Exercise Addiction Is an Underdiagnosed Epidemic

“Hey hun, have you seen my sneakers… the orange ones?”

My husband looked up from his phone and around the room. He located a pair of mismatched socks, flip-flops, my navy-blue Adidas, and a half-open umbrella, but my traffic cone-colored kicks were missing. I don’t have time for this, I thought. With a newborn, my day revolves around playtime, bedtime, feedings, and naps. Plus, the National Weather Service had just issued a warning: the air quality was crap and, according to my app, both heat stroke and exhaustion were possible. I slid my neoprene shorts on, one unshaven leg at a time. I downed a glass of lukewarm water, and I grabbed my keys, iPhone and headphones before lacing up a different pair of sneakers; no time to find the other, better ones. These would have to do.

“I’ll be back in a little bit,” I yelled — but that was a lie. One mile turned to two and two to four, and before I knew it, I was on the other side of this little island I call home because I have a problem. A huge problem. I am addicted to exercise. Specifically, I’m addicted to running.

“Exercise addiction often goes undiagnosed because it’s not recognized as a problem,” Alyssa Williamson — a psychotherapist in Dallas, TX who specializes in eating disorders — said. “We think of someone with an eating disorder as someone who is emaciated but never think that it could include elite athletes or that guy who talks about CrossFit and eats avocados.” But according to a 2011 study, 3% of adults in the United States work out more than they should, and Williamson told Vice that number may actually be higher.

“Because we glorify athleticism and thinness many people don’t see their relationship with exercise as a problem until their body starts developing complications, like heart issues, increased injuries, body density loss or loss of a menstrual cycle in women,” Williamson said. And that was the case with me. I was (and am) a “healthy” size and weight. My thighs appeared toned but full. My cheeks were rounded, not hollow, and my rib cage was concealed behind a decent layer of fat. Most saw me as nothing more than a distance runner, one who played hard, trained hard, and was “dedicated.” I was praised for my persistence, tenacity and grit. But my actions were not driven by passion or a desire to be fit: I ran because I had to. I “needed” to.

Like most addictions, my compulsions began benignly. I’ve battled mental illness most of my life and found running made me calmer and happier. When I was on the pavement, my anxiety lessened. The voices of fear and self-loathing were silenced by the screech of the subway and roar of traffic. But running became a problem in and of itself. Not running, I felt, put my mental and emotional health at risk.

No one suggested my behaviors were detrimental or dangerous. No one told me exercise was (or could be) bad. In fact, both my psychiatrist and general practitioner applauded me for my dedication. The former even worked running into my overall wellness plan, and for good reason. Numerous studies have proven that exercise is a natural mood booster.

But after eight years, I knew things were off. I was running further and longer. Unexpected storms or interruptions in my fitness schedule would induce panic attacks, and I felt controlled by it.

I continued to work out, through blizzard watches and heat warnings. I exercised when I was happy, sad, angry, afraid or alone. I’ve ended relationships, lost friendships, and skipped out on brunches, lunches, dinners, and dates to run. I’ve avoided vacations and changed entire itineraries of trips. I’ve turned down work and run in spite of illness and injury, and I can tell you what it's like to push my body beyond its boundaries. I’ve sprained my ankle twice and torn my Achilles tendon twice. I’ve run through muscle pains, strains and plantar fasciitis, and once I fell while running. I bruised my calf and my hip, tore open my knee, but kept going.

After I couldn't find my orange sneakers, I logged 10 miles before returning home. And today, I ran to the point of blacking out, and passing out. The bile in my stomach rose in tandem with the sun, and tears streamed down my face. The salty blend of sweat and sadness combatted the bitterness which flowed up (and through) my throat.

Of course, I was — and am — not alone. “A lot of muscle and skeletal injuries result from over-exercising,” Alice Holland, a doctor of physical therapy and director of Stride Strong Physical Therapy in Portland, told Vice. What’s more, since exercise addiction is not yet recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the problem persists. However, Hillary Cauthen, a doctor of psychology and executive board member for the Association for Applied Sport Psychology, explained the difference between a healthy habit and dysfunctional one is one of drive. For those addicted to “exercise [the act] is a compulsion, a desired behavior… they must do,” though Cauthen noted there are several other symptoms. Irritability, anxiety and frustration are common — particularly if/when the addict must take time off — as are obsessive thoughts.

I struggle to sleep because, when I am not running, I am lost and empty. I struggle with pain. My legs tremble constantly. I feel like I am in motion even when I am still, and I can tell you what it's like to measure life not in moments, but in miles. The absence of exercise caused me anxiety in and of itself. And that is when I knew my self-administered cure had crossed a line. Instead of healing my hurt, I was causing it.

Social media may also be affecting our relationship with health, wellness and exercise. We smile, sweat and log miles and laps for our “followers” to see. My Facebook was (and is) littered with pictures of my FitBit, not my family. But behind every fitness blog, Facebook post and Insta gram story is a person, and what we see is rarely what we get.

“Social media outlets, like Instagram, add to the mania and obsessive culture surrounding looking and feeling your best,” Holland said. “A constant fear of missing out or needing to keep up to ideals make[s] this addiction worse.”

Things have gotten better. I haven’t competed (or completed) a double digit-mile run since April. I’ve been honest: with myself, my psychologist and my psychiatrist. I have a problem. My addiction was one which had gotten out of control, and I’ve learned to sit, with myself and my thoughts . But the latter has been difficult as my mind still races. Stillness still hurts. Plus, I feel like I should be going. There is a voice in my head that tells me I'm not good enough or strong enough, that I’m pathetic and useless, a voice that I have a nagging feeling could be silenced if I just logged a few miles. But I don’t. Instead, I try to stay present, and allow myself to feel frustration, anger, sadness and pain; I’m working with my doctors become comfortable with the uncomfortable. We work on alternative therapies where I write or meditate to make space for myself. The compulsion is still there: Yesterday, I gave in and went on a run. I do not consider myself cured, and may never be. But I try to take life one minute, one step, and one day at a time.