We love and admire professional athletes for their talent, discipline, and amazing achievements.  Even more admirable are those sports celebrities who are using their status to shine a light on mental health issues. Their advocacy can reach a wide audience, not only normalizing mental health treatment, but also exposing the particular mental health disorders that athletes may face.

The British Journal of Medicine published a paper consensus statement titled: Mental health issues and psychological factors in athletes: detection, management, effect on performance and prevention: American Medical Society for Sports Medicine Position Statement—Executive Summary

This very thorough summary expresses the benefits and challenges of some of the personality traits commonly found among high-level athletes and can be a helpful guide in offering effective behavioral help therapies for them.

Here are some highlights of the summary.

“Certain personality traits can aid in athletic success, yet these same traits can also be associated with mental health (MH) disorders. The athletic culture may have an impact on performance and psychological health through its effect on existing personality traits and MH disorders. This article will focus on the competitive athlete, from the youth and collegiate athlete to the Olympian and professional athlete, and how the athletic care network1 and MH care providers can assist with the detection and treatment of psychological issues in this population. The American Medical Society for Sports Medicine convened a panel of experts to provide an evidence-based, best practices document to assist sports medicine physicians and other members of the athletic care network with the detection, treatment, and prevention of mental health issues in competitive athlete

 

There is an interactive relationship between athlete personality characteristics and the athletic culture that may have both positive and negative effects on the individual athlete as well as the team or sport environment. This relationship between internal and external variables is fluid and may mirror changes in culture as a whole and changing developmental patterns of individuals in their time of athletic engagement. Internal variables may include traits such as perfectionism, pessimism, or introversion, while external variables may include factors such as coaching culture, team performance, or socioeconomic status.

 

For example, the internal trait of perfectionism may contribute to anxiety about physical appearance in the athletic environment,6 while the external coaching environment may also influence athlete anxiety,7 or the internal trait of pessimism, in addition to the external factor of low socioeconomic status, may result in adjustment and performance issues. An athlete’s personality traits may also influence the athletic culture. For example, athletes who engage in aggressive or high-risk behaviors may see a performance benefit in sport, while simultaneously possibly being prone for substance use disorders, hazing or other behavioral issues outside of sport because they are high-risk takers.

 

However, many studies suggest that athletes generally show more positive personality characteristics than do nonathletes.9,10 Specifically, athletes show greater extraversion and conscientiousness and less hastiness and anger.10,11 Athletes also generally show higher sensation-seeking tendencies than do nonathletes.9 Contact sport athletes and male athletes express higher tendencies toward sensation-seeking than noncontact sport athletes and female athletes, respectively.12

 

Perfectionism is defined as an achievement-related personality trait that includes the setting and pursuit of excessively high standards of performance together with overly critical self-evaluations.14,15 Some distinguish positive perfectionism, with the underlying motivation being to obtain a favorable outcome, from negative perfectionism, which seeks to avoid adverse consequences.16 Both types may be risk factors for the development of EDs in athletes.8

 

Athlete identity is the degree to which an individual views themselves within the athletic role and looks to others for confirmation of that role.17 High athletic identity has been associated with both positive outcomes, such as better athletic performance, and negative outcomes, such as overtraining and the use of performance-enhancing drugs.17 Strong tendencies for athletes to evaluate themselves exclusively according to their athletic performance may be associated with depression.18

 

Because this population may be accustomed to being in charge, with others around them giving them special attention and being solicitous of their opinions due to their celebrity status, a “situational narcissism” can develop that can contribute to entitlement regarding scheduling of appointments and payment of fees for services.23 It is important for health care providers to be aware that establishing a relationship that does not follow usual treatment parameters may lead to boundary violations. ”

 

 

Chang C, Putukian M, Aerni G, et al British Journal of Sports Medicine 2020;54:216-220.

 

 

An article from Sparlin Mental Health highlights what 7 athletes had to say about their own mental health journeys and their hopes for sharing them.

What 7 Athletes Have Shared About Their Mental Health Journeys

  1. Michael Phelps – Ask for help.

From the outside, it seemed like Olympic swimmer Michael Phelps was on top of the world. After a dominating performance at the 2008 Olympics in Beijing, Phelps became a household name and swimming icon. But his “hero” image faltered when he was photographed smoking marijuana in 2009, and arrested for a DUI incident in 2014.

 

The 2014 arrest was Phelps’ second DUI, and resulted in a six-month ban from competition.

 

Phelps went to a rehab clinic in Arizona, and sought help from a therapist for depressionanxiety and thoughts of suicide. He then went on to make a return to the 2016 Olympics in Rio de Janeiro, where he became the most decorated Olympian of all time with 28 medals, 23 of which are gold. Today, he is focused on raising three boys with his wife, Nicole, and advocating for mental health resources.

 

Reflecting on his journey, Phelps shared a Tweet in May 2019, saying:

 

“I struggled with anxiety and depression and questioned whether or not I wanted to be alive anymore. It was when I hit this low that I decided to reach out and ask for the help of a licensed therapist. This decision ultimately helped save my life. You don’t have to wait for things.” – @MichaelPhelps via Twitter

 

 

  1. Aly Raisman – Healing is not linear.

Led by captain Aly Raisman, the “Fierce Five” Olympic gymnastics team captured our hearts when they won team gold at the 2012 summer games in London. Years later, a scandal was uncovered that revealed Larry Nassar, a team doctor, had sexually abused hundreds of gymnasts under the guise of physical therapy and performing “treatments.”

 

Sadly, Raisman and several of her Olympic teammates were among those victims.

 

Nassar was sentenced up to 175 years in prison for his actions. Raisman was present at his sentencing to read a victim impact statement and, in February of 2018, filed a lawsuit against USA gymnastics regarding their role in the scandal. When asked about her healing journey, Raisman said:

 

“I’ve definitely had moments where I worried I’m always going to feel like this, but I’ve learned through therapy that I’m not going to feel like this forever. And so hopefully, the more I speak on it, the more people I can help. Even if I just help one person it was really worth it.” via People magazine

 

 

  1. Andrew Luck – Make the right decision for YOU.

Andrew Luck shocked fans when he suddenly retired from the NFL at just 29 years old, two weeks before the 2019 season was set to begin. As quarterback for the Indianapolis Colts, selected first overall in the 2012 NFL draft, it seemed Luck’s career was only just beginning when it came to a halt.

 

After a strong start with the Colts, Luck missed the entire 2017 season due to an injury on his throwing shoulder. At a press conference where he announced his retirement, Luck revealed that a “constant cycle” of injury, pain and rehabilitation had been affecting his wellness. And although the knee-jerk reaction of many fans was one of frustration, Luck was commended by many others for taking a brave stand for his mental health.

 

“The only way forward for me is to remove myself from football and this cycle I’ve been in. I’ve come to the proverbial fork in the road, and I made a vow to myself that, if I ever did again, I would choose me.” – Andrew Luck, at a press conference on August 24, 2019

 

 

  1. Ronda Rousey – Mental illness is not a weakness.

Ronda “Rowdy” Rousey won a record-breaking six UFC women’s title defenses before her first professional loss in November of 2015. In a highly anticipated championship matchup against Holly Holm where she was heavily favored to win, Rousey was knocked out by a kick to the neck and placed on a medical suspension.

 

After losing her UFC title, Rousey admitted to having thoughts of suicide, which had also taken the lives of her father and grandfather. But Rousey was determined to make a comeback, and made a final UFC appearance before signing to a successful career with the WWE, where she became the only woman to win a championship in both leagues.

 

When questioned about her willingness to discuss suicidality, Rousey said:

 

“It’s not a weakness we should condemn. I’ve never shied away from talking about suicide or anything like that. It’s really heavily affected [my] family, and anything that I could do to make sure it affects as few people as possible; I’d be happy to do that. I do not see why it’s looked at as a bad thing.” via HuffPost 

 

 

  1. Abby Wambach – Do not be ashamed.

As a member of the U.S. women’s national soccer team (USWNT) for more than 10 years, Abby Wambach collected her fair share of hardware, including: two Olympic gold medals, a World Cup championship, and six U.S. Soccer Athlete of the Year awards. To this day, Wambach holds the record for the highest all-time scorer on the USWNT.

 

But Wambach has more to be proud of.

 

After an April 2016 arrest for driving under the influence of intoxicants (DUII), Wambach decided to get help for a years-long drug and alcohol addiction, which she details in her book, “Forward: A Memoir.” Calling the arrest her “rock bottom,” Wambach has maintained sobriety ever since. In a preview for “Forward,” Wambach said:

 

“It’s really hard to talk about things when you’re ashamed. And I’m not ashamed about what happened to me anymore because it led me to where I’m at right now. I’m proud of where I’m at.” via Associated Press

 

 

  1. DeMar DeRozan – No one is indestructible.

In the midst of a restless night, NBA player DeMar DeRozan posted a Tweet at 3 A.M. that started a movement:

 

“This depression get the best of me,” he said.

 

DeRozan grew up in Compton, California, where he was already being heavily recruited in high school. Selected 9th overall in the 2009 NBA draft and currently playing for the San Antonio Spurs, many players know DeRozan for his quiet intensity. But DeRozan deals with depression and anxiety, which he first revealed in that short, honest Tweet.

 

Because of advocacy from DeRozan and others, the NBA adopted a new rule for teams to have at least one full-time licensed mental health professional on staff, beginning with the 2019-2020 season. Looking back on that Tweet, DeRozan said:

 

“It’s one of them things that no matter how indestructible we look like we are, we’re all human at the end of the day. We all got feelings . . . all of that. Sometimes […] it gets the best of you, where times everything in the whole world’s on top of you.” via The Star

 

 

  1. Kevin Love – Everyone is going through something.

NBA player Kevin Love, a five-time All Star and member of the gold medal-winning 2012 U.S. Olympic team, suffered his first panic attack at 29 years old, during a game early in the season with the Cleveland Cavaliers. Quietly, he started seeing a therapist and wrestling with a fear that he might be perceived as “weak.”

 

Then, he saw DeMar DeRozan’s Tweet.

 

In an essay for The Players’ Tribune, “Everyone Is Going Through Something,” Love specifically named DeRozan as an inspiration for deciding to come forward in his struggles with anxiety. Love said:

 

Everyone is going through something that we can’t see. The thing is, because we can’t see it, we don’t know who’s going through what and we don’t know when and we don’t always know why. Mental health is an invisible thing, but it touches all of us at some point or another. It’s part of life.” via The Players’ Tribune

 

 

 

If you have a young athlete or an elite athlete that is struggling with mental health challenges, know that help is always available. Contact me today for a free consultation.