Bigger Than a Run: Our Relationship With Running

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Keely Henninger

By: Keely Henninger

Professional Trail Runner | Scientist 👩‍🔬 | Fighting for athletes to treat their bodies with respect. Co-host of Trail Society Podcast.

Editor’s Note: This is the first in a three part series by our resident ultra-nerd, Keely Henninger, which will address the current state of mental and physical health, body image, and fueling in trail and ultrarunning community.

Being sidelined by injury, while not fun, always allows me time to reflect on my own reasons for choosing to willingly train for and race ultramarathons. Trail running is invigorating, empowering and fills me with extreme happiness and accomplishment. However, for a long time, running was a lot more than that. It was my default to control my stress, my body, and give myself an outlet from the nuances of everyday life. It saddens me to think about all the life experiences I left on the table just so I could go for a run. For a while running was my sole identity, and I did it in excess. I prioritized it over everything else and allowed it to consume all my thoughts – driving a lot of my unhealthy behaviors around training, fueling, and body image. I love running, but it has taken me years to put it in its own place and dissect my motivations and goals on their own.

Sport can bring out the best in us, but also the worst. It can heal and invigorate us by showing us our true potential and pushing us to new heights, but it can also control and manipulate our self-worth, and leave us feeling worthless without it. Is there a middle ground? Can we have a healthy, balanced relationship with running and mitigate some of the negatives? My aim with this article is to address the benefits and negative consequences of trail and ultrarunning, normalize mental health struggles common in our sport, and provide advice towards evaluating your own relationship with running (with the help of Danielle Snyder, licensed social worker and mindset coach).

Having a relationship with running can be great for us

There is a lot of research that shows just how beneficial exercise can be to overall health and well-being, feelings of belonging, and stress management (12,13). Exercise has even been used to improve the overall mood of participants with clinical depression (12). A systematic review by Thompson and colleagues (2011) revealed that natural, peaceful environments have also been shown to improve happiness and decrease anger and tension (17). Exercising while in nature is a one-two punch that makes trail running a perfect way to break up the day and improve your mood. Running extremely long races also requires extreme mental fortitude. Ultrarunning and endurance exercise have been shown to improve overall mental toughness and resilience (6,14,15), equip us with skills to navigate stressful situations and stay motivated to complete the task at hand (8). Athletes are typically better at coping with the demands of sport, negative emotions, and stressful situations (4). However, due to the nature of our sport, it is easy to let the demands of running start to leach into other areas of our lives.

Keely Henninger preps with her crew before the Western States 100 mile race in June of 2022.
PC: Moe Lauchert

Our relationship with running can become messy

Disclaimer: this section dives into the prevalence of mental health struggles and eating disorders in the sport of ultra/trail running. If either of these are triggering to you, please skip ahead to the final section with Danielle Snyder “Our relationship with running can be something we challenge and improve“.

As with anything, there can be too much of a good thing. Eating one plate of broccoli is good for your health, but eating 40 plates of broccoli will wreak havoc on your digestive system and most likely leave you feeling terrible. We can think of running and exercising in a similar way. When done in moderate amounts, exercise has many benefits, however, when done in excess, used as an escape from life, without rest days or through injuries, it can be negative (1). Identifying too closely with the sport of ultrarunning may make us more susceptible to these patterns and lead us to putting a lot of weight on our perceived success as an ultrarunner (9).

Some recent studies have shown that there seems to be a higher prevalence of mental health disorders (anxiety, depression, disordered eating, and exercise dependence) in trail and ultrarunners than the normal population (2,3). Some studies have even shown that the prevalence of mental health issues, disordered eating, and mood disruptions may increase as training volume increases (3). Since ultrarunning demands a lot of training, for some athletes it may be adding fuel to the fire of potential underlying issues.

A lot of enthusiastic runners and exercisers alike frequently exclaim, “I’m addicted to (insert sport here) !” without properly understanding the real weight of that term. Exercise dependence, or exercise addiction, can manifest in many ways and can produce sensations of withdrawal like other types of addiction (1). Our identification with and dedication to the sport can become excessive and leave us thinking obsessively about running, using exercise to modulate emotions, and with uncontrollable desires to run regardless of things like injury, illness, work, family, or community obligations (1,11).

Some of the skills that allow us to persevere through these extremely difficult races are also skills that may harm us. Resiliency is key to completing an ultramarathon, however, in a longitudinal study conducted in 2004 by Dr. Hoffman, over 75% of ultrarunners were likely to continue participating in the sport even if they were told it was bad for their health (7). Increased pain tolerance is extremely beneficial for finishing ultramarathons; however, it can also lead to injury and illness when ignored during training (6). Our ability to endure long training runs, training cycles, and races may become excessive or impetus for behavioral change.

Our relationship with running can start to impact our training and our health

Mental health can impact (and heck is as important as) physical health. Increased risk for exercise dependence is typically linked to an increased risk of disordered eating and both have been shown in the literature to be related to increased symptoms of low energy availability (LEA). (5,18). LEA is a state when the body does not have enough energy to perform all the necessary physiological functions (19). The long-term consequences of LEA are still being studied; however, it may impact many physiological processes important to performance and overall health (5). Strongly identifying with your sport, skipping social gatherings, and feeling guilt when not exercising, have been shown to be related to increased risk for symptoms of LEA in some athletes (20). Other mental illnesses (depression and anxiety) may also impact excessive exercise habits and manifest in disordered eating and thus could also result in symptoms of low energy availability for some athletes (10). We will dive into the nuances of LEA in part two of this series.

Our relationship with running can be something we challenge and improve

Mental health is not something to hide. Ultrarunners are typically healthy individuals with high drive and ambition, however, that does not make us immune to these issues. Our ability to persevere is noteworthy but persevering through constant mental turmoil is not necessary and can hurt our overall performance and happiness. To dig into this more we have reached out to our in-house mental health therapist, Danielle Snyder, for her advice on dealing with and addressing our relationship with running.

“First of all, if you are struggling with any of the above, I encourage you to work with an individual practitioner on determining your best course forward. When we are in a cycle of training, it can often be difficult to set aside and unpack our motivations for running. It can be difficult to understand the nuances of our relationship with running until we are forced to take a break from it. Taking a break to reevaluate how you utilize exercise can be instrumental in creating a healthy relationship with it. While running is an amazing sport, it is not therapy, we can’t ‘run’ from our problems– they always catch up. We can also ask ourselves specific questions around our own motivations for running.”

What do my current motivations for running/exercising look like?

This one is extremely challenging because this can require unearthing unconscious feelings as well. Here are some thoughts to consider and really think about.

  • How do I feel when I am running? Would I be okay without it?
  • How do I feel about myself when I am not running? Does my narrative change?
  • Does my ego take a hit when I miss some training days? Does this translate to how I see myself in my day-to-day life?
  • Do I need to exercise or is it a productive addition to my training?
  • Am I using running as my sole coping skill?
  • Are you able to fuel your body properly when on a break from exercising?
  • Am I worried about gaining weight if I do not exercise?

We give and receive high praise for suffering in the sport of ultrarunning. We are used to pushing our body and mind to their limits, ignoring pains and discomforts, and training for hours. However, there are some experiences and struggles that we shouldn’t ignore or suppress. Taking a deeper look into our relationship with running may seem daunting, but unearthing areas of improvement won’t make us weaker, it will only make us stronger. We can choose to make this sport just a little bit easier by prioritizing our mental health and well-being. We can work on making our relationship with running a little healthier by decoupling it from a lot of other aspects of our lives and identities. We can strive to get to a place where running complements our life but doesn’t define it, so that when we inevitably come to a fork in the trail, we will be okay with wherever it may take us.


(1)Allegre, B., et al. Definitions and measures of exercise dependence. Addiction Research & Theory. 14.6 (2006):631-646. DOI: 10.1080/16066350600903302

(2)Buck, Katherine et al. “Psychological Attributes of Ultramarathoners.” Wilderness & environmental medicine vol. 29,1 (2018): 66-71. doi:10.1016/j.wem.2017.09.003

(3) Colangelo, Jill Ann. Prevalence and Type of Psychopathology in Ultra Endurance Athletes. Master’s thesis, Harvard University Division of Continuing Education. (2020)

(4) Crust, L. The relationship between mental toughness and affect intensity. Personality and Individual Differences, Volume 47, Issue 8, 2009:959-963. https://doi.org/10.1016/j.paid.2009.07.023.

(5) Fahrenholtz I., et al. Risk of Low Energy Availability, Disordered Eating, Exercise Addiction, and Food Intolerances in Female Endurance Athletes. Front. Sports Act. Living 4.8 69594 (2022). doi: 10.3389/fspor.2022.869594

(6) Gauld, Christophe. (2021). Psychological and Cognitive Specificities of the Ultra-Marathon Runner: Perspectives of Biomarkers for Mental Health. 10.13140/RG.2.2.27502.74568.

(7) Hoffman,M. Would You Stop Running if You Knew It Was Bad for You? The Ultramarathon Runner Response, Wilderness & Environmental Medicine, 26.4 (2015): e4-e5. https://doi.org/10.1016/j.wem.2015.03.014.

(8) Jaeschke, Anna-Marie & Sachs, Michael & Dieffenbach, Kristen. Ultramarathon Runners’ Perceptions of Mental Toughness: A Qualitative Inquiry. The Sport Psychologist. 30 (2016).

(9) Lantz, C., et al. Eating Attitudes, Exercise Identity, and Body Alienation in Competitive Ultramarathoners. International journal of sport nutrition and exercise metabolism. 14 (2004):406-18.

(10) Levit, Maayan, Ayelet Weinstein, Yitzhak Weinstein, Dana Tzur-Bitan, and Aviv Weinstein. “A study on the relationship between exercise addiction, abnormal eating attitudes, anxiety and depression among athletes in Israel”. Journal of Behavioral Addictions 7.3 (2018): 800-805. < https://doi.org/10.1556/2006.7.2018.83>.

(11) Lichtenstein MB, Melin AK, Szabo A and Holm L The Prevalence of Exercise Addiction Symptoms in a Sample of National Level Elite Athletes. Front. Sports Act. Living 3.635418 (2021). doi: 10.3389/fspor.2021.635418

(12) Ligeza, T. S., Maciejczyk, M., Wyczesany, M., & Junghofer, M.The effects of a single aerobic exercise session on mood and neural emotional reactivity in depressed and healthy young adults: A late positive potential study. Psychophysiology. 00. e14137 (2022). https://doi.org/10.1111/psyp.14137

(13) Martinez, T., et al. Trail and Ultrarunning: The Impact of Distance, Nature, and Personality on Flow and Well-Being. Psi Chi Journal of Psychological Research. 21 (2016):6-15.

(14) Roebuck GS., et al. The psychology of ultra-marathon runners: A systematic review. Psychol Sport Exerc. 37. (2018):43–58.

(15) Roebuck, G., et al. Psychological characteristics associated with ultra-marathon running: An exploratory self-report and psychophysiological study. Australian Journal of Psychology. 72 (2020)

(16) Shephard, R., & Åstrand, P. (2008). Endurance in sport: An IOC Medical Commission publication (6th ed., pp. p. 211-214). Hoboken: John Wiley & Sons Incorporated.

(17) Thompson Coon, J., et al. Does participating in physical activity in outdoor natural environments have a greater effect on physical and mental wellbeing than physical activity indoors? A systematic review. Environ Sci Technol. 45.5 (2011):1761-72. doi: 10.1021/es102947t. Epub 2011 Feb 3. PMID: 21291246.

(18) Torstveit MK, Fahrenholtz IL, Lichtenstein MB, et al. Exercise dependence, eating disorder symptoms and biomarkers of Relative Energy Deficiency in Sports (RED-S) among male endurance athletes
BMJ Open Sport & Exercise Medicine. 5.e000439 (2019). doi: 10.1136/bmjsem-2018-000439

(19) Wasserfurth, P., Palmowski, J., Hahn, A. et al. Reasons for and Consequences of Low Energy Availability in Female and Male Athletes: Social Environment, Adaptations, and Prevention. Sports Med – Open 6. 44 (2020). https://doi.org/10.1186/s40798-020-00275-6

(20) Weinstein, A., Maayan, G., and Weinsteing, Y. A study on the relationship between compulsive exercise, depression and anxiety. J. Behav. Addict. 4. (2015):315–318. doi: 10.1556/2006.4.2015.034

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