Sharing the Podium: Elite Athletes & Mental Health

Posted: 10th April 2024

Source: (3) Sharing the Podium: Elite Athletes & Mental Health | LinkedIn

Sporting icons are revered for their competitive prowess and pursuit of sporting excellence, although this admiration can get distorted when viewed through the social media lens. Athletes, renowned for their ‘superhuman’ physical capabilities are expected to be equally internally resilient. For an athlete to disclose mental health difficulties, they run the real risk of being perceived as ‘weak’, attracting unwanted media attention and even team de-selection.

As of late, several high-profile sporting professionals have opened up about their own mental health challenges, which have helped demonstrate the pervasive nature of mental illness and that it can even impact on those with a coveted, social standing. As a result, sporting professionals disclosing these difficulties can be great source of inspiration for those affected by mental illness.

Research has shown that athletes experience a range of mental health difficulties with similar rates to that of the general population (you and I). For example, limited studies on athlete depression suggests similar trends to that seen in the general population e.g. being more common in females and in those experiencing pain.

Whilst sport and exercise participation can potentially protect against mood disorders, athletes don’t exercise primarily for their health. In fact, their competitive environment can contain risk factors for depression especially injury and career transitions such as de-selection and unscheduled retirement. To complicate matters further, depression in sporting professionals can result from self-treatment using alcohol, recreational drugs or gambling behaviours, which could obscure the primary mental health problem.

Footballers are often cited in the media for alcohol and recreational substance misuse behavior. A recent observational, “snap-shot” study on 253 current and former professional footballers, found that former footballers had greater levels of depression and anxiety than current players. Twenty-six percent (26%) of current players had clinical symptoms of depression or anxiety and 19% possessed adverse drinking habits. This trend correlates with the Professional Footballers’ Association’s (PFA) figures stating that year on year, since its inception back in 2012, a greater number of footballers are seeking councilling support for their mental health.

In May 2017, former-Everton and England football winger, Aaron Lennon underwent a ‘mental health breakdown’ and was detained by concerned police under section 136 of the Mental Health Act (MHA), 1983. This led to significant media coverage and overwhelming levels of well wishes and support. Unfortunately, one media report at the time trivialized his mental health breakdown and questioned how this is possible when one commands a lucrative, professional footballer’s salary.

Despite this challenging experience, Aaron’s brave discussion on his recovery allowed media outlets and sport-related charities to comment on less familiar topics such as the MHA 1983, depression and stress-related reactions. Following his mental health recovery, Aaron outlined how,

“There is amazing help out there and anyone feeling anything out of the ordinary should seek support because it’s great and good to talk”

The MHA is the main legislative piece that sets out how individuals with mental health problems should be assessed and treated.As Aaron was in a public area, suffering with a mental disorder that would have required immediate care or control, he was placed under section 136 (MHA) by the police. Police would have then escorted him to a designated ‘place of safety’, so that mental health care professionals could formally assess his mental state. Following this assessment, proposed support options include being taken off section, being offered community support or being admitted into hospital under MHA section or on a voluntary basis.

A second example outlining the power of athlete mental health disclosure is that of Bobby Clay. In February 2018, Bobby, a 20-year old ex-GB middle-distance runner informed the media that through excessive training she was unable to menstruate (have periods) and that her bones were very susceptible to breaking. This condition, ‘Female Athlete Triad’ (FAT) consists of an eating disorder (low energy with inadequate dietary intake), amenorrhea (lack of menstrual periods) and decreased bone mineral density (increased bone fracture risk). This situation requires medical expertise to support nutritional, physical and psychological needs to address energy deficiency, i.e. nutritional intake needs to match energy expenditure through physical activity levels. Whilst reflecting on her experience, Ms. Clay stated,

“I wanted to be the most successful athlete I could be. This selfish desire to be the best in the world meant that I sort of put blinkers on to warning signs…I don’t want any girl to be in the position I was in”

Athletes are at greater risk of eating disorders (ED) compared to the general population, especially those competing in endurance (e.g. long-distance running), aesthetic (e.g. gymnastics) or weight category (e.g. boxing) sports. ED is an umbrella term consisting ofa range of psychological disorders with varying levels of severity e.g. anorexia nervosa, bulimia and binge eating disorder characterized by abnormal or disturbed eating habits. Anorexia nervosa has the highest death rate, due to associated medical complications and increased suicide rates. The UK’s largest eating disorder charity, BEAT estimates that1.25 million people in the UK possess an eating disorder and that ED prevalence in society is increasing over time.

To help ensure that elite athletes experiencing mental health distress are adequately supported, the Department for Digital, Culture, Media & Sport recently announced an action plan through its ‘Sporting Future’ initiative.

For anyone in the community affected by any of the outlined mental health issues, there are National Health Service support options that can be accessed via your GP or local mental health team. Everyone deserves access to tailored, one-to-one mental health support, be it through a combination of medical (psychiatric) expertise, talking therapy (psychological) or social support.

The recent commendable actions of high-profile sporting figures will help normalise mental health difficulties and combat encountered stigma within the general population. Mental health issues can impact on us all, even those standing on the podium.

Dr Amit D Mistry

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