Research Essay: Depression in sport

Jun 26, 14 Research Essay: Depression in sport
The streets of Kelly Holmes’ hometown in Kent, UK, were lined with more than 40 000 people in September, 2004, waiting to welcome home their hero. Holmes, the winner of the 800 m and 1500 m track gold medals at the Athens Olympics, is the first Briton in more than 80 years to achieve the Olympic middle-distance double. Later awarded the title of Dame Commander of the Most Excellent Order of the British Empire, Holmes was indeed living the dream. Her dream was, however, laced with nightmares. Her battles with depression in the lead up to her Olympic successes now a matter of public record, she provides a graphic example that even elite athletes are susceptible to one of society’s largest problems—depression. By Prof Kerry Mummery PhD

Depression can be a transitory sadness or a debilitating mental illness, needing clinical treatment. Generally, those affected present with disturbed mood, feelings of guilt or low self-worth, disturbed sleep or appetite, loss of interest or pleasure, low energy, and poor concentration. These problems can become pervasive or recurrent, and lead to great difficulties in a person’s ability to attend to his or her everyday activities. Endemic in current society, depression is listed by WHO as the leading cause of disability and the fourth leading contributor to the global burden of disease (second among adolescents and adults younger than age 45 years) in terms of years of life affected. By 2020, depression will probably be the second largest contributor to the burden of disease across both sexes and all age groups.

 

The streets of Kelly Holmes' hometown in Kent, UK, were lined with more than 40 000 people in September, 2004 where at the time they did not know her Olympic dream was laced with nightmares of depression a long the way" - Picture by www.courier.co.uk

The streets of Kelly Holmes’ hometown in Kent, UK, were lined with more than 40 000 people in September, 2004 where at the time they did not know her Olympic dream was laced with nightmares of depression along the way” – Picture by www.courier.co.uk

As evidenced by Kelly Holmes, sportswomen and sportsmen are not immune to depression. Although the general cause is uncertain, most agree that depression is a product of a complex interplay of biopsychosocial factors. The lack of research into depression among athletes probably reflects the focus on more acute aspects of sport performance—such as anxiety—by sport psychologists, and an acknowledged lack of attention to this population by psychiatrists. Yet athletes may be more predisposed than the general population to depression, because of the physical and psychological demands placed on them by the sporting environment. Stress, for example, is associated with depression and is inherent in the life of an athlete. Not all stress is negative stress, however; nor is all stress psychological. The systematic application and removal of physical stress to the body of an athlete is the basis of training in sport. To reach the highest levels of physical potential, athletes must train optimally. Too much or too little training results in substandard performances in terms of physical preparedness. The physical demands of today’s sporting activities go beyond those presented at the competitive venue. The volume, duration, and intensity of training have increased over the past few decades, with many athletes now in physical training for more than 20 hours every week over 11—12 months of the year.
As evidenced by Kelly Holmes, sportswomen and sportsmen are not immune to depression. Ricky Hatton is another example of a sport person whom suffered with the crippling disease - Picture by www.theguardian.com

As evidenced by Kelly Holmes, sportswomen and sportsmen are not immune to depression. Ricky Hatton is another example of a sport person whom suffered with the crippling disease – Picture by www.theguardian.com

Most agree that to compete as an elite athlete a lot of training is required. However, though exercise has gained much attention as a way to improve mood in the general population, little is actually known about the relation between training volume and psychological disturbance or dysfunction. Results of research suggest that the association is U-shaped, with too much exercise—in terms of volume or intensity, or both—related to depressive symptoms. Many terms have been attached to the issue of supraoptimum training in sport—eg, over-reaching, staleness, overwork, overtraining, and burnout. The terms overtraining and burnout generally suggest different underlying pathologies that present as similar biobehavioural outcomes, with depression being a symptom of both. Overtraining, defined as an accumulation of training and non-training stress that results in long-term performance impairment, is normally viewed from a physiological perspective. Two types of overtraining have been identified; sympathetic overtraining, normally associated with high-intensity sports, and parasympathetic overtraining, often related to endurance-based sports. Although various physiological markers exist for both sympathetic and parasympathetic overtraining, mood disturbances and an increase in depressive symptoms remain key factors in the detection of supraoptimum training loads. Burnout, by comparison with overtraining, has been defined as physical or emotional exhaustion caused by long-term stress, the perception of which often relates to the mindset of the individual competitor. Although generally concomitant with high training volumes, burnout often has more of a mental than a physical underpinning. Findings of research in clinical psychology have shown a strong relation between mental wellbeing and a maladaptive goal-setting behaviour called goal linking or conditional goal setting. The linking theory proposes that individuals who use inappropriate strategies to set and pursue life goals are vulnerable to depression. Linkers are individuals who believe that the path to a higher-order goal, such as happiness, is available only through the achievement of lower-order tangible goals, such as winning a race, event, or championship. Ironically, goal linkers can display what might seem to some as contradictory outcomes—that of being highly successful yet still depressed. Essentially, goal-linkers set challenging lower-order goals and work hard to achieve them, only to habituate quickly to their new found success without achieving the higher-order goal of happiness and contentment. Repetitive striving for seemingly unattainable outcomes is often associated with the notion of athletic burnout.
Kerry Mummery explains that "Depression will affect performance and that the issue of depression in this population should, therefore, be taken seriously by the research community" - Picture by www.zeit.de

Kerry Mummery explains that “Depression will affect performance and that the issue of depression in this population should, therefore, be taken seriously by the research community” – Picture by www.zeit.de

 

 

Depression and depressive symptoms in athletes might be related to high volumes and intensities of training, to maladaptive cognitions in relation to sport and competition, or to a combination of both. To understand and address the issues that underlie depression and depressive symptoms in athletes, therefore, the relative contribution made by the amount of training and the mind-set of the participant needs to be established. Psychosocial issues, relating to burnout and depression, require a different form of attention and treatment than do mood disturbances caused by physical overload or exhaustion. Several professional issues affect the availability of treatment for the sportsperson with depression. People skilled in the educative aspects, but not the clinical aspects, of sport psychology and performance often provide sport-psychology services to teams or competitors. In Australia there has been much discussion at the various institutes of sport about the role of the sport psychologist to try to identify whether their function is to enhance performance through novel and cutting-edge techniques or to provide support and service to the athletic population in terms of optimum mental health and wellbeing. Some think that psychological problems, such as major depression, are best left to clinical psychologists and psychiatrists. But there is a notable absence of psychiatrists with any specific expertise about the athletic population. Irrespective of whom an athlete should turn to, the facts remain that any level of depression will affect performance and that the issue of depression in this population should, therefore, be taken seriously by the research community.

 

 

A former national-level professional swimming coach in his native Canada, Kerry Mummery now teaches sport and exercise psychology at Central Queensland University while researching in the area of physical activity, health, and wellbeing. Kerry is Editor of Sport Health.

 

 

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