We all know that exercise is good for our wellbeing, but what many of us are not aware of is, that in excess it can be detrimental to our physical and mental health. So how do we know when we, or a loved one, are overdoing it? What issues does it really cause? And, if we are excessively exercising, how do we bring balance?
As a former excessive exerciser, and as a psychotherapist working closely with others who have had this issue, I intimately know some of the damage it can cause. Often excessive exercise is combined with obsessive body image concerns, Eating Disorders or someone on the edge of developing an eating disorder, and/ or Body Dysmorphic Disorder. However, still many people that excessively exercise do not have eating- or body image-issues per say but do have an unbalanced compulsive relationship with exercise.
Signs of Excessive Exercise
Not being able to take off time from exercise without experiencing moderate to intense agitation, fear, guilt, and/or disgust
Working out intensely most of the time; not enough down time
Working out alone, or not being able to work out with someone who does any less (not as fast, not as fit, not as long etc.)
Fatigue that sleep does not take away, and kicks in a few hours after exercise
Increased anxiety/agitation except during and immediately after exercise
Not following training recommendations for rest, nutrition, or other needs
Thinking constantly about how, when, where, and other logistics about exercise
Prioritizes exercise over socializing, family, job, sleep etc. working those things in around the exercise
Common Issues from Chronic Over Exercise
Chronic overuse wears the physical body down. Muscles, joints, bones, ligaments and etc. Chronic pain, arthritis, and injuries become extremely common
Studies show that cortisol and other related hormones rise and stay too high. Eventually, a down regulation starts occurring to combat the chronic sympathetic nervous system activation, leading to fluctuations in sleep, anxiety, agitation, restlessness, chronic fatigue and etc.
Additionally, other hormones may begin to become off balance to compensate, possibly leading to an array of other endocrine system issues
The body’s immune system engages to fight off invaders, or infection, however, when there are no infections to fight, the immune system begins to attack its own body. Autoimmune disorders become more likely
The second brain, our gut, becomes disrupted from stress responses and digestion issues become more likely
Even when eating regularly, there may be a lack of adequate nutrition to meet needs
May also cause heart abnormalities/murmurs
Issues with Excessive Exercise Combined w/ an Eating Disorder
All of the above issues
Severe depression, anxiety, irritability, isolation, apathy, and personality changes
Decreased concentration & decision making
Weakness, edema, hypothermia, dental problems, and/or heart abnormalities/murmurs
Paresthesia: damage to the nerves
Decreased basal metabolic rate
Decreases in sexual interest
For most, if not all, over-exercisers there are neural pathways hardwired in for the compulsive drives to continue the behaviors, and anything less than (less duration, intensity, or frequency) does not feel right. Cognitively deciding to make healthy changes, unfortunately for most, is not enough. And in some cases, where disordered eating and body image issues occur, it takes a combination of help from doctors, mental health -and nutritional professionals to stabilize health.
The good news is that there are effective ways to help. Dialectical Behavioral Therapy (DBT), a skills-based psychotherapy, has amble research supporting its effectiveness with obsessive and compulsive behaviors such as excessive exercise, as well as with more intensive populations, such as eating disorders and more. DBT, with skills practice, can beneficially make lasting changes. It teaches realistic and doable ways on how to better tolerate distress, incorporate mindfulness into your daily life, regulate difficult emotions, enhance interpersonal relationships, and build greater capacity for acceptance.
Eye Movement Desensitization Reprocessing Therapy (EMDR), endorsed as an effective evidence-based treatment for trauma & PTSD by the APA, World Health Org, VA, and US Department of Health & Human Services, has shown promising research on loosening obsessive thinking and compulsive behaviors. It has solid research helping with eating disorders, that are often linked to complex trauma and attachment. These techniques can be effectively combined with gentle exposure and/or somatic techniques to enhance effectiveness.
The therapeutic relationship must not be minimized, when working with any professional on personal and intimate behaviors and feelings, a non-judgmental, trusting, and collaborative relationship is essential. It is also important to find professionals who are well trained in their modality as well as in working with these specific types of concerns.