Mental health and sport: we need to talk about it.

Studies have beyond a shadow of doubt proven that exercise can play a deeply therapeutic role in addressing psychological disorders such as depression, with one’s physical self-worth directly linked to improved self-esteem. Physical activity can also prevent cognitive decline, boost brainpower, sharpen memory, increase relaxation and help control addiction in some people. Regular exercise also has the power to increase one’s concentrations of norepinephrine, a chemical that can moderate the brain’s response to stress. And, since getting proper nutrition is part of the package when it comes to physical health, the psychological effects of a healthy diet are worth a mention too: reduced chances of bipolar episodes, reduced anxiety and reduced negative symptoms of attention-deficit/hyperactivity disorder. We haven’t even yet factored in the social and inter-personal benefits of physical activity for individuals and communities.

But with the positive physical and mental health consequences of sport so readily acknowledged by health professionals, doctors, mental health experts and sports professionals, we rarely stop to consider that sport can also have negative consequences on a person’s mental health. Particularly those who have opted to make sport their life.

Most of us believe elite athletes are immune to mental health issues.

Traditionally, support for elite athletes has largely consisted of and been based around managing physical injury and enhancing physical performance. With dedicated teams of medical professionals, physiotherapists, chiropractors, coaches and exercise physiologists on hand 24/7, athletes typically have access to all the support required in order to ensure a speedy return to competition following an injury, as well as all the support required to master physical performance. But why are there decidedly fewer mental health professionals on hand to support athletes both in the lead up to, during, and following retirement from elite competition? Why are elite athletes only now beginning to speak up about mental health issues – and why has there been such little discourse surrounding the issue?

In years gone by, many high-profile sport professionals have taken their lives or sought professional help for severe mental health issues. Welsh soccer team manager Gary Speed, Rick Rypien, Jeff Alm, Jovan Belcher and Dave Duerson are just some names on the growing list of athletes or sport professionals who elected to end their lives rather than seek help. When Gary Speed committed suicide in November 2011 it acted as a catalyst for change in the football world in particular, with retired football players including Stan Collymore, Neil Lennon, and Clarke Carlisle speaking out about experiencing mental health problems in their playing days. Mental health campaigns, suicide awareness month and the establishment of organizations including The Movember Foundation are just some of the many positive ramifications of the growing sense of awareness about depression and mental health in sports.

But elite sporting programs unfortunately still lack vital mental health components – perhaps a side effect of the naive assumption that strong physical health equals strong mental health. And athletes are suffering for it. Restricted by incredibly intense schedules and training programs, often geographically estranged from family and other support networks, elite athletes often fail to seek help from professionals where needed.

This is despite the findings of recent studies by mental health organization Mind which showed elite athletes to be particularly at risk from severe anxiety and stress.

“Sportspeople experience a unique set of pressures in their jobs from scoring goals and winning trophies to facing media scrutiny and meeting the high expectations of adoring fans,” the study concluded, with the recommendation that managers, coaches, clubs and governing bodies needed to take a more active stance on mental health issue recognition and awareness, particularly during key stages of athlete transition in sports.

Retirement from elite sport is often acknowledged as an incredibly difficult time for athletes, with many high-profile sportspeople having admitted to struggling with mental health issues, addiction and coming to terms with their identities after retiring from the sports that once dominated their lives. An Australian study that surveyed 224 elite athletes after retirement found the most common mental health issues among them were depression, eating disorders, and general psychological distress. A similar Australian study conducted in 2015 found that almost half of A-League football players found their transition from playing to retirement “difficult to very difficult” and one in five had experienced mental health problems.

On a two-part edition of the SBS television show Insight, retired Australian AFL star Barry Hall confessed that he struggled mentally with the lack of routine following a seven-year stint with the Swans.

“I had two or three months… that I really struggled. I didn’t get out of bed. I didn’t answer mates’ phone calls, I was eating terribly, drinking heavily. A tough time. And look, I didn’t know at that stage it was a form of depression,” he said.

Athletes are vulnerable to mental illness for so many reasons. One: they experience a sense of disempowerment of their own lives as a result of the rigorous schedule of externally organized activities they must endure on a daily basis. Two: overtraining and burnout have been linked to affective disorders such as major depressive disorder. Three: injury, failure, ageing and retirement from sport are often closely followed by depression, with the injury process likened to the grief process observed following bereavement. Four: the sense of identity built through elite competition does not accommodate the shaping of any alternative identity, leaving athletes feeling worthless and “identity-less” upon retirement.

There needs to be better support structures in place for vulnerable athletes, athletes who are – despite popular belief– not unsusceptible to psychological damage. Early identification and intervention are absolutely essential if we want to prevent another tragedy from taking place.

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