The fitness fallacy: You can’t outrun a mental-health problem

"The most unhealthy people I know are very fit people who use extreme exercise to mask serious root cause issues," says mental health campaigner Niall Breslin, aka Bressie.

In what was once consigned to the “madhouse” of Irish sporting circles, since the turn of this century endurance sports have been flooded by an ever-rising tide of devotees. And while much is written on the numerous health benefits of the multi-kilometre run, cycle or swim – or multi-sports such as triathlon, duathlon or ironman – little is often said on the mental, social and emotional impact such punishing, extreme exercise can have on the amateur athlete, and those closest to him or her.

As a triathlete and ironman, and former intercounty footballer and professional rugby player, Breslin is better positioned than most to comment. “I have noticed that a lot of people are mentally struggling, and using sport for the wrong reasons. If you’re doing that, no matter who you think you are, you cannot outrun a mental problem. Exercise is an amazing treatment to use, but only along with a number of other effective therapies and treatments.

“In recent years I’ve put more emphasis on my brain than I ever did on my body: how to strengthen my mind, protect it and avoid the triggers that in the past had devastating effects on my mental health. But I do know from doing triathlon and endurance sports, some are doing it for great reasons but for the wrong outcomes. They think it’s going to help whatever mental health issues they’re dealing with, but it won’t on its own.”

The Blizzards frontman admits that when training up to 24 hours a week for the “immensely selfish pursuit” of ironman last year, he was mentally miserable at times. However, he says setting that challenge, committing to it and achieving it ultimately had a huge pay-off for him. So how does one begin to square that circle?

“The thing about exercise is that when you focus on your goal and achieve it, you start to be able to adapt the same mentality into your everyday life. You become more resilient, to embrace adversity and come back from it. And it’s usually a very supportive, positive, caring environment you’re in, as it’s so important to be around people who aren’t toxic or deeply negative.”

And before taking on an onerous, time-consuming endurance challenge, make sure you’ve got a really powerful, deep motivation for doing it, he says. “Don’t ignore the mental side of it: start engaging with mindfulness, visualisation, positive self-talk and mental imagery, for example. This isn’t bulls**t, or some hippy stuff. It’s scientifically proven by top researchers all over the world. Mental fitness can work for everybody, and there is so much evidence to support it.”

Addiction Vs Balance

"The market for these extreme events has been influenced by the pressure to try look like a film star and have the physique of an athlete," says Keith Begley, an accredited sports psychologist with the Sport Ireland Institute and a former physical education teacher. "People are looking to live the next high or hit in the world."

Begley sees a distinction between those of the Facebook generation (aged 15-30) pursuing endurance sports, compared to those from 40 upwards.

“With social media, there is a very high proportion of the Facebook generation who feel pressure to look well and feel good. Today with selfies and social media, there is a pressure with young people always to look really good. They’re so body and image conscious that a lot of people would start presenting with disorders such as body dysmorphic disorder.”

And for the older athlete, Begley says some can get caught up in exercise addiction.

“When we exercise, there are different chemicals released in your brain, such as serotonin, which makes you feel really good, or adrenaline in some competitive situations. Then there’s dopamine, which is released with a sense of achievement. These are all very very addictive. Some people get addicted to social media or gambling or alcohol, but dopamine is the same driver for exercise as well. While exercise is great and so healthy, it’s all about balance and perspective.”

"In all sporting environments, we should be encouraging balance," says Dr Olivia Hurley, lecturer in sport psychology in UCD and IADT in Dún Laoghaire. A chartered psychologist, she is also a sport psychologist with the Sport Ireland Institute.

“Healthy people are physically and mentally fit and balanced, have a variety of interests and a good social support network, which is what we should value and promote. Elite athletes are not immune from mental health difficulties just because they engage in high levels of physical activity. In some cases, these high levels of physical training can result in burnout, which has negative physical and psychological symptoms.”

Hurley points out that all people – athlete or otherwise – can suffer from a lack of training in positive and effective coping skills to help them manage stress in their lives. However, some elite athletes may have a very high “athletic identity”, as measured by the 10-step Athletic Identity Measurement Scale. Scoring very high on the scale can indicate an athlete is overly invested in his or her sport.

With all eggs stacked in the one fragile basket, it’s of little surprise that regular set-backs, such as illness or injury, let alone retirement due to a sudden or serious injury, can cause severe psychological and emotional distress.

Rather than an “obsessive passion”, Hurley advocates “harmonious passion” instead. “We should strive to enjoy and feel in control of our work lives, and so, too, our sporting lives. While we should absolutely value sporting activities and participation, we should not emphasise winning at all costs. Consistency and excellence in life and in sport is what we should be seeking and advocating, not perfection. And we should value resilience: the ability to experience set-backs and to overcome them.”

Balance Vs Integration

"There is a phenomenon happening at the moment with endurance sports in Ireland," says performance coach, sport psychologist and former All Star-winning Armagh Gaelic footballer Enda McNulty. "I think it's very social and hugely positive. Unfortunately, there are very significant consequences if an endurance athlete doesn't get the integration right."

And it's integration, rather than balance that McNulty is most keen to stress. Alongside the likes of the Irish national rugby team, he works with corporate clients attempting everything from ultramarathons and Tour de France stage routes to mountain climbing and long-distance Antarctic crossings. But it's those who integrate training and competing into their broader life who are the ones that are flourishing, he says; not just in achieving peak performance but flourishing professionally, in their relationships, their family lives and their contact with friends.

Furthermore, the vast majority of professional athletes, let alone amateurs, don’t give such an integration plan sufficient thought. “I think if you keep missing out on family and friends, it will eventually impact your emotional health.

“The people who tend to get involved in, and be relentless about, endurance sports tend to be Type A personalities. They are the type of people who do most damage to themselves – they literally run themselves into the ground.”

McNulty says that in his new book, Commit, many of these topics are covered in full, including the need to prioritise. This might entail a significant endurance sport goal over the next 18 months, for example, but only in the context of thereafter prioritising time for family. And he speaks from experience: 14 demanding years playing football had, like all other intercounty players, a massive impact on his personal life – missing weddings, birthdays, even funerals.

So, what can be done?

“You need to have an integration plan that allows you to enjoy your endurance sport, but also stepping back to reflect on work-life-training-competing integration. You’re considering the overall emotional climate of your family, plus your own emotions, while being a bit more thoughtful and mindful of the consequences of your training choices and how to integrate them with the other important things in your life,” says McNulty.

“Review on a fortnightly basis not only how your times or performance or energy levels are going, but ask how are you feeling emotionally? What’s going on in terms of your social health at home, with wider family and with friends. Has your work performance been impacted in any way? But the evidence and research shows that, by and large, endurance athletes are much psychologically healthier than an inactive population. That much is conclusive.”

A 10-step integration plan for successful endurance sports

“How can you ensure that the endurance athlete is resilient and mentally tough with the right emotional control to be able to endure? Put these 10 enablers in place to ensure peak performance,” says Enda McNulty.

1) The right physical fitness programme, ie designed by a suitably experienced and knowledgeable coach or tutor.
2) The right mental training programme.
3) The right macro-micro schedule, eg mixing advanced endurance training blocks with strength, speed or technical training blocks.
4) The right technical coaching for the endurance sport in question.
5) The right nutrition and hydration.
6) The right recovery plan, ie including sleep and time-off training.
7) The right integration plan that combines work, family and friends with training and competing.
8) The right physio and/or medical and/or sports massage support, ie a session each month to ensure you are proactive in your "prehabilitation".
9) The right gear/equipment preparation, eg running shoes or bike set up.
10) The right team around you, eg a supportive and empathetic partner, or an experienced training mate who keeps perspective on wider, more important aspects of life.

The famous five of sport psychology

Like the mentally tough in other fields, mentally tough athletes tend to exhibit four key characteristics: a strong confidence in their ability to perform well; a driven, internal motivation to succeed; the ability, in the face of distraction, to focus their thoughts and feelings without distraction, and, lastly, composure under pressure.

But what are the leading tools and techniques mentally tough athletes adopt to help attain peak performance?

1) Goal setting: if you don't set-out a clear goal from the outset, how can you know if you achieved it? Mixing short-term with long-term varieties, goals should be specific, measurable, difficult but attainable, time-based and written down/recorded.

2) Imagery: powerful imagery attempts to create as lifelike an image as possible using multiple senses, realistic timing, perspective, and an accurate, attainable portrayal of the task.

3) Arousal regulation: achieving and maintaining an optimal level of cognitive and physiological activation – and not just to get pumped prior to an event.

4) Self-talk: phrases or words used to direct attention to sharpen focus and performance. While its effectiveness depends on how the phrase is interpreted by the individual, the use of positive self-talk typically proves more successful than negativity.

5) Pre-performance routines: the actions we consciously use to prepare for performance, from choice of music (if any) to specific warm-up routines.

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