This series by BLOC Staff Coach Brooke Haubenstricker about coaching lifters with depression has been a welcome addition to Barbell Logic’s content on lifting and mental health. Part 1 laid a framework for thinking about depression as a coach. Often, we fill an important supporting role at the nexus of a person’s physical and mental health. Part 2 analyzed the myriad of benefits lifters with depression get from training and looked at some comparisons between strength-based training and other types of physical activities. Here, Part 3 gives us practical advice, including building or maintaining trust and having conversations about depression. And Part 4 helps shore up many coaches’ concerns about programming and how to provide value as a coach while supporting lifters through challenging times.

Coaching Lifters with Depression: Coaching Considerations

Part 3 of 4

One of the earliest observations I made when I began coaching lifters who struggled with depression was that coaching them the same as I would any other lifter often led to less-than-ideal outcomes: decreased compliance, decreased communication, and a greater likelihood of the lifter having a negative experience with strength training. Not to mention, it made my coaching efforts feel fruitless or circulatory, with infrequent contact and sporadic workouts alternating with periods of complete radio silence. Needless to say, this situation can become stressful on both sides.

Eventually, I realized that our relationship was as essential to their success as technical feedback and programming – if not more so. The trust that had been built as lifter and coach had a cascading effect: a stronger relationship led to better communication – even during difficult periods – which led to more effort and better problem-solving to aid compliance. Long-term, the lifters had a better attitude toward training, they were better able to continue training during depressive episodes, and they had better mental health and fitness outcomes. The training difference can be stark: in one instance, prioritizing our relationship resulted in a lifter continuing with his training membership four times longer than he had previously under a different coach.

One of the challenges with online coaching is learning how to build up relationships with clients while limited by time, distance, and communication mode. With in-person coaching, conversation flows easily during warm-ups and rest periods, reinforced by tone and body language. The closest replica online is video feedback and video chats, but not all coaches prefer these modes of communication, and conversations can still easily get stuck on training. The strongest relationships I’ve formed with clients – including depressed clients – have been the ones where we spent the greatest amount of time talking about things unrelated to training: pets, kids, hobbies, tv shows, vacations, or whatever else is valuable to them. Taking a moment to ask more about their busy weekend or throw in a fun conversation starter like the strange snowfall you experienced in Texas opens the door to building that connection. Funny gifs and pictures can also inject personality into what may otherwise be an uneventful form check.

Over time, these small moments of connection accumulated to create a strong relationship, and the natural product of a strong relationship is trust. I cannot overstate how important it is that a lifter trusts you as their coach. It takes a lot of trust to open up to someone about a tough personal issue like depression.

Getting to this point in the relationship isn’t always easy. In addition to their inner struggles with depression, many individuals have experienced rejection, invalidation, and stigmatization from others. These experiences erode their ability to trust others, leading them to bottle everything up and hindering their ability to problem-solve with the help of another person. Remaining patient is paramount. Don’t give up. Continue reaching out for connection, and your consistency will show them that you care and that the relationship is worth emotionally investing in.

Conversations About Depression

When a lifter has trusted you enough to open up to you about their depression, how you respond will leave a lasting impression. It will convey to the lifter whether they’ve made a mistake sharing something so personal with you or if you’re someone they can rely on during those tough periods in their life. Because of this, it’s important that you are thoughtful and deliberate with your words and actions.

There is no one particular way that depression is brought up; it completely depends on the lifter. In my experience, lifters will often explicitly mention it after encountering issues in training due to their depression, such as missed workouts. However, the exact timing, presentation, and circumstances surrounding the conversation have plenty of variability. Regardless of how or when the subject comes up, I tend to follow these rules:

1. Reinforce positive behavior. Starting feedback with “Thank you for telling me [xyz],” “I appreciate you doing [xyz],” or something similar is a wonderful way of encouraging the lifter to communicate this kind of information in the future. At the same time, it can make a person feel as though what they’ve said has been wholly received without negative judgment. These statements also happen to be more neutral responses to receiving this sensitive information compared to “I’m sorry,” which can be embarrassing or exacerbating for some, or the habit of skipping right to questions, which in online communication can come across as unsympathetic, abrupt, or pushy.
2. Keep the focus on the client. There are situations in which it may be appropriate to share a personal story with lifters or that of another lifter you’ve coached. However, to have a positive outcome, the timing, presentation, and amount of information shared needs to be right for that lifter. If it’s not, it could leave them feeling misunderstood or like their personal issues are being swept aside. When unsure of their reaction, wait to share these stories and be deliberate about which details to include. When in doubt, it’s better to share nothing and keep the focus solely on the lifter.
3. Actively listen. Absorb as much as possible of what the lifter is saying about their depression: how they’re feeling, what they’re struggling with, changes in thinking or behavioral patterns, suspected triggers. Ask questions as needed. All of this will give a more complete picture that can be used to plan out their training.
4. Be careful when giving mental health advice. Depression is complicated. Not all types of depression are experienced or treated the same way. Despite having the best of intentions, any advice you give may have unforeseen consequences. Encourage the lifter to see a mental health professional if they need guidance with their depression treatment.

Being emotionally vulnerable is scary for many people. It opens them up for more emotional pain at a time when they are already feeling low. They may also be experiencing intense guilt surrounding their training: guilt about underperforming, missing workouts, suboptimal recovery, slowing progress, poor communication, and “wasting your time.” Thoughtful communication with the lifter can be the difference between a strong, long-lasting relationship with you and their training versus the lifter believing they weren’t cut out for strength training.

Obstacles to Training

Obstacles to training are things that get in the way of a lifter’s ability to complete their workouts. They can be directly related to the workout prescription, but that’s not always the case. This is important to note because it means adjusting a lifter’s programming will not improve their noncompliance if it’s not addressing the root issue. Taking the time to identify a lifter’s specific obstacles will allow you to effectively problem-solve.

Examples of direct training obstacles include:

• Specific exercises
• Exercise intensity
• Failing reps
• Using “bad” technique
• Workout length
• Training-induced fatigue

Examples of indirect training obstacles include:

• Getting out of bed
• Getting ready to go to the gym
• Eating enough food
• Feeling mentally/emotionally drained
• Feeling tired constantly
• Apathy
• Driving to the gym or getting out of the car
• Starting the workout
• Not wanting to be around other people
• Crying or displaying standoffish behavior at the gym
• Not wanting to read workout feedback later
• Placing unrealistic expectations on themselves

It can take a great deal of self-reflection for someone to identify all of their particular obstacles, so lifters may only be aware of a couple of their obstacles at first. Asking initially will give an idea of what’s standing out to them, and it will bring their attention to this subject so they can be on the lookout for more obstacles.

Keep in mind that obstacles to training often appear to be irrational, making it tempting to try to talk them into a different mindset. However, attempting to rationalize with a depressed person about an irrational issue is often ineffective, and it can give the impression of diminishing issues that can be life-altering, embarrassing, and frustrating. Instead, focus on how the lifter can work around it. If you truly believe a conversation can break down this obstacle, my recommendation is to wait until the lifter is out of their depressive episode first.

During a depressive episode, present the lifter with short-term solutions to their obstacles. Personally, I prefer to present lifters with just a couple of potential solutions at once so they can choose whichever one they think they can implement, which will also get them involved with problem-solving. Another option is to present one solution at a time to steer lifters down a particular path, adding complexity or greater changes only as-needed.

The solutions to direct obstacles are usually straightforward, and these are addressed in part 4 of this series. Indirect obstacles require more creative thinking.

Examples:

Obstacle: Not wanting to be around other people.

Can they go to the gym at a less popular time?

Can they switch to a less popular gym?

Can they set up a home gym?

Can they do home workouts with zero or limited equipment temporarily?

Obstacle: Not wanting to read workout feedback later.

Would increasing positive feedback or encouragement help?

Would reducing constructive feedback to 1 item per exercise or workout help?

If they are a proficient lifter, would temporarily eliminating constructive feedback altogether help?

This process works well for many indirect obstacles, but not all. There are some obstacles that can be critically impacted by depression and require professional intervention. For instance, individuals with severe depression may have a difficult time getting out of bed to the point where it affects essential tasks, like working. Overcoming this problem may require a specialized treatment plan. So, encouraging them to seek professional help right away may be the best and only way you can help.

After the lifter is out of their depressive episode, it becomes much easier to have an in-depth discussion about obstacles and to brainstorm more effective or elaborate solutions to their most frequently encountered obstacles to training.

A Note on Self-Critical Thoughts

People who are depressed tend to be very critical of themselves. They’ll often hold themselves to unrealistically high standards. I often see perfectionistic tendencies, idealized thinking, and comparisons to other people. These standards can be in-place even after depressive episodes, although they may not be quite as extreme. Here are a few examples:

Technique: Frustration that their form doesn’t “feel right” or look perfect.

Intensity: Unhappy about not lifting a specific heavy weight. Possibly ignoring important considerations like genetics, years spent training, recovering from an injury, etc.

Progress: Believing progress is too slow, especially without recognizing how factors like poor recovery or compliance can hinder adaptation.

Aesthetics: Dissatisfied with their appearance. (There may also be a disconnect between how they think they look and how they actually look as if they’re looking into a funhouse mirror.)

These standards pose a huge risk to training because the negative feelings that surround these standards can leak into training itself. They can ding motivation, make obstacles feel even bigger, and equate training with negative thoughts and feelings. If these standards are severe enough, they will need therapy to overcome them (particularly with aesthetics), but there are a couple of things you can do as a coach to help.

First, try to understand where these standards are coming from by asking questions. It may turn out that they don’t know why they have these standards for themselves. Trying to dig deeper can uncover what’s really behind these standards, and it will give you a better understanding of what’s going on inside someone’s head.

Second, gently combat those standards. Instead of trying to tackle these standards head-on, gradually reshape them into something that’s realistic and positive for that lifter. Here are some ways that can be done:

Technique. Are they often unhappy about their deadlift technique? Reduce your technical feedback and instead praise the heck out of it. Point out everything they’re doing right, applaud their progress, and let them know that it’s ok for them to be imperfect and to accept that imperfection. I’ve also had lifters who would list out everything they did wrong after every workout. I would tell them that if they do that, they have to tell me what they did right too, no matter how small. When I got their feedback, I would let them know if I agree or disagree and again praise them for noticing what they were doing correctly. (“Reinforce positive behavior” can apply here too!) Over time, their workout expectations become more realistic, and they learn how to be kind to themselves.

Intensity. Instead of focusing so hard on where they want to be, bring the focus back around to what they need to do to get there. What’s within their control, what steps need to be taken. Don’t let them beat themselves up about their mistakes; what’s done is done. Help them see that every choice they make now will affect their path to their goal. Every workout, every exercise, every rep is valuable. Encourage them to enjoy where they are right now in their training and to seek meaning beyond PRs: the importance of pushing through, making progress, being a role model for loved ones, and investing in their health.

Progress. There are so many elements that influence our training progress, but to someone who’s not as familiar with that process, it can be easy to overlook those relationships. After all, the gym is where all the action happens. Educating the lifter on where each part fits into the picture can open their eyes to how they may have been falling short with their recovery or how an injury may have played a bigger role in derailing their progress than they realized.

Membership Cancellation

Membership cancellation is a more complicated subject than it seems on its surface. From a coach’s perspective, if a lifter isn’t training, it makes sense to recommend they cancel their membership and come back when they are in a better position to train. Most coaches feel uncomfortable accepting payment for services not rendered, plus they may feel wholly unqualified and ineffective in helping a lifter train through a depressive episode. Admittedly, this was my perspective until I worked with a client who had frequent, intense depressive episodes that would take him away from the gym for months at a time. He told me that he feared receiving a membership termination email as it would be a sign that he hadn’t been a good client, despite his best efforts. From the client’s perspective, a well-meaning cancellation suggestion can instill feelings of failure and disappointment. Depressed lifters don’t expect to be pulled away from the gym for long stretches of time, and they’re usually trying to fight their way back under the bar. A coach remaining patient and positive during those periods and genuinely believing in the abilities of their lifter is an invaluable part of that process.

It can be tricky to accurately determine how committed a depressed lifter is to strength training. I’ve had compliant lifters abruptly leave and noncompliant lifters fervently committed to staying. When in doubt, let the lifter decide. Membership cancellation propositions are best brought up by them, at least explicitly. It’s unlikely that a lifter is unaware of their financial commitment, and if they felt like it wasn’t a good investment for them at that time, they would cancel their membership. Two exceptions I would make are 1. if a lifter is known or suspected to be struggling financially or 2. needs serious medical attention. They may need that push to reset their priorities.

If it seems like a lifter would benefit from canceling their membership, the idea can be brought up indirectly by asking questions like, “Are you benefitting from coaching?” and, “Is there anything I can do to help you get back to the gym?” These questions bring a lifter’s attention to their current training situation and the value that coaching is bringing them at that moment. As an added benefit, it gets the lifter thinking about self-improvement and what they need out of coaching, which can lead to more problem-solving and, hopefully, bring them another step closer to returning to strength training.

Despite all your best efforts to establish a positive relationship with your client and provide them with coaching and programming that suits their exact needs, there are no assurances that they will go to the gym consistently or communicate with you regularly. They may end up canceling their membership, too. But by investing in your relationship with this person and making them feel heard and valued, they will take all their positive memories of coaching and training along with them, making it more likely that they will continue to train on their own or return to it later.

Continue Reading with Part 4: Programming Strategies —>

<—Read Part 2: Training Benefits