I once explained the lethargy of depression to my brother by asking him what he does when he’s thirsty. He gave me a “duh” look and said, “Get something to drink.” I said it’s not always that simple. I told him I might feel thirsty and think, “I should go to the kitchen and get some water.” Then, I might imagine rising from a chair, walking to another room, getting a glass, and turning on the faucet. Often, I said, picturing myself going through that process leads to the thought, “That’s a lot of work. Stay put until you’re ready.”
This prehearsal of desired activities before deciding not to do them sounds strange to people like my brother, but brings nods of understanding from people with depression. Fatigue is often listed as a symptom of depression. I don’t think that’s quite the right word. Fatigue is being seventeen miles into a hilly twenty-miler when your longest run in the last two months was fourteen miles. “Perceived fatigue” more accurately captures the phenomenon of thinking about doing something and postponing doing it until you feel you have enough energy. Initiative can be especially lacking if your depression includes a feeling of meaninglessness. Why bother getting up and doing something if your efforts don’t matter? Inertia can take on a life of its own; a body at rest tends to stay at rest, after all, which leads to feeling that much droopier. Running is a daily way to break free from lassitude. Getting out the door changes the narrative and creates momentum.
“I think of running as helping depression through activation, through the improved energy that comes from running,” says clinical psychiatrist Brian Vasey. Clinical psychologist Laura Fredendall says of people with depression, “I have not had a patient who wouldn’t benefit from increasing their activity level. When you’re depressed, your brain is more turned off. Going for a run activates your brain cells. Having that wake-up experience can make you feel better.”
In my early years of running, I often struggled with activation. I’d picture myself five miles from home and think, “Not yet. Wait until you’re up for it.” This happened even though I knew that the magical infusion of energy I was waiting for would come only by doing the thing I was finding reasons to avoid. I seldom have these silly procrastination battles now. I have decades more evidence that just a few miles will energize mind and body like nothing else. Another key is internalizing the lesson that something is better than nothing in these situations. That’s another way of saying when you know you need a run, don’t visualize yourself five miles from home. On my worst days with depression, I tell myself all that’s required is a token run, at no faster than a stumble. If you feel worse after ten minutes, the internal monologue goes, you can go home. You can probably guess that I almost always stay out longer, and return home feeling victorious.
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To bridge the gap between hibernating sloth and runner in motion, I picture myself going to bed that night. As I turn off the light, will I be happier that I got myself to run? Of course. I also find a way to change into my running clothes and start my prerun routine of stretching and other exercises. On particularly tough days, I tell myself all I have to do in the immediate future is some gentle stretching, which will feel better if I’m wearing running gear. This low level of activity starts the energizing process; seeing myself outside and in motion begins to seem possible. Fredendall will sometimes have a patient stand and join her in breathing exercises or arm swings to get a slight activation effect.
Rich Harfst, of Annandale, Virginia, has also learned over the years that running can be most helpful when it seems least likely. After competing in high school and college, he was a self-described fitness runner for the first part of his professional life. When he began to run again after back surgery in 2004, he decided to resume racing, and now, in his fifties, is trying to break 3:00 for the marathon.
“I’ve achieved a point—knock on wood—where I’m pretty good at heading it off,” Harfst says of days-long depressive episodes that used to be more common. “The worst periods are now down to a matter of days, where I just fight my way out of it. That’s where running comes in—I stay consistent even on really bad days. Something might happen and I might crawl in a hole and go to bed for a while, but I’ll get out of bed and go for a run just because I don’t want to put a zero in my training log. It slowly starts to bring me out on the other side.” The just-do-it approach isn’t to belittle the struggles of runners who sometimes miss days even though they know running will energize them. Rob Krar is a two-time winner of the Western States Endurance Run, a hundred-miler that’s considered the most prestigious ultramarathon in the United States. Yet even he sometimes finds himself dressed to run and simply unable to step through the door to a better day. “I don’t have that magic wand to wave and get myself out of it,” he says. “Sometimes I can and sometimes I can’t.”
Ian Kellogg is another fast runner whose competitive goals aren’t enough to activate him when his depression is especially bad. “More often than not, I don’t run on those days, even though I know that just half an hour will make me feel better,” the Otterbein University cross-country ace says. “I can’t find the energy or willpower to get out the door.” Kellogg’s father, John, is also a runner. He’s often Ian’s escort out of the negative feedback loop of inactivity. “My dad will say, ‘Come jog a few miles with me,’” Ian says. “He understands what’s going on in my head. My best memories are going on runs with my dad and talking or sometimes not talking at all. If he does that a few times, that helps me get out of my funk, or it at least sparks a drive for me to get running again. And then I’m usually able to get back to normal.”
Conventional wisdom advises arranging runs with others for people who lack consistency, on the theory that you’re less likely to blow off a run if you know someone is waiting for you. Fredendall would approve of the elder Kellogg’s wiliness in applying this advice to his son’s depression. “If you’re depressed, you might be more likely to show up for someone else than you are to show up for yourself,” she says. Tricking yourself in this way means activation, and the relief from depressive symptoms that comes with it.
Excerpted from Running Is My Therapy: Relieve Stress and Anxiety, Fight Depression, Ditch Bad Habits, and Live Happier © Scott Douglas 2018. Reprinted with permission of the publisher. Available wherever books are sold.