We proceeded to make turns in powder and 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. And, may also lead to a very serious tone in this blogpost. 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.
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
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
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. The remission category can also be
used for patients receiving agonist therapy (such as methadone maintenance) or for those
living in a controlled, drug-free environment.
Source: American Psychiatric Association. Diagnostic and Statistical Manual of Mental
Disorders. Fourth Edition. Washington, DC: American Psychiatric Association, 2000.
So to meet the criteria, I’ll 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 2-10 hours.
2. Withdrawal. Do I get irritable when I haven’t had a good ride in too long. You bet. *See above. *See below for my meager attempt at substituting a similar substance to avoid withdrawal.
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 remembered fondly, once recovery from said epic has occurred. Yup, I got this one too.
4. Persistent desire to cut down and control use. Not really. But I am genuinely trying to cut back on racing this year. Ask anyone. Its true. So far I’ve only registered for 1 race. And it hasn’t been easy. So I would say I meet this criterion as well. That’s 4:4, but lets keep going.
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 6:7 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?
So after I had my fill of skiing the fresh powder this morning, (I lasted a whole whopping hour), I sat in Andrea’s car and waited for one of the other girls to wander down and be ready to go ride bikes. Colleen wasn’t feeling well, so she and I bailed while Andrea kept skiing (all day long I presume- she might have an addiction of her own). At home, I frantically made some tunes to my new rigid singlespeed and checked the weather reports everywhere within an hour drive, trying to predict the driest place to ride. I gambled on Eagle, CO and off I went. I drove through soaking rain to get there, hoping against all hope that somehow it would be dry enough to ride when I arrived. About 5 minutes from the trailhead, 2 tears ran down my face as I resigned myself to my fate. I could either ride the wet trails and cause unethical trail damage, or I could turn around and drive home, my craving left unsatisfied.
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?
PS- I am about to cry again as I just got a winter storm warning in my inbox.
Summit County trail conditions: Facebook page- Like it!
Recent article I read about mountain biking addiction. I think it has a bit too strong of a Jeff Foxworthy element for my tastes, but it also makes some valid points: 20 signs your addicted to mountain biking