Byron Jamar Terry, 22, started playing recreational football at the age of 6.
“It was fun. Yes, it was,” he says. In fact, he loves the sport so much that he hasn’t stopped playing since, except when injured.
For Terry, the best thing about playing was having fun with friends and learning more about the sport, he says.
But Terry, a rising college senior at Kennesaw State University in Georgia, admits life as a football player has had its rough patches.
In high school, he was part of a multistate champion football program.
“Everything was serious – workouts, training and training, even outside of team workouts,” says Terry. “It was really serious and I wasn’t making as much progress on the field as I would have hoped or wished. Football wasn’t exactly fun anymore.”
Terry felt during this difficult period that football was no longer the safe haven it had once been for him. At one point, Terry says, the sport felt more like a job than the sport he fell in love with as a kid.
For Terry, being on such a competitive football team aggravated his depression, a mental illness he’d been diagnosed with in middle school after his parents’ divorce.
“My problems with football didn’t help that much mentally,” he says. “If I wasn’t good at sports, I would be sadder and it would increase my depression.”
His family also moved a lot, which also made his depression worse. “I didn’t fit in too much,” says Terry. “I just felt very alone.”
Terry says he first had suicidal thoughts in middle school. And by the time he got into high school and football was getting more and more stressful, Terry started having suicidal thoughts again. However, he didn’t tell anyone because he thought it would ruin his chances of becoming the professional soccer player he dreamed of becoming. He felt he had to keep his mental health issues a secret.
“Having a mental disorder is stigmatizing,” says Terry. “Athletes have to be tough, and things can’t bother you because you have to be so deeply rooted in your sport. That’s why I didn’t want to tell anyone. I didn’t want to upset anyone, so people were used to seeing me as a happy person who was always smiling and joking around.
“You would never know [I was suicidal] because I looked so happy,” he adds.
A Wide-Ranging Problem
According to a study of more than 11,000 participants, published in PLoS One in June 2022, research shows that participating in team sports can offer children and adolescents several mental health benefits, including reduced anxiety, depression and attention problems. This may interest you : The World Health Organization (WHO) has released a report calling for fairness in the expansion of genomics education.
According to a study published in May 2019, participating in sports teams is also associated with better adult mental health in children affected by adverse childhood events, such as domestic or sexual abuse, their parents’ separation or divorce, or a parent in prison in JAMA Pediatrics. The study enrolled nearly 10,000 participants, who were in grades 7 through 12 at the start of the study and were between the ages of 24 and 32 at the end of the study.
So what went wrong for Terry and other young athletes like him? Experts believe that the challenges of elite and high-level sport, in particular, may play a role in causing or worsening depression, anxiety and suicidal thoughts in young adults and even adolescents.
“There is a great debate about the specialization and professionalization of youth sports, where youth and younger athletes are being encouraged to practice and play similar to professionals,” said Ashwin L. Rao, MD, a Seattle sports medicine physician and the university’s athletics team physician of Washington.
“This can lead to injuries and burnout, and many young athletes can be deterred from this level of stress and therefore from the sport at a young age. These effects and implications are still being studied,” adds Dr. added Rao.
In fact, researchers are just beginning to get a handle on how prevalent mental health problems are among elite teens and young adult athletes, says Rao, who adds that many previous studies have focused on older adults.
An analysis of several scientific studies on mental health disorders in elite athletes, including young adults, published in June 2019 in the British Journal of Sports Medicine, found that the prevalence of mental health problems in athletes ranged from 19% to 34% for alcohol abuse and for anxiety and depression. Currently, experts believe this prevalence is similar to that of the general population, but more research is needed to know for sure.
And although suicide is the second leading cause of death for all youth ages 10 to 14 and adults ages 25 to 34, suicide among young adolescent athletes is not well-studied, according to the Suicide Prevention Resource Center, Rao says. It is currently believed that suicidal ideation and behaviors among young elite athletes are similar to those of the general population.
A study of top Swedish athletes, published in the British Journal of Sports Medicine in February 2021, showed that 17.4% of male and 14.2% of female athletes had suicidal thoughts – a similar rate to the general population. The participants were on average 29 years old.
Another study published in Sports Health: A Multidisciplinary Approach in September 2015 found that suicides accounted for 7.3% of all student and athlete deaths in the National Collegiate Athletic Association (NCAA) between the 2003–2004 and 2011 seasons –2012 season.
What Is It About Elite Sports That Can Cause or Worsen Mental Health Issues?
While team sports have been shown to be very beneficial for the mental health of children, adolescents and young adults, the pressure can compound, particularly in high-performance and elite competition with other issues such as the pre-existing depression Terry had and the pressure to perform Parents, teachers and peers to succeed academically and athletically, perfectionism and unrealistic goals. Left unchecked, these stressors can be dangerous and cause athletes to feel like failures when they feel they are not meeting the expectations of others or their own. This may interest you : St. Charles Health System is out of business, eliminating 2 top positions amid financial, hiring, ‘over capacity’ challenges. Worst of all, they often don’t share how this pressure is destroying them.
“If you ask an athlete if they’re depressed, we think they’re going to try to give you an answer that you want to hear,” warns Dr. Eugene Hong, chief physician at the Medical University of South Carolina (MUSC). Physicians and MUSC Health and Professor of Orthopedics and Family Medicine at MUSC in Mount Pleasant, South Carolina. He was previously the team physician for athletes of all major sports at Drexel University, Philadelphia University and Saint Joseph’s University in Philadelphia.
A reason? Many young athletes worry they won’t get playing time and may not get the same opportunities if they talk about mental health issues as if they haven’t admitted to those issues, says Dr. Hong.
This is especially problematic because athletes have unique risk factors for depression, Hong says. They risk injuries every time they play, and those injuries can temporarily take them out of the game or end their careers, leaving them feeling isolated.
“We all have aspects of self-identity, but the concept of athletic self-identity is very important,” says Hong.
In fact, some athletes’ toughest moments can come when they leave the sport, either voluntarily or due to injury. The aforementioned analysis, published in the British Journal of Sports Medicine, found that 16 percent of ex-athletes suffered from stress and 26 percent of athletes suffered from anxiety and depression.
Terry’s darkest moments came when he tore his meniscus and required knee surgery and injured his hip.
“One of the hardest things I’ve ever had to do was watch people I know and people in general playing football and all giving them their props while I was at home and it was me on TV and on social media,” explains Terry. “It hurt me so much. I didn’t even really want to watch college football or go to one of my college football games because of the mental strain it would take on me. I got better at it over time, but it still hurt.”
Another reason experts say high school and collegiate athletes struggle with mental health issues is the amount of time it takes to be a student athlete.
“A Division 1 collegiate athlete might spend 40 hours a week on their sport, in addition to their academics. The time pressure alone can be overwhelming,” says Hong.
In addition, the environment in which athletes live and compete is very complex due to the internal and external pressures they face on a daily basis.
“Athletes have a complicated, high-performing mindset and have high expectations of themselves based on their ability,” says Paralympic gold medalist Cheri Blauwet, MD, who is now an exercise medicine physician at Brigham and Women’s Hospital in Boston and Spaulding Rehabilitation Hospital in Charlestown, Massachusetts.
“That alone makes it difficult for athletes to empathize. As a result, they may struggle for some time and not seek or receive the help they need,” adds Dr. Added blue.
High-Profile Elite Athletes Struggle, Too
The above statistics are corroborated by a number of recent events. Read also : Shawnee Co. health department among 19 chronic risk reduction grants.
Katie Meyer, 22, a soccer goaltender at Stanford University, died by suicide in March 2022. The combined pressures of school and sports, as well as fear of possible disciplinary action from the school over an incident on campus, may have contributed to her suicide. according to today.
About a month later, James Madison University (JMU) softball star Lauren Bernett, 20, died by suicide. She had just been named Colonial Athletic Association Player of the Week, according to JMU.
This recent spike in suicides among high-profile athletes may be due to suicide contagion, a phenomenon in which direct or indirect exposure to a suicide can lead to an increase in suicides or copycat deaths, Rao says.
Experts believe athletes are less likely to die from suicide than non-athletes, Rao wrote in an invited comment published in the December 2021 issue of Current Sports Medicine Reports. But experts say the untimely deaths of these athletes underscore the need to screen high school, college and Olympic athletes for mental health problems using suicide-specific screening tools.
“I believe that as an overall athlete care network, we need to get better at screening our athletes for depression, anxiety and suicidality,” says Rao. “What is clear is that just asking about depression and anxiety is not enough. We also need to ask about suicidal thoughts, plans and intentions.”
In fact, some high-profile athletes are leading by example in breaking out of the veil of secrecy that surrounds their mental health issues. In May 2021, tennis pro Naomi Osaka withdrew from the French Open because she was struggling with depression and anxiety. Just a few months later, in July 2021, Olympic gymnast Simone Biles withdrew from multiple events at the postponed Tokyo 2020 Olympics due to ongoing mental health issues.
Osaka and Biles Inspired a Young Athlete to Put Her Mental Health First
Biles and Osaka’s impressive actions resonated throughout the sporting world and beyond.
Kai McClelland, 18, of Apex, North Carolina, an aspiring Division 3 cross-country runner sophomore at Trinity University in San Antonio, Texas, has struggled with anxiety and depression for most of her life. Like Biles and Osaka, McClelland eventually retired from her sport to attend to her mental health.
McClelland’s mental health problems began in high school, where the pressure to balance her academics and a competitive sport shook her to the core.
“I was in a really competitive high school,” says McClelland. “There was a lot of pressure to be successful and to take advanced (AP) courses and not regular courses.
“Anytime there were factors out of my control or [things] got complicated, I didn’t have any coping mechanisms to figure out what to do,” adds McClelland. “I freaked out. Asking for help felt like admitting weakness.”
By the end of 10th grade, McClelland had begun having panic attacks and unexplained vomiting to the point where she could not hold down food and eventually had to be hospitalized. Doctors said her condition was related to stress, leading McClelland to decide she needed time off from her sport.
“I was always afraid that people would see my temporary problems as permanent,” says McClelland. “[Biles and Osaka] have shown that taking a break for mental health is worth it. You can put yourself above your sporting achievement to have future success in both your life and your sport.”
How Do We Stop the Pattern?
“On the one hand, athletes are so resilient and do incredible things. On the other hand, athletes are so fragile that we have to take care of them,” says Emily Clark, PsyD, a licensed clinical psychologist and associate director of mental health services for the United States Olympic and Paralympic Committees in Colorado Springs, Colorado.
The good news? Research shows that evidence-based mental health treatment works: medication and psychotherapy can help people manage and improve symptoms of various mental illnesses, including depression and anxiety.
But experts say we need to change our approach to keep athletes and everyone else sane. Because many athletes still don’t know they can — and should — seek help, they’re missing out on early intervention and possibly even prevention, says Dr. Clark.
“We need to normalize mental illness or [mental] struggles so that athletes feel comfortable seeking and receiving help,” Rao says.
Clark has very specific methods to help her athletes avoid long-term mental health issues. The United States Olympic and Paralympic Committees are now using two recently developed mental health assessment tools, which are short-answer questions that allow them to assess whether the 4,500 athletes they work with regularly are at risk for mental health problems are or are already suffering from mental health problems.
Athletes also participate in educational programs designed to help them understand and be aware of mental health issues so they learn to recognize the signs and symptoms and know when to seek help, ideally before a crisis. For example, Clark says she helps athletes distinguish the signs and symptoms of clinical anxiety from ordinary, everyday anxiety, because sometimes it can be normal for athletes to feel sadness or fatigue.
“The goal isn’t to make sure nobody ever has problems,” explains Clark. “If you live on this planet long enough, you will encounter obstacles and deal with grief and loss. So our goal is to make sure people know when they’re having trouble. That’s the mental health literacy piece.”
Clark also works hard to destigmatize mental health issues and help-seeking in her athletes by building trust in them.
“I want them to know they can access care without telling me, and I don’t want it to be a bottleneck,” Clark adds. “My goal here is to break down access barriers and expand access points. I want them to feel empowered.”
Athlete coaches and staff are trained in Mental Health First Aid, a national program that teaches people how to recognize, understand, and respond to signs of mental health and substance abuse problems.
College athletic programs across the country employ many of the same strategies because many athletes have similar mindsets.
“In general, there are studies that suggest providers are not comfortable when it comes to mental health. Therefore, providers who care for amateur, competitive, and professional athletes must be willing to request and use validated screening tools,” says Rao.
At the University of Washington in particular, Rao adds, athletes have access to resources such as psychologists, social workers, doctors, coaches and coaches, some with advanced skills to help athletes struggling with mental health issues and one Have awareness of the need to care for the body and mind of athletes.
“I’m proud of them for speaking up when they have concerns because it will allow us to help improve their mental health,” says Rao.
Prevention Needs to Start at a Young Age
Research shows that children who participate in team sports often experience multiple mental health benefits, including a reduced risk of anxiety and depression. But to be competitive, many parents are trying to get their kids into sports earlier and are looking for a child who specializes in one sport, says Bradley Donohue, PhD, a distinguished professor of clinical psychology at the University of Nevada in Las Vegas .
That’s not always a good idea, experts say. “If you have a specific goal in an area of life and something happens like you get an injury or something else happens that’s out of your control and it doesn’t work, it’s because you’ve been so extremely focused and driven everything beyond it can lead to a psychological problem,” says Dr. Donohue.
To reduce this risk, he says, as long as they don’t do a lot of travel focused on the sport itself, it’s best to get younger elementary school kids involved in a variety of sports or club sports. Sports team travel can be problematic, says Donohue.
“Then they don’t really have a lot of opportunity to develop social skills and intimacy the way a typical kid does,” he says. Children need to “spread out and have multiple identities beyond sport. So if something doesn’t work out, they don’t have all the fear that comes with it,” says Donohue.
He also says that parents shouldn’t just praise a child’s achievements in sports.
“An optimal exercise program should focus on all things, including mental well-being and strength and stability, as well as physical health and relationships,” says Donohue.
Of course, parents are very important when it comes to modeling athleticism in their children, and they shouldn’t just be spectators in the stands at their children’s sporting events.
Parents should be “cautious and proactive” in their child’s involvement in sports, says child and adolescent psychiatrist Patrice Harris, MD, MA, FAPA, president of the American Medical Association 2020-2021 and editor-in-chief for health and medicine at Everyday Health. Some examples of this:
From Secrecy to Speaking Out: How Terry Bounced Back
Terry’s life began to turn around when he revealed his depression to his college coaches.
“You worked with me on it. They told me if I had to go home and see my therapist, that would be fine,” says Terry. “I felt like they understood or had some idea of what I was going through mentally.
“What also helped me get out of my funk and cope with my mental health issues was drawing on my faith, seeing a therapist, and connecting with other athletes and regular people who struggle with the same mental health issues have, and hearing their stories about mental health,” says Terry, adding that he writes his struggles online for Medium.
Terry has also found it rewarding to coach fifth and sixth graders and high school kids in soccer.
“I try to be a role model by showing good character, hard work and leadership,” he says. “I also want them to know that I care about them beyond their sport.”
These days, Terry says he’s successfully coping with his mental health issues. He says he wishes he had told those around him about his mental health issues sooner. “It would have made a bigger difference,” says Terry.
“It’s okay not to be okay and it’s okay to get help,” he adds.
The National Suicide Prevention Lifeline is available 24 hours a day on 988 as of July 16, 2022. You can also text 741741 for free crisis advice.
