nearly nine stone.

Image copyright Martin Eberlen

Michelle now runs twice a week and can comfortably complete 10km.

She says that going for a run gives her a sense of achievement, while concentrating on breathing and music helps her to forget her troubles.

She says afterwards, she feels “ready to take on the world”.

Beth Lackenby

Image copyright Martin Eberlen

Beth Lackenby regularly jogs around her local parks in south London, using the activity to manage her anxiety and obsessive-compulsive disorder.

She says her OCD manifests itself in the form of intrusive thoughts, leading to guilt and anxiety. Running helps her clear her mind and keep in control of her OCD, not letting anxiety disrupt her life.

Image copyright Martin Eberlen

Coralie Frost

Image copyright Martin Eberlen

Coralie Frost says she faced a choice between running, or being controlled by an eating disorder, for the rest of her life. She suffered from anorexia for more than 10 years.

She chose to run.

In 2016, she started a blog about how running had helped her mental health. Through it she developed a new-found respect for her body.

She believes that sport – combined with therapy – can play a key role in alleviating mental health problems.

Image copyright Martin Eberlen

Coralie is a member of Serpentine running club, where she is one of the mental health ambassadors. She often hosts a Run Chat, where club members can run with her while chatting through any worries they might have, in confidence.

She met her boyfriend while training for her first marathon, and hangs her race number in her living room to remember the time that her life was transformed through running.

Paul Shepherd

Image copyright Martin Eberlen

Paul Shepherd runs along the beach front and promenades near his home on the south coast of England. Running gives him structure, frees his mind and gives him valuable time to himself, helping him to manage the depression he previously experienced.

In 2016, after a long stretch of night shifts and working long hours, Paul found himself sleep-deprived. This lasted for almost a year, leading to alcohol-filled weekends. He says this left him feeling depressed and suicidal.

Image copyright Martin Eberlen

In January 2017, Paul was in a dark place. One evening, he listened to an interview with music artist Professor Green, talking about his grief when his father passed away. Paul suddenly imagined how his son would feel, if he were to grow up without a dad.

Soon after Paul contacted the charity Calm, who offered him assistance and advice, so that he could turn his life around.

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Paul is thankful that the running then allows him to enjoy his time with his son. He says that life is all about putting one foot in front of the other – and that’s what he’s going to continue to do.

Lucy Thraves

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Lucy Thraves says she couldn’t imagine her life without running, and recently ran the London Marathon. But her first foray into running wasn’t a positive experience.

While at university one morning, she headed out for a run and was hit by a car. She broke both her arms.

For weeks after the accident she found it increasingly difficult to leave the house, and began to experience symptoms of post-traumatic stress and raised levels of anxiety. This gradually spiralled out of control, leading to insomnia, paranoia and a challenging relationship with food. It was then that she checked herself in to a mental health clinic.

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With correct guidance and a combination of therapy, healthy eating, anti-depressants and a gradual growth in self-confidence Lucy was able to build up the strength to start running again.

Lucy says that running was never initially about getting “personal bests” – instead it was an activity that she took on to help her recovery.

Karen Jones

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Karen Jones says she has not looked back since taking up running in 2005.

At the age of 36, Karen suffered from postnatal depression. Her health visitor suggested an exercise programme might help her. Karen chose to run, as she lived in the countryside.

In 2006, she ran the London Marathon, raising money for a cancer charity in memory of her grandparents, who both died of the disease.

Not only did running help her overcome her depression, she found that the combination of healthy eating and exercise vastly improved her overall mental health and happiness.

She kept up the running for five years, until her marriage broke down and she found herself going back to work after being a stay-at-home mum for many years.

Faced with starting a new career at 44, Karen decided to embrace her love of exercise and trained to become a personal trainer. She now teaches people how to get fit, and help them to gradually overcome depression and anxiety.

Kareem and Jack

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Kareem and Jack have recently been inspired to revolutionise their morning routine, following a trip to India. Getting up at 05:30, they combine meditation and running to start their day in a positive frame of mind.

The couple has found running has helped improve their mental health. Kareem has battled with depression and anxiety for years. She says her new morning routine of yoga, meditation and jogging has completely changed her life.

Jack focuses his mornings more on running, viewing it as a form of meditation. However, he says that running is not just an opportunity for headspace, it helps him manage the challenging relationship he previously had with food, along with the body dysmorphia he once experienced.

Exercise used to be an obsessive way for Jack to maintain a weight that he viewed as acceptable. Jack now has a better understanding of mental health issues and says he now runs for the right reasons, one of which is that it allows him to view himself in a positive light.

The couple say their morning routine enables them to feel more in tune with one another.

Marika Wiebe-Williams

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NHS worker Marika Wiebe-Williams says she runs for mental, as well as physical, health benefits. She is on continuous chemotherapy after being diagnosed with recurrent, incurable breast cancer in 2016. Her body is responding well to the treatments, which she believes is down to the fact that she has always tried to stay in good physical shape.

When running, Marika follows a local loop that circles her home, so that she can keep close to her house in case she feels tired and wants to cut her run short.

Marika values her running club community, which has enabled her to make close friends and have a busy social life.

This year she took part in the London and Edinburgh Marathons. Her husband has also taken up running, completing his first half-marathon earlier this year.

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