By Ilse alfonsIMost are aware that exercise has positive benefits for mental health. The NHS recommends that adults should do a physical activity every day, including strengthening activities on at least 2 days of the week, with a minimum of 150 minutes of moderately intense exercise a week, or 75 minutes of vigorous activity per week. They further indicate that physical activity can not only increase self-esteem, sleep quality, and energy, but can also reduce the risk of stress, dementia, depression, and Alzheimer’s. Whilst the general public is expected to incorporate this into their daily lives as it suits them, for the elite athlete (whether in school, university, or as a professional career) this – along with nutrition, discipline, and routine checks on their physical health – is the minimum expected of them. So, if they are constantly doing activities which should reduce the risk of psychological distress, why do athletes experience depression? In the podcast The Sport Psychologist, M. Treasa (2020) indicates that the high pressure to continuously improve, the many transitions that take place within a sports career, and (career-ending) injuries can all contribute to the poor mental health of athletes. Professional athletes are expected to continuously go above and beyond, and external factors such as sponsorships only increase this pressure. Many athletes start their careers as an adolescent, and continue with it into their adult life. It is this period of ‘teen to adult’ where the average person is most susceptible to mental health problems as one’s personal life is going through many changes. Add to this a high-pressure career, as well as the expectation to perform well in school or university, and it becomes very difficult to remain unaffected. Sport itself is also a microcosm of a full career. Whilst the average career may last around fifty years, a full sports career is compressed into ten years, or even shorter due to an injury. A. Wolanin, M. Gross, and E. Hong (2015) state that empirical data shows that athletes are just as likely to suffer from depression as non-athletes. Storch et al. (2005, cited in A. Wolanin, M. Gross and E. Hong, 2015) were the first to compare depression rates of athletes to non-athletes. They hypothesised that because athletes deal with more stress than non-athletes, there would be a higher rate of alcohol use, depressive symptoms, social anxiety, and less social support. Their results supported the hypothesis, with findings that female athletes had greater symptoms of depression, had less support, and had greater social anxiety compared to male athletes, and female and male non-athletes. Yang et al. (2007, cited in A. Wolanin, M. Gross and E. Hong, 2015) had similar findings in terms of gender as results were consistent with the general population, where women report higher rates of depression than men. Of course, this could be due to the stigma surrounding mental health as, in general, men may feel less comfortable expressing emotions as they are socially conditioned to do so. As such, Armstrong and Oomen-Early (2009, cited in A. Wolanin, M. Gross and E. Hong, 2015) suggested that a strong social network and support from team members or coaches may act as a major protective factor against developing depression. Pluhar et al. (2019) investigated the difference between individual and team athletes. The objective of the study was to find out whether there is a difference in the number of athletes with mental health diagnoses in individual sports (e.g. gymnastics, running, horse riding) as compared to team sports (e.g. hockey, football, basketball). This study found that individual sports athletes more frequently reported depression and anxiety compared to team athletes. This is due to team sports offering support and feelings of acceptance, which can reduce the risk of depression and offer opportunities to form healthy relationships with peers. Individual sports athletes also carry all the responsibility of succeeding within their sport, and require more self-reliance. If they lose, they may experience more shame or guilt as all the responsibility was on them, whilst in a team accountability is shared. This internalisation of failure, and perhaps feelings of isolation, may then lead to psychological distress. Sports injury is the most widely studied risk factor of psychological distress (A. Wolanin, M. Gross and E. Hong, 2015). A survey of sports medicine physicians reported that 80% of athletes who needed treatment for an injury also discussed their mental health in relation to the accident. Brewer and Petrie (1995, cited in A. Wolanin, M. Gross and E. Hong, 2015) were the first to compare athletes who had experienced injuries to those who had not, with the former obtaining slightly higher depressive symptom scores. This relates to the transition factor in an athlete’s life, as an injury is an involuntary career end. The termination of a sports career also affects athletic identity, as when the career ends the identity is often lost. Baillie and Danish (1992, cited in A. Wolanin, M. Gross and E. Hong, 2015) found that athletes with a strong athletic identity tend to experience greater social and emotional adjustment issues after the end of a sports career, thus further contributing to stress. Whilst depression amongst athletes is not inevitable, it is preventable. M. Treasa (2020) indicates that sportsmen and women often consult sport psychologists when it is too late. Similar to how physical health is routinely checked such as through physiotherapists, sports psychologists should be sought before the issues become serious. This could lead to a more open discussion on mental health in the sports world, where the stigma is even greater compared to the general public (D.A. Baron et al., 2013). This could also decrease the number of athletes who avoid help, as it could help them understand different treatment methods. Some may avoid mentioning psychological distress due to the fear that anti-depressants may affect athletic performance, or they do not want to be perceived as ‘weak’ by their coaches and teammates. They could instead be introduced to CBT and ACT, or given a tailored plan on how to deal with their psychological distress to both maintain their performance and gain back their happiness. M. Treasa further highlights that athletes all respond differently to situations, as one might already have very good coping strategies, whilst another may crumble under the pressure. Whilst it does depend on the individual athlete, exercise can still help combat mental health issues, yet the goal should no longer be to continuously improve, but should instead focus on enjoying the exercise for what it is. References
Baron, D.A., Baron, S.H., Tompkins, J., & Polat, A. (2013). Assessing and Treating Depression in Athletes. In D.A. Baron, C.L. Reardon & S.H. Baron (Eds.), Clinical Sports Psychiatry: An International Perspective (pp.65-78). [PDF]. Retrieved from https://onlinelibrary.wiley.com/doi/pdf/10.1002/9781118404904.ch7. National Health Service. (2018). “Benefits of exercise.” https://www.nhs.uk/live-well/exercise/exercise-health-benefits/. National Health Service. (2019). “Exercise.” https://www.nhs.uk/live-well/exercise/. Pluhar, E., McCracken, C., Griffith, K.L., Christino, M.A., Sugimoto, D., & Meehan III, W.P. (2019). Team Sport Athletes May Be Less Likely to Suffer Anxiety or Depression than Individual Sport Athletes. Journal of Sports Science and Medicine, 18(3), 490-496. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683619/. Treasa, M. (Host). (June 2020). If exercise is so good for you, why do athletes get depressed? [Audio podcast episode]. In The Sport Psychologist. Spotify. Wolanin, A., Gross, M., & Hong, E. (2015). Depression in Athletes: Prevalence and Risk Factors. Current Sports Medicine Reports, 40(1), 56-60. DOI: https://doi.org/10.1249/JSR.0000000000000123.
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