According to the World Health Organization, an estimate of 300 (three hundred) million individuals globally have clinical depression or a depressive disorder (WHO, 2018). There is a common consensus that risk factors exist that are more unique to athletes that may increase their risk of depression (Wolanin, Gross and Hong, 2015, p. 59).
The aim of this essay is to provide evidence to the hypothesis that there is a link between depression and high performance athletes by analysing numerous scholarly articles, examining research done on the subject, as well as reviewing evidence on the association between depression and athletes. The risk factors of depression that may be unique to athletes will be thoroughly discussed.
The Australian Government’s Department of Health describes depression or depressive disorders as “a group of illnesses characterised by excessive or long-term depressed mood and loss of interest in activities that used to be enjoyable”, (2014).
It is imperative that one clearly distinguishes depressive disorder from a depressed mood, of which the latter is generally brief and ubiquitous, while a depressive disorder usually refers to the occurrence of episodes which are more persistent and causes extreme disturbances in mood. (Australian Institute of Health and Welfare, 1998).
The symptoms of depressive disorder include insomnia, loss of interest or pleasure, fatigue, loss of energy, psychomotor agitation, feelings of worthlessness, inappropriate guilt, suicidal thoughts, excessive sleeping or large increase or decrease in appetite (AIHW, 1998). For the remainder of the essay the term “depression” refers to a depressive disorder or symptoms of such.
Unique circumstances that may trigger depression
There are both non-sport triggers, which include demands such as separation from friends and family in certain cases, and sport triggers such as training volume, injuries and stress during competitions, that may lead to depression in high performance athletes (Weber, Puta, Lesinksi, et al., 2018; Lebrun, MacNamara, Rodgers, et al., 2018).
Potential Triggers of Depression
Researchers have identified a variety of triggers that leads to depression in athletes of which sustaining a serious injury, career termination and athletic performance are the most common.
Injuries and Career Termination as Risk Factors. Research suggests that serious injuries in certain circumstances may prompt depression in serious athletes (Smith and Milliner,1994, p. 340). This is, however, dependent on various factors such as the personality of the athlete, coping resources, relationships with team members if the athlete is participating a team sport, history of mental illness or severe stress, severity of the injury and the athlete’s emotional response to the injury (Smith and Milliner,1994, p. 340).
It is advised that a trainer should consider these factors when discerning whether injured athletes are at risk of depression (Smith and Milliner,1994, p. 341).
According to Margot Putukian, past president of the American Medical Society for Sports Medicine, there is no predictable sequence on the manner in which athletes may respond to injuries (Putukian, n.d.). It is thus imperative that trainers and team physicians pay attention to any signs or symptoms for mental health issues and use the available resources to treat these issues before the athlete’s mental condition worsens (Putukian, n.d.).
Depression and suicide in athletes have gained global attention in recent years. There are a number of studies researchers have done which support the theory that serious sport injuries can lead to depression and suicide.
An instance of the negative impact a serious injury could have on an elite athlete is the suicide of wide receiver for the Denver Broncos, Kenny McKinley, whom was found dead in 2010, of a self-inflicted gunshot wound (Putukian, n.d). A serious knee injury left McKinley unable to play football and it has been widely speculated that McKinley’s injuries, combined with the stress of gambling debt and depression, were the reasons for his suicide (Associated Press, 2010).
Former English footballer, Leon McKenzie, has been outspoken on how a hamstring injury triggered his depression and led to a suicide attempt, as well as the stigma surrounding mental illnesses, which McKenzie believes is one of the greatest obstacles in combating depression and high suicide rates (Grez, 2018).
Thus, there is common consensus among researchers, as well as athletes that serious injuries can trigger depression in high performance athletes. This view is also supported by a participant in a study done by Lebrun, MacNamara, Rodgers and Collins, who describes how a severe injury that led to his forced retirement, triggered his depression (Lebrun, MacNamara, Rodgers, et al., 2018).
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All the above mentioned individuals were elite athletes and were forced to retire, which ultimately led to the feelings of loss experienced by each of them. According to Park, Lavallee and Todd, the period during which an athlete undergoes the transition to retirement is a high risk period for depression, since many athletes suffer a loss of identity (2013, p. 22-53).
It is imperative to mention that it was not just the injury itself that led to the above individuals’ depression and one’s suicide, but the combined consequences of the injury. The injury to McKinley’s knee prohibited him from continuing his football career and therefore receiving a salary, which would have had an enormous negative impact on his reportedly huge amounts of gambling debt and family financial support he felt responsible for.
For the participant in the study done by Lebrun, MacNamara, Rodgers and Collins, forced retirement meant losing the job he had since graduating from high school (2018). It is clear that there are many factors that contribute to whether a serious injury will trigger depression or suicidal tendencies in an athlete. In these above cases the injury, as well as the financial, social and identity related consequences triggered depression and suicide.
Athletic Performance as a Risk Factor. There is great pressure on athletes to perform. This pressure might be placed on the athlete by himself or herself, family members, trainers, teammates, etc. When facing a decline in performance, athletes might experience feelings of helplessness, excessive guilt, negative self-perception and hopelessness which are all symptoms of depression (Wolanin, Gross and Hong, 2015, p. 58), which might be ubiquitous or develop into a depression disorder.
A participant in the same above mentioned study done by Lebrun, MacNamara, Rodgers and Collins, holds a strong belief that his depression was triggered by the intense stress he was put under by the sport organisation he belonged to, which also included institutional mistreatment and bullying (2018).
Research also shows that athletes participating in an aesthetic sport such as gymnastics, are usually more prone to develop eating disorders or a substance abuse problem, which are also symptoms of depression (Gorczynski, Coyle and Gibson, n.d.). It is speculated that the cause of these specific depressive symptoms in individuals who participate in aesthetic sports, are the pressure and attention that is frequently placed on gymnasts’ looks and body build (Gorczynski, Coyle and Gibson, n.d.).
It can thus be concluded that athletic performance is a unique risk factor which might trigger depression in athletes who are frequently put under immense pressure either by trainers, parents or themselves.
Depression: More Prevalent in Individual Sports than Team Sports
When competing in an individual sport, an athlete’s success or failure is based on the sole individual athlete’s performance (Nixdorf, Frank, and Beckmann, 2016). The results of a study done by researchers at the Technical University of Munich in Germany, show that depression is more prevalent in athletes competing in individual sports than athletes competing in team sports (Nixdorf, Frank, and Beckmann, 2016).
There is consensus among the researchers of the study that an internal attribution style is more prevalent in individual sports, which is justifiable since an athlete competing in an individual sport do not have teammates who can be credited or blamed. This internal attribution style could lead to an athlete competing in an individual sport, experiencing stronger emotions (Nixdorf, Frank, and Beckmann, 2016). One can therefore assume that athletes competing in individual sports are more prone to experience depressive symptoms or have depressive disorder.
Female Athletes at a Higher Risk of Depressive Symptoms
Various studies have reported that depression is more frequent in female athletes than male athletes (Ghaedi and Kosnin, 2014, p. 38). However, research also indicates that female athletes are twice more likely to report depressive symptoms in comparison to male athletes (Gorczynski, Coyle and Gibson, n.d.)
There is common consensus that depression in general is more prevalent in females than in males. According to the World Health Organization (n.d.) the existence of gender specific risk factors, such as gender based violence, income inequality and socioeconomic disadvantages, that disproportionally affect women are related to the higher rate of depression in females.
However, more research is needed in order to understand why depression is more prevalent in females than males.
Numerous studies and research on the association between depression and athletes indicate that there are indeed unique circumstances that might trigger depression in certain athletes.
There are strong arguments provided by researchers in the articles I reviewed and analysed in order to provide evidence that unique circumstances that might cause depression in athlete, exist There is common consensus that severe injuries hindering performance or leading to early career retirement and the pressure to perform or excel are one of the leading triggers of depressive symptoms, depressive disorders and even suicide. Female athletes, as well as athletes who compete in individual sports, are more prone to suffer from depression or experience depressive symptoms than male athletes and athletes who compete in team sports.
However, certain variables can be factored into the occurrence of depression in athletes. Therefore, factors such as a severe injury or early career retirement, should not be regarded as absolute determinants of depression in athletes. Factors such as psychological makeup, support systems and economic and financial status are also defining factors in the occurrence of depressive symptoms or depression disorder.
- Associated Press. (2010, December 1). Knee injury, gambling debt weighed on late
- Bronco McKinley. Associated Press. Retrieved from http://www.nfl.com/news/story/09000d5d81c8fedb/article/knee-injury-gambling-debt-weighed-on-late-bronco-mckinley.
- Australian Government Department of Health. (2007, May). What is a depressive disorder? Retrieved from https://www1.health.gov.au/internet/main/publishing.nsf/Content/01583965211717A9CA257BF0001E8D74/$File/whatdep2.pdf.
- Australian Institute of Health and Welfare. (1998). Mental Health: A Report Focusing on Depression. Retrieved from https://www.aihw.gov.au/getmedia/76c6d76b- 047c-4f17-938a-331b9ee13593/nhpamh98.pdf.aspx?inline=true.
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- Gorczynski, P.F., Coyle, M., Gibson, K. (2017). Comparing depressive symptoms in high-performance athletes and non-athletes. British Journal of Sports Medicine 51, 1348-1354. Retrieved from https://doi.org/10.1136/bjsports-2016-096455.
- Grez, M. (2018, January 18). Inside the mind of a suicidal sports star: I wanted ‘to kill myself,’ recalls Leon McKenzie. CNN. Retrieved from https://edition.cnn.com/2018/01/18/sport/football-suicide-blue-monday-leon-mckenzie/index.html.
- Lebrun, F., MacNamara, A., Rodgers, S. and Collins D. (2018). Depressive symptoms in high-performance athletes and non-athletes: A comparative meta-analysis. Frontiers in Psychology, 9, 2062. DOI: 10.3389/fpsyg.2018.02062.
- National Collegiate Athletic Association. (2014). Mind, body and sport: Understanding and supporting student-athlete mental wellness. Indiana: NCAA.
- Nixdorf, I., Frank, R. and Beckmann, J. (2016). Comparison of athletes’ proneness to depressive symptoms in individual and team sports. Frontiers in Psychology, 7, 893. DOI: 10.3389/fpsyg.2016.00893
- Park S., Lavallee D., Tod D. (2013). Athletes’ career transition out of sport: A systematic review. International Review Sport Exercise Psychology. 6, 22–53. DOI: 10.1080/1750984X.2012.687053.
- Putukian, M. (n.d.) Mind, body and sport: How being injured affects mental health. Retrieved from http://www.ncaa.org/sport-science-institute/mind-body-and-sport-how-being-injured-affects-mental-health.
- Smith, A.M., Milliner, E.K. (1994) Injured athletes and the risk of suicide. Journal of Athletic Training, 29(4), 337-341. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1317809/pdf/jathtrain00028-0051.pdf
- Wolanin, A., Gross, M. and Hong, E. (2015). Depression in Athletes. Current Sports Medicine Reports, 14(1), 56-60. https://pdfs.semanticscholar.org/7ae5/746d8ccc2ea2107d292710f0816e3b23583a.pdf.
- World Health Organization. (2018, March 22). Depression. Retrieved from https://www.who.int/news-room/fact-sheets/detail/depression.
- World Health Organization (n.d.). Gender and women’s mental health. Retrieved from https://www.who.int/mental_health/prevention/genderwomen/en/.