McKinley's apparent suicide casts light on athletes' risk of depression

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You may recall that during his fairly disastrous tenure with the New Orleans Saints, Williams had a habit of answering questions without removing his football helmet. But that wasn't all. After practice, he would leave the locker room and head to the Burger King drive-thru, only to realize that he would have to interact with someone to place an order. So he would head home to spend the rest of the day in seclusion. The phone would ring and he wouldn't pick up. "At practice [the next day] my teammates would be like, 'Hey, what did you do last night?' " Williams recalled. "I'm thinking, I went from the living room to the office to the bedroom."

The team did little to help. Only after tooling around the Internet did Williams self-diagnose himself with social anxiety disorder. He finally massed the courage to confront the Saints' hidebound coach, Jim Haslett. He explained that he was seeking treatment for a psychological issue. According to Williams, Haslett used profanity to tell him, in so many words, "to stop being a baby and just play football." (Haslett did not respond to SI's questions about the incident.)

Around the same time, Williams broke his ankle. The team treated his recovery as a matter of vital importance. Trainers and rehab specialists oversaw his every move and asked for near-daily updates on his condition. Teammates texted him daily. Williams was struck by the contrast. "There's a physical prejudice in sports," he says. "When it's a broken bone, the teams will do everything in their power to make sure it's OK. When it's a broken soul, it's like a weakness."

I recalled this when the news broke that Denver Broncos wide receiver Kenny McKinley was found dead on Monday afternoon in Arapahoe County of an apparent self-inflicted gunshot wound. While the investigation is ongoing and McKinley hasn't been officially linked to depression, one has to wonder if he was depressed, especially after he was placed on injured reserve with a knee injury. (According to the National Institute of Mental Health, the risk factors for suicide include depression and other mental disorders or a substance abuse disorder. More than 90 percent of people who commit suicide have these risk factors.)

To the uninitiated, it makes no sense. Aren't these young, sculpted, famous, rich gladiators antithetical to the whole concept of depression? Aren't pro athletes supposed to be impervious to all manner of pain? Don't they collide violently against each other, and need to be talked out of playing with the kinds of injuries that would incapacitate most of us for weeks?

In the macho, less-than-enlightened Republic of Sports, depression and other mental illnesses are often stigmatized as maladies for the weak. "Gutless" was the term Bobby Valentine, then the Mets manager, allegedly used to describe Pete Harnisch after the pitcher suffered a depressive episode. "Run it off," an NBA coach once told Vin Baker when the player tried to explain his depression. "Don't let the blues get you down!"

"Head case" remains one of the most damning labels in the front office. Sports psychologists know that if they want acceptance among athletes, they're better off re-branding themselves as the less-menacing "performance coaches."

The abiding irony: it's entirely possible that athletes in pro sports -- the ultimate kennel of alpha dogs -- might be MORE prone to mental illness than members of society at large. After hereditary influences, the biggest risk factor for depression is stress. Performing in front of thousands of fans, having your work scrutinized and judged regularly, and laboring in a field where success and failure are so clear-cut can exact a huge psychic toll. There's also the stress of knowing that your career, and thus the window of opportunity to make millions, is narrow. As McKinley's agent, Andrew Bondrarowicz, told the Denver Post: "These guys, they're made of steel on the outside. But for a lot of them, the challenge of being at your best and living up to all the expectations is a difficult situation. Some people are better equipped and have the support system."

Other factors include:

• Head injuries. Studies show that someone who has endured multiple concussions is up to four times more likely to suffer depression. Athletes, of course, are at a far greater risk than the general population to suffer cranial injuries, which can alter brain chemistry. Andre Waters, the Eagles' fearsome defensive back, committed suicide in 2006 at age 43; an autopsy revealed that his brain tissue had degenerated to that befitting a man in his 80s.

Another Philadelphia football player, Owen Thomas, a reserve for Penn, committed suicide in April and was honored posthumously just last weekend. According to researchers, he, too, showed early signs of chronic traumatic encephalopathy.

• Childhood trauma. Researchers know that exposure to trauma at a young age can lead to an increased likelihood of depression and mental illness later in life. (Studies have also shown that growing up in a single-parent household can increase the risk.) Think about how many "athlete narratives" contain almost unimaginably bleak childhood episodes.

Apart from medication and therapy, mental health can be improved by social stability and a solid home life. For all the perks of playing sports for a living, social stability does not rank high on the list. From the road games to the constant possibility of a trade to an all-consuming regular season to the dissonance that accompanies coming into vast sums of wealth overnight, sports are hardly conducive to social stability.

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The wheels of progress tend to turn slowly in sports. But they do rotate. As mental health has become better understood and accepted in the mainstream -- where the National Institute of Mental Health suggests that a quarter of American adults suffer from a diagnosable mental disorder in a given year -- so too are psychological issues beginning to lose some of their stigma in sports. In recent years a welter of athletes in a variety of sports (Jennifer Capriati, Joey Votto, Stephane Richer) have unashamedly admitted to battling mental illness. It was the inimitable Ron Artest who, during his memorable monologue after the NBA Finals, expressed profuse thanks to his psychiatrist.

In this excellent recent article, my colleague Pablo Torre notes that Royals pitcher Zack Greinke is even hailed as the "Jackie Robinson" of mental illness. Greinke missed most of an entire season to address and treat social anxiety disorder and clinical depression. Crediting therapy and anti-depressants, he returned to win the Cy Young Award. "Whether he likes it or not, [Greinke] is the guy who really paved the way for the modern player to come out about these issues," Mike Sweeney, a former teammate, told SI.

Scan the injured reserve or disabled list and, likely for the first time, explanations of "social anxiety" and "stress-related" are among the listed causes. To Ricky Williams' point, athletes now can have a credible reason for missing games even if the malady doesn't appear on an X-Ray or MRI.

In some cases, teams and leagues and even college programs have gone proactive, educating athletes and making psychiatrists, psychologists and mental health experts readily available. In Torre's story, source after source suggested that the culture in sports is, finally, shifting. As it should be. Athletes like Kenny McKinley might appear to be made of steel on the outside. Inside? They're simply as prone to mental illness as the rest of us -- likely more so.