Diagnosing my mountain bike addiction

One not-so-bright morning in late May of last year, I awoke to the sad tone of my iphone’s powder alert app. The curse of 7 inches of fresh snow in the past 24 hours was a nasty pill for me to swallow. The previous day’s report was 5 inches. That’s a foot in 2 days for all the math geeks out there. So I was begrudgingly forced to crawl around and bring my skis back upstairs and I began to prepare myself for another day without wheels. It had been a solid week since I had gone on a legit bike ride on dirt, and with the fresh snow, any chance of riding local trails was buried. Andrea and Colleen picked me up at 8 am and off I went, to the only ski area that was still open in Summit County, A-Basin. We chatted about our plans for tomorrow and what we’d been up to lately. Andrea asked me from the driver’s seat, “Do you think you might be addicted to mountain biking?” It was at that moment that I suddenly came to a realization and after barely a breath of pondering I answered definitively, “Oh yeah.”

We proceeded to make creamy turns in the fresh spring powder. The other girls seemed to be really enjoying themselves. I felt like such a sour grape. I do enjoy skiing. No, really I do. We’ve had some glorious powder days this year. Today might have been one of them. But for me, all I could think about was riding my bike on some singletrack.

I work as a family nurse practitioner. That means I’m constantly coming up with diagnoses and trying to help my patients live more healthy lives. My medical background and education give me some knowledge about addiction. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the bible of the American Psychiatric Association. Psychiatrists and other mental health professionals refer to it to diagnose patients with mental health disorders. 

(The latest edition, the DSM V, kind of blows). So I will refer to the DSM IV. 

*Kindly skip ahead if you are easily bored by medical jargon.

Addiction (termed substance dependence by the American Psychiatric Association) is 
defined as a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring any time in the same 12-month period: 
1. Tolerance, as defined by either of the following: 
 (a) A need for markedly increased amounts of the substance to achieve intoxication or 
the desired effect 
 (b) Markedly diminished effect with continued use of the same amount of the substance. 

2. Withdrawal, as manifested by either of the following: 
 (a) The characteristic withdrawal syndrome for the substance 
(b) The same (or closely related) substance is taken to relieve or avoid withdrawal 

3. The substance is often taken in larger amounts or over a longer period than intended. 

4. There is a persistent desire or unsuccessful efforts to cut down or control substance use. 

5. A great deal of time is spent in activities necessary to obtain the substance (such as 
visiting multiple doctors or driving long distances), use the substance (for example, 
chain-smoking), or recover from its effects. 6. Important social, occupational, or recreational activities are given up or reduced because of substance use. 

7. The substance use is continued despite knowledge of having a persistent physical or 
psychological problem that is likely to have been caused or exacerbated by the 
substance (for example, current cocaine use despite recognition of cocaine-induced 
depression or continued drinking despite recognition that an ulcer was made worse by 
alcohol consumption). 
DSM-IV criteria for substance dependence include several specifiers, one of which outlines whether substance dependence is with physiologic dependence (evidence of tolerance or withdrawal) or without physiologic dependence (no evidence of tolerance or withdrawal). In addition, remission categories are classified into four subtypes: (1) full, (2) early partial, (3) sustained, and (4) sustained partial; on the basis of whether any of the criteria for abuse or dependence have been met and over what time frame. 

Source: American Psychiatric Association. Diagnostic and Statistical Manual of Mental 
Disorders. Fourth Edition. Washington, DC: American Psychiatric Association, 2000. 

According to the DSM-IV, to meet the criteria for addiction, I only need to demonstrate 3 (or more) of those characteristics up above. Lets go down the list in an orderly fashion:

1. Tolerance. That’s an easy one. In the cycling world we call this conditioning. And yes, I have acquired some tolerance. I like my rides to last between 1-10 hours.          

2. Withdrawal. Do I get irritable when I haven’t had a good ride in too long? You bet. *See above.

3. The substance is taken in larger amounts over a longer period of time than intended. I have a special word for this: “epics.” Its a noun. Epics are typically unintended, but are remembered fondly, once recovery from said epic has occurred. Yup, I’ve got this one too.

4. Persistent desire to cut down and control use. Not really. But I did genuinely trying to cut back on racing last year. I planned to focus on fostering grow in other ladies in the sport and work on my technical riding skills instead of racing constantly (that to me meant cutting back). I ended up doing about 5 enduros in 2014. This year instead of cutting down on mountain biking, I aim to increase my “use” of chain lube, spare parts and tires. This one doesn’t really work because my desire to cut back is not persistent.

5. Do I spend a great deal of time trying to get to trailheads, staring at bike porn, in the saddle and recovering from rides. Well, duh.

6. Important activities are given up because of use. This one is fuzzy because mountain biking is my social and recreational activity of choice. (I’m sure junkies have said the same thing about heroin). But it doesn’t pay the bills. I haven’t actually given up or lost a job because of mountain biking. But I have missed work due to races and injuries. Lets say I don’t meet this one because its a little grey.

7. Do I keep riding, despite multiple head injuries, numerous scars and scabs, loss of 1 tooth and a good bit of facial tissue? Yes. Have people told me its not good for me? Yes. 

So I meet at least 5 out of 7 of the diagnostic criteria above. But what about the definition itself? “A maladaptive pattern of ‘substance’ use leading to clinically significant impairment or distress.” Here’s the real tricky part. Is mountain biking maladaptive? Does it cause me significant impairment?

On the contrary I feel as though I am thriving in my physical and mental health, in my personal relationships, in my community and I feel like I’m just a generally better person because of mountain biking. I am more fit, happier, and have more to share with others thanks to the bike. 

Yes I have a problem. But its part of who I am. I may demonstrate some maladaptive behaviors and I do exhibit distress related to my problem. But at least I can admit that I have a problem. What about you?

If you are interested in some weekly group therapy, hit my up for Wednesday night group rides. Hoping to gain enough interest for monthly, Ladies-Only groups ride here in Summit County, Colorado.

By Leigh Bowe, mountain-biking addict in Frisco, Colorado