Why Are Athletes Vulnerable to Depression?

Although there is existing knowledge on depressive criteria, as well as its pervasiveness and treatment approaches, there are still widespread deficiencies regarding this phenomenon in regard to those performing high-level sports. It was previously considered that participation in sporting activities is advantageous for an individual’s self-confidence, anxiety and stress, among other factors. Furthermore, there has been increased focus in studies in the literature on showing how sports participation can be beneficial for reducing mental disorder symptoms and enhancing overall mental wellbeing, with particular attention on depression.

Hence, this leads to the question as to why such a large number of high-level sporting professionals are suffering from and revealing that they have depressive episodes and different conditions associated with stress. In fact, the subject has not been thoroughly investigated and it should be questioned whether sport itself could be the cause of the phenomenon. The end of an athlete’s career has consistently been regarded as an important turning point for athlete’s approaching retirement, particularly as a result of the role that athletic identity plays in their lives. Other key periods of transition that athlete’s experience during their careers have also recently been defined as “critical moments”; for instance, these could include being omitted from a team, suffering injuries, moving to a new location, and overtraining syndrome, which all have the potential to be detrimental to the physiological and physical wellbeing of the athlete and have been associated with depression among sports professionals (Puffer and McShane, 1992; Armstrong and Van Heest, 2002), mechanisms and factors associated with specific sports, exceeding stress (Frank et al., 2013; Wolanin et al., 2015) or potentially being elevated to the position of captain of a team. Given the aforementioned factors, it is important to investigate whether sport has the capability to augment levels of stress as a result of the supplementary stressors that athletes face. Recently conducted studies have shown that this hypothesis is correct. For instance, it is proposed that athletes may experience increased stress when competing in high-performance sports in competitive environments. Additionally, it is possible that athletes will suffer from post-injury depression after prolonged periods of rehabilitation caused by injury (Leddy et al., 1994). Appaneal et al. (2009) presented similar findings showing that athletes’ depression scores were elevated between 1 week and 1 month after experiencing an injury in comparison to injury-free controls. There is growing evidence that concussion related to sporting activities can cause alterations in an athlete’s emotional condition (Hutchison et al, 2009) and could be associated with depression (Kerr et al, 2012). However, although there could be an important connection between concussions and depression, evidence also shows that differing sporting injuries could have similar or stronger impacts on psychological wellbeing (Mainwaring et al, 2010).

There is a general belief that elite sportspersons are “living the dream”, with the opportunity to travel to many different destinations, compete in their chosen sport as a career, stay in luxury hotels and earn substantial salaries for playing their sport. Nevertheless, as detailed by international cricket player Marcus Trescothick, “the demands of playing every northern hemisphere summer at home as well as every southern hemisphere summer on tour, meant we now spent almost 12 months a year living out of suitcases and in hotel rooms, of course the lifestyle was considered luxurious, our every off-field need was catered for by a solid back-up staff including a doctor, nutritionist, sport psychologist, etc., we were very well paid for our efforts and it beat real work any day. … That, coupled with the four-wall fever that can strike you when you are stuck inside a hotel bedroom complete with en-suite bathroom for days on end prior to moving onto the next one, was simply not a natural way to live. It creates extraordinary strains for the players not to mention their wives and families.”

Participation in sport may act as both a physical and social outlet, but it does not offer complete protection against depression. It is significantly important that the parents and coaches of athletes consider that their children/athletes resistant to mental disorders and should stay alert in order to discern the symptoms. In numerous situations, stress is the cause of depression.

As suggested by German academics from the Technical University of Munich in their presentation at the British Psychological Society Annual Sport and Exercise Conference in Cardiff (Wales), sporting professionals competing individually have increased susceptibility to depression in comparison to those who participating in team events (Nixdorf et al, 2013). Their findings confirmed that it is not only long-distance runners that suffer from loneliness, but individual sportspersons experience a variety of different depressive symptoms. Findings recently presented by Prof Jürgen Beckmann, the University’s Chair of Sports Psychology, indicate that sport does have an impact, where the depressive symptoms differ according to the kind of sport in which the athlete participates. “Individual sport athletes attribute failure more to themselves than team sports members, and shoulder the blame more than team sport players, who tend to share a diffusion of responsibility (Schaal et al., 2011; Nixdorf et al, 2013).” Researchers made comparisons between 128 young athletes in Germany playing football and hockey and 71 junior athletes participating in solo sports such as speed skating, swimming, and badminton. All athletes were evaluated according to a depression scale that assessed symptoms like culpability, unhappiness and suicidal intentions. The findings imply that sportspersons participating in individual sports exhibited a greater number of symptoms in comparison to those competing in team events.

These results were reproduced in research conducted on 162 senior high-level sportspersons competing in a variety of different German national teams. Athletes competed in individual sports such as triathlon, golf and cycling. The study findings revealed that they experienced more symptoms of depression than those participating in rugby, volleyball and football. The researchers additionally determined that athletes competing in individual sports were more prone to negative effects, feelings of guilt and perceived that they were responsible for their lack of sporting success (Tracy and Robins, 2004; Hull and Mendolia, 1991; Alloy et al., 2006).  Nevertheless, this is not an indication that athletes competing in team sports are immune to depression even though they are surrounded by a support network consisting of their teammates (Hanrahan and Cerin, 2009). For example, in 2009, the 32-year-old German football goalkeeper Robert Enke committed suicide by throwing himself in front of a train after fighting depression for many years. He effectively concealed the symptoms of depression from his spouse, coach and other team members. In another example, another German football player, father of two children 33-year-old Andreas Bierman, also experienced bouts of depression for many years, which consequently led him to commit suicide in 2014. Prior to doing this, he revealed that he had attempted suicide on three previous occasions. The research conducted by the University of Portsmouth was pioneering in that it compared depressive symptoms in elite sportsperson and those who do not perform sports. The findings revealed that high-level sportsperson did not have an increased likelihood of experiencing low or more serious symptoms of depression. The study performed by Dr Paul Gorczynski from the University’s Department of Sport and Exercise Science analysed data from 1,545 elite athletes and 1,811 non-sportspersons. According to Dr Gorczynski, “This statistical research is important because for so long sport and exercise have been thought to relieve the symptoms of depression, but when played at a high level this clearly isn’t the case.

“Some athletes can be plagued by body image issues – especially those who compete in sports like diving and gymnastics – which may cause eating disorders and substance abuse. Athletes can also feel vulnerable and depressed if faced with sudden or unexpected retirement.

“Clearly, the results show that we need to do more to raise awareness of mental health issues in elite athletes. Creating a climate where athletes feel comfortable to seek support is vital but sometimes it gets in the way of One aspect include perfectionistic concerns is perfectionistic expectations from others. Athletes, coaches, officials, sporting bodies, we all need to make sure we’re tackling mental illness stigma and ensuring access to proper care (Enns and Cox, 2002; Stoeber et al., 2004).

In the research, data was examined from five studies on high-performance athletes whose ages ranged between 12 and 41 years, where 54 percent were females. In terms of the non-sportspersons, a total of 52 percent of those studied were female and their ages varied between 12 and 81 years. Female sportspersons had a greater than 50% likelihood of declaring symptoms in comparison to male sportsperson, and similar findings were found in relation to non-sportspersons.

“Although this finding indicates there should be extra support for athletes to understand and acknowledge symptoms of depression, the self-reported nature of the research means that women aren’t necessarily more depressed, they’re just more willing to report their symptoms,” said Dr Gorczynski.

The data was extracted from research performed in Iran, Germany, Switzerland and the United States.

According to a statement by Dr Gorzvynski, when data is self-reported, it inherently has certain shortcomings: “There could be other athletes out there who chose not to report symptoms because of the stigma surrounding depression or because they want to appear mentally tough – an attribute that allows athletes to excel.

“This also applies to those who don’t do sport. In future I’d like to enhance the research by using structured clinical interviews to examine symptoms of depression, rather than relying on self-reported data.”

Similarly, research presented at the Cardiff Conference indicated that sportspersons competing in solo sports have increased personal investment in their successes and failures than those competing in team sports. “The internal attribution could lead to stronger experiences of emotions such as pride (positive events) and guilt or shame (negative events) in athletes in individual sports,” (Tracy and Robins 2004). It was their expectation that there would be increased indications of perfectionism exhibited by solo sportspersons, but the results were surprising in that they showed that those participating in team sports were in fact more inclined to perfectionism. A different extended study revealed both chronic stress and perfectionism frequently cause burnout, although not depression, while depression is connected to the insufficient amount of time allocated to recovering from stress and injuries (Scanlan, 1984; Widmeyer et al, 1992). Following research has indicated that the degree could be even more elevated but only for individual sportspersons. For instance, extremely high rates of prevalence of depressive symptoms can be observed among swimmers. The celebrated Australian swimmer Ian Thorpe, who achieved considerable success at the 2000 Olympic Games, revealed that “I was surrounded by people but had this intense loneliness.”

Research has shown that symptoms of depression are specifically widespread among sportspersons. Professors Beckman alluded to the fact that the fundamental problem lies with the athletes. Individuals who are provided with a supportive social environment by their parents and friends suffer significantly lower levels of stress in comparison to those who have no such support. He discovered that as many as 20% of sporting professions experience problems with elevated depression scores. Among the general public, this figure varies between 9% and 12%. Although these athletes are generally not diagnosed with depression, according to the depression scale, their scores are at the upper end.

Professor Beckman also suggested that increased support should be provided to athletes to assist them with identifying the indicators of depression and to recommend methods of addressing the problem. Furthermore, he stated that in Germany, a burnout screening tool has been developed specifically for junior athletes.

As suggested by the mental health charity ‘Mind’, researchers attending the Cardiff Conference emphasised the specific stresses that athletes face. Hayley Jarvis, Mind’s community program manager for sport, stated that as a result of the growing number of retired sportsperson who have revealed their own experiences with fighting health problems in addition to several suicides of famous athletes, the charity commissioned research to investigate the existing approaches taken by sporting authorities and player organisations in regard to psychological wellbeing so as to determine the specific techniques and strategies that function most effectively. Their objective is to establish the right conditions in which all sporting professionals have the ability to reach their potential. They believe that it is important that all managers, coaches, clubs, authorities and players’ organisations provide the necessary support to sportspersons that will allow them to effectively manage their mental health.

The Andy Baddeley Story

Andy Baddeley competed in two Olympic Games and was previously ranked as Great Britain’s no. 1 runner for the 1,500 m distance.

In an interview with The Guardian newspaper (UK), he said:

…the most challenging aspect of running is the feeling of isolation prior to starting a race. In positive situations, that is a bonus. There is no sense of dependence on 10 teammates performing at the highest level in for me to achieve my goals. However, this also means that there is no safety net. The essence of athletics is that only one person can win any given race, meaning that there are 11 other athletes who are not winners. Thus, it’s the unpredictable nature of the sport that is the most challenging aspect. The relationship I had with my coach reached the point where I was unable to explain the depths of my depression. I do not reveal this to many people.

…I do not have a team surrounding me. I am not required to present myself at a training pitch. I sometimes think that team sports would be more suitable for my character. I take the most satisfaction from training with others, but due to the fundamental essence of long-distance running, that does not happen very often…

…You are the only person who can train intensively. You are alone when making that decision on a daily basis, particularly when the weather is bad. If I arrange to train with someone else, it seems to have a positive effect on my level of motivation. But it’s those days when there is nobody training with me that my motivation levels are at their lowest. Having someone to talk to has always been a great source of support. My mental wellbeing is at its strongest when I have the opportunity to meet coaches and peers on the team…

…Struggling with your mental health does not imply that your mental strength when racing is reduced. They are not the same thing. It is still possible to run through the pain barrier but still experience negative effects – the two things are not mutually exclusive…

…the perception is that revealing you are struggling with your mental health is a sign of weakness that leaves you vulnerable to defeat. However, after I disclosed my problems, it increased my strength…

I was fortunate to have the opportunity to visit a sports psychologist in the period I received funding from the lottery. When I had an injury, I sought private assistance and that was beneficial. I intentionally decided to visit a non-sports psychologist as I wanted to understand what was considered normal, instead of the perception of normality in relation to high-level sport (Paulson et al., 1999).

Conclusion

The findings presented here facilitate the understanding of how sporting culture and the interconnection between an athlete’s sense of self and the environment of high-level performance have an impact on how they experience, express and react to depressing throughout their sporting careers. The three areas comprise the primary themes revealed in the process of collecting data and present a categorical interpretation of the manner in which the development of depression was acknowledged, how depression materialised in the athletes and what strategies they took to successfully complete the process of recovery.

Analysis of the data indicated how masculine values, dedication to excellence and elevated levels of athletic identity that were adopted by the athletes (Steinfeldt and Steinfeldt, 2012) and supported by the elite sporting conditions significantly contributed to the emergence and sustained presence of their depression (Miller and Kerr, 2002). Additionally, the findings indicate that the manner in which the athletes suffered from and reacted to their depression throughout their sporting careers was affected by numerous different factors inherent to masculine high-level sporting environments (Evans et al, 2012). The athletes participating in sports within this elite environment seemed to react by increasing their level of investment in the sport as well as with more atypical, externalising or methods of avoiding the distress they experienced inside. The process of recovery was analysed and showed times or moments of peaks, troughs or critical moments. As with many other conditions, this process of recovery is not simple or linear. Effective strategies that athletes apply to manage such situations include: revealing susceptibility and establishing sincere relationships with other people, withdrawing from the high-level sporting environment and utilising the increased levels of dedication (an attribute of athletes) to comprehend depression (Brewer et al., 1993). Forming a wider sense of identity and re-entering the sporting arena with increased self-knowledge, a higher degree of self-belief, and a healthier relationship with sport in general are key aspects of the recovery process. Although it can potentially offer coaches, sports organisations and mental health professionals with a basic understanding of the problem of depression in high-performance sporting environments, additional studies are required to further the understanding of this complicated and under-researched issue as there are various different symptoms that should be investigated for athletes and non-athletes. One conclusion that can be drawn is that if greater levels of support were provided, the pressure would be reduced. Athletes should increase their socialisation within their team, whether it is with coaching staff or teammates, rather than remaining isolated as this will allow them to discuss their problems instead of suppressing them.

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