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Depression in Sport

So what exactly is Depression?

Depression is a serious issue; it is not a sign of weakness. It’s a genuine illness that can hit anyone at any time. Depression is a common mental disorder that causes people to experience depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration amongst other things.

Most people will feel sad or blue every now and again and this is a normal part of life but when the sad mood lasts for a long time (two weeks or more) and it stops you from doing things you might normally do, this could be the early stages of depression.

Depression is more common than most people think – affecting about one in ten people at some time in their lives. In the UK alone, it’s estimated that 1 in 4 people will suffer from some kind of mental health problem. That means that most people will either suffer or know a family member or friend who experiences a mental health problem such as depression. Unfortunately, there is still a stigma around depression and many people feel ashamed and try to hide their depression. Someone may be suffering yet show no outward signs. When actor Robin Williams and Football Manager Gary Speed both committed suicide there was a general feeling of astonishment as they had not appeared to be suffering to the outside world. There is now some great work being done in the UK with the Royal Family supporting the ‘Heads Together’ campaign. As a nation we need to continue to keep encouraging people to talk more openly about depression as the chance of a faster recovery is dramatically increased when people feel like they have someone to open up to.

Some people may experience a one-off episode of depression and it might pass without any outside help. For others, depression may last longer or come back multiple times. In these cases, it may require more specific treatment, or in extreme situations even admission to hospital. There is no doubt that depression can be a very painful and difficult human experience. The good news is that with the right focus and treatment, people can not only deal with depressive symptoms but also make a full recovery.

The key symptoms of depression can be broadly characterised into two groups of either behavioural/physical (what you actually do) or psychological (what’s going on in your head) symptoms. These are as follows:

Psychological symptoms

  • Feelings of low mood (including sadness, tearfulness, unhappiness, and hopelessness)
  • Anhedonia – lack of interest in doing things and no enjoyment doing things that you would normally enjoy
  • Loss of self-confidence or self-esteem
  • Feelings of worthlessness and / or guilt
  • Poor concentration or memory, difficulty following a conversation or reading or remembering events

Behavioural symptoms

  • Withdrawal from family and friends
  • Change in energy levels (Either low energy tiredness or anxious and shakiness)
  • Problems dealing with everyday tasks

Changes in appetite and/or weight – this could go in either direction – you could comfort eat or lose your appetite

Changes in sleep – again this could go in either direction – you might have insomnia and have trouble sleeping or you may have hypersomnia and want to sleep all the time

  • Reducing self-care

Extreme cases may lead to self-harm and/or suicidal tendencies

Depression often includes distorted thinking habits about what’s happened to you and your situation. This can be helped by training our brain to think differently. Although there is no logic when it comes to how depression may come about there is logic in how you might best deal with it when it does.

What causes depression?

There’s no single cause of depression. It can occur for a variety of reasons and it has many different triggers. Although depression has been shown to be more common in some groups it can hit anyone at any time and often there is no logic as to how it can hit. There are however the big five sources of depression and it may be a combination of these things on top of one another.

The big five sources of depression

  1. Life events

A major life event like losing a loved one, a marriage breakdown or the loss of a job can sometimes trigger depression, particularly if it involves a major loss and there’s a lack of a supportive social network.

  1. Everyday on-going stress.

For some people, there is not a single or major event that gets depression started. Sometimes depression is caused by problems that seem to go and on, with no solution in sight. These problems can be much more ordinary things, such as ongoing problems with money, work, mortgage or rent, ongoing tension in relationships, or loneliness. These stresses can cause depression if they make people feel trapped or humiliated and they can’t see a way out.

  1. Irrational thinking (including the way you think about yourself, others and the world)

Most of the time, it’s not the actual thing that happens that causes the onset or continuation of depression – but your interpretation of the event – classic CBT or Cognitive Behavioural Therapy thinking. An event that may cause you to feel low one day – on another occasion when you were in a better place might not even have registered with you as significant. Irrational thoughts may be about yourself, others or the world in general.

  1. Upbringing and genetics

Research has shown that people with parents or siblings who have depression are up to three times more likely to have the condition. This can be due to heredity genetic or environmental factors that have a strong influence.

  1. The brain and biology / physiology

When people are depressed, there are changes in the brain, both in levels of specific brain chemicals and in electrical activity. These changes are more marked in people who suffer a lot of physical symptoms of depression such as difficulty sleeping, change in appetite and lethargy. When people recover from depression, these changes disappear and brain activity goes back to normal. Other aspects of physiology may also contribute to depression. For example, disturbed sleep can lead to fatigue, irritability and poor problem-solving

Depression in Sport

Sport is littered with stories of depression, many of them tragic. When Gary Speed took his own life in 2013 the world of sport gasped and then grieved together; Robert Enke’s suicide, Kelly Holmes act of self-harming, Frank Bruno being sectioned and Marcus Trescothick’s departure from the world’s most renowned cricket tour due to panic attacks and depression, are examples within elite sport that act as a cruel reminder of how depression can impact sportspeople as easily as anyone else. From the outside, many cannot understand how an elite athlete, who appears to be living the dream – getting paid well for playing sport, travelling in luxury and adored by many, could suffer from depression. As stated above, depression is not selective it can land on anyone irrespective of walk of life, personal situation and the size of pay packet. Sport brings huge pressure to achieve, to progress, to win, to maintain confidence and form whilst under the media spotlight. In addition, a loss of form, injury, being away from home for extended periods of time or nearing retirement age when your sport is your ‘identity’ can all contribute to feelings of anxiety and depression.

Although for some this anxiety is short-lived and accepted as part of the journey, for others it may develop into something more serious. As international cricketer, Marcus Trescothick explained, “Demands of playing every northern hemisphere summer at home as well as every southern hemisphere summer on tour, meant we spent almost 12 months a year living out of suitcases and in hotel rooms. Of course, the lifestyle was considered luxurious, our every off-field need was catered for by a solid back-up staff including a doctor, nutritionist, sport psychologist, etc., we were very well paid for our efforts and it beat real work any day. … however, the four-wall fever that can strike you when you are stuck inside a hotel bedroom for days on end prior to moving onto the next one, was simply not a natural way to live. It creates extraordinary strains for the players not to mention their wives and families.”

Some of the high profile cases of depression in sport include the following:

Clarke Carlise

“Everyone else thought I’d made it, that I had the dream life. And I did. I was a 21-year-old professional footballer for QPR and the England Under-21s. I had a nice flat, a nice car, and a loving family. My irrational mind had made me think suicide was a rational action though. So I went to a park near my home in Acton armed with lots of painkillers and thought “I’m going to take all these pills and kill myself because I’m no use to anyone”.

I’d just suffered a severe knee injury and had convinced myself that without football, people would see me for what I really was, which nothing was. I sat on a bench in that park, washed the pills down with a can of beer, and waited for it to happen. In the end, I was incredibly lucky because my girlfriend found me and I was rushed to hospital in time to have my stomach pumped. I survived and didn’t tell another soul about the incident for years and didn’t ask for any help. I just locked this suicide attempt away in Pandora’s Box.

I go back to this spot in my BBC Three documentary, Football’s Suicide Secret. As you’ll see, it was horrible to go back there, I couldn’t stand it. It was awful to think something so strong could have come over me to make me lose sight of all the good in my life. I thought about what I could have missed out on – the great relationship with my daughter, meeting my wife – and I was so ashamed. That’s why speaking to Gary Speed’s sister Lesley was such a profound moment, an epiphany in fact. Speaking to her made me see what I could have put my own family through. I saw the butterfly effect, how the lives of Gary’s parents, children, wife, neighbours, and the wider football community were all traumatised by his decision to take his own life. It’s the first time Lesley has spoken publicly about Gary’s death. She says that if someone had asked her whether Gary was suffering from depression before that, she would have said absolutely not; “He hid it from us and it stopped him asking for help,” she tells me. Yet still, she regrets not having been able to help him. “We were just so sad that we couldn’t help him through,” she says. “That’s a huge regret that I didn’t get him to one side and say ‘is everything alright?’”

‘I know only too well that most depressives are great actors who can put on a different persona, a facade.’ What you need to be able to do is open up, yet the cruelty of the illness is that it won’t let you. Working on the documentary was very cathartic. I spoke to other professional footballers who have suffered in silence with depression, and I now believe there are hundreds of pros and ex-pros who are suffering from the illness, even though they might not know it.

Marcus Trescothick

Hero of the 2005 Ashes who had to leave two England tours due to the illness and also returned home from India during Somerset’s autumn trip there. It’s hard to explain but you can’t sleep, you can’t focus or concentrate on things during the day and, when you pull all that together, it creates one big storm. I considered hurting myself to show people how much pain I was in. I spoke first to the doctor who was travelling with the team. I told him something wasn’t quite right, I didn’t feel right. I was taking sleeping tablets and they weren’t working, I couldn’t eat or drink and, obviously, being in India that was a big problem. It quickly manifested itself after two or three days. After telling someone, two or three days later I thought, ‘I can’t stay here any longer’.

My first reaction was, ‘I’m ill. I’ve got cancer or something’. I knew something wasn’t right. There were moments when I was fielding in Australia — the second time it happened — and I went to the toilet, walked off and that was it. I crashed out the back. I still get heaps of letters and 90 percent of them are about coming back from India and depression. I have a lot of sympathy for people who become suicidal from it. It must be a totally desperate situation that they feel they have no other way out. Only the people who suffer from the illness really understand it. It’s important for people to know that it’s not a weakness in people, it’s an illness.

These examples reiterate that depression is a serious issue; it is not a sign of weakness. It’s a genuine illness that can hit anyone at any time. Remember, often people suffering from depression are great actors who can put on a different persona, a facade. Look out for those around you, are they really OK?