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Exercising a lot or a healthy lifestyle, when does this become a problem? “Substance use, compulsive dieting or obstacles to daily life are worrying developments. But if someone shows up at the gym every day, that is also a signal to start a conversation and ask questions,” says Vulink.
Mieke Terlouw (40) from Haarlem now dares to honestly admit that she struggled with a sports addiction. She wrote the book In de dean van het Leven about her father’s suicide and its impact on her life. Her sports addiction started about ten years ago. “I had just gone through a phase of partying and drugs. I then found the stimuli and distraction that I previously got from going out in marathons. I wanted to be healthy, started training a lot and completely lost track of it. Sports became my solution to everything. Even when I had injuries, I had to keep going.”
‘Just relax for a moment’
Being so obsessive about sports and her body made it easier for Terlouw to ignore her sadness. “As is often the case with addictions, with a sports addiction you want to feel as little as possible. That’s why I never wanted to do nothing, because then all kinds of thoughts and feelings would arise. As a result, I felt an increasing urge to exercise. Sometimes up to three hours a day. And if I didn’t exercise enough on holiday, I could hardly relax.”
People in the Terlouw area were surprised by her passion for sports. “It was all about burning calories and releasing endorphins. Friends sometimes said to me: ‘Just relax for a moment.’ Then I dismissed that and found them undisciplined.”
But the excessive exercise took its toll on Terlouw. “I started having problems with my back and knees. And despite various complaints, I continued to run and do strength training. My back actually screamed at me, “Stop!” Terlouw says that she would rather have been addicted to drugs than to sports. Why? “We all know that drugs are bad for us, but sports have a different image. Plus, you can kick drugs and never touch them again. But never exercising again is not really healthy. So you have to learn to deal with the drug you are addicted to.”
Heart complaints
The Frisian Marit Dijkstra (24) is actually still in the middle of that struggle that both Vulink and Terlouw talk about. “I have a distorted body image, urge to exercise and compulsion and an eating disorder.” A battle she has been fighting for about four years now. “Extreme sports,” Dijkstra calls her urge to exercise. “I had to take at least 25,000 steps a day, sometimes walking, running or playing football for hours and was barely allowed to sit. But it took on forms that made me no longer enjoy it. “I was only concerned with: ‘How much do I burn?’ ‘How much do I walk?’ Movement came before everything. I avoided meeting people as much as possible. And if the weather was bad or I had a busy schedule, there was panic.”
“When I went on a group trip to South Africa last year, all I really cared about was sitting still on the plane or during the safari. While others were sitting by the pool, I was walking laps around the grounds or in my room.” Dijkstra lost a lot of weight, but also suffered from joints, muscles, heart problems and was overtired. “Of course, people around me told me I had to cut down, but I couldn’t.” When her heart complaints became even more extreme, a cardiologist concluded that Dijkstra’s heart could not handle the efforts. “I had to stop exercising abruptly and am now allowed to walk on a limited basis. But getting under 10,000 steps a day is not an option for me. Actually still not.”
Dijkstra says that quitting sports is twofold for her. “I cried a lot at first. On the one hand I felt panic, but on the other hand also relief. I was so done with it, but I couldn’t stop.”
Causes
Psychiatrist Vulink explains that BDD often results from a number of factors. Genetics, trauma and personality play a role in this. “Around 70 percent of BDD patients have experienced traumatic life experiences. This may be due to bullying, sexual abuse or emotional neglect. But we also often see personality traits such as perfectionism. In addition, we often notice that appearance was of great importance in the family of origin or the environment in which we grew up. Many patients grew up in an environment in which identity was often determined by what you look like.”
Terlouw explains that she struggled with low self-esteem for a long time.
“I thought I was fat, ugly and felt a lot of shame, but that belief ran very deep.” She describes herself as ‘a bundle of shame’. “In high school I turned red and started sweating when I had to talk. That shame eventually settled on my appearance. Exercising relieved that pain.”
Suicide
Such a sports addiction requires a lot of discipline. Terlouw also recognizes this in himself. “I have always had that urge to prove and discipline. This was also the case in my work. I really wanted to do well, to be seen and recognized, and I let my self-esteem depend on that.”
Terlouw can now explain her obsessive behavior. She already struggled with an eating problem during her adolescence. “My parents divorced when I was eleven years old and my mother left the family. In addition, my father and mother suffered from psychological problems. My mother’s departure has become a deep-seated trauma for me. That’s where the shame comes from. I was ashamed of the fact that my mother could not take care of me.” Terlouw was largely raised by her father, but he eventually decided to take his own life. For Terlouw, the moment she could no longer go back. “When my father committed suicide, I went very deep and had to go to therapy. “
Social media
There is no shortage of toned bodies on social media and people like to share their sports achievements. But do social media channels encourage BBD? Vulink is concerned about that. “Research has shown that social media has a negative effect on body image. We also know that BDD patients spend a lot of time on social media and I also hear that in the clinic.” According to Vulink, obsessive social media use is part of the compulsive rituals of BDD patients. “Some take a thousand photos a day and only one is good enough. But nowadays there are also apps that rate your photos or advise which cosmetic procedure you should undergo. That is very worrying.”
24-year-old Dijkstra recognizes this. “People encouraged me. You get a lot of compliments and are constantly told that you are ‘doing well’. That just makes it more complicated.” This also happens on social media. “There you also see images with which you compare yourself.”
Research
As for treatment, the psychiatrist explains that BDD patients often receive medication and therapy. “This is often a combination of modern antidepressants and cognitive behavioral therapy. But there are also more and more other forms of treatment, which focus, for example, on self-compassion and acceptance. Those types of treatments also look promising.”
Vulink would like to do more research into BDD with sports doctors and gyms. “How many people in the gym focus a lot on that appearance? I would like to map that data.”
therapy
Terlouw describes the period after her father’s suicide as dark and depressive years, during which she underwent a lot of therapy and treatment. “That brought me to the core of the problem. Through therapy I was able to process past experiences and work on my own self-image.” And because she discovered the psychological cause of her addiction, the urge to exercise obsessively became less and less. She currently gives yoga and pilates classes, but exercises a lot less than before. “I don’t do strength training or running anymore.”
Terlouw once again mentions the low self-esteem of BDD patients. “You can say to someone like that: ‘You are good just the way you are’, but it doesn’t work that way. Someone with low self-esteem does not feel that. That is why you have to go deep within to tackle the core of the problem and combine this with body-oriented therapy.”
Dijkstra has now had clinical admissions and had to make strict agreements about exercise. “I want to get rid of it. I hope in the future to be able to exercise again with pleasure instead of urge.” She is currently undergoing psychomotor therapy (PMT) and receiving treatment for her eating disorder. “PMT focuses on body image. But it takes a lot of time.” Dijkstra was diagnosed with bordeline and personality problems. The latter mainly influences her dealing with emotion. “As a result, I seek extreme control in other matters. That appears to be a pattern of destructive behavior.” At the same time, she is trying to complete her college education, but her ‘addiction’ has significantly delayed her studies. “It hasn’t been as good as it is now for years. But if I’m honest, I’m still not doing very well.”
Unhealthy
When, according to Terlouw, should you question your own diet and exercise urge? “As soon as sports takes over in your daily life and you cannot do other things. For example, you may be disappointed by an unexpected dinner or become anxious or nervous about it. Simply because you can’t exercise.”
For a long time, Dijkstra herself did not realize that she was being unhealthy. “That line is very thin. But if it becomes too much ‘having to’ and the enjoyment disappears, then you can start asking questions. I would recommend stopping exercise for a month. Does that not work and do you pass on? Then it might be advisable to sound the alarm.” Although Dijkstra was dreading the interview for this article, she still gathered her courage. “It is important that people know that this is happening. Because there is a lot of misunderstanding regarding sports addiction and BDD. In addition, an eating disorder is not just about ‘not eating’. All BDD variants are associated with a distorted body image. Personally, a nonsensical comment can bother me for weeks.”
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2024-01-01 08:34:40
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