One winter, after a particularly bad breakup, I took a pretty deep turn into depression. Growing up as an only child, I had learned early on how to be a self-sufficient person, which also meant never letting others control my emotions. Normally, I could manage whatever came my way. But this, this was different.
I had never felt so out of control. All the habits I had taught myself weren’t working; I was sleeping at all hours of the day and avoiding social interactions. This lasted for a few months before one day I got up and decided to go for a run.
Lacing up my sneakers, I hit the street and did about two miles before my lungs felt like they might jump out of my chest. In the following days I started to run more often and was doing up to 10 miles consistently and beginning to feel like myself again. As runners, we know the physical health benefits of the sport and have read the research on its morphine-like endorphins that put us in better moods. But sometimes we forget about its very-real mental health capacities.
Back then I hadn’t attributed my recovery to running. But I later realized that it had become my Prozac, my little blue pill that brought me out of depression.
By the Numbers
According to the Anxiety and Depression Association of America (ADAA), “Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18.1 percent of the population every year.” They go on to say that those with anxiety disorders often also suffer from depression and vice versa.
Worldwide, depression is named as the leading cause of disability with more than 350 million people across the globe suffering from it. “Almost 75 percent of people with mental disorders remain untreated in developing countries with almost 1 million people taking their lives each year,” states the ADAA. “In addition, according to the World Health Organization (WHO), 1 in 13 globally suffers from anxiety.” Those are some pretty significant numbers.
In October of 2017, Business Insider reported that there had been 307 mass shootings already in the US. That’s almost one a day for one year. Following these shootings, conversations surrounding mental health grew and have continued to be discussed and debated in the media and in public circles. So where do we begin to confront this global issue and how does running fit into all of it?
Running as Therapy
I recently spoke with Sepideh Saremi—a licensed clinical social worker and psychotherapist based in Los Angeles, CA—who is tackling clinical depression and anxiety, one run at a time. Saremi is the founder of Run Walk Talk, a method of mental health treatment which utilizes mindful running/walking and talk therapy at the beach.
In her mid-20s, Saremi suffered from a family crisis and began running to cope with depression along with attending traditional therapy sessions at the same time. “I wasn’t doing them concurrently in the same session, but they both really helped me,” shared Saremi. “I started seeing the research about running and exercise as a mental health intervention and got curious about why it wasn’t actually a bigger part of the way therapists practice. So that kind of planted the seed for me.”
After graduating college with a BA in Creative Writing from USC, Saremi switched tracks and went on to get a Master’s in Social Welfare from UCLA. In her early days of therapy, she found that some of her patients were wanting a more active approach to their treatments but she couldn’t provide it without having her own practice. In 2014, Saremi opened a private practice in Beverly Hills where she began running with patients as a way to treat clinical depression and anxiety.
Today, Saremi works with entrepreneurs and high achievers out of her Redondo Beach location and has continued to use her run-walk-talk approach to therapy. Although this method isn’t new, it’s still a relatively underused practice in the US. “I didn’t start running therapy. Running therapy started 40 years ago, maybe even more,” said Saremi. “The originator was a guy [named] Thaddeus Kostrubala, he wrote the Joy of Running; he was a psychiatrist.”
Though she didn’t know about Kostrubala when she began her work, she has since learned more about his studies and has found others using this technique. It’s also more widely used in Germany where they have schools that train therapists on it.
Your Mind on Runs
What I didn’t realize when I began running after my breakup was that there was more going on in my brain and body than just endorphins being released to make me feel happier. There were many other factors combining together to help me regain balance. Part of what Saremi saw in her early years of researching running and mental health is that the former had various dimensions to it that worked to help treat the latter. The first dimension deals with ritual, spiritual and psychological well-being. This is one we’re all pretty used to; we run because it makes us feel good and more connected to ourselves. The second is a neurochemical response that affects your brain and the third deals with behavioral aspects.
“If you think about it neurochemically, there are always these things happening in your brain when you’re exercising at some intensity. One is that your body is producing BDNF [Brain-Derived Neurotrophic Factor],” said Saremi. “Research has shown that low levels of BDNF has been linked to Alzheimer’s, accelerated aging, obesity, depression and schizophrenia. So, it stands to reason, that having higher levels of it will be protective for people.” The other chemicals being produced during high intensity workouts are called endocannabinoids, neurotransmitters that help regulate things like sleep, mood or appetite.
Another element Saremi saw happening with running therapy was its fake-it-till-you-make-it effects. Clinically this is called Behavioral Activation. It’s basically doing a behavior that’s good for you, even if you don’t feel like it, because eventually you’ll start to enjoy it. “It’s very effective for depression. And running is kind of like that way anyway. Most people don’t wake up feeling like they want to go for a run. But once you start doing it, you’re really into it,” Saremi stated.
Along with the neurochemical benefits of running, research has shown that patients participating in physical movements in therapy can process depression and anxiety more effectively. Bilateral Stimulation is a concept that comes from EMDR (Eye Movement Desensitization and Reprocessing) therapy which is used in trauma treatments. “It’s not totally clear how bilateral stimulation works but the thought is that it helps to process trauma in a way that is more effective than just by sitting and talking about it,” said Saremi. “Bilateral stimulation basically means moving both sides of the body, engaging both sides of the brain and body.”
Saremi’s typical 50-minute running sessions take place on a three-mile loop at the beach. First, patients will meet at her office, walk two blocks down to the beach as a warm-up and then begin the run which typically lasts for 30 minutes. There are no rules and no set pace, patients customize their experience based on how they feel that day. Upon their return, they’ll spend some time stretching and chatting.
Entering her fourth year now using this unique type of treatment, Saremi has already noticed how effective running therapy is. “I work with a lot of men and often men have a really hard time opening up when you’re working face to face,” said Saremi. “They’re not socialized to talk about themselves and talk about their feelings in a way that women often are. There’s something about being side-by-side that helps them open up in a different way.”
In her own life, Saremi didn’t begin running until her early 20s. “It took me literally years to feel comfortable running. I didn’t start running until I was 24 or 25,” she shared. “I had thought about running when I was like 11. But it was like ‘I’m too chubby, I’m not fast enough or I’m not good enough.’ I didn’t think it belonged to me.”
Because of this, she can easily relate to patients who may not feel up to the task of running or believe they are unequipped to do so. Sometimes, this technique can also be a catalyst to her patients running on their own time. “Sometimes my work is really just to serve as someone who makes running accessible and possible for them,” she stated.
At the end of the day, Saremi remains one of the few therapists in the US leading the charge for running therapy. But her hope is that more therapists will see the benefits of this method and begin practicing it more regularly. Before ending our chat, Saremi left us with one last thought to encourage people who may be on the fence about running in general or in her sessions.
“Running belongs to you, you don’t belong to running” she urged. “I think that is something that can be very empowering for people to think about it that way. I don’t actually have to perform here, I’m doing something that feels good for me so what do I want to get out of it and how do I want it to go?”