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  • Kate Mihevc Edwards PT, DPT

How Viewing Mental Health on a Continuum Can Help You THRIVE!

Written By: Dr.Leda McDanial PT, DPT

How many times have you heard the phrase “mental health” and immediately jumped to the similar but NOT equivalent phrase “mental illness?” I imagine A LOT, if you are living in the United States, where mental illness, and health, is sadly stigmatized to a great degree.

In Episode #7 of the More Than Miles Podcast, Physical Therapists Dr. Kate Mihevc Edwards and Dr. Kacy Seynders, interview clinical and sports psychologist, Dr. Kensa Gunter and try to unpack some of the issues surrounding mental health. They discuss many facets of mental health and dive into an inspiring conversation on cultural themes regarding mental health and endurance athletes, common pitfalls that athletes may experience, and ways to improve mental health in life and on race day!

Dr. Gunter explains some of the common misconceptions about mental health saying, “In our society a stigma has generally existed when you think about mental health…and so when we say ‘mental health,’ most people think ‘mental illness.’” She goes on to explain how mental health, much like physical health, is better viewed as a continuum, from wellness to illness; and most of us function in the middle of that continuum! So, we all have mental health just like we have physical and emotional health.

One strategy we can use to move our mental health toward the ‘wellness’ side of the continuum, is by increasing our awareness around what factors are contributing to mental wellness versus pushing us towards mental dis-ease or illness. Dr. Gunter uses the analogy of a stop light to help us check in and be mindful of where we are on a day-to-day basis. As she explains, a “greenlight,” might mean being in a good mental state, “orange/yellow light,” may serve as a warning signal, and a “red light,” could indicate the need to seek help or support for our mental or emotional health. Some warning signs to look out for as you check in with your own mental and emotional states, would be if you are experiencing problems in daily functions (e.g, appetite or sleep changes, poor attention, impaired work duties) and if these changes have been going on for a significant amount of time (e.g., at least 2-3 weeks), with no clear cause from the environment or circumstances. This may mean you could benefit from seeking external support such as a

trained psychologist or therapist to get back to a healthy mental and emotional state.

Equally important to mental health in our overall lives, is our mental health as we engage in and relate to our athletic pursuits. As an endurance athlete, messages from our sports culture many times include a “tough it out” or “suck it up” mentality and we may experience implicit pressure to internalize negative body feelings or emotions. While having “mental toughness,” or “grit,” to stick out hard training sessions or a grueling endurance race may be positive attributes, pushing yourself to ignore mental anguish within your life or finding yourself dreading engaging in your sport are not situations to ignore or just push through.

In the podcast interview, Dr. Gunter discusses some other patterns of cognitive distortions commonly experienced by endurance athletes. These include a tendency to view outcomes as linked to effort

(e.g., “if I work hard, I should perform well” and “If I performed badly, it means I have not worked hard enough”) and a tendency to conceptualize a race or experience in a lens of “all or nothing” or “black and white” thinking. The first cognitive distortion may be insidious to your training and racing experiences and decrease enjoyment of your sport.

A healthier way to conceptualize or “reframe” training and racing experiences that are less than ideal

(e.g., running a slower time than your goal time for a 5k race), would be to also include environmental

and contextual factors when evaluating your performance. For example, your race time may have been affected by poor weather on race day or the stomach bug that you were recovering from a week before the race. Giving yourself some grace and acknowledging the plethora of external and environmental influences on your race experience may help you avoid the trap of attributing negative experiences to being fully under your control or your “fault.”

Also, endurance athletes could mentally evaluate a training session or race with the cognitive fallacy of “all or nothing” thinking. For example, we may view a race performance as “a goodrace” or “a bad race” without bringing awareness to the diversity of experiences and performance variables that went into that single race day. If you had a race you viewed as “bad,” you might think back to that day and reevaluate some of the nuances of your preparation and experience that may have been “good.” Factors like having a good warmup, being excited to run with friends, or going out at a planned pace for your first race segment could all be positive moments to celebrate within the context of the overall race outcome. Once you bring this awareness to your thought patterns and training and racing experiences, I bet you will find that there are positives that can be found in almost all situations. Next time you have a “bad” race, try this trick

to focus on some of the things you did well in addition to ways to improve parts that weren’t ideal.

Sometimes, however, awareness is not enough to turn around the negative effects of these cognitive distortions or other mental health struggles that may be taking a toll on our overall health and athletic performance! In this case, we can acknowledge that all of these troublesome emotions are perfectly normal and part of our human experience. Choosing to seek help for mental or emotional support and being vulnerable in admitting a need for help can be incredibly gratifying and also empowering! Plus, by addressing your mental and emotional needs, you are likely to experience greater longevity in your ability to engage in the sports that you love. This not only includes having more enjoyment in training and competition but could also mean reduced stress hormones and negative cognitions leading to improved physical health overall via their influence on our neurobiology and endocrine functions that impact ALL of your body systems! How cool is that?!

Another very insightful part of the interview comes with Dr. Gunter sharing strategies for better self-awareness and mental health practices for our wellbeing and includes tactics that she sees in in highly successful endurance athletes. These include:

  • Knowing your OWN baseline of mental, physical, and emotional health and readiness to train. This habit of “checking in” with yourself will build better self-awareness to know when something feels “off” or when you feel ready to push your training intensity up a notch that day. Remember, this is unique to YOU and not a “one-size-fits-all,” plan.

  • Maintaining purpose in training and competition. This relates to keeping in mind your personal, “WHY,” for engaging in your sport such as, to be competitive as a triathlete, to be healthier, to spend time with friends, or because running, swimming, biking is FUN!

  • Refraining from comparison with others (what is best for someone else, may not be the best training strategy, shoe type, mental pattern etc. for YOU to be successful and healthy)

  • Allowing yourself to experience the full spectrum of human emotions. This could mean celebrating race PRs, enjoying the “runner’s high” after a hard training run, but also grieving loss when experiencing injury or illness or feeling tired when you wake up before work to get in a swimming workout.

Ultimately, one of the keys to success is to add in more positives to each facet of health: mental,

emotional, and physical. As Dr. Gunter sees it, “I think we also need to be much more intentional about identifying those things that fill us up and make us feel good and integrate those into our lives on a much more regular and intentional basis to promote wellness not just to alleviate distress and discomfort.”

Hopefully these strategies may help you strive for more mental wellness in your life and sport. For more information and insights from Dr. Gunter, check out the full podcast episode below:

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