The dark side of becoming an IronMan – mental health struggles (part 2a): 5 ways to manage as an athlete

Disclaimer: I have no medical background and nothing in this post should be construed as medical advice. Please consult your healthcare professional before making major decisions that could affect your long-term health.

My previous post spoke about what post-race depression is and what could possibly have caused it. If you haven’t read that post yet, please do so now before continuing with this one. It is very important background info to consider, and you can find it here.

Next we are going to go into how to manage it. This post suggests ways to manage as an athlete, and the next one suggests ways to support a loved one through it. It would be useful to read this one first, but if you’d like you can jump straight to the next post if that’s all you’re after.

Notice that I keep using the word “manage”, and not words like prevent, avoid, or cure. Because the truth is, it cannot really be prevented. We can manage the severity of it and dilute it somewhat, we can even delay it, but there is no way to get away from it if it is going to happen to you. With time and experience you can perhaps get away with avoiding it completely, but that comes from going through it first and then (consciously or unconsciously) applying some of the management techniques.

How to manage PRD as an athlete

1) Be gentle with yourself

Completing Ironman is no small feat. Crossing the finish line is only another phase of the journey done. Now your body needs to recover. Research on muscle recovery after an iron-distance event indicates that muscles require 2-3 weeks of recovery following an Ironman, but other things such as joint cartilage usually require a few months to fully recover. Good news for experienced runners is that those with a history of long-distance running would have more conditioned cartilage that recovers much faster from the stresses of the race. For a race like Comrades, a coach once told me that it takes 6 months to recover fully from the race. I’ve never done Comrades, but I know the struggles are similar. Either way, it may be much longer before the mind and the rest of the body are fully recovered.

You have a lot of physical and mental fatigue that you need to work through. Your body begs for rest, so you give it what it craves. You might sleep in all day but still be exhausted. Now you feel guilty because you’ve been doing all this resting. Let go of that guilt, it’s OK. You deserve the rest without the guilt.

There will come a time when you feel rested, and you try to start training again. Nothing major, maybe just a short 5km run. Maybe you go out and you suck at it. You think your performance is the problem, because you see other people doing massive races shortly after Ironman successfully. Please know that what you see in those people is not normal. People with different levels of experience, abilities, and levels of exertion during the race will react differently post-race. And they are the ones who are outliers, not you. It is normal to compare yourself, but don’t use it as a judgement on them or on you.

Don’t feel like you have to have a big goal to work towards next, or even that you need to know what comes next. Everything will come in its own time. Now is the time to look after yourself and make sure you’ve recovered properly before jumping into major goals. If you rush things, you might get injured (much) further down the line and wonder why. So take the time to be lazy, you have a darn good excuse to be.

After Ironman I knew that there was no way I could attempt the Two Oceans 56km in just a few weeks, but I thought doing it the following year was reasonable. During one training run I did with one of the well-known public long run groups, I took so long to do 20km that the volunteers had already packed up and left when I got back to the finish, with my car keys! And my phone was in my car. It took me and my sister another few hours to track them down to come back with my keys. It was a super low point for me, one where I realised without any doubt that I will not be able to do Oceans that year. I still did the qualifier marathon a few weeks later, and finished, but not within the required time to qualify. In the end, Oceans was cancelled due to the pandemic. Putting pressure on myself to get back into my previous running life of smashing marathons and ultras was putting additional psychological pressure on my recovery. It doesn’t usually take that long (for other people) to get back into it, but it was for me, because doing Ironman took so much more out of me. I should have just been more gentle with myself.

2) Talk to those who have gone before you

Athletes who have done the race before you and your coaches are excellent sources of help. You’ve used their advice in the run-up to the race, and you do not have to stop once the race is over. Chat to them if you’re struggling physically or mentally. They have walked the path before you, and in the case of a coach, guided many athletes through the path. They are well equipped to offer you some guidance as well, even if it’s just reassurance that what you’re going through is normal.

In 2018, I did the Ironman 70.3 at the end of January. I was determined to do the Two Oceans 56km ultramarathon at the end of March because I had DNF’d the year before. So I had a structured plan to rest for just 2 weeks and then get straight into building up mileage for the ultra. I did finish the 56km successfully. Later that year I picked up a slight knee niggle after a rogue camel ran into me in Egypt on a mountain and I fell (no I’m not going to cover that story here, LOL), and it worried me because I was planning to do full Ironman in April 2019. I bumped into my 70.3 coach, Pat Lawson, at a conference one day. He was attending the conference and I was judging a hackathon at the same event. Now that he wasn’t my coach any more, our relationship had evolved into more like peers, although I would always respect him as having been my coach. I chatted to him during one of the breaks about my concerns about my running and how I am worried it’s going to affect my Ironman readiness. He assured me that I had nothing to worry about. He was very aware of my running abilities, and calmly and confidently told me: “You have to be able to run 15km by the end of December and 21km by the end of January to be ready for the Ironman programme. You still have lots of time, I wouldn’t worry about it.” He was absolutely right. By January I could run 21km comfortably and my niggle did not affect my Ironman prep or race. That reassurance from someone that I trusted and respected did a lot to put my mind at ease.

Many months after Ironman (I think it was 5/6 months later), I ran into Gareth at the gym and we had a lekker chat. Gareth was part of our coaching team as well, although he was never my direct coach. He had done multiple Ironmans though and was a very strong athlete. It was the 1st time I saw him after the race and he congratulated me and asked how I’m doing. I told him that I am really struggling to get my fitness back and am still not able to even feel comfortable on runs. He could see I was feeling pretty down about it. He told me it’s normal and I must go easy during the recovery and not put pressure on myself. I asked him: “But even now, 6 months later? It feels like it’s taking forever.” He said “Yes, even 6 months later. It takes a long time to recover, don’t rush into anything. Even if it takes a year, that’s fine”. He advised me to do other things besides swim, bike, run. “Do other things that you didn’t have time to do before. Go for a hike, do trail running, yoga, anything else.”

Again, this advice was gold. Gareth was not a back-of-the-pack athlete like me. He was strong across all 3 disciplines, a stellar achiever. In fact, Coach Pat told me that he was being coached by Gareth. So if he tells me it’s normal for recovery to take this many months, then I’d best believe him.

Listen to the experienced ones, they know of what they speak.

3) Talk to those who have walked the road with you

The athletes you trained with for the race can be one of your greatest sources of support. They are your tribe, so just remember that it is safe there. You went through all the ups and downs of training together, and hopefully you’ve all made it through. As I’ve said in the previous post, they are more than likely also going through the same thing, so reach out to them. I gave this advice to someone who reached out to me while she was suffering from PRD last year. I checked in on her a while later and she had taken my advice, and said that it was so helpful to talk to her athlete friends whom she’d done the race with. She had no idea that it was so common and that so many people suffered from it until she spoke to them, and it had helped a great deal.

4) Stay involved and active

A large part of PRD struggles is the result of being disconnected from community, losing your tribe. Because you’re no longer training for the race, maybe you don’t go to sessions any more so you never interact with the triathlon community you’ve grown so close to. But even though you are not smashing sessions, you can still stay involved with the community in innovative ways. Here are some of the things I did:

• Volunteer at canal swims to do sign-ins and registration
• Be the lead cyclist for a running or walking race
• Man a water point / snack table on a big training run
• Perform sweep duties at a trail race (I did UTCT with my sister)
• Support at a major road race like Comrades, Two Oceans, Ironman, or a local marathon

The above things allow you to be part of the social aspect of the session or race, without being an active participant doing it. And most of them are things that the clubs often struggle to find people to do, because everyone is either doing the race or training, or doesn’t want to get up early to be a volunteer. That’s just the things I did, and I’m sure there are other things that you can think of to do that’s not on the list.

Supporting is hard work. It is super tiring, but it makes you feel so good because the athletes appreciate it so much and that makes all that hard work worthwhile. At Ironman recently, while I was still cheering well into the night on the run course, an elderly man (clearly not from SA, judging by his accent) was running on the other side of the road and walked over to me on the opposite pavement after he had run past me several times on his run loops. He took the time to break his marathon gait just to come over and say to me in a very heartfelt tone: “Thank you SO much. I wanted to come over and tell you how much your support meant to me on this run. I’m going home after this and I wanted to tell you now, I am so grateful.” I am so grateful that he verbalised his feelings. 🥰 Fadeelah and Shameema, along with other total strangers, supported me on my Ironman until the very end of the race into the dead of night, so I do know how much that kind of support means to an athlete.

When I thought about it, one other thing I realised was having an unexpected health benefit while I was training was the canal swims. Canal swims were my favourite session of the week. I loved being in the water and swimming…but there are so many obstacles before you get to the enjoyable part, and even the enjoyable part is tough. When it got to the last few, we were swimming a few kilometres at a time on a Friday morning. It was March, and it was not yet light at 6am. So you first had to get yourself there in time, then psyche yourself up to do 3-4km in icy cold water before 6am. Getting ready on the platform, everyone is still busy waking up and yawning, and chatting about how we just can’t wait for all of this to be over. Truth is that I loved those chats, and although ignorant about it at the time, part of me really didn’t want it to be over. To think that we were out here socialising and being productive, cracking jokes and laughing but trying to keep our voice down to not wake up the city, while most people are still fast asleep.

The unexpected health benefit I am referring to though, is that of a cold water immersion. Science has shown that the benefits of immersing in cold water include a stronger immune system, high energy, and well-balanced mental health, amongst others. We were getting that on a weekly basis for more than an hour at a time. When I stopped going, I suspect I was losing that effect a bit. I eventually went back a few months later and when I did return, it was amazing to just swim and enjoy being in the water without the pressure of hitting your paces or doing crazy distances. I could even stop swimming and just float and look around at the island section, something I never did when I was training. So, if you have access to swim at something other than a pool… JUST KEEP SWIMMING.

5) Have a recovery plan

Just like you had a training plan to get ready for the race, have a recovery plan for how to wind down after the race. Of course it will not be as detailed as your training plan was, but it helps to have a vague idea of how you will cope. If you have something exciting coming up that is not time-sensitive, plan it for shortly after the race instead of before. Planning on buying a new car? Do it post-race to have something to focus your energies. If you can afford to and otherwise able to take a holiday, that is one of the best things you can do shortly after. It will help with both physical and mental recovery.

Plan things like when and how you will get back to exercising. What events will you do, if any? What kinds of other (not swim, bike, run) activities will you do? Plan some catch-up time with your friends who you were not able to spend time with while you were constantly training. Plan some quality family time activities, especially if you have kids. If you’re very community-oriented, maybe there is a community project that you’d like to start up or get more involved in to refocus your energies.

But didn’t you say events were not a great idea?! You might wonder why I’m referring to events as part of a recovery plan. Doesn’t it contradict what I said in point 1 about not rushing into them? Actually no, it doesn’t. Depending on the race you did, doing events soon after can be the best or the worst idea. If your body can handle it, it is hands down the best way to temporarily get out of PRD. The challenge is that you need to know your body very well and understand what it can handle. After my Ironman 70.3 in East London, more than half the group immediately signed up for the Durban 70.3 which took place a few months later. They were to go straight into the new programme and I was slightly jealous that they could do that, because they would then not suffer the separation anxiety that I was. Because my next goal was OMTOM 56km in 2 months’ time, and then full Ironman in a year from then, Durban was not an option for me. When a charity entry opportunity came up for CT Cycle Tour just days before the race, I jumped at it despite the high price tag of 5x the usual entry fee. The race and what came with it was electrifying and I was on top of the world again. The same thing happened at OMTOM and other local races…I was so happy and my PRD lifted as I was immersed into the race atmosphere and saw people from my tribe again. Soon after, the PRD would continue again though. It became clear that doing races was a very effective solution to feeling better, although it was still temporary. Conversely, after Ironman it took a painstakingly long time before I was able to do races again. Races and events can be used in your recovery plan if you understand this.

What about throwing yourself into work? Be very careful of throwing yourself fully into work as a coping mechanism, as this can be even more dangerous to your mental health. If your job comes with high stress, pouring yourself into that aspect of life over and above what is required, will exacerbate any other stress you are dealing with. It would be wiser to have a more holistic approach to PRD management.

That concludes the 5 aspects that I wanted to speak about. I haven’t covered any medication or supplementation aspects, because I don’t feel comfortable delving into that area. Is there anything else that I’ve missed that perhaps worked for you? Tell me down in the comments below or feel free to send me a private message.

One final thing I want to say on this to athletes… and I feel it is very important, is this:

The things mentioned above are coping mechanisms that I feel can and will assist you to get through PRD. However, it is very important that you do not try and suppress what you are feeling. Feel it all and let the process run its course. How does the saying go? If you’re going through hell, keep going! If you’re already in it, the only way out is through. If it does not run it’s course, it will rear its ugly head again at some point in the future. It might even rear its ugly head if you do think you’re over it. It might come and go in waves, and appear when you least expect it, and much later than you expect it. Also, do not hesitate to seek professional help if you need it.

Personally, I must admit that I don’t know if I will ever really get over it. And maybe that’s ok. Maybe I need to be content with the realisation that I will always be searching for something more, something to give me that next adrenaline jolt, something that will stretch me beyond what I am capable of at this moment in time. I suspect I am not the only one who feels that way. It’s the proverbial crossing the Rubicon… you can never go back to who and what you were before, and you wouldn’t want to. There is no turning back, so let’s keep moving forward!

The final instalment in this series covers what you can do to support a loved one through PRD.