Expectancy of Agency, or, a Discussion on Mental Health

I started writing this post a couple of days ago inspired by what I'll call "mid training burnout" and a bad run on Sunday. A couple of years ago, I did my 4th marathon and it was precisely what people who think marathons are awful envision when they think of slogging 26.2 miles on your own two feet. Had I not had an Ironman on the books, Cleveland Marathon would have broken my spirit entirely. It was THAT bad.

It might look good, but it was utter shit.

It's taken a couple years, due to injuries and well, burnout, to even be tempted by a 5th (and final) marathon. My running career is rapidly coming to a place that's requiring me to reconsider my long distance dreams. And that's ok (ok, it's not, but I'm working on accepting that) but while I was writing that post about the disappointment of injury and the frustration of aging, something else happened:

I started writing about me and why I run and how it's helped me deal with my anxiety and depression and, in other ways, why it's sometimes an expression of my anxiety. Up front: this is a messy blog post that doesn't really succinctly tie everything into a bow in the end. But for reasons unknown, I feel like I need to talk about this with all 0 of you who read this blog.

A couple of years ago, I'd have been incredibly closed off about my mental health struggles. Even more recently, I'd be a self-deprecating, sarcastic jerk about the whole thing.

I'm fluent in meme sarcasm.

I, like a lot of people, have a general anxiety disorder (and the subsequent flirtations with general depression). I'm kinda over the stigma, totally aware I'm not alone, very clear that I'm a special snowflake on how I deal with it and how it materializes throughout my life. A while back, I saw an NIH post about anxiety and one of the "risk factors" for anxiety is - get this - being a woman. Haa.

I remember the first time I knew I needed to "do" something about my anxiety. I think I was 24. I got home from work, the house was dark, I lay down in bed and I felt nothing, just darkness and silence creeping in from every corner of the room. I could not get up. Chadd came home shortly after me and found me there, face down in bed, in a puddle of tears that happened without actually crying. Pretty sure, about 12 hours later, I had what is, to date, the worst panic attack I have ever had. Maybe because I had no idea why this was happening. There was no "trigger" or warning that these things can happen to people. This was 7+ years ago, the public discussion about mental health has made great strides since then. Anxiety? That's something you have before a big exam and it's normal.

Until it isn't, which is where I found myself that night face down on my bed, my cat trying to nuzzle his way into my face.

This fat pumpkin. Good nuzzler. 

While I sought out a bunch of different things over the years (some which have helped, some which have not), my relationship with running has been a persistent, important part of my mental health. Even when I hated it (who wants to run at 6am in an ice storm? No one.), it forced me out of bed or taught me to face the things I'd blown way out of proportion (14 mile training run on a gorgeous day).

My running partners have been critical in some of my worst moments by simply being present and good listeners. I'm sure there are studies talking about how running is similar to rapid eye movement therapy (EMDR). There are, of course, all the physical effects (endorphin production, serotonin increase, dopamine levels rise). I'm sure there are psychological reasons linking structure, endurance, and self-care through running with positive impacts on one's mental health.

But, like most endurance athletes, especially those with anxiety, sometimes the thing you're using as an aid becomes a security blanket, and, in my case, an excuse for not dealing with pretty much anything else in my life. So, I did some digging into the compulsion of endurance sports.

A few years ago, I stumbled upon a BBC article about the Everest tragedies - inspired by the most recent earthquake and subsequent deaths on the mountain. The old, tired question of "what compels mountaineers" came up.

Instead of the usual (Thrill Seekers! Risk Takers!) The truth is that mountain climbing, much like many endurance sports, is a slog. It's a decision to push through because you have set your mind on one thing. In fact, the entire thing is almost entirely devoid of thrills, endorphins, and heart racing excitement. I learned three terms I've probably annoyed my therapist with:

Counterphobia

Counterphobic attitude is a response to anxiety that, instead of fleeing the source of fear in the manner of a phobia, actively seeks it out, in the hope of overcoming the original anxiousness.

From the article: Rather than avoid the things they fear, they feel compelled to face-off with those elements. “It’s a misnomer that climbers are fearless,” Barlow says. "Instead, as a climber, I know I will be afraid, but the key bit is that I approach that fear and try to overcome it.” 

If you could have seen my shaking hands signing up for an Ironman. Or the sleepless nights before big races, or even had a brief view into my mind while I tried to sleep on Saturday night before my long run on Sunday, you'd see it there. Now, don't get me wrong. I don't fear running. I don't fear racing, but there's a slice of something nameless and dark in there.

Why is counterphobia so powerful? That, my friends, is called...

Transfer Effect/Transfer of Training

Transfer of training refers to the effect that knowledge or abilities acquired in one area have on problem-solving or knowledge acquisition in other areas

From the article: Like a junkie who’s got his fix, mountaineers usually report a transfer effect from their experience – a feeling of satiation immediately after returning from a peak...To continue to sate that desire, mountaineers thus set their sights on increasingly challenging peaks, routes or circumstances...

It's the basic mental bargaining we all do: well, if I got through X then Y must be a cakewalk. You hear people say this a lot about childbirth. Having absolutely no experience there, I can't confirm, but I'd be lying to you if I said I didn't occasionally say "I did an Ironman, how much worse could this be?"

If those weren't enough, I've saved the best for last:

Expectancy of Agency

From the article: A climber himself, Barlow suspected that sensation-seeking theory has long been misapplied to mountaineers. His research suggests that, compared to other athletes, mountaineers tend to possess an exaggerated “expectancy of agency”. In other words, they crave a feeling of control over their lives. Because the complexities of modern life defy such control, they are forced to seek agency elsewhere. As Barlow explains: “To demonstrate that I have influence over my life, I might go into an environment that is incredibly difficult to control – like the high mountains.”

I'm 31 years old. When I was 19 and first started running, I craved control but in such a different way. I was an adult, but not really. I didn't have a full-time job and I wanted desperately to get to a place in my life where I had more responsibility and influence.

Then I was in my mid 20's and running to somehow make up for all the things I wasn't doing in my life that all my friends were: having stable careers, getting married, having children, moving into houses and gardening or whatever you do when you have a normal, stable life. Taking up microbrewing? So, I kept running.

Somehow, my late 20's showed up and the career thing stabilized a bit, but nothing else did and I ran so much and so hard and because I still believed that I was immune to injuries, I, of course, managed to seriously injure myself during the thing I love the most: Ragnar.

The thing I used as an escape chewed me up and spit me out and gave me 6 months of limited mobility and coming up on a year of almost daily pain. A lot of my endurance and speed is gone, too. So my ego's pretty much been disassembled. And with it, a lot of the assuredness I'd created for myself through the ugly triumvirate of the above terms.

So here we are. I'm trying to train for my 5th marathon. And I don't even know if I can do it anymore. We'll get there in another post.

But for now, I leave you with five postscripts regarding mental health:

1. I have a therapist and she's the greatest. It took me a LONG TIME to find the right one. She doesn't think my self-deprecating jokes are funny, but she's never once told me to stop running so she can stay. I recommend you also invest in a professional therapist. Why? I have spent thousands of dollars on physical therapy, podiatry, massage therapy, cardiology, and probably some other kind of health-related field in my 10+ year athletic career. It is ridiculous to not also invest in my mental health. 
2. Mental health is far more precarious (for some people, like me) than physical health. I can take 2 weeks off running (even if I hate that). I can't back out of my life for 2 weeks (as much as I would like to.) And when I couldn't run, my mental health was impacted and in need of greater care so I could continue doing things like going to work, engaging with friends and family, and generally making it through the day feeling *something.* Invest - find the time, work with your insurance, seek out free resources. 
3. Medication is not the only answer, but that doesn't mean there's something wrong with medication. Personally, I have yet to find a medication that addresses my particular brand of symptoms without also basically removing my entire agency. So I don't take medication regularly. Instead, I have found that I can maintain a healthy balance with regular exercise (specifically running and powerlifting). On days when I get to run and lift (separate sessions), my body replicates the cool feeling of medication in my veins. Therapy has been revolutionary as has been doing this thing where I say what I mean (outcome of therapy). Whole body/mind approaches to mental health are incredibly important and effective. For some, this includes medication, for others, it does not. Be open. 
4. Expect strange methods of processing. Often times, it's totally reliable but, sometimes, you find yourself crying in a gym shower for no reason. It's fun. Don't be hard on yourself.
5. My GP was very very wrong. I wouldn't go to my GP to diagnose a bone spur that fractured and subsequently triggered redundant nerve pain. I'd go to her to refer to me a good podiatrist. I made this serious error a few years ago and allowed a GP to prescribe two very heavy medications for anxiety/depression after a 5 minute conversation. Why? I didn't know better. My PT took longer to diagnose me and come up with a treatment plan (for the foot) than my GP did (for my brain). Y'all, take the time. Find a good psychiatrist (with the help of your GP). But do not mistake a GP's legal ability to prescribe medication with their capability of accurately prescribing that medication. It has very serious, lasting consequences. 

And with that. Happy Tuesday.

(see what I mean? no good bow on this story)