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Lots of exercise or a healthy lifestyle, when does it become a problem? “Substance use, compulsive dieting or obstacles to daily living are worrying developments. But if someone shows up at the gym every day, that’s also a signal to start a conversation and ask questions,” Vulink says.
Mieke Terlouw (40) from Haarlem now dares to honestly admit that she has struggled with a sports addiction. She wrote the book In de dean van het Leven about her father’s suicide and her impact on her life. His addiction to sports began about ten years ago. “I had just gone through a phase of partying and drugs. I then found the stimuli and distractions that I previously obtained by participating in marathons. I wanted to be healthy, I started working out a lot and completely lost track of it. Sports became my solution to everything. Even when I had injuries, I had to keep going.”
“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, even with sports addiction you want to feel as little as possible. This is why I never wanted to do anything, because otherwise all kinds of thoughts and feelings would arise. As a result, I felt an increasing need to exercise. Sometimes up to three hours a day. And if I didn’t do enough exercise on holiday, I would hardly be able to relax.”
The people of the Terlouw area were surprised by his passion for sport. “It was about burning calories and releasing endorphins. Friends would sometimes tell me, “Relax for a minute.” Then I rejected it and found them undisciplined.”
But excessive exercise took a toll on Terlouw. “I started having back and knee problems. And despite various complaints, I continued running and strength training. My back actually screamed at me, “Stop!” Terlouw says he would have preferred to be addicted to drugs rather than sports. Why? “We all know that drugs are bad for you, but sport has a different image. Plus, you can get rid of the drugs and never touch them again. But never exercising again is just not healthy. So you have to learn to manage the drug you’re addicted to.”
Cardiac complaints
Friesian Marit Dijkstra (24) is actually still in the middle of that fight that both Vulink and Terlouw talk about. “I have a distorted body image, urge to exercise, compulsion and an eating disorder.” A battle he has been fighting for about four years now. “Extreme sports,” Dijkstra calls his desire to exercise. “I had to take at least 25,000 steps a day, sometimes walking, running or playing football for hours and I could barely sit down. But it took on forms that no longer made me like it. “I just worried, ‘How much do I burn?’ “How much do I walk?” Movement came first. 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 took a group trip to South Africa last year, all I really cared about was sitting still on the plane or on safari. While the others sat by the pool, I went for laps in the park or in my room. Dijkstra lost a lot of weight, but he also suffered from joint, muscle and heart problems and was tired. “Of course, people around me told me I needed to cut back, but I couldn’t.” When his heart problems became even more extreme, a cardiologist concluded that Dijkstra’s heart couldn’t handle the strain. “I had to abruptly stop exercising and now I can walk to a limited extent. But going below 10,000 steps a day is not an option for me. Actually not yet.”
Dijkstra says that for her, giving up the sport has a double meaning. “At first I cried a lot. On the one hand I felt panic, but on the other I also felt relief. I had enough, but I couldn’t stop.
Causes
Psychiatrist Vulink explains that BDD often stems from a number of factors. Genetics, trauma, and personality play a role in this. “Approximately 70% 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 like perfectionism. Furthermore, we often notice that appearance had great importance in our family of origin or in the environment in which we grew up. Many patients grew up in an environment where identity was often determined by one’s appearance.”
Terlouw explains that he has long struggled with low self-esteem.
“I thought I was fat, ugly and felt a lot of shame, but that belief was very deep.” He describes himself as “a bundle of shame”. “In high school I would turn red and start sweating when I had to speak. That shame eventually transferred to my appearance. Exercise relieved that pain.
Suicide
Such an addiction to sports requires a lot of discipline. Terlouw also recognizes this in himself. “I’ve always had that need to demonstrate 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 it.
Terlouw can now explain his obsessive behavior. She already struggled with eating problems during her teenage years. “My parents divorced when I was eleven and my mother abandoned the family. Furthermore, my father and mother suffered from psychological problems. My mother’s departure became a deep trauma for me. That’s where shame comes from. I was ashamed that my mother couldn’t take care of me.” Terlouw was largely raised by her father, but ultimately she decided to take her life. For her Terlouw, the moment when she could no longer go back. “When my father committed suicide, I went very deep and had to go to therapy. “
Social means
There is no shortage of toned bodies on social media and people love sharing their sporting achievements. But do social media channels encourage BBD? Vulink is worried about this. “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 feel this in the clinic too.” According to Vulink, obsessive use of social media is part of the compulsive rituals of BDD patients. “Some take a thousand photos a day and only one is enough. But nowadays there are also apps that evaluate your photos or advise you which cosmetic procedure you should undergo. This is very worrying.”
Dijkstra, 24, recognizes this. “People encouraged me. You get a lot of compliments and are constantly told that “you’re doing well.” This makes things even more complicated.” This also happens on social media. “There you also see images with which you compare yourself.”
Research
Regarding treatment, the psychiatrist explains that patients with BDD often receive medications and therapies. “This is often a combination of modern antidepressants and cognitive behavioral therapy. But there are increasingly also other forms of treatment that focus, for example, on self-compassion and acceptance. These types of treatments also seem promising.”
Vulink would like to do more research on BDD with sports doctors and gyms. “How many people in the gym focus a lot on that aspect? I’d like to map that data.”
therapy
Terlouw describes the period following her father’s suicide as dark and depressive years, during which she underwent much therapy and treatment. “This brought me to the heart of the problem. Through therapy I have been able to process past experiences and work on my self-image. And as she discovered the psychological cause of her addiction, the desire to exercise obsessively became less and less. She currently gives yoga and pilates classes, but she does much less physical activity than before. “I don’t do strength training or running anymore.”
Terlouw once again mentions the low self-esteem of BDD patients. “You can tell someone like this: ‘You’re fine the way you are,’ but it doesn’t work like that. Someone with low self-esteem doesn’t feel this. That’s why we need to go deep to address the core of the problem and combine it with body-oriented therapy.”
Dijkstra has now had clinical admissions and had to make strict agreements on exercise. “I want to get rid of it. I hope in the future to be able to exercise again with pleasure rather than urgency.” She is currently undergoing psychomotor therapy (PMT) and is receiving treatment for her eating disorder. “PMT focuses on body image. But it takes a long time.” Dijkstra has been diagnosed with borderline and personality problems. The latter mainly influences the management of her emotions. “As a result, I seek extreme control over other matters. It appears to be a pattern of destructive behavior.” At the same time, she is trying to complete her university studies, but her “addiction” has significantly delayed her studies. “It hasn’t been as good as it is now in years. But if I’m honest, I’m still not doing very well.”
Unhealthy
When, according to Terlouw, should you question your diet and your need to exercise? “As soon as sport takes over your daily life and you can’t do anything else. 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 unhealthy. “That line is very thin. But if the “having to do” becomes too much and the pleasure disappears, then you can start asking questions. I would recommend stopping physical activity for a month. It doesn’t work and you move on? Then perhaps it would be appropriate to raise the alarm.” Even though Dijkstra dreaded the interview for this article, she still gathered her courage. “It’s important that people know this is happening. Because there are many misconceptions regarding sports addiction and BDD. Plus, an eating disorder isn’t just about “not eating.” All BDD variants are associated with a distorted body image. Personally, one meaningless comment can bother me for weeks.”
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2024-01-01 08:34:40
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