by Dr. Hy Gia Park and Dr. Charles Park
“I struggle more than people know… I remember sitting in my room for four or five days not wanting to be alive, not talking to anybody. That was a struggle for me.”
This is Michael Phelps, the most decorated Olympian of all time, describing his depression that led him to seek treatment. Athletes, even the most elite that appear superhuman, are not immune to the brain disease we call clinical depression. In fact, studies suggest that the annual occurrence of depression in athletes is similar if not higher than the general population rate of 6.7%.1 It has been estimated that 34% of current elite athletes have anxiety and depression and 26% in former elite athletes.2 In our two previous articles, we present the more updated theory regarding depression being a brain disorder that results from prolonged stress. Athletes experience a substantial amount of stress ranging from training, performance, winning, competition, physical injury, recovery, and retirement (see articles and public response to Andrew Luck). In fact, studies have identified more than 640 distinct stressors that could induce mental health symptoms and disorders during and after a professional or elite sport career. 2
Despite the clear data showing that athletes are susceptible to developing depression, there are numerous barriers to identifying and treating the disease in a timely manner. Stigma continues to be the biggest obstacle. For the athlete, there is fear about the implications regarding their athletic prowess and the subsequent consequences, such as loss of their sports career and financial security, should they disclose they are suffering from a mental health disorder. There is also the failure to understand what depression looks like; what is normal sadness versus true clinical depression. Furthermore, depression arises insidiously as opposed to a broken bone, which is more tangible and easier to identify. Larry Sanders summed it up best when he said, “It’s hard for people in my field to respect mental health. We say that the game is 90 percent mental, but yet mental health doesn’t get the respect of, like, an ACL [knee injury].” The good news is that mental health in elite sports is gaining more publicity in the last few years, whether it be headlines highlighting the tragic deaths of athletes from suicide or substance use or athletes like Michael Phelps and Larry Sanders who have come forward to share their stories. Their courage in showing their humanness is coming at a time when we have better treatments to address this debilitating medical condition.
Depression is a treatable condition, especially with new innovative technologies, like deep transcranial magnetic stimulation (dTMS). dTMS may be a good treatment option for athletes because it focally targets the brain’s prefrontal cortex (PFC), where it is believed that the dysfunction in neuro-chemical and neuro-circuitry of depression lie. Depression is not just someone feeling sad, it is a brain disease that impairs a person’s thinking. For the athlete where executive functions of the PFC like, planning, problem solving, reasoning, working memory (understanding the environment around them), mental flexibility and creativity, focus, and impulse control, is the distinguishing factor between a “good” versus an “elite” player, treating the impaired part of the brain that is debilitated by depression is literally, a make it or break it deal.3 Targeted treatment means fewer side effects that are typically experienced with antidepressant medications and electroconvulsive therapy (ECT), such as weight gain, memory problems, abnormal movements, coordination problems, constipation/diarrhea, vision problems, dry mouth, and headaches. Olympic swimmer Allison Schmitt once said, “Being vulnerable is not weakness. It shows you are strong enough to know that life is sometimes hard for you to handle and you need support.” In next month’s article we will further explore the topic of treatments for depression; why it treatment important, which treatments are backed by scientific evidence and which may potentially be harmful.
References:
– E.M.
"Their entire team is FABULOUS. They have always treated me with dignity and respect. I have watched them with other clients as well and I see their genuine compassion for everyone that walks thru the door. I initially went to them because I moved to CO in late 2017 and they were the first place that had an opening. I needed a psychiatrist to keep me on my Rx. I was surprised when Dr Park spent more than 15 mins going over my past Rx history with me, as has been my experience for many years. Not only did we discuss Rx, he then spent another 45 mins talking to me as a counselor. I had never had a psychiatrist/counselor combo before and was amazed at how effective it is when your Dr hears more about what's going in your life than just the effects of your current Rx. This treatment model is not practiced by someone that doesn't care about his patients. He could offer the basics that most psychiatrists offer and still bill insurance the same amount but he wants his patients to succeed and is invested in their progress. He also doesn't believe in keeping someone in therapy forever. Even if it means less income for him, when you stabilize to the point that you have better things to do than spend 30 mins with him, it's a sign that you may be ready to engage in therapy less often and he will tell you that. Dr Park has been a life and marriage saver for me and he is amazingly efficient. He gets done in 1-2 sessions what would take 6 months for another counselor because he doesn't dance around the issues. To do this, he may be more blunt with you than you might have experienced before and that may be off putting to some. If you are ready to do the hard work to make your life enjoyable again, Dr Park is your man! He also got me hooked up with TMS. If you are someone that has struggled with depression for a long time and taken Rx that hasn't been effective, talk to someone about TMS. It's a game changer. It may sound like hokey fake science. It's not. It works and works fast. THANK YOU!"