When sport turns into addiction
In recent years, much has been reflected on the impact that sport has on a person’s life. Physical activity is usually positively connected with health and well-being; however, in some cases sport can give rise to a real addiction
Virgilia Crescenzi – OPEN SCHOOL, Cognitive Studies San Benedetto del Tronto
Sport and psychology began to collaborate from the 1920s, integrating the psychological aspects of sport into a joint research area. Psychology has been primarily concerned with understanding areas such as motivation, group dynamics and mental training. Another line of studies focused on identifying talent in order to predict an athlete’s success. These studies have taken into consideration the personality traits that are the engine for practicing a sport as amateurs or becoming an athlete who can go on to do prestigious races
Within the context mentioned, in recent years, much has been reflected on the impact that sport has on a person’s life. Obviously, physical activity is often positively connected with health, well-being, beauty, improvements in mood, symptoms of anxiety and even in serious psychopathologies, benefits can be found; all in all a perfect medicine for the mind and body, at any age (World Healt Organization) ..
In the scientific literature, however, there are also articles that highlight how sport can hide some negative aspects, almost as if it were a devil disguised as an angel, who instead of doing exclusively good, with some individuals, the most “vulnerable” ones, turns into a bad seducer. This is a similarity that shows what can happen when sport becomes an obsession or when addiction is established.
Therefore, although there are many advantages to practicing sport in a healthy and constant way, the negative implications that it can have from a psychological point of view cannot be ignored. If on the one hand, moving improves vital signs, appearance and so on, on the other, doing too much can lead to consequences such as chronic changes in hormonal release, a greater risk of accidents and, as anticipated, important psychological implications, including the establishment of a real addiction (with the complicity of a social acceptance) or a psychological disorder that arises mainly from a problem of self-esteem and perception of one’s own image.
It is good to make a further distinction between those who, practicing sports, establish an addiction that leads them to always overcome their limits, to be obsessed with them and unable to control their behavior, living with the sole objective of making movement; by those who instead conceal a discomfort towards their body, a constant disgust towards themselves and towards their defects, in this case physical activity is driven by both a negative self-assessment and possible social pressures and is the means by which to improve your physical appearance more and more.
It is therefore necessary to emphasize the psychopathological implications and take into consideration this distinction, which is useful above all for the classification and treatment of symptoms of body dysmorphic disorders or eating disorders. It is also important to understand what the negative behaviors that addiction to sports bring and what aspects could harm the athlete. In fact, many points remain to be clarified regarding the way to evaluate sport in the psychopathological field.
In recent decades, sportsmen have increased exponentially. The aim is mainly to improve mental and physical well-being, and there must be a certain constancy to maintain the benefits over time. Physical activity is a mainly positive factor in everyone’s life: it is socially recognized as a positive and healthy habit, it also benefits the relational aspects of the individual’s life, it is useful for improving one’s self-esteem and in some cases it moves away from possible harmful habits.
However, abandoning oneself to excessive and uncontrollable activity can lead to recurrent negative effects, increasing the inability to manage different life contexts, such as social and work, for example, and the susceptibility to musculoskeletal injuries; in addition, overtraining increases the risk of acute problems (hypoglycaemia, chest pain, arrhythmia and others) leading to a malfunction of the immune system.
This phenomenon can be defined as a sports addiction disorder, characterized by loss of control of one’s behavior and thought, resulting in a compulsion, in which the symptoms of a behavioral addiction manifest themselves.
In DSM-5 it is considered among the behavioral addiction disorders. It is not officially included in the classification, but according to Griffith (2005) it is recognized in the same characteristics of a behavioral dependence: the pre-eminence (the behavior assumes the greatest importance for the person), the influence on the tone of mood (emotional disturbances related to both practice and abstention), tolerance (intensifying behavior to induce increasingly intense effects), abstinence (negative feelings due to physical activity), conflict (conflicts that occur in the person’s life between dependence and other aspects, on which it begins to get better and better), recidivism (high drop-out).
In general, recognizing an addiction to exercise is difficult because of the large positive, widely shared consideration of this practice: social recognition, well-being, acceptance, better quality of life, exercise is socially accepted behavior, perhaps even if taken to extremes. Striving for a slim and fit body is usually perceived as a sign of a healthy lifestyle and personal success, and family and friends can accept and encourage fitness athletes to maintain excessive exercise habits. In a study by Lichtenstein et al. (2017) it was confirmed, through a cross-sexual study, that it is difficult to recognize an addiction to sports precisely because of the social support that gravitates around it.
In general, after carrying out any physical activity, the individual experiences feelings of euphoria, it happens because there is a release of endorphins, dopamine and serotonin, which have a fundamental role in the sense of well-being of the individual, however they play a role also fundamental in establishing a sports addiction. Two types of addiction can be recognized in various researches: physiological and psychological. The first proposes models that describe the causes of a possible presence of addiction to hormonal release, to the change of the organism, therefore to the only physiological need for pleasure that pushes the individual to develop compulsive behavior; one of the most accredited is the hypothesis of sympathetic activation: when the adaptation of the organism gets used to physical exercise it establishes an addiction, occurs when the individual moves, activates the organism and this arousal improves physiological parameters. Psychological models, on the other hand, show that the main cause of exercise addiction concerns the mental, thought and personality aspects of an individual, motivation, and behavior patterns capable of reducing stressful symptoms.
Recently, however, a model has been focused on taking into consideration both the physiological and the psychological aspects, which work in synergy to ensure that a positive conditioning of the learned behavior is established, in fact they are considered as interacting factors: personal value, social image, lifestyle and ways of reducing stress, which involve the physiological aspects to achieve a state of well-being (Egorov at al 2013).
Links between exercise and nutrition addiction, disturbances regarding obsessive exercise patterns, body control and perfectionist personality traits have been found. (Lichtenstein, Christiansen et al. 2014). The attitude is to implement excessive motor activity as compensation for food binges, alternatively to other eliminatory behaviors. Comorbidity is particularly observable in women with bulimia nervosa or anorexia.
Muscular dysmorphy is a variant of body dysmorphism characterized by beliefs about the insufficiency of muscularity and involvement in exaggerated muscle building physical activities such as weight lifting and the use of anabolic steroids, up to the so-called Vigoressia. Athletes with muscle dysmorphism often try to maintain low body fat by following targeted diets and eating habits. The syndrome has a strong component of addiction to compulsive physical activity, it has an important concomitance that is caused by the extreme attention to the achievement of fitness and muscle shape goals.
Eating disorders and body dysmorphic disorder are recognized as psychiatric disorders in diagnostic manuals (American Psychiatric Association, 2013; World Health Organization, 1992), exercise addiction is still not. However, these conditions often appear simultaneously, so much so that Davis and Claridge have proposed that comorbidity with exercise addiction be considered in eating disorders (Davis & Claridge, 1998). The two scholars found that obsessive-compulsive traits were associated with worry about weight and excessive exercise in patients with eating disorders.
Other researchers have observed correlations between addiction and mood disorders, e.g. Linchestein et al (2018), found that depression and stress lead to a high risk of exercise addiction, which can be conducted as a coping strategy to overcome to psychic suffering. Scholars have realized that addiction can be recognized both through the observation of compulsive behavior and confirmed by continuous musculoskeletal injuries to which the individual does not give importance by returning ahead of time to practice the various activities.
In accordance with these results, the Work Craving Model offers three dimensions through which a dependence on physical exercise is maintained: “hedony”, “compulsion” and “cognitive components”. With WCM, Wojdylo et al. (2013) outline an interaction between neurotic perfectionism (learned), obsessive-compulsive trait, reduction of withdrawal symptoms and an increase in positive self-esteem of the dependent behavior in question. Both perfectionism and the obsessive-compulsive component have been shown to correlate with excessive exercise, particularly when competing with eating disorders, while maintaining craving behavior is often related to depressive and anxiety disorders, a confirmation of these correspondences is a study by Macfarlane (2016).
Bruno et al. (2014), found that a high risk of developing a sports addiction is due to a narcissistic personality, especially to ensure omnipotence and provide protection against loss of satisfaction and admiration. Not only that, low self-esteem seems to be, also a predictor of Exercise Addiction since it makes the individual safer, increasing self-confidence and the confidence of pleasing the other by showing sporting attitudes.
Finally, it is not difficult to imagine that this type of addiction can also manifest itself in comorbidity with social anxiety disorder, especially if this concerns one’s own physical characteristics.
In western countries, sport is widespread, which is why you can do a little sport at any age, in gyms, clubs, in the open air.
Therefore it must be considered an important and influential aspect in a person’s life exactly like work, family and friends circle etc.
It is still not clear the mechanism that establishes an addiction and if it can be considered really as such in every individual (even comparing it to the most common and current ones such as gambling or internet addiction), beyond which the boundaries are not yet outlined between normal activity and negative sports addiction. In fact, some studies have shown that even athletes are not immune from addiction to exercise compared to simple practitioners, the passion for sport plays a fundamental role and can be a motivational drive to do more and more compulsively; moreover, it is possible that it may be established by carrying out any type of specialty practiced.
In psychotherapy, the relationship that the person has with sport must be taken into account, how much he practices and if, for greater performance, he helps himself with supplements, this can be useful in the initial phase to deepen other aspects that define the diagnosis and specify if sport can be a prodrome of other comorbidities or differential diagnoses with specific disorders. It can be useful to investigate how sport is perceived, if it is experienced as a compulsion, or if it is really a moment of leisure or detachment with problems, or if it is done in order to achieve an ideal weight-form.
In each specific case, it will be necessary to evaluate the most suitable psychotherapeutic technique to achieve a balance and adequate coping strategies and that addresses dysfunctional behaviors with respect to sports practice and the psychic problem that supports them.