How swimming laps helped my recovery

This is a composite story, drawn from common experiences shared in the schizophrenia community. It does not depict a real individual.

I am 36, a woman, and I live in Seattle. I have schizoaffective disorder. Three years ago, my psychiatrist asked me to add one new thing to my routine — anything physical, anything regular. I had been gaining weight on olanzapine, my voices were louder than they had been in two years, and I was sleeping poorly. I told her I would try swimming because the rec center was a five-minute walk from my apartment and the membership was $25 a month.

Three years later, swimming laps is the single most important non-medical thing I do for my mental health. I want to write about why, because I had read for years that exercise was supposed to help and I had never been able to make it stick. The pool was different.

What the literature said and what I had ignored

I had read all of it. The WHO physical activity guidelines, the NIMH material on lifestyle factors, the meta-analyses showing aerobic exercise reduces both positive and negative symptoms in schizophrenia. I had bought running shoes twice. I had joined a gym three times. None of it had stuck. Running on a treadmill made my voices louder, not quieter, because the silence in my head got filled. Group fitness classes felt like being watched. Lifting weights at a gym felt like a stage I was always doing wrong.

The pool was the first kind of exercise that worked for me. I want to be specific about why.

What is different about swimming, for me

The water absorbs sound

When my head is under water, my voices either go quiet or are softened to a frequency I can ignore. I have no scientific explanation for this, but I have heard the same thing from two other people with schizophrenia at my pool. The combination of the white-noise drone of the water, the rhythm of my breathing, and the physical sensation of being held by something seems to occupy whatever attentional system the voices were running on.

You cannot perform in a swimming pool

Nobody at the pool is watching me. Nobody can see my face under the water. The lifeguard is watching the water for safety, not me as a person. There is no mirror. I cannot dress wrong. My weight does not show under a swimsuit in the same psychologically loud way it shows in a t-shirt at a gym.

The rhythm is automatic

Once I am two laps in, I am not thinking about technique. The breath-stroke-stroke-stroke-breath pattern is the closest thing to meditation I have ever managed. I cannot meditate sitting still. I can meditate moving through water.

It is low-impact

I have stiff knees from years of high-dose olanzapine and from being sedentary during my worst years. The pool does not punish my joints the way running did.

It is finishable

My goal is twenty laps. I know what twenty laps takes. I can finish. The completability of the workout is part of why I keep going. Open-ended exercise — "go run for a while" — never worked for me. A pool with a length and a number is a closed task with a clear end.

The first three months

I was bad at it. I had not swum since high school. The first day I made four laps before I had to hold the wall and breathe. I went three times that first week. I went home and slept for eleven hours after each session. My voices were quieter that night than they had been in months. My psychiatrist was the only person I told.

By the end of the first month, I was at twelve laps three times a week. By month three, I was at twenty laps four times a week, in a low gear that I could keep up for forty-five minutes. The weight loss happened slowly — eight pounds over the first six months — and was less important to me than the symptom changes.

What changed in my symptoms

• Voices. Quieter on swim days, often quieter the next day too. They have not gone away. They have become background instead of foreground.
• Sleep. Deeper, more consolidated. The trazodone I had been taking for sleep was titrated down by my psychiatrist after three months.
• Mood. Less reactive. Smaller swings. A sense of forward motion across weeks instead of static existence.
• Concentration. Books became readable again. I can sit through a forty-minute lecture.
• Anxiety in waiting rooms. Lower, possibly because I am now physically tired in a way that used to register as edginess.

I want to be honest. Swimming did not cure my schizoaffective disorder. The voices are still there. I am still on medication. I still see my treatment team. The point is that swimming changed the floor — the baseline of how my days felt — in a way that medication alone had not.

What I had to do to make it stick

I scheduled it

I went at the same time on the same days. Tuesday, Thursday, Saturday at 7 a.m., before the pool got crowded with families. Putting it on the calendar like an appointment was what made it survive bad weeks.

I bought equipment that lowered the friction

Two swimsuits, so one could be drying while the other was at the pool. A pair of goggles I actually liked. A swim cap. A waterproof bag. The total cost was about $80. The friction-reduction was worth more than the money.

I told one person

My therapist. We tracked it together at our weekly sessions. The accountability of having to report on it in therapy was, in the early months, half the reason I kept going.

I treated it as treatment, not as a hobby

I gave it the seriousness of a medication. Missing a swim session was, in my mental framing, the same as missing a dose. That re-frame changed how willing I was to skip.

What I would say to someone trying to start exercising

• Try the kind of exercise you can actually imagine doing on a bad day, not the kind your healthy friends recommend.
• Pools are not the answer for everyone. Walking, cycling, dancing, weightlifting, yard work — anything that moves your body in a way you can sustain for at least 30 minutes a few times a week is enough to start.
• Schedule it. Treat it as treatment, not as a hobby.
• Start lower than you think you should. The goal of week one is not fitness, it is showing up again in week two.
• Tell your treatment team. Track the changes in your symptoms. The data will keep you motivated when motivation runs out.

For more, see exercise and schizophrenia, swimming and schizophrenia, and exercise versus antipsychotic weight gain.

This article is for educational purposes only and is not medical advice, diagnosis, or treatment. Always consult a qualified mental health professional. If you or someone you know is in crisis, call or text 988 in the US, or your local emergency number.