Understanding anxiety issues isn’t easy

Want to know what it’s like for a baseball player suffering from anxiety disorder?

There is no one answer, no all-encompassing connection between players who recently have dealt with the condition, players as prominent as Brewers right-hander Zack Greinke and Reds first baseman Joey Votto.

But when Dodgers trainer Stan Conte talks about the plight of left-hander Hong Chih-Kuo, who recently spent more than a month on the disabled list with anxiety disorder, the effect is nothing short of chilling.

Kuo, who turns 30 next month, is one of the game’s top left-handed relievers when healthy. But he has undergone four elbow operations and battled the “yips” — an inability to throw the ball with accuracy — in 2009. In early May, during a series in Pittsburgh, he told Conte he no longer could pitch due to his anxiety.

Conte, after receiving permission from Kuo, spoke at length about the pitcher’s condition.

“The analogy I use is if you’re scared of small places, you’re claustrophobic and you’re scared of snakes. But you’re really good at catching those snakes, and they ask you every day to walk into a small, closed window-less room to grab them,” Conte said.

“They bite you. It hurts. But you’re the best in the world at doing it and they pay you a lot of money to do it. And every day it becomes worse and worse. It makes you believe you can’t do it, not for glory, not for fame, not for money.

“That’s how he was in Pittsburgh. He was like a guy in water who couldn’t float and begging to get out of the water. It was very emotional, the way he was begging us not to put him out there.”

In ’09, Kuo became unnerved by pitching in exposed bullpens in foul territory, such as the ones at Wrigley Field in Chicago and AT&T Park in San Francisco. During his rehabilitation, Conte sent him only to minor-league ballparks that had “closed” bullpens so that Kuo could warm up comfortably. Eventually, Kuo resumed pitching in open bullpens too.

Even today, mental-health conditions are difficult for many to grasp and interpreted by some as a form of weakness.

Conte, to the contrary, lauds Kuo’s mental toughness.

“He’s gone through two Tommy Johns, four elbow surgeries,” Conte said. “His elbow hurts on every pitch, has for years. Most people would have stopped. But he found ways to pitch through that pain, perform at a high level. That takes a lot of mental toughness.

“He comes in at 11 or 12 (for a 7 o’clock game). He’ll start working out, work all the way through batting practice. During games, he’s in the bullpen, throwing the ball against the wall. You’ll see him do that at Dodger Stadium. And then he’ll do a whole workout for an hour after the game.

“He’s doing everything he can possibly do every day. I know there are so many stories about guys who work hard. But this guy actually does it every day. Then to have this (anxiety) problem, fight back in 2009, have an unbelievable season in 2010 and then fall off again . . .

“What impressed me more than anything else is that he could have said my elbow hurts, I can’t pitch anymore. I asked him, ‘What do you want me to do as far as the DL? Just use the elbow?’ He said no, just tell them I have this anxiety problem. He put it out there.

“And then once again, to climb back up the mountain . . . to me, that shows how mentally tough he is. That’s the epitome of someone who loves the game and doesn’t want to quit.”

I first talked with Conte about Kuo last week at Dodger Stadium. We spoke again by phone Saturday night after Kuo granted him permission to talk on the record. Later that night, Conte sent me an email with one final thought.

“This is not something that goes away,” Conte said. “Kuo deals with this constantly, on every pitch, in the bullpen and in the games, whether he is doing well or not. It is not an injury that heals and is only a memory.

“Some days it is more tolerable than others but he has to control it and learn how to cope for the rest of his career. He knows this and at times it wears him down mentally. That is why I think he is so mentally tough.”



A general manager of a potential seller said over the weekend that he was surprised how tight money was for a number of teams.

In some cases, declining home attendance could be a factor.

White Sox general manager Ken Williams frequently has spoken about how attendance influences his trade activity. While some clubs might turn aggressive in an effort to boost their attendance, several contenders through Saturday were experiencing significant per-game dropoffs from 2010:

Rays: 4,274

Mariners: 3,365

White Sox: 3,294

Cardinals: 3,070

Braves: 2,834

Rockies: 1,743

Diamondbacks: 1,644

Each case is different. The Cardinals, for example, had average crowds of 37,685 and still were on pace to draw three million. The Rays, meanwhile, dropped their payroll from $72 million to $41 million, so their expenses are declining along with their revenues.

Then there are the Rangers and Giants, who are getting the customary bump in attendance the year after appearing in the World Series.

The Rangers’ average crowd has increased by 6,369, the Giants’ by 4,230. The Indians, thanks to their strong first half, are up 2,397 per game. But their average attendance of 19,832 still ranks only 26th in the majors.



In the first two days after Jim Riggleman resigned as Nationals manager, I found little support for his decision when speaking with executives around the game.

On Saturday, however, two executives said they at least understood Riggleman’s rationale.

The first exec raised a point that I had not considered: Baseball people in the final years of contracts cannot look for other jobs. Thus, if the Nationals wanted to delay their decision on Riggleman, they at least should have given him some kind of protection, perhaps a buyout of half his salary.

Of course, the Nationals also could have eased Riggleman’s mind simply by exercising his option; such a move would not have precluded them from firing him at the end of the season. Riggleman’s option was worth $600,000, or about 0.48 percent of the $126 million that the team has committed to outfielder Jayson Werth.

The second exec said it is simply not proper for a team to leave a manager in such an uncertain spot in the final year of his contract. I generally agree, but it happens all the time. The Tigers’ Jim Leyland currently is in that position.



With Davey Johnson taking over the Nationals, MLB on Fox’s Kenny Albert started thinking: How many managers have won a World Series and managed in the majors 25 or more years later?

STATS LLC had the answer: Johnson is the fifth such manager — and first since the 1950s.

Connie Mack won a World Series in 1910 and his last year managing was 1950 — a spread of 40 years. Bucky Harris managed 36 years after winning a World Series title, John McGraw and Rogers Hornsby 27 years each.

Johnson, of course, won the 1986 Series with the Mets, and is taking over the Nationals exactly a quarter-century later.



Albert, who worked the Mets-Rangers game for MLB on Fox on Saturday, came up with another gem for his broadcast:

Both of the starting pitchers in Jack McKeon’s first game as a manager nearly 40 years ago were in the park working for the Rangers.

The date was April 6, 1973. Nolan Ryan, now the Rangers’ club president, started for the Angels. Steve Busby, now a Rangers’ radio announcer, started for the Rangers.

This gets better:

The first-base umpire in McKeon’s first game was Lou DiMuro. His son, Mike DiMuro, had the plate Saturday.



Diamondbacks general manager Kevin Towers, continuing his never-ending hunt for relievers, spent part of last week scouting bullpen arms at the team’s Triple-A affiliate.

Towers plans to look internally before seeking external solutions. Right-hander Sam Demel, recovering from shoulder tendinitis, could rejoin the team soon. Right-hander Yhency Brazoban and lefty Alberto Castillo also are candidates to fill middle-inning roles.

In a perfect world, Towers would trade for one of his old Padres’ relievers, right-hander Mike Adams, and go with a late-inning trio of Adams, David Hernandez and J.J. Putz. The Padres, though, are unlikely to trade Adams – and they sure aren’t sending him to Towers.

The Diamondbacks believe that the Giants’ greatest advantage over them is in the bullpen, but one rival executive points out that the D-Backs also possess an inferior rotation — and are particularly vulnerable behind right-handers Ian Kennedy and Daniel Hudson.

The statistics suggest that the exec is right — the Diamondbacks rank 11th in the NL with a 4.04 rotation ERA while the Giants are third at 3.34. The Phillies lead at 3.02.



The Astros remain unlikely to trade right fielder Hunter Pence unless new owner Jim Crane is approved before July 31 and orders such a move.

The odds of Crane consenting to a trade of Pence in one of his first acts are slim. But shouldn’t the Astros at least be entertaining the idea?

Club officials view Pence, 28, as a core player for the future. Pence, though, is getting pricey — his current salary is $6.9 million and he’s arbitration-eligible for two more seasons.

Meanwhile, offense is down. A number of contenders are eager to add right-handed thump. And Pence would be perhaps the most appealing bat on the market.

The Astros need to rebuild around pitching. They’ve got right-handers Bud Norris and Jordan Lyles in place. What if they could move Pence to the Braves for a package built around one or more of Atlanta’s many appealing young arms?

They would save money. They would increase their inventory of young talent. They would kick-start a rebuilding process that is long overdue.



Indians manager Manny Acta says that right-hander Carlos Carrasco’s back-to-back performances in 1-0 victories over the Twins and Yankees helped prevent the Tribe’s season from possibly “getting ugly.”

Carrasco, one of the pitchers the Indians acquired from the Phillies for left-hander Cliff Lee, had a reputation for being “soft” earlier in his career.

Acta said that description was unfair, considering that Carrasco only turned 24 in March.

“I felt it was early to be labeling a guy,” Acta said. “He’s still not a finished product.”



• Given the abundance of available relievers, the Cardinals could try to acquire two pitchers to reinforce the seventh and eighth innings rather than push for a closer such as the Padres’ Heath Bell.

Cardinals closer Fernando Salas is best when pitching one inning. His ERA is 2.10 this season when used for one inning or less, 4.15 when used for more.

The Cardinals, by the way, do not plan to pursue a hitter in the absence of first baseman Albert Pujols. Third baseman David Freese will rejoin the team Tuesday, and Allen Craig is expected back around the All-Star break.

The addition of say, Padres outfielder Ryan Ludwick, would provide only a marginal upgrade over Craig, and at a much higher salary.

• Speaking of Bell, the Dodgers, Red Sox and Rangers are the teams that have shown the most trade interest in him in the past.

The Dodgers are likely to sell rather than buy. The Red Sox could use bullpen help, but GM Theo Epstein will be reluctant to move premium young talent for a reliever.

The Rangers, on the other hand, are deep in young arms, and would be in better position than most clubs to absorb the remainder of Bell’s $7.5 million salary.

• A scout who witnessed Barry Zito’s final rehabilitation start at Triple A said little has changed for the Giants’ left-hander — even though Zito threw a two-hit shutout.

“It takes him eight or nine curveballs and changeups to finally get the feel,” the scout says. “If he doesn’t command his fastball in the first inning, he’s in big trouble.”

Zito is scheduled to make his first start of the season for the Giants on Tuesday at Wrigley Field.

• The Athletics are encouraged not only by Jemile Weeks at second base, but also by Scott Sizemore at third. If Weeks continues to hit, Mark Ellis will be that much more redundant.

Weeks, 5-foot-9 and 160 pounds, possesses surprising power, “a little like Jimmy Rollins,” in the estimation of one executive. Rollins is slightly heavier — his listed weight is 170 — but Weeks is wiry strong.

• One-run outcomes are partly attributable to luck; a game can turn on any number of plays. The Marlins, then, deserve some pity — their recent misery includes 12 straight losses in one-run games dating to May 27.

Prior to that, the Fish were 14-4 in such games — the best record in the majors.

• And finally, how about the Red Sox losing consecutive series to the Padres and Pirates?

I know the Pirates are improved. I know the Red Sox are dealing with injuries. I know that Sox designated hitter David Ortiz cannot start in NL parks.

It’s still hard to believe.

The Sox lead the majors in scoring, averaging 5.31 runs per game. The major-league average is only 4.18. If the margin holds, it will be one of the largest since the inception of divisional play in 1969.