What have they got to be depressed about? Elite athletes... and you

Introduction

If you are suffering from depression or are caring for a loved one who is in the grip of the “black dog”, then it’s a fair bet to assume that the life of a Premier League footballer or Olympic champion seems of little or no consequence to you.

But what if that title-winning sportsman or woman has been felled by the “malignant sadness” of depression? What if he or she – like you or yours – has been sapped by melancholy’s “living death”? Is there anything that we, the general public, can learn from elite athletes and their struggles with feelings of worthlessness, guilt and suicide?

And here’s another question to ponder (and return to) whilst considering the relationship between athletic endeavour at the highest level and depressive illness: what was your reaction on discovering that the cricketer Marcus Trescothick (hero of the 2005 Ashes), the middle-distance runner Kelly Holmes (double gold winner at the Athens Olympics) or the boxer Frank Bruno (heavyweight champion of the world) had been laid low by depression? Were you shocked and surprised… and perhaps even disappointed?

What Triggers Depression?

Our current understanding of the factors that provoke depression is far from perfect. Nevertheless, the evidence overwhelmingly suggests that the illness has no single, causal explanation; rather, it is triggered by a miscellany of interacting genetic, organic, social and psychological influences.

It is clear to anyone working in the world of mental health that life-changing events such as bereavement, divorce, illness and redundancy frequently contribute to the onset of depression. Moreover, it is likely that certain personality traits – notably a tendency towards obsessive, compulsive or perfectionist behaviour – may increase an individual’s vulnerability to depression. Finally, traumatic early-life experiences and dysfunctional relationships can leave a seemingly indelible mark on a person’s psyche.

Depression and the Sporting Life

If life events that generate loss, stress and anxiety are frequently a precursor to depression; and if perfectionism is a common characteristic of mood disorders, then it should come as no surprise to learn that athletes are as likely as you or I to be swamped by depression’s dark cloud. Because professional sportsmen and women inhabit a culture of risk, where their livelihood may be imperilled at any moment by loss of form, fitness or favour.

Furthermore, sport is an industry that is built on a series of tensions, such as respect for – but rivalry with – fellow competitors (and team-mates) and the not-always-delicate balance between aggression and restraint. And let’s not forget that the life of a footballer or Olympic athlete is an all-encompassing existence that requires enormous dedication and self-sacrifice: to reach the very top – and to conserve his or her position there – a sportsperson needs to be supremely driven and motivated… maybe even to the point of obsession.

From Perfectionism to Punishment

One of the defining characteristics of the elite athlete, even the most naturally gifted, is his or her constant quest for self-improvement. But training regimes, whether internally or externally imposed, are often loaded with excessive self-punishment and deprivation. Performance programmes can lead, in more extreme cases, to eating disorders or substance abuse, especially in endurance sports or events where a specific weight needs to be attained.

The very best representatives of their sport aim for perfection not just in competition but also on a daily basis in training. But the failure to attain or maintain these demanding standards can damage self-esteem and bleed into self-punishment and depression.

I was so desperate to get it right, so driven by the annoyance and fear of not getting it perfect, that the anger I felt inside began to express itself physically. I didn’t know what it was, but my frustration was so intense that I started shouting at the walls, screaming obscenities. I punished myself for my mistakes too… At one stage, I was so livid that, before I knew it, I was sinking my teeth into my hand, trying to bite through the skin between my thumb and index finger. It immediately started to bruise and the pain was intense.

Punitive self-recrimination, ungovernable indignation and the fleeting relief and horror of self-harm… many depression sufferers will doubtless be familiar with the overwhelming emotional distress captured in the above description. The writer, plummeting further into depression, continues:

I carried on screaming as long and as loud as I could and I didn’t stop until I was hoarse. I simply could not find any other way of dealing with this non-stop barrage of thoughts and negativity.

If you are trying to make sense of your own feelings of hopelessness and helplessness, then the above account should serve as further proof that depression is not linked to a lack of mental fortitude (or physical strength). For these words were penned by one of the most fearless, accomplished, admired and respected sportsmen England has ever produced: Jonny Wilkinson, who, as a young man, dropped the goal that won the rugby World Cup for England just over a decade ago. Jonny’s description of his inner turmoil – written for the mental health charity Time to Change – demonstrates that even extremely high achievers, individuals who have dominated the international stage, can be paralyzed by mental illness.

We could hazard, too, that Wilkinson’s descent into depression might have been related to a traumatic life event: the succession of injuries that blighted a large part of his career, when he risked losing both his physical health and livelihood.

The world champion cyclist Graeme Obree, who knows more than most about top-level sport and depression, has an interesting perspective on the “nuclear reaction” that propels athletes to sharpen their physical prowess literally ad nauseam. As Obree explained to Cycling Weekly magazine: “A happy-go-lucky person isn’t going to reach the extreme heights of success in a sporting context because they aren’t that driven”. But, the cyclist adds, it would be a mistake to surmise that elite competition causes mental illness:

It’s not that sport makes people depressed. A lot of people who suffer from depression have a tendency to have obsessive behaviour – that’s why more of them exist in the top end of sport. The sport is actually a self-medicating process of survival.

Sport and Loss

Loss, as we have already indicated, is often a critical component in the emergence of clinical depression. And there are few vocations as pockmarked by loss, separation, transition and change as the career of the professional athlete.

Whether you are an Olympic swimmer or international batsman, your chosen sport subjects you to a succession of potential executions, from failing to qualify for the next heat to the menace of losing your wicket on the very next ball.

Loss of form and the fear of being “dropped” (an evocative term in itself) are also ever-present tensions for even the most accomplished performer. As the Australian test cricketer Ed Cowan explains: “A professional sportsperson is his or her performances. From experience I can say it can feel like you have ceased to exist when failure is the story of your day”. But perhaps the sportsperson’s greatest fear is the life event from which there is no return: serious injury.