Emotional Rehabilitation From Sports Injuries

Introduction

Importance of Mental Health

Athletes work and train all their lives to become the greatest version of themselves in their field of sports. Oftentimes, athletes who are talented in the sport they perform in, become heavily reliant on their performance in relation to their self-worth. When they become injured and can no longer train, whether it be as an adolescence, college, or elite-level (professional) athlete, more focus is put on the physical recovery rather than the emotional adversities that entails. Physical injuries and illnesses have typically attracted more attention from athletes, coaches, physicians, and support staff than depression and other mental disorders (Frank, Nixdorf, and Beckman, 2013). The purpose of this project is to outline how career-ending injuries may affect athletes’ mental health leading to depression.

From high school level to professional level, athletes strive to be the best but with this achievement comes with great risk such as injuries. Injuries can come from many different variables and without notice. These injuries can be minimal in which athletes can recover from or even detrimental causing them to end their careers. The worst thing to happen to an athlete is having a career compromising injury. These compromising injuries can affect the mental health of athletes and can lead to depression. One study found the prevalence of mental health symptoms and disorders ranged from 19% for alcohol misuse to 34% for anxiety/depression for current elite athletes (Gouttebarge et al, 2019). Often these symptoms are not noticed by coaches of athletes because coaches are more worried about the physical health of athletes rather than mental. The topic is important because there needs to be a larger access to psychological support when it comes to recovering athletes and their families, coaches, and teammates.

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Literature Review

Preface: Injuries Lead to Depression

The life of an athlete revolves around sports and one of the most drastic things that can happen in their life is an injury. Experiencing an injury can be very emotionally devastating because it can end an athletes career at any time. Injuries often promote negative emotions, mood disorders, and the fear of re-injury. The identity of an athlete is sometimes lost when going through an injury, this loss of identity can create emotional disturbances leading to depression as well as the loss of self-worth. Following injuries, athletes go through many different experiences that either facilitate positive or negative outcomes.

What is Depression?

There’s a major difference between feeling depressed and being clinically depressed. Oftentimes, these two are confused, however, both can create feelings of anxiety and over thinking. Sport scientists have used the term depression to reflect both negative affect (i.e., depressed mood) and psychiatric disturbance (i.e., major depression) (Rice et al. 2018). Depressed mood is a transient state of feeling sad or down, whereas major depression is a medical condition consisting of an array of symptoms beyond merely depressed mood. Individuals diagnosed with a major depressive disorder (MDD) exhibit multiple symptoms, including decreased motivation and/or interest in activities, low energy, a loss of pleasure, impaired concentration, changes in sleep and/or appetite, and feelings of worthlessness or hopelessness (APA, 2000; NIMH, 2000a).

Those dealing with depression don’t always have to be diagnosed by a doctor. Self-diagnosing is popular amongst people portraying all symptoms. It may begin with a loss of appetite or change in sleep cycle, to becoming extremely temperamental and unpredictably sad over anything for no apparent big reason. It feels like a pattern of defeat over even the simplest things in life that may seem miniscule to others.

Symptoms vary among individuals. Depression affects almost seven percent of Americans, in other words, about 16.2 million (Koskie, 2018). Signs of depression are seen in even the youngest of ages, most popular within young adults. Depression can also be seen in women postpartum. The mood disorder is extremely complex in which all depressions are unique to its carrier. There isn’t one specific reason why people become depressed, it may vary from genetics and brain chemistry, to environment and past trauma (Lyness, 2016). Depression may become more fatal and serious by causing eating disorders, suicidal thoughts and attempts, bipolar disorder, or psychotic breaks. Sixty percent of people who commit suicide are diagnosed with a mood disorder of some sort, such as bipolar or major depressive disorder (HHS.gov, 2014).

Life After Injuries/Recovery

Competitiveness is a common trait that athletes carry. In combination with the feelings of defeat, deniability, and competitiveness, athletes will become stubborn and try to rush through the recovery process. They may even possibly deny physical help and try to “walk it off.” Because they associate self-worth with sports performance, many will try to downplay their injuries to go back into the game. By further compromising the injury, this can prolong recovery and even end a career.

The recovery period is the most vital to an athlete’s ability to gain confidence back. Although many injuries require surgery and physical rehabilitation, it’s also recommended to give a psychiatrist a visit in case the athlete is showing signs of depression or anxiety. In a study, injured athletes were split into two groups where one saw a doctor whilst the other self-diagnosed through a survey. Many of the athletes in the study actually did end up showing major symptoms of depression in the interview group, identified by actual doctors. Those with the survey showed inconsistencies, which concluded may also be from in denial (Appaneal, Levine, Perna, and Roh, 2009). It’s pertinent for the coaches, families and friends of athletes to provide emotional support and be as involved as possible. It’s quite easy to overlook the injury as just a physical adversity, rather than a mental one as well. A major symptom of depression is being in denial with one’s feelings and downplaying it. Therefore, it’s vital for individuals, such as athletes, to have a support system that will get them not just physical help, but also advise seeing a psychiatrist, psychologist, or therapist to seek emotional assistance.

Athletes experience a major change in lifestyle. From revolving their lives around going to practice and games several times a week, to becoming in a sort of “stuck” state can cause them to feel defeated. Defeat can severely damage their confidence and ability to perform the everyday activities of life. A few ways loved ones can show support without overstepping and suffocating the athlete may be through challenging them by allowing them to continue doing less-physically demanding tasks of life, within the severity of the injury of course. Also, spending more time with athletes doesn’t allow them to cloud their mental space with negative thoughts. Simply sticking around for physical rehab or waiting until their therapy session is over are just a couple little things that parents or friends can do to reassure their support. Coaches should also keep in contact as much as possible. Checking up on your athlete and consistently inviting them to practices and games can go long ways for an athlete’s confidence. Reminding athletes to trust the process and give into both physical and emotional rehabilitation can formulate less strain on themselves and loved ones, and also create a smoother, faster path to full recovery. A sports journal found that giving into help can save athletes from stress that may compromise their mental health (Sheinbin, 2016).

Conclusion

More Than Just a Physical Injury

For athletes, going through an injury can be one of the hardest times in their lives. Though people on the outside only see it as a physical injury, the mental health of the athletes is also affected. Athletes experiencing injuries go through a range of emotions which affects the mental health of the athlete. From novice to professional level sports, athletes experiencing injuries develop psychological like re-injury anxiety, loss of athletic identity, and depressive symptoms (Sheinbein 2016). Athletes have to face adversity when dealing with injuries, especially depression. Whether athletes recover from a career ending injury it is always hard for them to be mental stable knowing that they can never be able to play the sport that was always part of their life.

Depression is a common disorder and is widely researched but not specifically in athletes involved in sports injuries. Mental health is often not talked about in sports and considering that depression is a mental disorder it was difficult to find information about athletes who go through mental issues. Current research includes psychological traits when athletes go through injuries but does not specify their mental health or condition. The trait of depression is certain throughout many different sources when indicating athletes with injuries. One of the limitations for this topic is that it sometimes gets repetitive in the information given. For future research there should be more interviews with athletes that went through injuries and describe their experiences and recovery. Though there are similar stories within athletes it is better to have a variety of experiences to determine the multiple mental health outcomes from injury.

As expressed, injuries are a detrimental moment in an athlete’s life. These injuries can cause severe mental health problems especially depression. This mental disorder can really affect the life of an athlete by creating a sense of loss and sadness. Observation of mental health while dealing with an injury in sports is minimal but it should be taken seriously. Though athletes can recover from physical injuries it is hard for them to fully recover mentally. More research should be done to discover the process of how athletes cope with injuries mentally. Implications of depression can be seen by athletes through their behavioral patterns.

References

1. American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR (4 ed.). Washington, DC: American Psychiatric Association.
2. Appaneal, R. N., Levine, B. R., Perna, F. M., & Roh, J. L. (2009). Measuring Postinjury Depression Among Male and Female Competitive Athletes. Journal of Sport & Exercise Psychology, 31(1), 60–76.
3. Depression: Facts, Statistics, and You. (2020). Healthline. Retrieved 7 April 2020, from https://www.healthline.com/health/depression/facts-statistics-infographic#1
4. Does depression increase the risk for suicide?. (2015). HHS.gov. Retrieved 7 April 2020, from https://www.hhs.gov/answers/mental-health-and-substance-abuse/does-depression-increase-risk-of-suicide/index.html
5. National Institute of Mental Health (NIMH). (2000a). Depression: A detailed booklet that describes symptoms, causes, and treatments, with information on getting help and coping. Retrieved June 23 2006, from http://www.nimh.nih.gov/publicat/depression.cfm
6. Sheinbein, S. (2016). Psychological Effect of Injury on the Athlete: A Recommendation for Psychological Intervention. AMAA Journal, 29(3), 8–10.
7. Why Do People Get Depressed? (for Teens) - Nemours KidsHealth. (2020). Kidshealth.org. Retrieved 7 April 2020, from https://kidshealth.org/en/teens/why-depressed.html