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Running, the Perfect Medicine

In an excerpt from a new book, a running medical doctor describes how running improves emotional well-being, brain health, and helps forge connections to new friends.


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One weekend I woke up at 4 a.m., full of energy. I crept downstairs trying not to wake my family, still peaceful in their beds. I began to listen to the radio, and before long was entranced by a fascinating Italian-English accent that belonged to an addiction psychiatrist named Henrietta Bowden-Jones. She grew up in Milan then moved to England for her schooling. She said she came to the field of addictions because of a fascination with the mind and the experiences of seeing young men and women injecting heroin in the parks of Milan flanking her walk to school in the 1970s. Many others would have witnessed the same events and experienced only disgust and revulsion, but not Henrietta. In the interview she described becoming interested in behavioural addictions and gambling addiction in particular. The interviewer asked her how she coped with the emotional trauma of her work, and her answer left me ringing with understanding — “Running.” She described running an hour at a time to shed the stress of her work.

It’s often much easier to think and plan when running. I have all my best ideas and come up with my most ambitious plans when running. When do other people do their best thinking? I remember reading that Alan Turing, who developed some of the fundamental ideas behind computing, artificial intelligence, and cryptography, began to run while at Cambridge and had moments of inspiration while on the fields running between Cambridge and the nearby cathedral town of Ely. One summer day in 1936 he was so overwhelmed by ideas during a run that he lay down in an apple orchard to focus on his thoughts. He ran the fifty-kilometre route to Ely and back frequently. He used running to cope with the stress of his work, saying that the only way he could release the stress was by running hard. He was so fast he even tried out for the British Olympic Team, but an injury kept him off the team.

Exercise reduces anxiety, at least in part, by causing the neurons that release the calming neurotransmitter gamma-aminobutyric acid (GABA) to proliferate. GABA inhibits excitatory brain activity, thus releasing more GABA makes a person feel calmer. The brains of animals that are made to run more go on to develop more excitable neurons and more GABA-releasing neurons. Running also makes you feel sharper and more alert. Though exercise leads to more excitatory neurons and synapses, animal studies suggest GABA-releasing neurons are also more likely to be activated in response to stress. In one study, mice who ran on wheels regularly recovered from the stress of being placed in cold water more quickly than sedentary mice.

Exercise boosts our mood and cognitive function through the production of brain-derived neurotrophic factor (BDNF). The trigger to release BDNF after exercise may be anandamide, the body’s endocannabinoid molecule, which is itself released by exercise and may be responsible for the runner’s high. Thus, it should be no surprise that running, in particular, boosts the production of BDNF. Running leads to a healthier body, and BDNF helps ensure that running also leads to a healthier brain. BDNF promotes the growth of dendrites, the long arms connecting neurons to each other. It strengthens synapses — the bridges between neurons. And finally, BDNF makes stem cells turn into healthy new neurons.

More and more evidence shows that endurance exercise actually stimulates the growth of new brain cells, and is linked with improved cognitive function.  Most exercise-induced brain growth in humans occurs in the hippocampus. Exercise is also neuroprotective — it improves factors related to neurodegenerative diseases such as age of onset, progression, and severity of symptoms. Finally, exercise improves recovery from a range of injuries to the brain.

Exercise makes young people smarter and is associated with better school performance. A study of a million young Swedish men who joined the military found that markers of physical fitness were correlated with higher IQ. This correlation was true even among identical twins, showing the importance of physical activity during childhood. The boys with higher IQs also went on to have higher paying careers. Other studies show that after only six weeks of regular exercise individuals have improved working memory and visuospatial processing.  Regular exercisers also improve their performance on creative problem-solving tests after a short workout.  

Researchers have proposed other explanations for the positive effects of exercise on the brain apart from its stimulation of the release of BDNF. One is that exercise increases blood and oxygen consumption in the brain. Another is that exercise increases neurotransmitter quantity and quality, especially the neurotransmitters that we know impact our mood and cognitive abilities: dopamine, norepinephrine, and serotonin. For example, when we have looked at the genetic activity in the hippocampus of mice that have been encouraged to exercise, it looks similar to those of other mice that were given serotonin-boosting medications. Thus, exercise may work in part by boosting serotonin levels, the same effect of most common antidepressants, such as Prozac.

Dopamine is the brain’s principal molecule of pleasure. The reason we lose the will to be active as we age remains a mystery. My son bounces off the walls, but an elderly person is content to sit quietly for hours. What is different in their brains? A fascinating study that looked at non-human animals noted that this age-related decline in activity is seen across many other species.  The author decided that the explanation involved dopamine. Both reduced dopamine release and loss of dopamine receptors seem to contribute to the decline in activity seen with aging. What’s more, when dopamine levels are enhanced in the brain of older animals, their activity levels go up. In a real sense, dopamine seems to motivate us to be active. This desire to exercise, in turn, alters our brain’s neurochemistry and creates a feedback loop whereby our pleasure molecule drives us to achieve more happiness…

Exercise changes our brains and therefore our mental health. Running also draws in other runners, opening the door to forming adult friendships, even at a time in life when many people think the time for making new friends has passed. New friends help you weave a nest of well-being around your life. Children make new friends in the playground. Running can be a passport back to that child-like fellowship. When we feel good around people, we associate them with that good feeling. That person makes me feel good about myself, we think. That is the key to friendship.

When a new couple and their young son moved in across the street, I quickly discovered that not only was Jorg, the tall German father, a runner, but he was also fresh from running his first marathon a few months before.

“We should go running together” was the easiest thing to say when I first met him a few weeks later, and then it was simple to text him one morning to arrange a lunchtime run for later that day. As we traced my familiar route around Dow’s Lake, I showed him the features of the route, like a child showing a friend the toys in his bedroom: this is where we cross the canal; this is the little peninsula that takes us into the lake; this is where we cross Bronson Bridge back into the neighbourhood.

Afterwards, we sat on the front porch, drinking cold water, talking about our families and the renovation work Jorg was doing on his new house.

A few weeks later, after the kids were in bed, we drove to Pine Grove Forest. We parked in a small lot next to signs warning of coyotes. We debated bringing headlamps but decided to leave them behind. Then we set off on the dirt trail.

We ran side by side when the path was wide enough, taking turns leading single file when it narrowed. We came across only a handful of other people out walking their dogs in the late summer light. The ice and snow had been late to melt this year; the rains were relentless, but on this night the ground was dry and the sky was clear. Jorg had found a job as an architect working on a visitor centre for Canada’s Parliament, so we talked about how we would fit our runs into our work and family schedule. At one point we lost the path and had to run parallel with a road before we found the path again and continued across the road into a part of the forest that had neat rows of towering pines planted after the original woods had been cut down decades before.

The forest was quiet beyond the sound of our footsteps falling quickly in near unison. In the final moments I imagined we were approaching the finish line of a race. It was still light, but dusk was falling fast. As soon as we stopped to walk the final few metres to the car, we entered a zone of mosquitoes. We talked about how much concern there is about declining insect numbers, and yet it’s hard to be concerned when they are biting you on the face. But despite the insects, our new friendship was flourishing, nourished by our time running through the woods and along the canal.

Two weeks later my brother Sascha came to stay, and we went for a morning run that looped up the canal, down the Rideau River, and back home. We set out at quarter to seven on a Sunday morning, but the air was already warm with fresh summer heat. Whatever else was happen- ing in the day or in our lives or in the world, it was so comforting to run together. Earlier that morning, my daughter had vomited on the living room couch after having had stomach pain through much of the night. I had cleaned her up and changed her pyjamas. She probably wouldn’t be able to go to school the next day.

But that was a concern for later. Now I was running, now I was rounding the corner and watching as Dow’s Lake unfolded before my feet. I was listening to Sascha explain how he was aiming for a step rate, or cadence, of 180 steps a minute, trying to relax his shoulders, trying to find the right zone for his heart rate as he trained for another trail race. Sascha is always learning and improving himself, and I was learning from him. I had followed his lead to become a runner and now I was following him toward drinking only oat milk, exploring veganism, and trying to shrink my carbon footprint.

A few months after our Sunday morning run, Sascha and I ran our first race together. Neither of us had trained as much or as hard as we would have liked. Sascha lamented to me that he hadn’t run for three weeks before the race because of his overloaded travel and work schedule.

I was surprised when he told me it would be his second organized race ever, the last being the Warsaw Marathon he had run eight years before, which had, in part, inspired me to become a runner. He told me he didn’t need the external motivation; he ran hard and trained consistently without a race. I had started by using races to give me the structure and the goals to push myself, but I also had been in fewer organized races as I matured as a runner.

On a Sunday in early August, we drove thirty minutes to a ski hill to start the 20K trail race. Sascha was excited, in particular, about the trails. He kept saying that this was why he ran, for these trails, for this glorious nature, for days like this. I couldn’t have agreed more. There were about two hundred other runners in our event, and our strategy was to start toward the back and speed up as the race progressed. It was a cool morning, and the trails were lovely. Often they were only wide enough for us to go single file, and Sascha paced me, looking back every few minutes to make sure I was keeping up. We knew that the key to trail running was to embrace the descents and just fly down in the spirit of British fell running. The descents were free speed and somehow our feet landed just right. At one point we went down a massive hill that just kept going down a curving gravel trail, and I forced myself to slow down to avoid breaking an ankle or flying forward and breaking a wrist, but Sascha let loose, racing down the trail. So much for not running in three weeks, I thought.

We were always either descending or climbing; there were only a few minutes when we were running on a flat, and that felt gloriously easy and straightforward. In the final kilometres we passed more and more runners. I was intoxicated with running, my neurochemicals were surging, the blood was racing through my brain, and I had an epiphany about racing. The other runners weren’t part of my race; they were running their own races. Each person was running their own race, set against their body and mind, their training, their goals. Everyone could win this race, even me, despite my relatively casual approach to training in recent months. And when, about fifteen glorious minutes later, we finished, I felt like we had won. I felt so much empathy and so much compassion for other runners. The runner’s high transported me to a Buddhist aware- ness of the oneness of everything.

And the amazing thing is that I felt the same a week later, even after the stiffness had left my calves and I could get out of a chair without making a grunting sound. My body hurt, but my brain had been strengthened by the race. I had bonded with my brother, overcome a challenge, spent two glorious hours in nature, and flooded my body and brain with anandamide, BDNF, and endorphins.

Excerpted from The Perfect Medicine: How Running Makes Us Healthier and Happier by Brodie Ramin ©2021. Published by Dundurn Press Limited.