Running As Medicine
/How a 55-mile run brought about a life-altering diagnosis
Maria Ordovas-Montanes does a 30-mile practice run ahead of her fkt attempt on the oxford green belt way. (PHoto by Maria Ordovas-Montanes)
Season 6 | Episode 9
In May of 2022, Maria Ordovas-Montanes set out to become the fastest woman to run the Oxford Green Belt Way, a 55-mile route through the English countryside.
She had always loved running, and this was an exciting challenge. But at the event, something happened that would derail her life — and lead to a shocking discovery.
On this episode, Maria shares her story.
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Welcome to Out There Podcast. Our stories are written for the ear, so for those able, we recommend listening while reading along. Transcripts may contain minor errors; please check the audio before quoting.
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WILLOW BELDEN: Alright, I am out for a bike ride, and I’m in a spot here where I can see three different mountain ranges. And I only know what one of them is.
Does that sound familiar? It happens to me a lot. I’ll be out for a hike or a bike ride, and I’ll find myself wondering what mountains I’m looking at.
This is where an app called PeakVisor comes in handy. PeakVisor is our presenting sponsor this season. Their app helps you identify mountains and plan adventures.
If you’d like to be a superhero of outdoor navigation, check out PeakVisor in the app store. You just might love it.
Hi, I’m Willow Belden, and you’re listening to Out There, the podcast that explores big questions through intimate stories outdoors.
There’s this thing that scientists do, when they’re studying genes. If they want to figure out what a specific gene does, they’ll remove it. Then they observe what happens. Does the organism grow more slowly? Is it susceptible to disease? These so-called “knockout experiments” help us understand what a gene does.
Scientists study this in laboratories. But the concept can apply to our everyday lives, as well. Today’s story is about what happens when a key part of your identity is taken away. It’s episode nine of our season on silence. Maria Ordovas-Montanes has the story. And just so you know, this episode mentions suicidal thoughts.
When I discovered the Oxford Green Belt Way, it was kind of by accident. I was living in England and looking for new places to run. So I scrolled around a map of Oxford. And something caught my eye: a path labeled Oxford Green Belt Way.
It turned out to be a long-distance loop that went through woods, farmland, and residential neighborhoods. It even followed the well-known Thames Path for a bit. The route was nearly 55 miles long.
Then, I stumbled across the Fastest Known Time page for the Green Belt, and it turned my route-finding from an ordinary planning session to something more.
Fastest Known Times — or FKTs — are just what they sound like. They’re the record for doing a route the fastest. The Green Belt already had four times listed for men, but the women’s section was blank. This meant that the first female to complete it could do it in any number of hours, and that would be the female FKT.
I wondered if it could be me. I’d never raced anything longer than a half marathon, and the Green Belt was over two marathons long. But I loved being outside, pushing myself. And after the academic challenge of defending my PhD, I was craving another challenge — a physical one.
Exercise, especially running, had been important to me for a long time. As a grad student, I’d run five times a week: Tuesday, Wednesday, Thursday, Saturday, and Sunday. It didn’t matter if it was raining. Those were my running days. Going to conferences or vacations, I’d map out routes in advance and bring my running shoes. I’d get up in the dark so I could get a run in before seminars or sightseeing.
On a daily basis, running energized me. And in the longer term, it gave me a sense of achievement. I could set goals, train consistently, and see the results.
It was September 2021 when I first found the Oxford Green Belt Way. And a few hours later, I was already thinking about logistics. How long would I need to train to run over 50 miles? Half a year? I felt like I was racing against a clock. Another woman could post a time before me. I made some calculations and circled May 28th for my FKT attempt.
I found a coach and started training. Over the months, I ran 30-mile weeks, then 40, then 50.
Fifty miles in a week. That’s a lot by most people’s standards, and I would have to cover that distance in a day.
A month before the FKT, I did a 30-mile practice run which also served as a dress rehearsal for some of my support crew. I wanted to make sure my aid stations, where I could refuel, were set up in optimal locations. And I also wanted to test my legs.
It went really well. I kept a steady pace, and by the time I got to the day’s finish line, I had lots of energy left. I thought this was a good sign. My body wanted to keep running after 30 miles.
Leading up to the FKT day, I was doing just as many logistical preparations as physical training. I sent my support crew members a 50-slide PDF with diagrams that outlined each transition of the day: which support car had to pick up each friend that would be helping, where my supplies would be, and which backup locations to use if the primary aid station was blocked off. I now fully understand why people pay to attend organized races.
The day before the attempt, my coach sent me a motivational email. One line stayed with me. “The training is the test,” he wrote. “The event is the celebration.”
This is exactly what I was thinking about as I was jogging and power-walking the first mile of the Oxford Green Belt Way. Today is the celebration! The celebratory glee powered me up the steepest hill of the route.
But at some point after mile 20, my left knee started hurting. In my training runs, I had brief pains come and go, but this was different. It wasn’t terrible, but it was constant. I stopped running, and power-walked the next few miles.
Eventually, I arrive at the mile 30 aid station, where I had ended my practice run. A month ago I felt like I had boundless energy, but today I feel slow, and my knee is hurting. And I still have about 25 miles left. But I’m hoping the knee pain will pass and I’ll start running again. I keep going.
“Every step is a new personal record!” a support crew member shouts. She’s referring to how I’ve never covered more than 30 miles in a day.
Over 40 miles in, I start crying. It’s getting dark. And the trail is getting rough. There are thick stalks of rapeseed that go up to my waist, and I am stomping them down, cursing the farmer who did not maintain this footpath.
An hour later, stinging nettles get added to the mix. It’s completely dark, and I can only see within the cone of light from my head torch.
About two miles from the finish, I stop as the sharpest pain of the whole day hits me. I’ve never felt agonizing pain like this.
After a long rest, I waddle forward, trying not to bend my knee more than I have to.
A friend is with me at this point, which is common for ultra marathons. So-called “pacers” will run with you for part of the event. They provide company and motivation when it gets tough. But even my pacer’s enthusiasm doesn’t propel me forward.
We’re going so slowly that I’m not generating much body heat. I’m wearing my extra layers, including the jacket I prepared for after the event. My pacer shivers and jogs in place each time I need to pause. I feel guilty for making him wait, and I’m thinking about the patience of my remaining support crew member. She’s waiting for us in the next village, and I cannot give her an estimated arrival time.
My pacer hands me an ibuprofen tablet as I wonder whether to head to the finish line or the hospital.
Thanks to the pain relief, I do end up finishing. But it’s not what I hoped for. I had imagined feeling triumphant at the finish. I envisioned celebrating with my whole support crew. But it’s the middle of the night. Completing the route took me four hours longer than I expected, and at the finish, it’s just me, two sleep-deprived team members, and people on the other side of the parking lot waiting for the two a.m. bus.
The next day, with my legs supported by multiple pillows, I wrote my submission for the FKT website. To get listed for the Fastest Known Time, you have to send in GPS tracking information, photos, and an overview of the day. The editors study these to verify your results.
I felt bittersweet. Yes, I met the goal to be the first female. But I didn’t finish strong and proud. Part of me was embarrassed for people to see it took me 17 hours and 51 minutes. That’s double some of the men’s times.
It’s well known that ultra runners need a break after a big event. Non-professional athletes usually take several weeks off and gradually return to training. But for me, several weeks wasn’t enough to recover.
A month after the FKT, my knee still hurt, so I booked a physical therapy appointment. That seemed to help. But by the time my knee recovered, another problem had come up. This time it was my left hip.
Months later, I still couldn’t run. Not the way I was used to, anyway. My physical therapist set up a very cautious running and walking schedule. I would follow it for a few weeks, and then things would get worse, and I’d be back to zero. Some weeks were so bad I could barely walk.
If you've ever had an injury or pain that keeps you from doing what you love, you know how frustrating it is. You're fidgety, restless, and you can't wait to get back to normal. But for me, there was more to the story. The longer I was away from exercise, the more I struggled mentally. And that ended up having huge ripple effects for my life.
It was like I had taken off noise-canceling headphones. Before the FKT, life had been relatively quiet. I could focus and be productive. I made logical transitions between thoughts. And it felt like my life was moving forward.
But now, everything seemed much louder. A chaotic parade of thoughts crowded my mind. What’s in the refrigerator? I need to buy carrots if I want to make that recipe. What’s that noise? The deadline is Friday. Have they replied to my email yet? Ugh, I can feel my clothing tag. Where did I leave my notebook? There is one stray hair on my face and I cannot think of anything else.
It was relentless. I couldn’t find silence or space to think. It was like there was an endless marching band going by, but each section was playing a different song, and a lot of the instruments were way out of tune.
With this cacophony in my head, simple tasks felt unmanageable. My brain felt slower. Getting a new work assignment felt like navigating through a fog. Or going to look something up, I’d get distracted and forget what I was trying to do. This happened over and over.
I also had trouble focusing. Or at least, trouble focusing on what I WANTED to focus on. I’d be working on something, and then a new email would pop up, and I’d get sidetracked with that for hours and forget about what I was supposed to be doing.
And to make everything worse, I had no way to relax. I was restless all the time. It was like my mind was a pinball machine. I’d start watching a movie, but I’d get bored instantly. So I’d switch to reading a book. But that would be boring too. And so I’d just keep bouncing from one thing to the next, over and over and over again.
Nothing was satisfying. Nothing helped me unwind or recharge. Nothing could quiet the noise in my head. The longer this went on, the more unbearable it was.
Over time, I got depressed. Really depressed. A dark emptiness crept in. My emotions went numb. Everything seemed hopeless. It was awful.
Five months after the FKT, it had gotten so bad that I was feeling suicidal. On a regular basis. The world seemed so loud. So dark. So out of my control. I couldn’t imagine how I was supposed to keep living like this.
A few days after I turned 30, my dad helped me find a psychiatrist who could see me the next day. This wasn’t my first time seeing a mental health professional. I’d been diagnosed with anxiety and depression, and I had tried various treatments. But nothing was helping. I was hoping the psychiatrist might have a new idea.
After speaking for ninety minutes, the psychiatrist agrees with the anxiety and depression diagnoses, but he isn’t saying anything new, and I feel like it’s been a waste of time. Then he pauses and starts carefully choosing his words.
“Excuse me for saying this,” he says. “I don’t mean to be rude, but I think you might want to consider an autism assessment.”
At first, I don’t understand. Autism? Me? I never acted out in school. What is he thinking?
But then he starts describing more subtle traits that can indicate autism. For example, intolerance to hearing people chew, sniffle, and other noises. Or sensitivities with smell and touch. These things fit me to a T. It’s as if he had read my mind.
He continues to speak, but my brain can’t hear everything he’s saying. I’m trying so hard to listen, but I jump to thinking of stereotypical presentations of autism, like boys obsessed with trains or math. I panic. If he’s right, I can’t have anyone know I might be autistic or I will be ostracized.
At first, getting an autism assessment felt like the last thing I wanted to do. I didn’t want to be labeled with another problem. On top of that, the National Health Service waitlist for an autism assessment is three years.
But my curiosity gets the better of me, and I start researching autism. I find a lot of medical websites, but also personal stories. I read article after article from people who were diagnosed as adults. And reading their stories, my own life starts to make more sense.
One of the first things that clicks with me is about eye contact. For me, eye contact feels invasive, like someone is revealing all their secrets in their gaze. I always thought that everyone felt this way, and we were all forcing ourselves to do it out of politeness. But it turns out this is an autistic trait. I also thought most people prepared for social interactions by rehearsing conversations in their head. That is another trait shared by many autistic people.
The more I learned about autism, the more it seemed to describe me. It explained the challenges I’d had since childhood. But it also shone a light on some of the things I love about myself. For example, autistic people are often really good at coming up with out-of-the-box ideas. That’s true for me. And they’re visual thinkers. Again, totally me.
I started feeling a sense of community in late-diagnosis blogs and forums. And I was eager to get an official assessment. I could not wait three years for this label I now wanted so badly. So I found a private clinic that could see me within a few months.
Leading up to my assessment, I kept researching neurodivergence. And I came across stories of people who identified not just as autistic, but also as ADHD. It felt like these narratives described the tug-of-war in my brain. I struggle with crippling anxiety related to change, but I also need novelty or I get bored. I feel constant, draining fatigue, but I cannot sit still. I have an exceptional long-term memory but struggle with short-term memory.
Eventually, I get my autism diagnosis. And when I do, my emotions are all over the place. It’s frustrating to know that I am an outlier compared to the majority. And I feel grief that it took me so long to get identified as neurodivergent. But I also feel relief and validation. Finally, I know why I’m struggling. It’s part of my neurology.
Later that month, I apply for an ADHD assessment. The waitlist is two years long. I’m still waiting.
The autism diagnosis explained a lot. But it didn’t quiet the noise in my head. Life didn’t magically become easier. And of course, I still couldn’t run. I had no way to release the build-up of energy and emotions. So I started looking for someone who could help me.
MAAYA HITOMI: I’m Maaya Hitomi, and I am an ADHD coach and academic strategist.
MARIA: Maaya is a psychologist who works with neurodivergent clients. I signed up for sessions with her. And right away, it was like she was seeing into my brain. Not just about neurodivergence, but also about exercise.
MAAYA: Does your reaction to losing exercise surprise me? No. In part, this is because my own background, right, is that as a swimmer, as a current triathlete, things like that, I rely on exercise. I, like, I wake up in a cold sweat from dreams that I can't exercise for long periods of time or ever again. It is, it is one of the things that I fear.
MARIA: Maaya identifies as ADHD and autistic and is also an athlete. So it was comforting to talk to her. But even more importantly, she helped me understand something crucial about myself. Something I hadn’t figured out in all my research about neurodivergence. And that understanding has been eye opening.
I had been trying to figure out why I fell apart when I did. What was it about not being able to exercise that caused me to unravel?
Maaya explained that exercise can be a really big deal for neurodivergent people, for a few main reasons. First, it provides routine.
MAAYA: Having a routine is something that is really helpful for a lot of autistic people, because it is a repetitive behavior that you can do over and over with the same or similar results. And you can kind of get a feel for it, right?
MARIA: This made sense. Routine has always been important to me.
One time, I was with a group of students, waiting for a seminar to start. A friend was looking for a climbing partner. He asked me if I was going to the gym tonight, and I said, “No, I go on Mondays, Wednesdays, and Fridays.” Then another friend chimed in.
“Routine is Maria’s middle name,” she said.
They laughed, and I joined them a few seconds late. I didn’t quite get the joke. Consistency felt like something to applaud, not laugh at. Now, here was Maaya, telling me that this kind of structure was part of what kept my life on track.
So, it makes sense that losing routine would be hard.
The second reason Maaya told me exercise is so helpful has to do with identity. Neurodivergent people can thrive on special interests, which are like intense hobbies that help us cope and give our lives meaning.
MAAYA: You found something that was a special interest for you. That you, it fills this need, fills your cup, in some very meaningful way, that you have trouble disengaging from.
This is a common thing for autistic people, generally, is that they have — we have — these, like, very bright, shiny interests that can last for months, years, our entire lives, that can feel almost all consuming and give us a sense of that identity.
MARIA: The loss of identity I’ve had while not exercising is real. At one point last year, I was filling out a health questionnaire, and they asked how much cardiovascular activity I get every week. The form only let me input numbers. I desperately wanted to tell them that I was an ultrarunner, but I can’t exercise now. That wasn’t an option. Instead, I had to type in zero minutes. I felt gutted, like I was stripped of my identity as an athlete.
But it was the final thing Maaya said that floored me.
MAAYA: For me, the difference between exercising and not exercising is honestly very similar to taking medication and not taking medication for my ADHD. That it regulates me in such a major way that I am far more likely to have a meltdown, I’m far more likely to be very emotional, I'm far more likely to be distracted, and all of those things, if I don't exercise.
Exercise isn't just like a nicety for me. It is medication for me.
And that is, like, I don't know if that's true for everybody, but I do think that it's probably true for a fair number of ADHD or autistic people.
MARIA: Exercise is like medication. This was mind blowing.
Maaya went on to explain the science. The way it works is that physical activity boosts levels of neurotransmitters like norepinephrine and dopamine. These neurotransmitters help us focus, think, and stay motivated.
This is true for everyone. We all get a dopamine boost when we work out. But for neurodivergent brains, it can be more important. That’s because a lot of neurodivergent people have lower levels of these neurotransmitters to begin with.
Hearing all this, the events of the previous year came into focus. Running had been my medicine. Literally. It helped regulate my attention and emotions, and so much more. Once I couldn’t do it, it was like suddenly stopping a drug. No wonder I had been struggling.
Looking back, I think of this whole experience as a kind of knockout experiment. Just like scientists remove genes in order to learn their function, I learned how critical exercise was, by having it taken away.
It’s been about two years since my FKT. I’m still trying to figure out how to navigate my post-diagnosis life. And I still can’t exercise. And that’s hard.
What makes it worse is that people don’t get how hard it is. They assume I’ve lost a hobby, like needlepoint or something. What they don’t realize is that exercise was so much more than a hobby for me. It was my lifeline. My medicine. My noise canceling headphones. It was how I coped.
I still haven’t found a replacement. And I’m not sure when or if I’ll hear the silence in my mind again. But in the meantime, if anyone is looking to set the next FKT for the Oxford Green Belt Way, I will gladly organize the logistics for you.
WILLOW: That was Maria Ordovas-Montanes. Maria was a production intern for Out There this season. She lives in the UK.
To give you an update on her situation, she has continued to experience pain in many different body parts since her FKT. It's gotten to the point where she's unable to walk. Her doctors suspect her condition is likely due to a chronic illness like fibromyalgia or hypermobility. Both of those can cause persistent pain and are more prevalent in neurodivergent individuals.
Coming up next time on Out There, what happens if prioritizing your own health and wellbeing means jeopardizing your relationship with a parent?
HOWARD NEVINS: It was hard for you to be with me, around me. Or, you know, ‘cause I was a reminder, if nothing else, of your hardships.
WILLOW: Tune in on July 25 for a story about a hike in the Grand Canyon that helped heal a strained relationship. It’s the final episode before we take a break for the summer.
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Thank you so much.
Alright, so I’ve opened up PeakVisor. It’s thinking.
PeakVisor is an app that helps you figure out what mountains you’re looking at. When you open it up, it shows you a panorama of everything you’re seeing, with all the peaks labeled.
Oh wow, ok. So I am looking all the way down into Rocky Mountain National Park. Like, I can see Long’s Peak from here. That’s pretty cool.
PeakVisor is our presenting sponsor this season. In addition to identifying mountains, they also have 3D maps to help you plan out adventures, and a peak bagging feature so you can keep track of your accomplishments.
If you’d like to be a superhero of outdoor navigation, check out PeakVisor in the app store. You just might love it.
Today’s story was written and narrated by Maria Ordovas-Montanes. Story editing by me, Willow Belden. Maria and I collaborated on the sound design. And special thanks to Katie Reuther and Francesca Turauskis for production assistance.
Out There’s audience growth director is Sheeba Joseph. Our ambassadors are Tiffany Duong, Ashley White, and Stacia Bennet. And our theme music was written by Jared Arnold.
Special thanks to all our listeners who are supporting Out There with financial contributions, including Justin Anderson, Eric Biederman, Doug Frick, Sue and Gary Peters, and Deb and Vince Garcia.
We’ll see you in two weeks. And in the meantime, have a beautiful day, be bold, go outside, and find your dreams.
Credits
Story by Maria Ordovas-Montanes
Story editing by Willow Belden
Sound design by Maria Ordovas-Montanes and Willow Belden
Production assistance from Katie Reuther and Francesca Turauskis
Music includes works from Blue Dot Sessions
Links
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Correction:
In this story, we introduced Maaya Hitomi as a psychologist. Maaya does have a Master’s in Psychology. However, in Canada, where Maaya lives, the term “psychologist” is reserved for people who are registered with their provincial college of psychologists, which Maaya is not.
This episode sponsored by PeakVisor
