As a physical health instructor working with individuals overcoming addiction, I have seen first-hand how exercise can have a positive impact on mood and energy levels. Spending time with my clients everyday also provides me with the opportunity to see how they change as exercise becomes a bigger part of their daily routine. My clients appear to feel more connected and alive. They’re getting out and moving and realizing that by exercising and taking care of themselves, they’re also saying, “I’m worth it.” This in turn impacts their self-esteem and feelings of shame and isolation — feelings that once dominated their self-concept. Working in this role as I have for so many years, I can see how exercise and physical health can really benefit those who struggle with addiction.
The number of Canadians struggling with alcoholism and other addictions is staggering. Current research estimates the prevalence of substance abuse in Canada at 11 per cent (about one in ten adults). Many addiction treatment centres require patients to abstain from all mood-altering substances while they are in treatment. This may be challenging, but in order to provide adequate care, the treatment centre should offer physical and emotional support from doctors, nurses and other healthcare professionals to help patients stay in treatment and minimize the likelihood that they will seek out alcohol or drugs.
After the clients have stabilized (usually about a week into treatment), a major focus of the therapists becomes teaching self-care techniques that clients can practice before they leave treatment. These must include behaviours that the client can realistically continue after they leave treatment and return to daily life. One of these behaviours is healthy exercise. When a person with an addiction completes treatment, it is ideal that he/she is already in the habit of working out several times a week. At the end of treatment, the client should be confident that they have acquired a variety of tools that will help them remain in recovery, one of which is physical exercise.
Exercise is important because it can help regulate and establish physical and emotional well being. The benefits of following a structured fitness program are many; improved cardiovascular health, better strength and balance, improved sense of well being, maintaining healthy body weight and better self-esteem. For many people, regular exercise paired with weekly support meetings, regular communication with their sponsor, healthy diet and adequate sleep provide a successful recovery experience.
Unfortunately, a large number of individuals suffering from addiction also suffer from depression. Many are prescribed with medication, but that alone is often not enough to help individuals establish meaningful recovery from addiction. In addition to abstaining from mood-altering substances, a regular cardiovascular exercise routine can provide a natural, effective alleviation of depression. In his book, The Depression Cure, Stephen Ilardi calls aerobic exercise a potent antidepressant. He recommends keeping one’s heart rate (HR) elevated to between 120 to 160 bpm (about 70-80 per cent of max HR) for 35 minutes three times a week. Endorphin levels peak approximately 30 minutes after the start of aerobic exercise. This is a great starting point and with a physician’s approval, these numbers can be gradually increased.
One of the main reasons why cardiovascular exercise helps to elevate mood is because certain chemical changes that occur in the body affect how we feel during and after strenuous exercise. Endorphins are classified as “endogenous opioid polypeptides” and they are thought to be produced by the pituitary gland and hypothalamus during strenuous exercise, and in response to pain, excitement and other stress stimuli. Once produced, endorphins are distributed throughout the nervous system where they interact with the opiate receptors to reduce our perception of pain. These natural pain relievers not only reduce the perception of pain, but they are also linked with an increased sense of euphoria and well-being. The amount of endorphins released depends on our physical fitness and regular cardiovascular exercise maximizes the potential benefit of endorphins.
Research studies suggest that those who suffer from depression may benefit more from group cardio classes than they do from exercising alone. The social benefits of group classes may further increase the endorphins released by the body during exercise. These findings suggest that it would be more beneficial to have people who are in treatment for addictions exercise together, rather than individually. If individuals recovering from addiction experience positive, energizing results from group cardio classes, they will be encouraged to continue with them after treatment.
Successful recovery from an addiction requires a comprehensive approach to physical, psychological, social and spiritual well being. Ideally, addiction treatment centres will offer a variety of cardio and yoga-type classes to help clients realize the benefits of frequent physical activity. It also works well if clients can choose to add additional independent sessions in a weight room or workout room. These sessions could include strength training and cardiovascular workouts.
Individuals in treatment should be encouraged to write down a detailed weekly exercise routine, including the type, location and frequency of exercise in which the client will engage. Treatment providers should also recommend that clients find a workout partner and/or take classes as part of their plan. It is harder to skip workouts when someone is waiting for you.
Finding a suitable fitness partner is invaluable. There are many organizations where you may speak to people or send an email regarding an interest in regular walking or attending a gym together. Those who are attending AA/NA meetings or other support programs could find a partner there. For some, having a co-worker for daily lunchtime walks works well. Churches, synagogues and other spiritual organizations may provide a great opportunity. It is advisable to exercise with someone who has goals and values that are similar to yours.
If you are planning to go to a recreation centre, you can make an appointment with a personal trainer on your first visit. Ask the trainer to help you set up a routine of cardiovascular exercise and resistance training that you can follow. Also, the personal trainer can recommend appropriate group classes for your level of fitness. If you are planning to start walking, jogging, cycling, or swimming independently, consider speaking to your family physician or a kinesiologist about frequency and intensity. If you aren’t able to exercise consistently for 35 minutes, gradually increase the length of your workout to maximize the benefits from endorphin release. Regular, enjoyable exercise can be an important factor in a person’s recovery from addiction and their commitment to the process. Just as missing support meetings are a red flag for relapse, so is missing workouts (for no real reason). Reach out for help and support to get back into your regular, healthy routine. Everyone, at every age is encouraged to include some cardiovascular exercise (i.e. walking) in his/her weekly schedule.
By Wendy Lee, BA Kin, CK, FIS.