8. 10. 2020

English Version | Feeling down? Surf's up.

by Sara Andrade


It is said that the effects of depression can be toned down every time you ride a wave. Vogue wanted to dive deep into this idea that the blues can be fought against by surfing the “blue”.

Before getting into therapy, it’s important to talk about the blues mention here in its phrase as a version for sadness, depression, anxiety - moods that seem to be one of the main concerns of the 21st century. Only they’re not only moods of the spirit, they’re moods of the body, too. And realizing the influence of the natural world over this set of diagnoses means realizing as well that depression isn’t something that’s exclusive to the psychological segment, but has some sort of biological touch too: “Classically, depression was classified as endogenous/biological or exogenous/reactive. The endogenous depression would correspond to the one that’s rooted in biological factors, whereas the exogenous one would be triggered by external factors, like struggling life events. Actually, it would make more sense considering depression as an interaction between the biological variables (including genetics and physiognomy) and environment factors (such as experiencing traumatic events, family and social context, etc) rather that the dichotomy biological/reactive. That said, there is in fact an increase risk of depression (two to four times higher) in people that have direct relatives with depression and the ability to ‘inherit’ depression is estimated to be of 40%, specially when related to personality traits that gives you a higher liability of developing the illness.” We couldn't have asked for a more detailed explanation than that of psychiatrist João Fernandes, adding right away that “one does not inherit depression, rather a set of genes that gives him/her a more or less likelihood of experiencing it. Knowing that there are environment factors that can condition the emergency and evolution of depression, the ability to modify those factores can be relevant to avoid or improve the course of depression. In the same way the eviction/control of these factors may reduce the manifest of a depressive state, a bigger presence or relevance of those same factors will worsen depression symptoms.” Joana Canha, clinical psychologist, also elaborates on the matter: “the biological and psychological go hand in hand and it’s not possible to consider one without the other. Illnesses coming from biological starting points influence our emotional mood and illnesses coming from the psyche have an influence on our bodies. Nevertheless, depression has a psychological root, even though it’s not possible (nor desirable) leaving genetic inheritance out of the equation. There is also ‘psychological’ inheritance, which is related o whats passed on emotionally, without us even realizing it. Even the environment/relationships in which the human being moves around may worsen/increase or trigger depression.” Sound mind in a sound body. If depression (also) is also biological, then, is it possible to consider the effects of the natural environment not only on the mind, but also on the body? 

Some studies relate being exposed to green (spots rich in plants, like parks) and blue (sea, rivers, lakes) locations with a better mental health”, starts off by saying the psychiatrist. “In one of those studies, which involved the elderly, it was seen that those leaving nearer to the coast and those that had a better view of the ocean had a lesser risk of depression than those who lived farther or had a worse view. Curiously, when the two factors were combined, only sea visibility remained a positive link to the lower manifestation of depression, but not the distance to shore. The mediators  associating exposure to blue spaces and mental health seem to be an increased physical activity done by those who usually go to these spots (for instance, swimming, walking on the beach), the promotion of social interaction that contrabate to a feeling of belonging and social cohesion, and the balancing effect of blue spaces (meaning, the degree in which the environment helps the person recover from daily stress, feeling relaxed or avoiding boredom). It is also suggested that the beneficial effects of water may be related to the unique sensorial stimulation provided by these said blue spaces, like the relaxing sound of waves or the saltwater smell”. “Several studies have shown that a bigger or lesser sea proximity influence your spirit”, agrees Joana Canha. Being near the sea/going to the beach is something described as important by a number of people when they need to be with themselves and even appear to have a relaxing effect and renewal of something. It’s frequent that the sea has a calming effect, where time slows down and there’s an invigorating feeling.” This relaxing effect of nature over the human being isn’t just a feeling, it has a name: biophilia. 

“Some of the links established on that level are anchored on a theory of psycho-evolution named biophilia, which says humans a trend that’s innate to look for connections with nature and other life forms”, explains the psychiatrist, referring once more to the theory when questioned if that’s a factor when justifying the pleasurable attraction we seem to have towards the sea. Even thou biophilia doesn't concern the ocean alone, when approaching the positive influence nature has on humans, this body of water have other characteristics that increases its benefits. The sea as a healing place - with therapeutical functions and applications - isn’t recent. For instance, by the end of the 16th century, english doctors started prescribing cold water - and later on, cold sea water - to help the body “jumpstart”, or at least shock it into a state to annihilate melancholy, hysteria, and other illnesses of the times. In mid-18th century, European doctors would prescribe beach days and soon enough there were spas and resorts with an ocean view popping up everywhere. “Intuitively, there’s a tradition for doctors to consider that certain waters are superior in the treatment of illnesses when compared to others. For instance, for the treatment of psoriasis, it’s recommended that you bathe in waters rich in minerals (the Dead Sea), or with a composition rich in minerals (Blue Lagoon, in Iceland). Apparently, there are studies that indicate that that can have a positive effect and that it’s not unrelated the composition of minerals existing in a body of water.” Indeed, in the mid-20th century, the Journal of the American Medical Association promoted the tryptic ‘sea, sun and outdoors’ for a series of illnesses. Throughout the centuries, the doctors recommended beach sessions to its patients, for its relaxing aforementioned effect on the brain. Why does it happen specifically near the coast? Because the crashing of waves and the water movement (like in waterfalls, for example) releases negative charged ions that influence the release of wellness chemicals in the body and alter brainwaves, increasing the oxygen flow into the brain and promoting clarity and mental energy. The negative ions are a sort of nature’s antidepressants, triggering the release of serotonin and endorphins, those neurotransmitters of happiness that relieve stress and makes us feel better. More or less like what happens with physical exercise. So, surfing, fitting in the latter and being practiced in the water, doubles that marine wellness effect?

“Working out has positive effects on the human being’s physical and mental health. Biologically speaking, serotonin (the so-called happiness hormone) is responsible for the sense of well-being that happens after you work out. It’s a practice that allows your whole body to work, and its very complete on several levels. But, focusing on the emotional part, physical exercise allows you to release accumulated stress and allows having a focus. Surf is an excellent example on this matter”, confirms the psychologist. “There’s lots of evidence on the benefits of the physical activity for mental health and, in particular, concerning the role of physical exercise on reducing the incidence and symptoms of depression”, corroborates the psychiatrist. “Thus, it seems plausible to consider that the practice of a physical activity as surfing, in a protection context like the sea, may be associated with the beneficial effects for mental health, including preventing and recovering of depression diagnosis. the evidence that supports this perception shows that the practice of physical activity outdoors versus indoors har bigger effects on stress, anger and depression and that the practice of physical activeis in the presente of water (versus its absence) may generate bigger improvements in the symptoms associated with depression.” Indeed, a study done by the US Navy, starting in 2013, has been studying the effects of surfing in post-traumatic stress disorders, for instance, after noticing an increase of 65% more ptsd diagnosis amongst service militaries, between 2001 and 2011. According to the research, that looked into inquiries done to militaries before, during and after a once-a-week surf program over the course of a month and a half, the preliminary results immediately showed that the sport led to a decrease in anxiety feelings and insomnia, also helping with toning down the negative vision of life and other symptoms of depression. João Fernandes adds that “the community spirit that is often developed amongst surfers, promoting social interaction and cohesion, may also work as a protective factor from depression”.


Indeed, surf has many strengths concerning its analogy with social living and more. António Pedro de Sá Leal, with connections to surf for over 20 years, not only as a surfer, but as a surf instructor and either of two books on the matter, Portugal Surf Guide e Surfing -The Next Step (and bolso a recently released novel called Salvadores), he founded the Surf Social Wave Association as a project that takes advantage of all these benefits from surfing for, ultimately, apply it for real on your day-to-day life: “surf has brought me joy every day of my life and the challenge was bringing that to other people”, he starts off by saying. “It has incredible characteristics that we can use in our daily professional, personal and social life, namely when life demands resilience, as the sea not always brings you what you want; we need to work on our way of prevailing when faced with adversities, specially when, as a surfer, we go to the sea and you simply cannot catch a good wave, or even work on our brain reaction when we’re confronted with second split decisions when we’re riding a wave of face different conditions whenever we swim into the sea. These and other soft skills are something surfers acquire naturally and that I’ve considered passing on to, through this project, other people’s professional, personal and social life, (…) a project that’s already in it’s 7th season, called Programa Cascais Surf para a Empregabilidade.” These skills are not only applied on your daily practical lifestyle: “when you go surfing, your mood, even if the surfing itself isn’t brilliant, changes”, adds the surfer and entrepreneur. “Being in the middle of the sea, in a direct contact with nature, is in itself an element of positive activations. Throughout the years during each I thought surf lessons, to children and adults alike, I got numerous feedbacks about the positive way that particular surf lesson was life changing to a specific person. I can tell you of a participant in our first edition of the program, in 2017, coming from a complex situation, and you could see in her face she though she was going ‘to die’ on the first wave when she started the lesson. The moment was clearly of tension and apprehension. When she stood up, I thought to myself that was a great first wave. And when she came back, her face had light up and I realized in that moment something had changed for her. I have a lot of similar stories, but none I believe as strong as this one. This individual is well today and keeps surfing, she found a job in a place she loves and is a different person. I dare to say happier.” “She” is Ana Sofia Costa and the job in a place she loves is Surf Social Wave Association itself: “I was really diagnosed. I was in a phase of severe and uncontrolled depression and anxiety. […] During my darkest periods, I felt great apathy, demotivation, indifference, social phobia, I sort of lost my independence. I stopped being able to go out on my own, was arraign of being home alone, I couldn’t drive myself… and that was always tagged along with sadness, feeling nothing made sense to me…”, she lays out the background. “When I started the program, back in 2017, I was in a tough time. I started psychotherapy in 2016, started being followed by a psychologist and a psychiatrist, too, and I was medicated for a moth. I worked in several places and, in between jobs, I had times when I was more at home - truthfully, not being able to get a job wasn’t so much because I wasn’t picked, but because I couldn’t get out of the house to go look for one. In one of those times, I was called by the unemployment centre to attend a presentation about a course and that’s when I heard of Surf Social Wave and met António [Pedro de Sá Leal]. I arrived super late, was nervous, couldn’t park my car, I was crying from nerves and when I heard the presentation, I felt hope. And to be able to feel that, on those days when my head was filled with negative thoughts, to feel curious about surfing, was enough to make me want to enroll. And that’s all I needed, at that moment, all I needed was to get out of the house, and it was very hard because I was feeling a lot of anxiety because i’d have to be with other people, let alone being with other people inside a closed room… Besides social isolation, it was very hard for me to communicate with others, something that has to do a me being prone to overthink everything, I though too much about what I was going to say or what would be perceived by others, and that created that fear, that anxiety…”

Surf practice, along with the group therapy sessions within the psychotherapy process she started in 2016, helped shift the youngster’s mood, underlining that everything, including those sessions, were factors in her improvement: “I sought help and all of it was important. And surfing was fundamental. Truly. In my first lesson, I was panicking that I would panic. One of the things that happened when I’d have anxiety moments was that it escalated to panic attacks. Antonio says the waves were like 50 centimeters tall, but in my head they felt like 1.5 meters… And I was so scared, so frightened, so depressive, all that state and mix of negative emotions and, at the same time, a little excited to be doing something new. And Antonio must have realized it because he took my hand and said, ‘It’s ok, relax’, grabbed my board, pushed me on a wave and… I stood up. And I went sliding for a couple of seconds… And the weather was cloudy, but I can assure you that, at the time, the sky opened up and the sun came shining bright, I felt a rush, logically, and I felt joy, genuine joy, something I hadn’t felt for a long time. And I was so overwhelmed that I remember looking to the sad and trying to hold back my tears. When I went back to the sea, near António, I was smiling.” What do you think caused it? Many factors. One of them, for sure, the feeling of conquering. When you’re surfing, you may put yourself in dangerous situations. When you’re fighting big waves and then you go inside a bus, you realize the notion of danger shifts. Surf also has this thing where you’re in the moment. Your brain stops. And, in that moment, for the first time in days, in weeks, maybe even months, my brain stopped. And when I was in the water, I was just there. And that’s a relief, it’s like breathing. This was a decisive moment”.  

This effect of surfing on the brain is as much biological as it is psychological; working out outdoor brings more benefits dor your mental health that working out any other place, something that’s particularly true in surfing, a sports that demands as much of the body as of the mind - surf, as an activity, releases a cocktail of wellness hormones to the brain, like adrenaline (sharpens your survival instinct, increasing your heart rate, breathing and blood flow, helping you deal with stressful situations), serotonin (the happiness hormone - when increased, reduces stress and builds up trust), endorphins (the bodies natural painkillers, they mask discomfort and pain and help you overcome struggling situations, at the same time their release is linked to euphoria) and dopamine (it activates the pleasure and reward side of the brain, always making us want to come back for more). Cheers to this cocktail, right? “We can get out of a surf session absolutely ecstatic because we caught that magical wave of a lifetime, but we can also be frustrated when the sessions don’t go as desired. Physiologically, I think it’s connected to the production of endorphins, that result from surfing, and they’re responsible for blocking the pain and control your emotions - it’s also due to them the sensations of pleasure we often associate with food, sexual relations and physical exercise. Psychologically, surfing makes you confront your fears, meaning when you overcome them, let’s say because you surfed a bigger wave, the sensation of conquest is incredible; on the other hand, surfing is one of those activities in which even if at first you don’t succeed, you feel it’s always possible and keep coming back until you do”, explains Sá Leal. 


Another reason to toast is the ability to be in the moment, be in the zone. In a time when everyone worships digital detoxes, getting in the water is putting the theory to practice. There, there is no room for status updates or filters, and the only story you can do is the one in your mind, that cannot shift from the present time: “the surfer is focused on ‘catching the wave’ which leads to an immediate pleasure, when accomplished. This brings with it the possibility of ‘stopping time’, not having a schedule, so your ability to focus increases; the goal is to enjoy, letting yourself go - something very hard to do even on a daily basis”, explains Joana Canha. Which doesn’t mean the sport gives you some sort of depression immunity to people who surf, enlightens the psychologist, but it can help: “surfers can also suffer from depression, but they managed to find a pretty intelligent way of dealing with it and decreasing the impact it has on their lives. they develop, in a very natural way, the ability to ‘disconnect’, avoiding overthinking (the kind of non-stop thinking and doesn’t allow any sort of rest) and can focus more on the sadness and despair, something that’s hard on depression. It’s not a therapy per se, in a way that it doesn’t look into solving what triggered depression (for instance), but it hells alleviate symptoms and allows you to live a different day to day; it’s frequent the feeling of escape”. It’s not randomly that a bit all over the globe projects using surf as a therapy have emerged: International Surf Therapy Organization (ISTO) collects dozens of organizations from all over the world that use surf as a therapeutical tool, and the goal is to encourage professional health practitioners to prescribe surf therapy as a form of health care, building, ultimately, a curriculum for university programs - like a graduation on Surf Therapy, for instance. In Portugal, Wave by Wave, amongst others, does its part already. Founders José Ferreira, National Surfing champ and racking a 15-year-long experience in surf competition, and Ema haw evangelista, clinical psychologist in love with the transforming power of surfing, coordinated in 2016 the first Portuguese project concerning the intervention in risk populations with the help of surfing. Titled Surf Salva Camp, over a period of three months, in Carcavelos beach, 48 youngster institutionalized from Lisbon’s Metropolitan Area were followed and “The results allowed us to conclude that using surf as an intromete for psychotherapeutically intervention may be beneficial for a healthy lifestyle, well-being and for social and personal skills in young people moving in psychosocial vulnerability contexts. From this study, the first scientific publication was issued on the matters of surf therapy”, says the organization. 

If there were still any doubts that surf as a therapy has a true application, Ana Sofia Costa brushes them all off: I have no doubts that surfing and the continuity of surfing helped me systematically. There were moments in when it seemed my emotions were completely out of control, that I felt too much and everything all at th same time; and there were other moments when it seemed I felt nothing, which sometimes were the most painful onesIn surfing, you are able to pinpoint what you’re feeling. You feel fear, you feel joy, you feel frustration… and I think it helped me understand my emotions and unblocking them. I feel it was very therapeutical for me.” “Surf g+has many characteristics, but it also has an unblocking effect on emotions that’s a powerful tool in in transforming and perceiving ourselves and realizing our potential”, confirms António. “When you recognize yourself with with your virtues and flaws, you become more available to pursue your dreams. What we do in the program Surf para a Empregabilidade (helping in the job hunt through surfing) is to incubate and speed up the process of looking for your dream job.” It was a year of evolution”, Ana recalls. “It wasn’t overnight, it was a year, and for me it was good that it was a long one. One of the things I learned in the group sessions, also important, was to stop using the word illness, because I am not the illness; I don’t have depression, I have fragilities, difficulties to improve and overcome, that mindset was very important. But I have no doubts still play a very important part nowadays, for me. I have also learned , when beginning to surf, that my mental health and my physical health, my health in general, are all intertwined. And that it’s a daily job to keep them healthy. Today, I don’t feel that big of a struggle on a daily basis, I do thinks more easily, but it’s still a struggle from one day to the other. If I stay too long without working out, It will truly affect my mood and well-being. And realizing that, realizing that it’s all intertwined, was, in itself, a huge learning process.” “I think it’s the contact with nature that increases looking inside of yourself.”, adds António Pedro. “Besides, of course the incredible feeling that is riding a wave and sliding along its wall. That pleasure feeling sticks with you for. long time. The sea is the place where I’m happy, where I learn, take pleasure and puts me in my place on the planet.” Joana Canha has another dimension of perception to add: “before birth, we’re in water, we spend nine months there. That’s our first home, our natural habitat in ‘the beginning’. It0s something to which we’re naturally drawn to.”

In spite of all the benefits surfing and sea can bring to one’s mood and its positive influence in fighting depression, it’s not a cure. In fact, talking about the power of the ocean and surfing is nothing more than listing its potential effects on a human being, but all human beings are different and the surf and the sea aren’t miraculous nor the only factor in relieving anxiety states. Everything counts, namely being followed by a psychologist and psychiatrist. If there’s something these lines don't want to convey is validating the thought that surfers don’t get depressed, even because history has shown unexpected cases of it in those who surf, like the suicide attempt of champ Sunny Garcia (50), in 2019, or the more dramatic example of Jean the Silva, Brazilian surfer that took his own life in 2017 (he was just 32 years old), or even, more recently, in June this year, the death of actor Pedro Lima, him too a lover of waves. He was 49. But the fact that it’s not infallible /neither sea or surfing) doesn’t take away its revitalizing power - in fact, there’s even an European project called Blue Health that’s taken upon themselves to study and research the way “blue” spaces, meaning, close to a body of water, affect a population’s well-being. The curiosity isn’t random: surfing may not be the cure for depression, but even in the aforementioned cases, only they could tell us how many times that morning surfing made them want to go through another day. The final exam is to try it for yourself: when you accomplish your first take off, you’ll want to incorporate surfing as a sort of frequent therapy. Like I did getting up at 06h30 in the morning, after finishing this article at 3 am. So I could re-read it with some sort of tranquility-blue, rather than anxiety-blue. 

*Originally translated from Vogue Portugal's Into the Blue issue, published october 2020.