Beyond bumps and bruises: How sports can change an athlete’s experience with mental health

Beyond bumps and bruises: How sports can change an athlete’s experience with mental health

For about six years now, Erica Stuart has find her spot on the sidelines of soccer fields – indoor and outdoor – all over the area.

She’s watched her 11-year-old son William run up and down fresh cut grass and AstroTurf countless times, but she still cheers just as loudly on the other side of the wall at BreakAway Sports. She’ll be the one yelling for “Butter,” the nickname William has had since he was a baby.

“He loves the team work aspect because they do a lot of passing. He loves the friends, and he loves trying to get goals,” Stuart said.

While she still loves to watch, the worrying gets progressively worse for Erica as her son and his opponents continue to get bigger and stronger. She says concussions and knee injuries are always top of mind, but not necessarily for William.

“As the game progresses and you get older, the game gets more physical, so I think that’s when you can get a little more worried,” Stuart said. “But they all want to play in the World Cup. They all want to be Renaldo and Messi, so they don’t think about that, you know?”

Dr. Claudia Reardon understands the pressure an athlete faces as well as anyone. She watched her brother run for Team USA, and when some of the Olympians learned she was studying to be a psychiatrist, she started to notice their unique needs.

“I started to get some very interesting clinical questions from them, things about performance anxiety, about medications they could take for insomnia or jet lag or depression that wouldn’t affect their performance at all,” Reardon explained. “We’re talking even .01 of a second because that can be the difference between fame and fortune and second place when it comes to top-level elite sport.”

The more she looked into the field, the more Reardon realized sports psychiatry was in great demand. She realized quickly that the perception of an athlete to be physically and mentally strong at all times could weigh heavily on a person’s ability to seek the help they need.

“There’s just significant stigma when it comes to receiving mental health treatment for anyone in the general population, but when it comes to athlete populations, it’s even stronger,” Reardon said. “It is really hard for the athlete who of course can’t show any signs of weakness on the playing field or on the court.”

Reardon, who is now an associate professor of psychiatry at UW-Madison and the lead psychiatrist for Badger athletics, says it can be harder to detect signs of mental health struggles in someone who participates in sports.

“It can be harder sometimes to pick up those nuanced signs and symptoms and presentations of mental illness,” Reardon said. “I definitely see athletes often who start to feel tired or lose weight, and it’ll be chalked up to, well, we’re in a really hard point in the training cycle.”

Reardon also points out that as with anyone, there are a number of biological and medical factors that can predispose an athlete to mental illness. On top of that, the pressures on and off the field can present a complicated situation, and physical injuries can play into it.

“You get a concussion, and suddenly, you’re pulled from play. You worry about your spot getting taken on the team, all sorts of factors, so not necessarily just the underlying biology of the concussion, but that’s definitely a risk factor for depression too,” Reardon explained.

“Their body has always served them very well, and particularly if it’s a really catastrophic or career-ending injury, it can be a big deal and can really set people up for depression, anxiety, or other psychiatric concerns,”Reardon added.

Reardon looks first and foremost at how a person’s sport is connected to their mental health, which can happen in one of three primary ways:

First, the sport could make the mental health condition worse. Reardon gives the example of an eating disorder getting more severe with a person’s increased participation in a sport.
Second, the sport and the mental illness could have nothing to do with one another. “The person in front of me may have a very strong family history of depression, so very strong genetic risk, and regardless of participation, they would have developed depression,” Reardon said.
Third, whatever a person is struggling with may have drawn them to the sport. Being an athlete can help someone cope with certain conditions.

Reardon says these relationships can morph over time, so that’s something she’s constantly in tune with. She does, however, see overall advantages to kids and adults being involved in sports. There’s strong research showing exercise can protect people against depression and anxiety.

“They are not immune from mental illness, and we have to be aware that they can suffer from mental illness as well, and that there might be unique ways that mental illness manifests itself in athletes,” Reardon said.

When her patients aren’t as open to treatment, Reardon finds herself changing the dialogue around mental health to something athletes are very familiar with: physical injuries.

“We need to figure out what kind of treatments we need to give you for this injury, when is the injury sufficiently rehabbed where it’s safe for you to fully participate in sport again,” Reardon said. “And so, that’s a framework they’re really familiar and comfortable with and I think does help destigmatize.”

Reardon also finds that making the connection between the effects on an athlete’s performance and their mental health can encourage that person to seek the help they need.

“If an athlete is badly depressed or anxious, that is not conducive to good sports performance,” Reardon explained. “So talking about it from a framework of, this is going to help you be the best student athlete you can be, certainly on the playing field, also as a student incidentally that’s important too, you know, I think that can get good buy-in.”

When it comes to younger athletes, Reardon says there are ways to support them that are more productive than others. While it’s easy to let the pressure to perform be the focus, she says parents and other cheerleaders should be making sure the sport continues to be something that fosters health and wellness, not a future college scholarship.

“A favorite statement that I like to make the kids I’m watching participating, that I’m making to my own kids, that hopefully other parents make as well is, I loved watching you play today, which says nothing about, I loved watching you play because you did a good job and therefore the implication is if you don’t do a good job, I don’t love watching you play as much,” Reardon said.

Erica has learned that eleven-year-old boys don’t open up about their feelings as much as she’d like, but she still looks out for changes in mood or behavior that could be a sign of something more. She also adheres to Reardon’s recommendation to make sure “Butter” knows there are more important things than scoring goals and being Messi.

“They want to do their best, and sometimes circumstances aren’t going to allow them to feel that way, and they can get kind of down,” Stuart said. “So you’ve got to kind of remind them that it’s just a game, just for fun. You know even if I’m cheering out here, it’s still for fun.”