The stigma of mental health: is it increased for athletes?

“Mental health has a stigma that is tied into weakness and is absolutely the antithesis of what athletes want to portray. ” (Dr. Thelma Dye Holmes)

When an athlete experiences physical injury, there is often a team of medical personnel including doctors, trainers and physiotherapists employed to ensure a speedy recovery. However, when an athlete experiences a mental health issue, the treatment process is often not quite as similar. Mental illness in sport is often overlooked and an athlete may be left with feelings of loneliness and abandonment, unsure of where to turn.

Many assume that mental health issues in athletes are rare, as they are often perceived to be extremely physically healthy individuals. Top elite athletes are are idealised within the media, often subjected to a large fan base, potentially giving the perception that they are immune to such problems.

Athletes often do not seek help from mental health services or fail to fully participate once they have begun. One of the reasons for this disconnect is stigma, namely, to avoid the label of mental illness and the harm that this often brings, for example, the potential diminishing of self-esteem (Corrigan, 2004). Mental health stigma is still an ongoing issue in society; however, this may be heightened even more in athletes who may fear the loss of their role model status.

Stigma on behalf of the professionals

There also appears to be a stigmatisation on behalf of medical professionals when diagnosing and treating athletes (Schwenk, 2000). Issues that stand out include:

1. Despite the known beneficial effects of exercise on mental illness, athletes are still susceptible, although, perhaps at a lower prevalence than the general population

2. Athletes may be vulnerable to misdiagnosis of mental illness than are non-athletes, particularly with problems that are related to athletic training and may be viewed from a more narrow physiological perspective rather than a broader bio-psychological perspective.

3.  The similarities between “depression” as a psychiatric disease, and “overtraining” as a consequence of continuous intense athletic training are remarkable.

The American Psychiatric Association has noted the dangers of the assumption that athletes should be mentally healthy in a bid to increase awareness and remove the stigma surrounding the mental health of athletes. They pointed out the following facts:

• Mental illness is very likely as common in athletes as in the general population
• It is not a sign of weakness and should be taken as seriously as a physical injury
• Getting help will most likely, improve, not damage one’s self-confidence

Why are athletes vulnerable to mental health issues?

Athletes may be vulnerable to developing mental health issues for a number of reasons. First of all, the stress and pressures of competing on a daily or weekly basis may leave the athlete with the potential to develop feelings of depression or anxiety. There is also reason to believe that “hidden” head injuries from contact sports may leave athletes with a predisposition to developing depression or post-traumatic stress disorder. In addition, other physical injuries, bad performances, issues with teammates or coaches, overtraining, aging and of course the dreaded retirement, may leave the athlete vulnerable to the development of mental health problems.

Athletes should not feel pressured into masking the problem; instead, the “gladiator barrier” that they often possess should be dropped, as this remains the primary barrier for seeking treatment. The idea that seeking help for mental health problems makes the athlete appear ‘weak’ needs to be addressed from both a general media perspective and from the perspective of the athlete themselves.