Dec 28

The Darker Side of Sport Participation

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The second issue deals with the darker side of sports participation, namely under-reported facts of suicide by amateur athletes, although elite and professional athletes tend to get more public attention due to their social ranks in society. Nevertheless, these suicides are attributed mostly to high expectations, pressure, depression, injuries, pain, and prescription drugs (and other drug use such as steroids). During late November and Pre-Christmas season, we tend to hear more of athletes’ suicides. Perhaps winter darkness contributes to low emotional states, greater introspection, and subsequent depression when evaluating dreams versus reality.

I found the following article by Antonia L. Baum, MD, George Washington University Medical Center, cited in Clinical Sports Med 21, (2005), 853-869. She made some interesting points (Abstract).

         …Not only are athletes at risk for psychiatric illness, but they are also at risk for suicide as well although this act of self-annihilation may seem in stark contrast to the goals and ideals of athletes, honing the body to perfection. This action could be seen as the extreme aggression being turned inside. The stakes are high in sports, and winning is ‘do-or-die.’ It is not unusual to read, in the context of an athlete’s suicide that some of the puzzlement is expressed as, “but he was a gifted athlete!” Review of medical literature from 1960 to 2000 reveals 71 cases of athletes, who contemplated, attempted, or completed suicide…

In a study by Hammond, Gialloreto, Kubas, and (Hap) Davis, published in 2013, researchers examined 50 varsity swimmers (28 men and 22 women) based at 2 Canadian universities, who were competing to represent Canada internationally.

Before competition, 68% of athletes met criteria for a major depressive episode. More female athletes experienced depression than their male peers. After competition, 34% of athletes met diagnostic criteria and 26% self-reported mild to moderate symptoms of depression. The prevalence of depression doubled among the elite top 25% of athletes assessed. Within this group, performance failure was significantly associated with depression. The findings suggest that the prevalence of depression among elite athletes is higher than what has been previously reported. Being ranked among the very elite athletes is related to an increase in susceptibility to depression, particularly in relation to a failed performance. Given these findings, it is important to consider the mental health of athletes and have appropriate support services in place.

Here are my thoughts: Given the present emotional state of many young children (reports of children being bullied in social media and school, athletes being harassed, etc.), we need to decide as coaches if we want to address these issues, and start integrating mental health education as early as 6-8 year olds in our programs. I have always believed that mental training should be included as soon as possible rather than waiting for pre-adolescent years. I understand that we have lots of responsibilities as coaches and not enough time in the day, but we also should reflect upon our role of safe keeping our athletes. Are you a performance coach (only) or are you a holistically oriented coach, concerned about playing your part in the overall welfare of your athletes? If you feel uncomfortable or not knowledgeable enough seek outside assistance for this part.

Here are Guidelines suggested by Loren Fogelman (http://www.selfgrowth.com/articles/signs-to-prevent-athlete-suicide). The following excerpt is taken from posting on her website with some modifications.

Signs to Prevent Athlete Suicide

Any time an athlete commits suicide it is a tragedy. The sporting community mourned the loss of four gifted athletes: Rick Rypien, 27, who had signed with the Winnipeg Jets in the National Hockey League, committed suicide in 2011; Derek Boogaard, 28, another NHL player, Jeret ‘Speedy’ Peterson, 29, U.S. Olympic silver medalist freestyle skier, and Dave Duerson, 50, former NFL player with the Chicago Bears, also committed suicide earlier that year.

The typical athlete appears strong in body and mind; however, like the general population, athletes experience depression, anxiety and mood disorders. They are granted hero status, and it is difficult to accept their personal struggles with issues affecting their mindset and stability. Some causes are sports-related such as repetitive blunt trauma to the head leading to concussions, whereas others are due to life circumstances or hereditary predisposition.

  • Regardless of the circumstances, the sporting community does a disservice to athletes who take their life because they were unable to find relief from their symptoms.
  • By embracing a new attitude in sports, these deaths could have been avoided. Viewing depression and other mental health issues as a stigma is based upon ignorance.
  • The stance can be turned around with education and support from clubs, leagues, teams and the sporting industry.
  • Mental illness does afflict athletes: They are not immune. Depression, anxiety, and other disorders affect athletes at the same rate as the general population. Minimizing the signs of depression and anxiety is not acceptable.
  • Now is the time to eradicate the stigma attached to emotional health issues: With more and more teams using sports psychologists, access to professional help is easier than ever. Education is the key to reducing the suicide rate. Learn the signs and know what to do.
  • Inherent risk for athletes: Even the best athlete suffers from periods of anxiety or depression. Elite athletes are under a significantly high amount of stress. The constant pressure to perform can provoke these conditions. Head injuries, concussions, and the resulting depression have been blamed for the high number of suicides among athletes. As a result, these players suffer from lowered quality of life due to serious injuries sustained while competing.
  • Mental health issues are not a sign of weakness: Just like physical problems, mental health problems are manageable. Athletes suffering from depression or anxiety should be treated the same way as an athlete with a broken leg: they both should be required to see a trained professional for assistance.
  • Remove the stigma: These athletes are not crazy. They are, however, reluctant to confide in their coach because of the possible consequences. Avoiding the issue only lengthens the amount of time the athlete suffers. Coaches who punish athletes for depression or anxiety are operating from ignorance. Taking away an athlete’s sport because of emotional health issues is a disservice to the athlete and the team. The sport might be the saving grace for that athlete.
  • Athletes, like warriors, are expected to be tough, resilient, durable and perfect: Perceiving anxiety, depression or uncontrolled rage as a weakness causes the afflicted athlete to deny their experience. Instead of seeking help they attempt to cover it up to avoid being stigmatized.
  • ‘Slumps’ and ‘chokes’ are some of the more common terms used for athletes anxious about being judged, performing under extreme pressure, or experiencing fear: Frequently mental health issues are masked by bad behavior. Often alcohol, drugs, gambling, and anger are outward symptoms of the internal struggles (Schloder: older athletes).
  • Embrace a new motto: “friends don’t let friends die”: Now is the time to turn this around. Prevent another unnecessary suicide. Fellow athletes, coaches, and others within an athlete’s support group have a responsibility to learn the signs of a troubled athlete. Just like the aid available to injured athletes, the league can easily develop a system for making a referral to a trained professional for mental health assessments and treatment. It is a matter of responsibility to our athletes and our community at large.
  • Activity – Get educated: Pay attention when talking with other athletes. No one I is expecting you to fix their problems. They are, however, looking for validation of their experience. Don’t deny or minimize their reality. It is very real to that individual.

If you believe an athlete is experiencing depression and or suicidal thoughts ask if he/she has someone to speak to about these feelings. Encourage him/her to seek professional help rather than suffering or dealing with this alone. With the right tools and support, it is possible to turn it around. Instead of feeling like you can’t change anything, learn about the available resources.

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