Sports must wake up about depression
"I’ve got a clean mind, and I’m healthy. I’m happier with myself than I’ve ever been,” NHL enforcer Rick Rypien told reporters in March, returning to hockey after taking two leaves of absence from the Vancouver Canucks in three years due to depression. “I think it’s going to be how I behave and how I act over time, but I’m just taking it one day at a time, and I’m more excited about hockey than I’ve ever been in my whole life."
Five months later, in August, Rypien took his own life.
For those who care about the mental health of elite athletes, the past two months have been a doozy.
A famous freestyle skier and Olympic silver medalist from Idaho shoots himself in a canyon in Utah. A retired New York Yankees pitcher from Japan hangs himself in his California home. Two NHL enforcers are found dead in suspected suicides within two weeks, which came only a few months after another enforcer died from mixing alcohol and painkillers. A retired Baltimore Orioles pitcher, Cy Young award winner and TV commentator shoots himself outside his home.
And most recently, former boxing champ Oscar de la Hoya tells the Spanish-language network Univision about his mental struggles, which led him toward drugs and alcohol, toward marital infidelity, toward thoughts of suicide, and finally toward seeking treatment earlier this year.
To us, the sports fan who can only dream of reaching elite status in any sport, none of this makes sense.
These are millionaires. These are our society’s versions of Hercules, those our children aspire to become. These are athletic heroes in macho professions, devoid of mental weaknesses like depression or anxiety, hardened and well-oiled sporting machines trained to perform to the highest athletic standards.
To Dr. Donald Malone of the Cleveland Clinic’s Center for Neurological Restoration, a psychiatrist who does one-on-one work with elite professional athletes across the sporting spectrum, these suicides are reminders of something else: that a modern Hercules is a human too, and that mental illnesses such as depression among elite athletes is something that needs to be out in the open.
“It’s pretty much swept under carpet,” said Malone, whose research has included anxiety disorders and anabolic steroid abuse in athletes. “Somebody like an elite-level athlete, they’re feeling depressed, and they think, ‘Why? Nothing should be making me depressed!’ And they get even harder on themselves. So they don’t seek help: ‘What’s the matter with you? You have the perfect life, you’re making millions!’ And so they go on and on, and they’re less likely to seek help than the general population.”
Like any suicide, these recent deaths have left us all wondering why. The disparate and reactionary explanations come soon after news breaks: It was money problems, in the case of retired Orioles pitcher Mike Flanagan. It was a decade-long battle with depression, in the case of Rypien. It was a life built on adrenalized sporting highs and traumatic personal lows, in the case of freestyle skier Jeret “Speedy” Peterson. It was the result of a career built on getting their heads smashed in, in the case of retired Chicago Bear Dave Duerson, who committed suicide earlier this year and whose brain was found to have chronic traumatic encephalopathy, a dementia-like brain condition brought on by multiple concussions and brain injuries.
It stemmed from a struggle to cope with a career-threatening injury, it can be blamed on the difficulties of a post-sporting life outside the limelight, it was the fault of a life lived in the coddling elite sports bubble did not prepare the elite athlete for a life lived in reality.
To point to one reason for this rash of suicides among professional athletes is a silly and reductive exercise. We are not inside their heads; we can never know what drove them to the edge and then over; any attempts to answer the inevitable question of why will inevitably fall short. Mental illness, depression, the effects of concussion, the inner workings of the brain: all are hugely complex things that science is only beginning to understand.
But to look at how views on mental illness are shifting in professional sports — albeit slowly, in the macho sports culture that’s historically been reluctant to discussing mental weaknesses — shows a few bright spots in the darkness.
“It’s weird,” Malone said. “If an athlete stubs their toe, they’re in an MRI machine, but if they’re having problems mentally, they feel they shouldn’t tell people about this. Like it may affect their next contract. There’s a little reality to it, but the bigger reality is if you get treatment, you’ll perform better.”
Major League Baseball has been lauded for leading the way in treating mental illnesses as seriously as outward, physical injuries. A Sports Illustrated story last year applauded certain ballplayers for speaking out about their mental struggles — like pitcher Zack Greinke’s struggles with social anxiety, or pitcher Ian Snell’s battle with depression — as well as baseball for its newly proactive approach to treatment. Other athletes have talked openly about their struggles: NFL running back Ricky Williams with social anxiety, NBA guard Delonte West with clinical depression, NFL commentator Terry Bradshaw with his depression. Ron Artest even thanked his psychiatrist after winning an NBA championship last year.
What American professional sports seem to slowly be grasping is something behavioral scientists have known for decades: That mental illnesses like depression, which affects about one in 10 Americans, don’t discriminate against race or class or athleticism. And that suicide — the cause of 35,000 American deaths a year, about the same as breast cancer — is more common than we’d ever expect.
The instances of concussion-related brain injuries, however, seem to be the wild card that’s more common in elite sports.
Premature deaths of athletes involved in contact sports — whether from suicide or from brain-related injuries — have become a cause for concern in recent years. Bob Probert was another NHL enforcer who died prematurely and unexpectedly last year, not from suicide but after experiencing severe chest pains then collapsing. Probert’s family sent his brain to researchers at Boston University, who found evidence of chronic traumatic encephalopathy.
That enigmatic, degenerative brain disease has been pointed to as a possible culprit in many of these suicides over the years as well in non-suicidal deaths like Probert’s.
“The numbers start to add up,” said Daniel Parkinson, a police chief in Ontario and Probert’s father-in-law. “It’s something that needs to be researched and threaded together somehow to see if there’s any commonality among those deaths. As a professional sport, I think the organizers and the owners and the players themselves should be concerned about wanting to see if the dots connect or not.”
In the instances where frequent concussions are made the culprit for an elite athlete’s dive into depression, there’s at least an explanation. But in so many other instances, we’re just left to wonder.
Judy L. Van Raalte, a psychology professor at Springfield College in Massachusetts, points to some thoughtful studies that have been done about how athletes identify themselves. When athletes base their self-worth solely on being a professional athlete, then when that career comes to an end, they lose their identity.
She points to another recent academic study, “The Athlete Versus the Jock.” While “athletes” have positive mental health outcomes for being involved in sports and all the associated exercise and camaraderie, “jocks” have an identity that promotes risky behavior and can increase depression.
“Athlete identity was associated with a decreased risk of suicide attempts,” the study concludes, “whereas jock identity was associated with an increased risk of suicide attempts.”
“You see the superstar,” Van Raalte said, “but there’s also this other piece, where people say they had no idea. I wonder if athletes become really good at hiding the pain. It’s changing, but I don’t think it’s changed.”
Ultimately, the lesson is simple: Neither money nor fame can insulate someone against mental illness. And the macho sports culture must fully realize that.
“The context and the content of a pro athlete’s depression may be unique, like the pro athlete who doesn’t know how to manage not being a star anymore,” said Marshall Mintz, a clinical and sport psychologist in New Jersey. “And being a pro athlete is different than a housewife that’s depressed ... But if you strip away the context, you’re going to get to issues of identity, self-esteem, impulsivity, problem-solving, coping skills, capacity to manage change. All those elements will be there in both people.”