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Thứ Hai, 14 tháng 12, 2015

Running Helped Me Cope With Depression, But Then I Got Injured

Michael Parkin for BuzzFeed News

I wake to muted daylight, stubborn rays forcing their way through the curtains. My alarm, set to the tune of Celine Dion’s “My Heart Will Go On,” plays for a good 30 seconds before I have the energy to tap the snooze button. Shut up, Celine, I think, and I unlock my phone and do what I do the first thing every morning: open Facebook and Twitter and my email, holding in my urine even though my bladder feels like a water balloon that’s about to burst. I am glued to my bed, fixed to it like a pinned insect.

I know I need to get up, but I can’t turn my eyes away from the screen, which emits a comforting glow like the nightlight in the bathroom in my childhood home. My indecisiveness, my ambivalence toward sliding one foot onto the floor, and then the other, toward actually starting my day with action, with peeing and making coffee and looking out the window and eating a yogurt, keeps me suspended in a melancholic immobility.

It’s my 20th day without a run, and I’m not just despondent. I’m barely functioning.

People often think of running as an evasive measure, a way to get away from something that besets us. Extra pounds. A wild animal. An assailant. Whatever we’re anxious about. (And many human beings are anxious about so many things.)

But running is more than that. It’s a way to contain yourself, to connect with breath and air and ground and movement. And when you struggle with depression and anxiety, running can become more than something you should do. It can quickly turn into something you need to do.

It was certainly something I needed. When I started going to a therapist in 2011, one of the first things he recommended to me was that I try to fit some kind of exercise into my weekly routine. Logically, I knew I needed to do that. I’ve dealt with depression since I was a teenager, and some kind of forced movement, I discovered in my early twenties, can help.

“Physical activity is an antidepressant, it’s an anti-anxiety. It serves to reduce anxiety, it increases self-esteem and is a major component of weight loss or weight loss management,” Dr. Kate Hays, a Canadian-based psychologist who specializes in sports psychology and runs a consulting practice called The Performing Edge, told me. In a 2010 paper called “The Effect of Exercise on Mental Health” by Andrea Dunn and Jennifer Jewell (published in Exercise and Mental Health), they write, “Based on recent evidence to demonstrate efficacy to treat some mental disorders like depression and anxiety, there is increasing support that exercise could be medicine for these disorders.”

When I was 18, I swallowed a bunch of Advil and ended up in a psychiatric ward for six days. I didn’t want to end my life; I wanted people to realize I existed. It was a cry for help, as so many suicide attempts are. But soon after I was released, I stopped taking medication. I didn’t like the way it made me feel.

In my early twenties, I started going to the gym on a semi-regular basis. My friend, who also using exercise to cope with depression, refers to it as sweating out the demons. And that’s what I tried to do. But I never could get myself to stick with it. Inevitably, my bad feelings would surface. I’d self-sabotage, and for a good chunk of my twenties, I ate and drank my feelings. That changed not long after I left New Hampshire and moved back to New York City.

Running meant taking action with my life, not stalling it.

By 2013, I was in therapy once a week and running three to four times a week. These runs were the difference between debilitating depression and being able to function. Even on days when cold rain tore at my skin, when my toes were numb from icy puddles, when I waited out a downpour underneath scaffolding: running meant taking action with my life, not stalling it.

One day I found myself rushing to a meeting that was just a 15-minute walk from my apartment. I was running late. A dull pain emanated from my left buttcheek. Several days later, during a long run in Prospect Park, the same feeling returned. It was so bad that I eventually gave up and called a taxi. I felt defeated, but I could no longer ignore it. I made an appointment with a sports doctor, who sent me for an MRI.

The news wasn’t good: a femoral neck stress fracture in my hip. My doctor told me to use crutches for at least two to three weeks, and a cane for a month after that.

I live in a third-floor walk-up. Getting in and out of the apartment isn’t easy when you’re on crutches. My boss let me work from home while I was healing, but stuck inside, unable to move around much, I felt restless and trapped, like a broken jack-in-the-box.

Shortly before the diagnosis, my boyfriend and I had booked a trip to Paris: a month in my favorite city to do nothing but read and write. It was too late to cancel the plane ticket and the apartment rental, so I found a French physical therapist who spoke English. A handsome Dutchman with blonde hair and a lean body, he resembled Patrick Swayze in Dirty Dancing. His office, accessed through an enclosed courtyard, was softly lit and minimalist; it felt more like a spa. Even the bathroom was welcoming, with elegant white towels rolled up for individual use. His strong hands massaged my butt, providing a relief from the pain even while bruising it. I spent time every morning doing clamshell exercises and sitting on an invisible seat, my back pressed up against the wall.

I used my cane to walk to the patisserie in the morning, bleary-eyed and uncaffeinated and craving the sugary and flaky pain aux raisins. Without the ability to exercise, though, I felt like a ghost of a person, a shadow self. My friend changed my social media passwords so I could get some space and clear my head. Without the alerts popping up on my phone, I fell deeper into books, my mind running away from my body.

When we returned to New York in September, I went for another MRI. I felt physically stronger after weeks of diligently following the physical therapy exercises. But once again, the news wasn’t good. The stress fracture was worse. I was told to spend four to six weeks on crutches.

Any sense of calm and focus I had dissipated, like ink fading away from the crumpled receipts at the bottom of my backpack. The world was louder than usual. I couldn’t stand all of the noises around me, both externally and internally.

Instead of writing through the pain and sadness, something I long ago learned actually helps, I sluggishly moved throughout my day, wasting hours on my phone before I could even motivate myself to open my computer. Taking forever to load, the dreaded pinwheel image frozen in place, my MacBook was just as broken as my body and mind.

Exercise provides the electric jolt that is necessary to get moving throughout a daily routine. But when that routine is abruptly disrupted, everything is affected.

“If you’re down on yourself, your body is producing all sorts of stress hormones, cortisone, that actually has the reverse effect on your body from healing,” Dr. Joan Ingalls, a licensed mental health counselor and sports counselor who practices in NYC and Connecticut, told me during a phone interview. “Cortisone almost attacks cellular structures of your body, and can be contrary to healing.”

Dr. Hays works with a wide range of people who exercise, from those who are just interested in physical activity to professional athletes. She’s the author of Working It Out: Using Exercise in Psychotherapy.

Hays says there are biochemical shifts that happen with “rhythmic, repetitive exercise” performed for at least 15 to 20 minutes. With her own patients, she has noticed that runners find “the absence of running” really challenging.

One of the reasons is because running requires a lot of diaphragmatic breathing, and that’s useful in helping with anxiety. Dr. Hays references one of her clients, a runner who overtrained and was injured, but tried yoga and liked it so much that she incorporated it into her regular routine.

There’s no arguing that exercising is a positive way to deal with mental health issues, and so it’s just that much harder to recover and get back to full speed when one is forced to take a break.

My friend Jennifer Pastiloff, a 40-year-old writer and retreat leader who lives in California, was used to exercising every day. She teaches yoga and tripped during one of her yoga retreats (not during yoga itself). But she broke her foot and couldn’t be active for two months.

“I fell into the deepest, darkest hole I had been in in years,” she told me via email recently. “I wasn’t currently on my anti-depressants (big mistake) and my old anorexia reared its ugly head. I felt trapped and depressed and stuck and like I couldn’t avoid my 'shit' any longer by running (literally) so I had to just sit. Exercising made me feel in control, so I felt out of control and desperate.”

That sitting and confronting oneself is one of the most difficult parts, and something I had to learn to dwell in. Ingalls says, “I understand people’s love of sports. Love of sports doesn’t mean you get victimized when you can’t do it.”

Trapped in my apartment, I wallowed in my inability to do anything. Instead of using the time to read and write, I found myself wiped clean of any desire to do anything.

But it’s hard not to feel that way. Trapped in my apartment, I wallowed in my inability to do anything. Instead of using the time to read and write, I found myself wiped clean of any desire to do anything.

One of my Facebook friends, Nick Ostidick, who is 28 and lives in Illinois, couldn’t run for four months after an overuse injury in which he fractured his pelvis. “I was seriously like a junkie drying out,” he said via email. “I tell people I am an addict and that my drug is running because it has seriously altered my brain chemistry. As long as my supply doesn’t run out, I’m good.” The reason Nick is so addicted is because it helps keep his “emotional ecosystem in balance, in check, running smooth.” Without it, he felt unable to cope with daily stresses; his mood changed and he wasn’t able to find pleasure in things he used to love.

Jennifer Purdie, a writer I’ve emailed with through a message board we’re part of, was a marathoner and triathlete who exercised six days a week before she had to take a break for four months due to plantar fasciitis. The 38-year-old suffers from clinical depression and isn’t medicated, due to bad experiences with antidepressants. Running was her self-medication. “It was the best hour a day (sometimes two on the weekends),” she says. “I craved it because it was a way to not feel sad for a while.” But when she was injured, she became more depressed, and couldn’t even go on Facebook because she needed to avoid reading posts about races by other runners.

I’ve felt tempted to do the same, honestly. There’s only so much “I ran another 10 miles today” I can take before I start to hate myself. And I feel guilty, because I used to be one of those runners who would share my stats on my own page. Now I know how bad it can make a person feel.

A few weeks after I was told about the stress fracture, I went to an orthopedic surgeon at the Hospital for Special Surgery for a second opinion. He ordered an MRI of my spine, and as I waited in the partially enclosed tube for the third time in three months, trying to stay calm, I anticipated even more bad news.

“You don’t have a stress fracture, and you never had one,” the doctor told me. “But we did discover a cyst in your liver that needs to be looked at.” I immediately imagined the worst scenarios, including being told I had only a couple of months to live. I turned to my social media network for support, the same place I also go to distract myself.

I felt suspended in a state of uncertainty until meeting with a liver doctor, who told me the cyst was nothing to worry about. By the end of September, I'd gone to a physical therapist who immediately diagnosed me with the real problem: piriformis syndrome, which explains the pain in my butt. If only I'd been told that in July, I’d have avoided a much larger pain in the ass — one that cost me thousands of dollars in cab rides and countless hours of stress.

Sometimes it seems like I’m spending every day of the week trying to fix myself.

Since September, I’ve had to force myself to go to the physical therapist twice a week, to aim to go to my acupuncturist and my therapist once a week. Sometimes it seems like I’m spending every day of the week trying to fix myself.

My boyfriend recently installed a new SSD drive in my laptop, and it’s like a brand-new computer. One can fix or replace digital devices relatively easy, given time or money. But a body doesn’t answer to those demands, nor does a mind. I’m easing my way back into exercising, not without a lot of frustration along the way. I started running again and had to stop because of more pain. I should be completely better by now, but I’m stuck using the elliptical machine and going to yoga classes for the time being. I’m grateful I can exercise at all, yet most days I walk past people who are out for a jog and stare at them as they glide past me, hungry for that runner’s high. My stomach has become softer. I try not to look at myself in the mirror.

I’m attempting to unfreeze myself, but right now I have to remain captivated by the spinning pinwheel that I am, an array of colors and possibilities.

To learn more about depression and anxiety, check out the resources at the National Institute of Mental Health here and here.

If you are dealing with thoughts of suicide, you can speak to someone immediately here or by calling the National Suicide Prevention Lifeline at 1-800-273-8255.




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