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Alicia Romeo, M.D. Headshot

When Failure Is Not an Option, the Real Battle Is Off the Field

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Every professional athlete is his/her own brand, and we judge every brand differently. We like to view our athletes through a super-human lens, as if by virtue of athletic success they are somehow immune to depression and other mood disorders. Professional athletes are as susceptible to mental illness as the fans watching from home. But in an "all or nothing" culture where weakness is anything short of the extraordinary, how does an athlete handle mental illness? If an introverted Marshawn Lynch can cause a media frenzy, what are athletes (their brand) to do if they're struggling with real issues?

To the everyday sports fan, admirers of the elite athlete, it doesn't get better than a Super Bowl followed by the Olympic Games. As spectators, we'll sit in front of our TVs or in the stands, dreaming of what it would be like to perform at such a high level, physically. Not for a moment will we consider the possibility that our high-performing idols and role models might be one of the six in 100 people in any given year that meet diagnostic criteria for depression.

As an audience, we have been slow to accept the humanity in our seemingly super-human athletes. Information about the number of athletes suffering from depression and mental illness trickles slowly into the mainstream. They are our heroes, yet we are so quick to dismiss or gawk, if they step out of the spotlight and ask for help or, worse, they don't ask for help and eventually harm themselves or those around them.

With the Super Bowl upon us, I can't help but remember the story of Barret Robbins. The Raiders' offensive lineman drove to Mexico in the middle of the night and missed the Super Bowl due to bipolar disorder. Jovan Belcher took the life of his girlfriend before driving to the Chiefs stadium parking lot to take his own life in front of his coach. Ricky Williams suffered from social anxiety disorder and eventually left the NFL. Gladiator-like athletes like Oscar de la Hoya have spoken openly about depression, spiraling into drugs and alcohol.

No athletic organization -- NFL, MLB, NHL, NBA, NCAA or Olympic Games -- has been spared the tale. Elite athletes ascended to the pinnacle of their professions yet some did not have avenues to support their mental health. An unlikely champion of mental health advocacy has been Ron Artest, also known as Metta World Peace, who famously thanked his psychiatrist following game seven of the 2010 NBA finals.

Depression is the cause of more than two-thirds of the 30,000 reported suicides in the United States each year. Depression is a condition that affects one in 10 Americans. More than 80 percent of the people who have symptoms of clinical depression are not receiving treatment. Depression does not discriminate. A high profile career with riches or celebrity cannot make an individual immune to mental health issues. There must be a culture shift in the world of professional athletics. The veil must be lifted; sweeping problems under the rug is simply inadequate.

Just like a torn ACL, an untreated mental illness can prematurely end athletic careers. And, unlike a ligamentous injury, an untreated mental illness can be fatal. At every level, from high school to elite athletics, a better understanding of the psychological stress on athletes is worth a closer look. In particular, recreational drug use, changes in athletic performance, energy, mood and sleep can be warning signs to coaches, trainers and teammates. Understanding and recognizing warning signs of depression and other mood disorders can lead to appropriate treatment that may save a career and a life.

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