The air whips past your face. The sweat trickles down your chest. Your shoes slap the ground, one after the other. Your legs ache, you’re getting cramps on your side, and you’re breathing heavily.

Running, jogging, walking, swimming, and cycling are all examples of aerobic activities.

Aerobic activity includes any exercise that works your cardiovascular system, which consists of your heart, lungs, veins, and arteries. If your heart rate increases to a level you can sustain for around twenty minutes or longer, then you’re successfully engaged in an aerobic exercise.

Both running and jogging aid in the development and maintenance of strong, healthy bones. They also strengthen muscles, joints, and improve overall health.

Running also decreases the risk of developing illnesses such as:

• Heart disease
• Heart attack
• Cancer
• Type 2 diabetes
• Hypertension
• Cataracts

And you don’t need to run marathons to reap these health benefits. Facts show that although longer is better, running five minutes a day will increase your life expectancy by three years. It will also cut your risk of cardiovascular disease by almost half. All these reasons are why the CDC recommends that children from age 6-17 engage in moderate/vigorous aerobic exercise, such as running or walking, at least three hours a week.

Running Elevates Your Mood

While the physical benefits of running are amazing, most runners don’t run to increase their life expectancy or reduce the risk of illness. They run because it consistently elevates their mood. Mountains of research demonstrate that regular exercise improves your quality of life over both the short- and long-term.

In rigorous studies, running reduced symptoms of anxiety and depression by almost 20%. Studies show that running for at least thirty consecutive minutes reduces a significant percentage of anxiety. Running has such a profound effect on mental health that psychiatrists often prescribe exercise to teens struggling with depression.

Yes – they write it out on the prescription pad!

Running releases endorphins – or, as recent studies show, endocannabinoids, which are molecules that occur naturally within your body that are responsible for producing feelings of bliss. That’s the reason why you feel a “runner’s high” once you finish a run. This is actually a real, evidence-based phenomenon – not something regular runners imagine. The endocannabinoids attach to endogenous cannabinoid receptors in our brain and promote “short-term psychoactive effects such as reduced anxiety and feelings of calm.”

Why is Running So Hard?

Running is physically strenuous. Your legs might ache and you might get cramps. Sometimes you feel sore for days after a run. Because our bodies are naturally programmed to avoid pain, teens need to summon their internal motivation to intentionally decide to do something that’s difficult in the short term. It hurts – or, at best, it is uncomfortable – to keep moving your legs constantly and to work yourself into a sweat. This, as an aside, is one reason why running is such a positive coping mechanism. It helps teens avoid rumination via the use of distraction. You can’t keep thinking negative thoughts if your primary concern is your aching legs.

Carolina Dozal, M.S., LPCC, is a dialectical behavior therapy (DBT)-trained primary therapist at Evolve Residential Treatment Center in Tarzana. As a Nike-affiliated runner and fitness trainer, she has completed countless triathlons and races. In her role as a therapist, she says teens can get overwhelmed by even the thought of a run.

“It sounds cool at first, but then it becomes daunting,” she says. “They want to run a marathon – without doing any training. Many teens also expect fast results. That’s when I teach them about building mastery.”

She knows they need to start with something simple and unintimidating.

That’s why Dozal encourages them to start by walking, at first.

“We set a goal that’s doable and possible, so they don’t feel like a failure.”

Building Mastery for Running

Building mastery means starting small and building yourself up incrementally to reach a specific goal. Dozal encourages all her clients who want to get into running to start small. She encourages them to try walking at first, even if it’s just around the block. Then she recommends alternating between walking and jogging for two minutes each at a time and then working up to running for 10 minutes at a time.

Only after a few days of that routine would she encourage teens to then try running a mile without stopping. Teens can increase the distance the next week. For example, she advises them to go from one mile to two miles, then two to three, and onward. She warns new runners not to skip from one mile to five miles without building up endurance in a realistic, stepwise manner.

Here are three more don’ts from Dozal:

• First: Don’t focus on how fast you’re going.
• Second: Don’t beat yourself up if you can’t finish that day’s goal.
• Third: Don’t compare yourself to others. Just compare your progress to your own.

Promoting Recovery During Treatment

Dozal integrates some sort of running exercise every day for her clients in residential treatment. Given the widely documented mental health benefits of running, she usually incorporates daily sprints, soccer,  or running games. In the past, Dozal took clients on runs and hikes. After several weeks of building mastery, two of her former clients completed a 13-mile run along with Dozal as their coach – and that’s incredible.

Dozal says that for certain clients, physical activity such as running promotes therapeutic disclosure that can facilitate recovery.

“For some of my clients, I find that there is potential for much more openness while engaged in exercise,” she observes. “Some clients become easily blocked or overwhelmed by the intimacy of therapy in an office setting.”

For example, teens with attention-deficit disorders may have trouble sitting still and focusing.

“Something about getting outside and moving really helps them stay on task and retain information.”

Dozal also finds that emotional awareness, self-awareness, creativity, and other positive therapeutic outcomes can heighten during movement and exercise.

“Some of the clients I have worked with who have been physically active report less anger and sadness directly after exercise than those who were just in the therapy room.”

While leading physical exercise during treatment, Dozal incorporates DBT skills such as:

• Behavioral Activation
• Three States of Mind
• Accumulating Positive Experiences
• IMPROVE the Moment
• Distract with Wise Mind
• ACCEPTS and PLEASE skills

Of course, sometimes clients don’t even want to get up and participate in fitness. And that’s where behavioral activation (BA) comes in, which we’ll explain below.

Running During COVID

During the COVID shelter-in-place guidelines, fitness enthusiasts were relieved when officials permitted outdoor exercise.

“Mid-march, right when the pandemic hit, running was the only thing that kept me going,” Dozal says.

She was lucky her favorite exercise was also one of the only recreational activities allowed early in the pandemic.

Later, however, her running came to a plateau. Despite weeks of preparation and training, organizers canceled a planned race with Nike in Los Angeles due to COVID. Her weekly running group was canceled as well. Dozal was disappointed. It was wintertime – which meant cold temperatures outside. The gloomy weather, lack of social contact, and media consumption all combined to affect her mood.

The thought of running simply exhausted her. “I thought, wow! This is what everybody else feels like when they think about going for a run!”

So she decided to just go on a walk.

“It was hard,” she admits. “It took a lot of mental effort and self-encouragement not to give up. But that’s when I got back into things.”

Behavioral Activation

Something similar happened to marathon runner Lindsey Crouse during the pandemic. Writing for the New York Times, Crouse wrote about how she felt stuck during COVID and couldn’t go on her regular runs anymore.

Until she learned about behavioral activation.

Behavioral activation is a treatment modality primarily used to treat depression, based on the premise that positive actions lead to positive emotions. Behavioral activation teaches you to act first, think later.

In essence: don’t wait to feel better before you act—just do it.

In her article about why she restarted running again, Ms. Crouse quoted Brad Stulberg, who coaches Olympic athletes on performance:

“There are two kinds of fatigue, according to Mr. Stulberg. One is when your mind and body are truly tired. The other is when that system tricks you into feeling tired because you are in a rut. When you’re tired, you need rest. But if you’re in a rut, you need to nudge yourself into action. “You don’t need to feel good to get going,” he said. “You need to get going to give yourself a chance to feel good.”

And that’s how Crouse – like Dozal – was able to get back into running.

Therapists promote behavioral activation when teens with depression say they aren’t feeling up to getting out and doing something – but that’s exactly why they need to get out in the first place. A major symptom of depression is becoming sedentary and losing motivation or interest in once pleasurable activities.

The cure? Get up and participate in those activities anyway, because they’ll make you feel better in both the short and long run (puns intended).

It’s like the famous Nike slogan:

Just do it!