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Beyond the Game: Athletes and Depression

Mental illness can emerge within anyone, this includes those champion athletic gladiators of sport. Raising awareness on the insidiousness of depression is critical to reducing its incidence. This can also go a long way in confronting the stigma about seeking mental health services.
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Two days ago, 11 year National Hockey League veteran Todd Ewen reportedly took his life. It was reported that Mr. Ewen battled depression in the years immediate previous to his passing. His death is the most recent of a number of high profile current and former professional athletes. This includes National Football League (NFL) Hall of Famer Junior Seau; NFL players Dave Duerson, Kenny McKinley, and Javon Belcher, the latter of which killed his partner before taking his own life in the presence of his head coach and general manager.

In addition, athletes such as NFL Hall of Famer Deion Sanders, National Basketball Association star Metta World Peace and Australian Football League player Harry O'Brien have recently come forward to acknowledge their struggles with depression and mental health issues. One of the most powerful testimonies was given by former NFLer Jonathan Martin described the role of emotional debilitation in his decision to retire from professional football:

Your job leads you to (try to) kill yourself on multiple occasions. You either sleep 12, 14, 16 hours a day when you can, or not at all. You drink too much, smoke weed constantly, have trouble focusing on your job... But one day you realize how absurd your current mindset is, that this shit doesn't matter... nothing matters besides your family, a few close friends, and your own personal happiness.

We need to talk about depression and suicide among athletes.

Prevalence
In a study of depression among current and former collegiate athletes, 17% endorsed symptoms consistent with depression. In discussing depression among professional athletes author Alfie Potts Harmer reported that athletes have among the highest rates of mental illness with as many as 25% experiencing depression. It remains clear that the mental health needs of this population are inadequately addressed.

Help-seeking
Despite exposure to stressors known to increase susceptibility to mental health issues, the help-seeking behaviors of these individuals remains alarmingly low. One study revealed that members of this group are less likely to report mental health problems and "less likely to report having received psychological or mental health services from a variety of providers including counselors and psychiatrist." This study suggest that coaches, trainers and those authority figures associated with the lives of athletes become vigilant in promoting that athletes in need seek mental health services.

I believe that hypermasculinity often prevalent within sports culture negatively impacts help-seeking. A primary idea perpetuated by this hegemonic masculinity is the idea that 'real men' do not need help and acknowledging vulnerable emotions such as sadness, grief or fear indicate weakness. 'Real men' buck up, get up and move on with things. Each of these notions provide cognitive barriers to reaching out for assistance. Individuals whom internalize these ideas struggle reaching out for help, and all too often those around them are unaware of the suffering being endured. Make no mistake traditional masculinity is an enemy of mental health.

Some individuals choose to cope with their emotional pain through externalizing behavior such as acting out. This can make recognizing depression challenging for family, friends, loved ones, coaches and trainers. Dr. Michele Leno revealed that high-risk behavior such as using drugs or engaging in violence can mask psychological dysfunction. Her study also revealed that family and social support are among the best protective factors to emotional debilitation for athletes. As Dr. Leno reported "athletes may be perceived as successful, wealthy, superman. However, career pressures, and struggles may be camouflaged".

Much of this article has been devoted to the mental health struggles of male athletes because males are considerably more likely than females to complete suicide. However, depression and suicidal ideation are by no means gender specific. In January 2014, University of Penn Freshman Cross Country and Track runner Madison Holleran took her life. According to a report she had been suffering from mental illness. Again, depression has no gender, or age restriction, it is open to any and every socio-demographic category; anyone can experience this disorder.

Unique Stressors
Professional and collegiate competitors experience clinical depression for reasons consistent with the general population. This includes lack of social support, feelings of hopelessness, grief, sadness, isolation, psycho social adjustment challenges, chemical imbalance, drug related issues, overwhelming anxiety among other symptoms. I believe, the intense pressure athletes face to 'win' can add significant psychological stress.

Also the unique professional hazard of routine exposure to injuries, rehabilitation from injuries obtained or forced cessation from athletics due to injuries sustained can all be viewed as risk factors for experiencing emotional debilitation. After sustaining two left knee injuries several months apart NFL player Kenny Mckinley was reported to have "made statements about not knowing what he would do without football" he would later take his life.

I agree with author John Bain that feeding some athletes' abstinence from mental health services is the erroneous idea that making millions and being a celebrity erases mental health issues. The fact is depression is an equal opportunity disease; it does not care about bank account size, celebrity status or athletic prowess. Anyone can experience depression.

I also believe the culture of athletic competition itself can facilitate non-disclosure of psychological pain. During play on the court, field, track, or gym psychological gamesmanship are played at their highest level. One aspect of this is convincing an opponent and self of ones invincibility; demonstrating the slightest weakness can negatively impact the outcome. However, what happens when such attitudes are continued after the game is over? I believe that some athletes may persist in this pretense in their personal lives. Choosing to suppress emotional trauma under the idea that to acknowledge suffering is 'weak'. I cannot say enough that reaching out and seeking assistance is the definition of courage.

Mental illness can emerge within anyone, this includes those champion athletic gladiators of sport. Raising awareness on the insidiousness of depression is critical to reducing its incidence. This can also go a long way in confronting the stigma about seeking mental health services. I agree with the above mentioned research calling on those working directly or in close proximics with athletes should make it a point to encourage the obtainment of mental health services and normalize the idea that anyone can benefit from competent psychological care.

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Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.