Pushing the Limits: Professional Athletes and Mental Health

We sit for hours watching their exploits, cheering them on and marveling at their physical skills. To many, professional athletes are heroes living the dream of fame and fortune in the world of sports. But just like every other vocation, there are those among the elite who suffer from the debilitating effects of mental illness.

Professional athletes face unique physical challenges during their careers. Whether it is exhausting training or intensive competition, they push their bodies beyond what many of us can imagine. But due in part to some recent high-profile cases, many are beginning to realize the importance of addressing the mental health of athletes and not just their physical condition.

Prevalence of Mental Illness

According to statistics from the National Institute of Mental Health, in 2014 there were an estimated 43.6 million adults aged 18 or older in the United States that suffered from some form of mental illness. That number represented more than 18 percent of all U.S. adults. NIMH also estimated 9.8 million adults aged 18 or older had a serious mental illness in that same year.

Statistics help illustrate the general scope of the issue, but public and professional concern is galvanized into action when specific situations are brought to light. For example, consider the following examples of professional athletes struggling with mental health concerns:

  • Terry Bradshaw, sports commentator and former quarterback for the Pittsburgh Steelers, admitted to dealing with anxiety attacks and depression.
  • Willie Burton, former professional basketball player, reportedly has unipolar depression.
  • Barret Robbins, former Oakland Raider, received five years probation and orders to be treated for bipolar disorder in relation to charges in 2005.
  • John Daly, professional golfer on the PGA Tour, has battled alcoholism, gambling problems and reportedly bipolar disorder.
  • Ricky Williams, Miami Dolphins running back and Heisman trophy winner, was diagnosed with social anxiety disorder.
  • Wendy Williams, former U.S. Olympic diver, was diagnosed with major depression in 1994 after a spinal injury that forced her to retire.
  • Earl Campbell, former football pro and current founder and president of Earl Campbell Meat Products, Inc., manages panic disorder and documented his life with panic disorder in The Earl Campbell Story: A Football Great’s Battle With Panic Disorder.
  • Kendall Gill, former NBA player for an array of teams such as the Charlotte Hornets, the Seattle SuperSonics and the Chicago Bulls, was diagnosed with clinical depression.

Injury and Mental Health

Regular exercise, especially moderate or vigorous-intensity aerobic activity, is important for helping prevent and recover from mental and physical health problems. However, when performed more intensely at a professional level, physical activity can actually compromise health.

Elite athletes face increased risk for sudden cardiac death and other non-cardiovascular conditions such as respiratory symptoms, immunological suppression and infection, gastrointestinal symptoms and a host of other potentially serious effects due to problems of overtraining, injury, burnout and other factors common among professional athletes.

While mental illness is not limited to those who experience injuries, the Sport Science Institute has noted a connection between injuries and the mental health of athletes. Most injuries can be managed with little-to-no disruption in sport participation and other activities of daily living, and professional sports organizations employ top-notch medical experts to treat and care for their athletes.

Even so, injury is par for the course among those who engage in high-level physical activities. These injuries understandably impose substantial physical and mental burdens. For some athletes, the psychological response to injury can trigger or unmask serious mental health issues such as depression, anxiety, disordered eating and substance use or abuse.

When an athlete sustains an injury, there is a normal emotional reaction that includes processing information about the injury provided by the medical team as well as coping emotionally with the injury. Common emotional responses include:

  • Sadness
  • Isolation
  • Irritation
  • Lack of motivation
  • Anger
  • Frustration
  • Changes in appetite
  • Sleep disturbance
  • Disengagement

There is no universal response to injury among athletes, but the possibility of negative effects upon mental health urge greater attention and monitoring of these often-overlooked aspects.

Unique Risk Factors for Athletes

Athletes may also have unique vulnerabilities to mental illness for several reasons associated with the world of professional sports:

  • The social world of many organized sports requires large investments of time and energy, often resulting in a loss of personal autonomy for athletes. High athletic identity has been linked to psychological distress when this function of identity is removed, and to overtraining and athlete burnout. These conditions correlate with affective disorders such as major depressive disorder.
  • Competitive failure, ageing, retirement from sport and other psychosocial stressors have also been shown to precipitate depression in athletes.
  • Athletes also face a range of other vulnerabilities, such as eating disorders and risk-taking behaviors, hazardous drinking, driving while intoxicated and unprotected sex.
  • Overtraining has been reported in 20-60 percent of professional athletes. Burnout, the most extreme end of the overtraining continuum, has been reported in approximately 10 percent of elite athletes.
  • Eating disorders among those participating in high-intensity sports reported a prevalence of 17.2 percent for males and 32 percent for females.
  • The injury experience of an elite athlete has been likened to the grief process that follows bereavement, with an estimated 10–20 percent of athletes warranting clinical intervention, with suicide a cause of concern.