Athletes are not immune to psychiatric issues

Psychiatric illness in sports is rarely discussed openly. The 1956 movie, “Fear Strikes Out” describes the struggle of Boston Red Sox player Jimmy Pearsall, who suffered from depression and anxiety. He eventually required hospitalization for his condition. That film may represent the first public testimonial of mental illness in an athlete.

Recently, former football great Herschel Walker wrote a book about his battle with a condition known as Dissociative Identity Disorder (DID). This is more commonly known as Multiple Personality Disorder. Although this condition has been dramatized in books and movies, it is now often diagnosed in conjunction with other psychiatric disorders. DID is defined as a state where two or more distinct personalities exist in an individual. As in all medical illnesses, there is a range of severity varying from mild to one requiring hospitalization.

DID is typically associated with stress, depression, and anxiety. Symptoms of physical abuse during childhood are a common finding. There are no specific medications to treat DID, but long-term psychotherapy has been successful in many instances.

The fact that athletes experience psychiatric conditions is not surprising. The demands placed on athletes, especially at the professional level, are astounding. They are expected to perform competitively, represent themselves and their team well. Many must also maintain a family life. They must do this while on the road for much of the year, away from family and support systems. It is impressive that psychiatric disorders are not more widespread in sports.

Dr. James O’Dea, Administrative Director of Psychiatric Services at Backus Hospital, agrees that the existence of psychiatric disorders shouldn’t be surprising. “It is crucial for athletes to overcome the stigma of mental illness and seek treatment,” O’Dea said.

Psychiatric disease is probably more common in sports than is at first apparent. This can be dangerous in athletes who are placed under extreme pressure and in hazardous situations. They may have access to narcotic medications due to sports injuries and this is always a troubling combination. Coaches, athletic trainers, and team physicians must carefully monitor athletes’ behaviors and be vigilant for signs of psychiatric illness.

Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital and in private practice at NeuroDiagnostics, LLC, in Norwich. E-mail him at aalessi@wwbh.org. If you wish to learn more about this column or other sports health topics – listen to the podcast, view the video or go to the Healthy Sports blog at www.backushospital.org.