Depression in athletes is not uncommon. Sport often places abnormal stresses on competitors and like a person’s physical attributes, mental health alters throughout life.
Recognizing a mental illness, such as depression is of utmost importance. One in four people is thought to be affected by mental health issues such as depression or anxiety so educating athletes and coaches about its effects is vital.
On this page:
- Signs of depression in athletes
- Psychological, physical, and social symptoms of depression
This article is not meant to replace a qualified professional. Always seek specialist advice.
Depression in athletes is now less stigmatised in the public arena, with more sportsmen and women speaking out or correctly asking for help like Marcus Trescothick or Dame Kelly Holmes. There are now organisations and sports psychologists set up to help either part-time, full-time, or immediately accessible within a sport.
Signs of Depression in Athletes:
Performances from athletes with mental illness can drop or alter in both competition and training. Skillset can also change due to tiredness and decreased concentration. Performances can drop over time and also in some athletes is associated with a more aggressive nature in team sports that could result in issues with the officials.
Fatigue, illness, injury or failing to recover
The athlete being more susceptible to injury or an increase in illness with days off are signs of depression. The athlete might start seeing the health professional more, either at the place of employment or outside if trying to hide the problem. Fatigue can also cause injuries or illness and an increase in masseur appointments or failing to properly recover day to day with adequate training loads can be signs of a mental health problem. If an athlete is injured or undergoing rehabilitation and not competing they are at an increased risk of becoming depressed. This could potentially make the injury take longer to heal and so the athlete needs to be looked after during this time.
Decreased interest in activities
Athletes with depression can become less interested in training or extra skills they require to perform. They may start turning up late or going straight away post the activity, instead of getting feedback and looking at an analysis of other teams or their opposition individually. They may also have decreased focus on the exercise and/or withdraw socially. They may talk less about the activity they are doing and some even quit the sport entirely.
Withdrawal from social contact – quietness
When the athlete can be seen to be less outgoing than their teammates and withdraws from contact socially, it’s a common sign of clinical depression. The person becomes more isolated than normal and becomes reclusive at times. This isolation and quietness may be when they are with their peers or other athletes, or alternatively around family and friends.
Change in personality or habits – more irritable
Depression can be associated with more anger and violence in some cases. Frustration in athletes can occur with themselves, teammates, or staff and are signs of a mental health problem. Irritability can be at the place of activity or outside. The athlete in some cases may cry more or alternatively look and act flat or be a different persona altogether. In some cases, the person may even self-harm and wear clothes to cover this up, or talk about death or dying. Athletes’ normal habits can alter depression and more isolation is usually a sign.
Change in sleeping or eating habits
Sleep times and quality is often monitored in athletes, with well-being questionnaires commonly done. A change in sleeping habits could include regular naps between sessions and sometimes an athlete finding a corner more regularly to sleep during the day. An increased look of tiredness and reduced concentration can also be signs of depression. Sometimes the athlete starts eating more on their own and weight losses or gains can be seen. These all affect performance in both training and competition.
Depression can cause difficulty in remembering or concentrating in meetings, during their activity or performance, and in everyday life. The athlete may also find it difficult to express or focus on what they are required to do. Their mind could wander whilst someone is talking to them. Concussion (traumatic brain injury) or a history of concussion can also cause reduced concentration levels and impair emotional state, and so people suffering from this injury should be monitored for depression.
Drinking habits can change with depression and some athletes may start drinking or drink more excessively and frequently. Athletes may even find an isolated place to drink, but as alcohol affects overall performance, there may be an issue with this in training or competition. Drug use can also be a sign that the athlete is depressed. Although this is usually picked up by anti-doping organizations, the athlete may not have been tested when the drug was in their system. With alcohol and drugs, teammates or other peers may notice a change in the person, or notice a covering or hiding approach.
It is important to recognize a mental illness issue and get help. Speaking out, as many top athletes have done with their experiences, will stop the stigma attached. Mental well-being is important and it is the role of all supporting staff, peers, family, and friends to manage and aid an athlete before, during, and post their activity or their career. Things like injury fear or what to do when retirement comes can create a depressive state and alter emotions and should be addressed with the athlete. Mental health training and programs are set up within some academy teams as part of their education. Feeling able to speak out or ask for help should be ingrained in all. It is important to recognise the signs or behavior changes and if depression is thought to be present, a mental health professional should be sought to help.
Symptoms of Depression
Symptoms of depression can be psychological, physical or social:
- Low self-esteem
- Continued feelings of sadness
- Feelings of hopelessness
- Feelings of guilt
- Lack of motivation
- Anxiety and stress
- Loss of sex drive
- Suicidal thoughts.
- Lack of energy
- Unexplained aches and pains
- Disturbed sleep patterns
- Changes to the menstrual cycle (in women)
- Slow speech and movement
- Changes in appetite (usually lowers)
- Sudden weight loss (or occasionally gain).
- Difficulties in home and family life
- Poor performance at work
- Avoidance of social activities
- Reduced interest in usual hobbies/pastimes.
Depression is a common condition with up to 15% of the population suffering from a bout of depression at some point in their lives. This figure is however just an estimate as many people do not seek help for depression. Women are twice as likely to suffer from depression as men, although men are less likely to visit their doctor about feelings of depression.
Once you have suffered from depression once, you are more likely to have further episodes in the future. Also if depression runs in your family, you are more at risk of becoming depressed yourself.
Causes of Depression
Depression can occur for many reasons. Most commonly it occurs as a reaction to a life event, such as death, divorce, illness, redundancy, or money issues. Depression can also be linked to hormone levels and so is common in women during pregnancy, miscarriage, childbirth, and menopause.
As already mentioned, depression can be hereditary. Studies have shown that a certain type of gene can be passed from parent to child which affects the levels of the chemical serotonin in the brain. This is a mood-altering chemical that is thought to be lower in concentration in those who are more at risk of suffering depression.
Other risk factors include the excessive use of alcohol or recreational drugs, as well as the continued use of certain prescribed medications.
Diagnosis and treatment
Diagnosis – There are no specific tests that can be carried out to diagnose depression and so this is done via a thorough consultation where the Doctor conducts a detailed interview regarding the patient’s symptoms, emotions, and life patterns or changes. The Doctor may also take blood or urine samples for testing, to rule out any conditions which can cause similar symptoms, such as an underactive thyroid.
Treatment of depression usually combines both medication, therapy, and self-help although will vary depending on the severity of the condition and the length of time it has been a problem.
Mild or short-lived cases may not initially be prescribed antidepressant medication. Instead, the patient may be monitored over a few weeks and may also be recommended to try:
- Self-help books
- Talking to someone, whether it be a friend, family member or undertaking professional counseling.
- Exercise – this has been shown to improve spirits in many cases.
In more severe cases then antidepressant medications are usually prescribed, again in combination with counseling or cognitive behavioral therapy.
Medications for Depression
There are several forms of antidepressants which are available and what works well for one person may not for another. They may also result in mild to moderate side-effects.
Antidepressants take 2 to 4 weeks from when they are first taken to start having an effect. Initially, you should be seen every one to two weeks by either your Doctor or a nurse to make sure that everything is ok with the medication. They can then administer any changes in medication or dose.
If working, then the medication should be taken continually whilst symptoms persist and then for up to 6 months after all symptoms have gone. In persistent cases of depression, the patient may be kept on the treatment indefinitely.
The most commonly prescribed form of antidepressants is SSRI’s (selective serotonin reuptake inhibitor). These are used initially in most cases of moderate to severe depression. They work by increasing the level of serotonin and other neurotransmitters in the brain. Side effects can include headaches, sleep disturbances, nausea, and anxiety, although these usually improve in time.