Fluctuating emotions in sport must not cloud mental diagnosis

Anybody who spent time at the Sporting Chance clinic will understand the significance of mental health in sport. When I visited the small cottage in rural Hampshire in 2011, Peter Kay, the former leader of the charity (who tragically died in 2013), had spent the morning counselling a footballer with severe depression.

"There is a common presumption that money and fame act as armour against problems, but they don't," Kay said. "Top sportsmen are just as prone to mental illness, anxiety, and just as prone to turn to drugs or drink as a route out of desperation."

The recent sectioning (compulsory commitment to psychiatric care) of Aaron Lennon, a wonderfully expressive winger, brought Kay's comments into sharp relief.

The stature of elite athletes, so often mythologised as supermen and women, can make it difficult to admit to vulnerability.

"They are worried about being labelled soft or weak," Kay said.

"They worry it will undermine their standing in the club, or that they will be targeted by opposition fans. That is why so many suffer in silence."

Don't we hear this testimony from Olympians, footballers and other elite athletes? They have lived with an ambition for so long, nurtured it so closely that, when they achieve it, they experience a gaping hole.

But this is not a syndrome. It is being human. To position such feelings as problems requiring medical intervention undermines a sense of personal agency.

Instead of mustering the courage to alter one's circumstances, it is all too easy to acquiesce in the notion that one is the victim of an inner pathology, perhaps in the brain.

"Too many people have come to view themselves as defective and powerless to change their life situations," the psychiatrist Vivek Datta has said. "Conversely, individual treatment with drugs or psychotherapy may cause individuals to reframe their problems in terms of neurochemistry or thinking styles - internalising a belief that they are the problem."

Football must confront this paradox head-on if it is going to safeguard elite athletes.

"I have met players who are on their knees, grappling with addiction or depression," said Kay.

"Many take far too long to reach out for help. But there is a difference between depression and sadness. We live in a society with under-reporting and over-diagnosis. That is why we need to get the balance right."

One positive statistic is that more players are coming forward to seek help. Last year, 160 members contacted the PFA (Professional Footballers' Association), resulting in 655 face-to-face sessions with counsellors.

But it would be misleading to claim that footballers are more "at risk" than other comparable groups, for this would create its own consequences.

Support must be given to those in need, but the game must also guard against turning players who are experiencing the normal rough and tumble of professional sport into victims.

The game has a duty to provide the best care for those, such as Lennon, who are in genuine need. This is a point that has been made forcefully by Clarke Carlisle, a former chairman of the PFA who himself attempted suicide.

The evidence is clear that for those with serious conditions, therapy, drugs, or both, can be life-transforming, which is why advocates like Carlisle are so important in a culture where the topic remains sensitive.

But the game must guard against the inflationary tendencies that we see in wider society, and which it is so easy to sleepwalk towards.

With prescriptions for antidepressants still rising by 7 per cent a year (in Britain), we should be worried. Medical intervention is crucial for those at risk, but it must not be allowed to stray towards the ever-receding horizon of over-diagnosis.


A version of this article appeared in the print edition of The Straits Times on May 09, 2017, with the headline 'Fluctuating emotions in sport must not cloud mental diagnosis'. Print Edition | Subscribe