The Correlation Between Sports and Depression; Does one exist?
We hear all the time about the benefits of moving as they relate to our physical, emotional and mental wellbeing. It makes sense considering two-thirds of American adults are overweight and a sedentary lifestyle has been shown to cause a host of diseases from type-II diabetes to premature death. Participating in sports is one great way to get active, as it provides both social and physical benefits. For high-level athletes though, sports are not just a way to be active or meet friends, but an entire lifestyle. In college, I had multiple friends on the University of Michigan soccer team quit because it all just became too much. This made me wonder, is there a point where sports become a detriment to an athlete’s mental health? Specifically what is there a relationship between participation in high-level athletics and depression? There are the obvious physical risks of injury, and overtraining, but what is less talked about is the psychological impact of elite athletics. So through this article, I sought to answer the age-old question; can there be too much of a good thing?
Despite the tough, resilient, even God-like status some college and professional athletes portray (Looking at you, Tom Brady), in recent years it has come to light that athletes, even the elite ones, are in fact human. Michael Phelps is one example. After Phelps was plagued by a few quite notorious encounters in with the law, he came out 
and spoke of his struggle with depression, even admitting to a period of suicidal ideation after his second DUI arrest. Luckily Phelps received counseling and leaned on friends and family for support and now say to be in a much better place. Since recovering, Phelps openly promotes the need to recognize and treat mental health issues in interviews and commercials that urge others struggling to get help. But Phelps is not the only elite athlete to struggle with depression, in fact he’s a far cry from it.
Recently, researchers and sports medicine professionals have also taken interest in the relationship between mental health issues and sports, indicating that there may be an association, or at least that athletes are not immune to such issues.
An article in USA Today reported that a study by Lynette Hughes and Gerard Leavey of the Northern Ireland Association of Mental Health found that 30% of NCAA Division I athletes surveyed said they had experienced depression and 50% reported to experience anxiety. Additionally, Eugene Hong and a team of researchers at Drexel University compiled a meta-analysis on depression in athletes. The article was first printed in a 2015 edition of Current Sports Medicine Reports and sought to determine the frequency and potential risk factors relating to depression among athletes. When compiling the data, the researchers found that depression rates among college athletes were as high as 15.6% to 21%. These rates are higher than the estimated 10.9% of Americans between the ages of 18-25 who suffer from depression as cited by the National Institute of Mental Health. The Drexel University team also found that female athletes were more likely to suffer from depression than male athletes. This finding is in line with more women than men suffering from depression among U.S. adults of all ages. The question still remains though, are high-level athletes suffering from greater rates of depression than non-athletes?
The answer? Ultimately studies have contradicted one another regarding whether athletes or non-athletes suffer from higher rates of depression. In the Drexel University team’s meta-analysis, some of studies that interviewed hundreds of college kids at NCAA Division I and II schools found that lower levels of depression were experienced among athletes than non-athletes. But other studies in the meta-analysis found the opposite or at least similar rates among both groups. One contraindication may be under-reporting. This has been a concern among clinicians and researchers and is thought to occur as an attempt to keep up the stoic athletic persona so often endorsed by coaches, parents, fans and players. So when you look at it whether or not a correlation exists depends who you ask. One thing is for sure though, there are definite risk factors associated with the development of depression in high-level athletes.
Although the evidence is mixed regarding whether participation in athletics at the college or professional level exposes one to an increased risk of depression, there is evidence that injury, performance issues and career termination pose as risk factors. The most well-known risk factor for mental health issues among athletes is injury. The Drexel University team revealed that 80% of injured athletes deal with “psychological issues related to the injury” demonstrating just how much of a mental impact injury can have on an athlete. Not only this, but, alarmingly, symptoms of depression were found to appear as early as one week after injury. Such an astronomical rate, warrants the need for counseling and mental health resources to be offered to athletes early on after injury as a preventative and supportive measure. Certain injuries–such as ACL injuries and concussions–may carry a higher risk factor for the development of depression although evidence regarding whether a correlation among injury type and depression exists remains unclear. Overtraining syndrome, as the name implies occurs due to a training schedule that is too demanding, can also be thought to also have an impact on the development of depression, but again, controversial evidence remains surrounding this relationship.
Other studied risk factors include career termination and performance troubles. Ending an athlete’s career though is not always met with emotional distress. The psychological risk usually depends on why the athlete ended their career (i.e. whether it was involuntary or voluntary). Those who involuntarily end their career are as expected at a greater risk for depression. Either way though, athlete’s ending their time on the field or the court may experience a huge lifestyle change and a feeling of loss of athletic identity which can put them at risk for depression. Yet contrary to my initial thoughts, the Drexel researchers found that career termination was not a significant risk factor for depression. Hong and his team did however find one definitive risk factor. Quote-on-quote choking or performance failures were indicated as cause for severe psychological distress, and researchers warned that when an athlete fails to meet performance expectations, practitioners and the athlete’s support system should be aware of the risk of depression. Knowing that a high risk resides due to the occurrence of performance failure is important because psychological and social support should be made available to the individual to alleviate the feeling of personal failure that the athlete may experience.
So in essence, the overall relationship between depression and high-level athletics continues to remain unclear, but one thing that does remain clear is that athletes are human and like anyone else they are not immune to depression nor should they suffer in silence if and when it does hit. For this reason, coaches, family, teammates and practitioners should be aware of the risks factors of depression in athletes and make counseling accessible rather than stigmatized in the world of high-stake athletics.
