There exercise addictionalthough it is not yet included in the diagnostic and statistical manual of mental disorders (DSM 5), it has been defined as a behavioral dependence (Demetrovics and Griffiths, 2005) as it occurs with distinctive characteristics of this problem (pre -eminence, changes in the tone of mood, tolerance, abstinence, personal conflicts and repercussions).
The authors who have studied this phenomenon have distinguished two forms in which it can present themselves: in the event that the exercise of exercise occurs in the absence of other psychological problems we talk about primary dependence on exercise; In the case (more frequent) in which it manifests itself as a consequence of other psychological dysfunctions (typically the disorder of eating behavior – DCA) is mentioned of secondary dependence.
The reason that pushes the person dependent on the physical exercise Excessive training, in the event that it is a primary form, is generally avoiding the perception of emotions, feelings or “negative” thoughts (Szabo, 2010) even if the dependent person is hardly aware of this process.
The addiction is therefore configured as a “escape” from a stressogenic condition, which causes discomfort persistently and that the person feels that he cannot face otherwise.
In the event that theexcessive exercise Instead, one associated with a disorder of eating behavior (in a framework of secondary dependence), the subject to the subject will be rather the weight loss (usually together with a rigid diet or food restrictions).
It is therefore clear that primary and secondary dependence have different etiology, although they manifest themselves with similar symptoms and consequences.
In the literature there is to date a large debate regarding the clinical legitimacy of the diagnosis of dependence primary by exercise, although they exist documented cases (Griffiths, 1997) in which i Eating disorders They are completely absent.
In addition to the differential diagnosis just described, in order to establish the clinical existence of a primary dependence on exerciseit is also necessary to carefully examine the characteristics, frequency and intensity of the symptoms of abstinence, as negative psychological sensations are reported by all those who exercise regularly when they cannot do it for some reason (Szabo et al., 1996).
The intensity of the abstinence symptoms constitutes a crucial factor to distinguish those who train regularly on those who depend on the exercise.
Comorbilities in exercise dependence
There is a close association between exercise dependence and eating disorders (Susk et al., 2001). Depressive disorders and anxiety disorders are often observable in comorbilities with this phenomenon.
If various studies have shown that pathological behaviors in nutrition often accompany (if not always) Excessive levels of physical activityit is also true that the subjects with Expert dependence They can present excessive concern for their body image, weight and control of the diet (Blaydon and Lindner, 2002).
This coexistence of pathologies often makes it difficult to establish which primary disorder is.
Causes of exercise dependence
Physiological hypotheses
According to the hypothesis of the “high run of the runner”, following intensive training in the race, the runners do not feel effort nor they feel exhausted but rather experience an intense sense of euphoria described as “feeling of flying” or of being able to “make movements without effort”. This feeling has been attributed to the brain activity of beta-endorphins that are activated during a running session.
According to another hypothesis, based on research carried out by Thompson and Blanton (1987), theeffect of training It is accompanied by a reduction in the activity of the sympathetic system at rest and therefore to a general decrease in vigilance (subjectively felt as sleepiness and asthenia). The reduction of vigilance is faced by sportsmen through theexercisebut since the effects of this are only temporary, further training sessions are systematically necessary.
According to a third hypothesis, the pleasant psychological condition characterized by the relaxing and anxiolytic effects of physical exercise pushes people to recover to train as soon as they begin to feel anxious again.
The increase in anxiety can lead to a greater need to exercise and therefore increasingly frequent and intense training sessions. In stress situations, the frequency, duration and intensity of the exercise can gradually increase as an antidote to stress and anxiety (that is, the condition called “tolerance” develops).
Psychological hypotheses
The hypothesis of affective regulation regarding the exercise addiction He suggests that exercise has a double effect on the mood tone (Hamer and Karageghis, 2007): it increases positive emotions and contributes to the improvement of the mood tone (understood as a psychological state that lasts for many hours or days) and reduces the impact of unpleasant emotions.
However, the regulation of affectivity through training induces only temporary effects: following periods of abstention from exercise Serious senses of deprivation or real abstinence symptoms that find relief only with the resumption of exercise can develop.
Typically, between one training session and the other, we begin to reduce rest periods to prevent the onset of abstinence symptoms. People who regularly carry out exercise can be motivated by the negative reinforcement just described (avoid abstinence symptoms) or positive reinforcement (the “high corridor high”).
The physical exercise motivated by the negative reinforcement is typical of people with addiction: in these cases the person feels that “he must” do it, not that “he wants”.
Psychotherapy of exercise dependence
Two psychotherapeutic interventions have proven effective in the treatment of various types of behavioral addictions and substances: the motivational interview (Miller and Rollnick, 2002) and cognitive-behavioral psychotherapy.
There are currently no clinical trials that have evaluated their usefulness in the exercise addictionbut these approaches can also be effective compared to this type of dependence (Rosemberg & Feder, 2014).
In exercise on exercise, as well as in other conditions, accurate diagnosis and differential diagnosis are the foundations of an effective therapeutic plan: it is necessary to consider concomitant disorders and all coexisting conditions must be treated.
The presence of other associated disorders can in fact establish a vicious circle that worsens the patient’s condition. Furthermore, it is important to ascertain that there is no personality disorder since, in these cases, targeted therapy for personality disorder can be resolved for exercise dependence.
It is important that the treatment clarifies what caused the appearance of addiction And which factors and situations determine the disturbance persistence. Furthermore, you have to work with the patient so that developments alternative more consions and effective strategies that replace excessive physical exercise.
A typical objective of psychotherapeutic treatment can be the return to a moderate or controlled exercise. In some cases, the implementation of different forms of training can be recommended.
Finally, the use of psycho-educational programs can also be an effective component of the treatment of exercise dependence on exercise, as there is often an insufficient knowledge of the negative repercussions of the extreme exercise on health, the body’s adaptation mechanism to the exercise and the need to rest between one training session and the other.
Bibliography
- Griffiths, MD (1997). Exercise Addiction: A Case Study. Addiction Research, 5161-168.
- Griffiths, MD (2005). A “Component” Model of Addiction Within A BiopsyChosocial Framework. Journal of Substance Use, 10191-197.
- Szabo, A. (2010). Addiction to exetrize: a sympom or a disorder? New York: Nova Science Publishers Inc.
- Rosemberg, K. P, & Feder, LC (2014). Behavoral Addictions. Criteria, Evidence and Treatment. Elsevier Inc.
