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Prisoners Of Depression Mental illness still carries a powerful stigma in pro sports, but there are signs that teams are finally facing the problem and trying to help troubled athletes

Sept. 08, 2003
Sept. 08, 2003

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Sept. 8, 2003

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Sports Illustrated Bonus Section: Si Adventure

Prisoners Of Depression Mental illness still carries a powerful stigma in pro sports, but there are signs that teams are finally facing the problem and trying to help troubled athletes

He came roaring down the mountain at nearly 85 miles an hour, a
blur in an aerodynamic Lycra suit. Headfirst on a sled barely
bigger than a cafeteria tray, Jim Shea was inches from rock-hard
ice, handling serpentine turns without the benefit of either
brakes or a steering wheel. The running joke is that Shea's
exhilarating sport, skeleton, got its name for a good reason: One
imprecise maneuver and he could be turned into a bag of broken
bones. It was the winter of 1999, and when Shea rounded the final
curve on his last heat .57 of a second ahead of the next-fastest
guy, he was suddenly a world champion.

This is an article from the Sept. 8, 2003 issue Original Layout

When coaches and teammates mobbed him on that cold afternoon in
Altenberg, Germany, it was as clear as the mountain air that
Shea, after thousands of hours spent training and traveling,
had reached the pinnacle of his sport. His spot on the U.S.
2002 Winter Olympic team was all but guaranteed. And Shea felt
... nothing. "It was total emptiness, like I didn't even care,"
he recalls. "The joy of winning? I could have broken a world
record and won the lottery on the same day and not been happy
about it."

The clinical term for this, he later learned, is anhedonia, and
Shea relies on weather analogies--"fog," "dark clouds" and
persistent "gloom"--to describe the feeling. Still, at the time,
Shea found nothing unusual about his lack of emotion in the face
of what was, by any measure, a triumph worthy of unbridled joy.
Shea's grandfather Jack was a speed skating pioneer who won two
gold medals at the 1932 Olympics. His father, Jim Sr., competed
in the 1964 Games in Nordic combined and cross-country. The men
in the Shea family were quiet, tough, bootstrapping types who
lived by a Spartan code of stoicism and self-reliance. Emotions
were best left bottled up. An uncle's suicide, for instance, was
not on the table for discussion. Since Jim had been in elementary
school, he'd known there was something preventing him from
experiencing emotional crests, an immovable force that kept him
mired in lows longer than any of his friends. "But I figured
those were the cards I was dealt," he says. "For me it was
normal."

A U.S. Olympic Committee psychologist at the training center near
San Diego thought otherwise and referred Shea to a local
psychiatrist, Michael Lardon, who had worked with dozens of elite
athletes. After one session Lardon ran through a checklist of
symptoms--persistent sadness, feelings of emptiness, the
inability to extract joy from pursuits that should be
pleasurable, irregular appetite and sleep patterns, decreased
energy--and noted how many applied to Shea. "Jim, listen," the
doctor said, "I think you suffer from depression." Shea's
reaction was typical of people like him. Me? Depressed? How could
that be? I'm an athlete.

It is an invisible incubus that will haunt 19 million Americans
this year. One in six people will be affected by it in their
lifetimes. It accounts for countless sick days and costs U.S.
industry $44 billion annually in medical expenses and lost
productivity. Depression is an equal-opportunity affliction, not
discriminating according to class or social standing. Among the
millions affected: Barbara Bush, Halle Berry and Winston
Churchill, who called his depression "my black dog," a companion
that seldom left his side.

The list of athletes who suffer from depression, bipolar disorder
or social anxiety disorder--three of the most common forms of
mental illness--would make for a hell of a table at a charity
dinner. Ricky Williams, the NFL's 2002 rushing leader, suffered
such overwhelming social anxiety that he couldn't bring himself
to leave his house to mail a letter. Terry Bradshaw, the star
quarterback and irrepressible NFL broadcaster, was once so
depressed that he would go to bed crying. On the eve of last
January's Super Bowl, Oakland Raiders center Barret Robbins
neglected to take medication to treat his bipolar disorder, went
on a Tijuana drinking jag, considered committing suicide and was
in a hospital during what should have been the biggest game of
his career. Mike Tyson was in the clutches of depression long
before he turned into a pitiable sideshow.

And those are among the few who have come to the public's
attention. Innumerable other athletes are familiar with the Via
Dolorosa traveled by the PGA golfer who contemplated suicide last
summer after failing to make the cut at the Greater Hartford
Open. Or the top pick in a recent major league draft whose deep
melancholy has forced him to take an indefinite leave from
baseball. Or the former NBA All-Star whose decline is widely
attributed to alcoholism but who actually suffers from crippling
depression. "An amazing number of athletes have these illnesses,"
says Lardon. "It's way more than you'd ever guess. I mean way
more."

But in a culture suffused with testosterone and seldom
characterized as either sensitive or progressive, mental illness
remains largely stigmatized--and, not surprisingly, largely
undiagnosed. "Blow out your knee, get into trouble with the law,
fail a drug test, and the team will help you back," says Russ
Johnson, a former Tampa Bay Devil Rays infielder whose depression
was diagnosed last year and who now plays for the Mets' Triple A
affiliate. "Suffer a mental or emotional injury, and it's a big
mark against you."

In the U.S. more than twice as many women as men suffer from
depression. Since there is little evidence that brain chemistry
is markedly different between genders, many believe that women
are simply more attuned to their emotions and more likely to seek
treatment. Anecdotally--no statistics are kept on how many
athletes suffer from or seek treatment for depression--the sports
world seems to mirror society at large. Though the majority of
professional athletes are men, some of the most high-profile
jocks to speak openly about their struggles with depression have
been women. Julie Krone, the Hall of Fame jockey, was so up-front
about her battle with depression that she landed an endorsement
deal with Pfizer, the maker of Zoloft. In her autobiography,
Picabo: Nothing to Hide, gold medal skier Picabo Street wrote
about the depression she endured while rehabbing from a gruesome
knee injury. Los Angeles Sparks point guard Nikki Teasley, the
MVP of this summer's WNBA All-Star Game, says of her depression,
"It's part of who I am."

But for half a century, since baseball player Jimmy Piersall
achieved notoriety after suffering a nervous breakdown, the
sports world has remained largely in the dark on matters of
mental health. "If you go into a locker room, there's no faster
way to alienate yourself than by saying the word psychology,"
says John Murray, a Miami-based clinical psychologist who treats
athletes. "It's definitely a taboo, and we can only speculate
why."

Perhaps it's because males in general (and alpha males in
particular) are much less likely than women to acknowledge their
mental illness. Perhaps it's because of the enduring
misconception that mental illness somehow indicates inner
weakness--a sentiment that, according to the National Mental
Health Association, is particularly common in the
African-American community, from which a disproportionate number
of athletes hail. Or perhaps it's because mental illness, unlike
a broken bone or a torn rotator cuff, doesn't readily appear on
an X-ray or an MRI.

The abiding irony is that athletes--our indestructible
gladiators, our iron-clad warriors--might be more prone to mental
illness than the population at large. "Athletes are so
paradoxical because physically they are so much healthier than
the average person," says Murray, "but from the clinical side of
things, they are very much an at-risk population." Among the
reasons why:

--STRESS After heredity, the biggest risk factor for depression
is stress. Performing in front of thousands of fans, having your
work scrutinized and judged regularly, laboring in a field where
success and failure are so clear-cut--all that 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. The stress can be equally intense in the less prominent
sports. An athlete such as Shea might not perform nightly in
front of multitudes, but he spent four years preparing for a
single event. "I knew, one mistake and it was over," he says.
"That's a lot to bear." Not for nothing does the USOC have a
phalanx of full-time psychologists on staff.

--LIFESTYLE Social stability and a solid home life improve mental
health. And athletes, regardless of the sport, live out of a
suitcase for months on end.

--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.)
The sports world is awash with athletes who have endured
circumstances that are deeply abject. "Think of how many athletes
you read about who grew up in terrible poverty, or had relatives
who were murdered, or don't know their dads," says Joe Schrank, a
former practice-squad defensive tackle at USC who is pursuing a
master's degree in social work with an emphasis on clinical
issues associated with athletes. "It's off the charts." For
instance, Leon Smith, a former Chicago hoops star, was raised in
a world inconceivable to most of us. A ward of the state, he was
shuttled among group homes, and he talks of having slept in cars.
In 1999, after he was drafted out of high school by the San
Antonio Spurs and immediately traded to the Dallas Mavericks, he
suffered a breakdown that doctors say was caused by depression.
After slathering green paint on his face, he threw a rock at a
car, then swallowed 250 aspirins in an apparent suicide attempt.
Smith never played for Dallas and most recently appeared in the
L.A. Pro Summer League, more than a long jump shot from the NBA.

--HEAD INJURIES Athletes are at a far greater risk than the
general population to suffer cranial injuries, which can alter
brain chemistry. Studies show that someone who has endured
multiple concussions is up to four times more likely to suffer
depression. Not surprisingly, anecdotal evidence suggests that
depression is common in hockey, a sport in which there are nearly
as many concussions as dislodged teeth. This off-season alone,
two professional players have committed suicide. Pat LaFontaine,
the former NHL All-Star, suffered a nasty concussion in 1996, and
virtually overnight, hockey lost all significance to him. Team
doctors puzzled over his lack of passion. Only after a trip to
the Mayo Clinic was his condition diagnosed as depression, the
result of postconcussion syndrome.

What about the notion that the incidence of mental illness in
sports should be lower because the weak have been winnowed out?
Wouldn't anyone battling an incapacitating case of depression
simply fail to make it to an elite level? Not necessarily.
"Depression often doesn't kick in till someone hits his early or
mid-20s," says Dennis Charney, chief of the Mood and Anxiety
Disorders Research Program at the National Institute of Mental
Health. "So you could grow up fine, then have your [onset] once
you've made it to the pros."

Take Bradshaw, who led four Pittsburgh Steelers teams to Super
Bowl titles and won the NFL's MVP Award in 1978. He was the
picture of calm on the field, but when the game ended, he would
hemorrhage sweat and dissolve into tears. "People say, 'You
couldn't have been depressed--I saw you throw for all those
touchdowns,'" says Bradshaw. "Shoot, the football was the easy
part. I could concentrate for three hours, and the games were an
escape. It was the rest of my life that was going to hell in a
handbasket." Despite a jovial public persona that splinters the
stereotype of how someone who's depressed acts, Bradshaw grew
more melancholy after retiring from football. Finally he sought
help. After going to counseling and taking Paxil (an
antidepressant he is now paid to endorse), he stopped
experiencing the inexplicable lows. "And the rest," he says,
commencing his familiar cackle, "is history, baby."

Although it's commonly thought that physical activity and the
pursuit of goals have a salutary effect on mental health, those
alone don't necessarily reduce athletes' risks. While exercise in
conjunction with therapy and medication can help elevate mood,
alone it is no match for depression. "Anyone who has had
depression will tell you, it's not the kind of thing where you
can go for a run and suddenly feel all better," says Charney.
"That's a big misconception."

Athletes also have at their disposal a raft of handlers,
apologists and other sycophants who help excuse behavior that
would otherwise seem pathological. Consider Ricky Williams, who
struggled for years with social anxiety disorder before finally
seeking successful treatment. When he was a high school football
star in San Diego, he sensed that he was "wired differently" from
classmates. He would recoil from social situations, even from
speaking in class. He believes that because he was a football
star, his extreme introversion was shrugged off as behavior
typical of a coddled athlete. "It was always, 'Oh, Ricky's just
aloof,' or 'Ricky's moody,' or 'Ricky's arrogant,' when it was
really so much more," he says.

As Williams developed a national profile at the University of
Texas, he turned further inward. As his anxiety worsened, he
enlisted what he wryly calls "a support system" to run
interference. "If I didn't want to honor an obligation," he says,
"I knew someone would cover me. If I didn't want to do something,
they said, 'Don't do it.'" Boosters, for example, would be
waiting to meet Williams only to have an athletic department
flack explain that Williams's car had broken down, or that he was
sick, or that his mom was sick. "A lot of people made it easy for
me to hide," he says.

By the time he had won the 1998 Heisman Trophy and been drafted
by the New Orleans Saints, Williams's social anxiety had
intensified to the point that he would conduct interviews without
removing his helmet. He would seldom make eye contact--much less
speak--with teammates unless absolutely necessary. He would
quickly leave practice and head to the Burger King drive-through,
only to realize that he'd have to interact with someone to place
an order. So he'd head home and spend the rest of the day in
seclusion. "At practice my teammates would be like, 'Hey, what
did you do last night?'" he says. "I'm thinking, I went from the
living room to the office to the bedroom."

During a disappointing second NFL season--exacerbated by a
risible performance-based contract--Williams broke his ankle. His
recovery was treated by the team as a matter of vital importance.
Trainers and rehab specialists oversaw his every move and asked
for near-daily updates on his condition. Williams marveled that
while his bum ankle was getting all the attention, his wounded
psyche was going unnoticed. "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 O.K. When it's a
broken soul, it's like a weakness."

Finally Williams decided to get help. He tooled around the
Internet trying to diagnose his symptoms and confided in the
mother of a childhood friend. Together, they concluded that he
suffered from social phobia, or social anxiety disorder. He went
to see a therapist, who confirmed the diagnosis. Williams
approached the Saints' coach, Jim Haslett, to explain that he was
seeking treatment for a psychological issue. Williams says that
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.)

Williams's story nevertheless took a happy turn. With the help of
psychotherapy sessions (which included going to malls and other
crowded public spaces) and a daily dose of Paxil, he grew
increasingly comfortable in social situations, so much so that he
agreed to be a spokesman for GlaxoSmithKline, the maker of Paxil.
In the 2002 off-season Williams was traded to the Miami Dolphins,
and the new environment is serving him well. With no funny looks
from teammates and with a franchise that has more than a passing
familiarity with mental illness--in 1999, Dolphins defensive
tackle Dimitrius Underwood, affected by bipolar disorder, took a
knife to his neck--Williams has thrived. Quite apart from his
status as an elite running back, he cuts a genial, confident
figure. "Just going into a mall or walking through the airport
now and not worrying about it, I can't describe how good that
feels," he says. "It's like I got my old self back."

New Orleans fans would be within their rights to wonder if the
league's top rusher wouldn't still be in the Saints' backfield
had the team been more enlightened about Williams's social
phobia. But the Saints' reaction was hardly atypical. "That's how
it is in football," says Bradshaw. "We're supposed to be big,
tough guys. 'You have depression? Shoot, that's not depression.
That's weakness.' That's how the thinking goes."

Take the case of Robbins, who got scant sympathy from his
teammates after he missed the Super Bowl. The memorable postgame
quote from Robbins's linemate Mo Collins spoke volumes: "Whatever
rock he came up from, he can stay there as far as I'm concerned."
Even after Robbins's circumstances came more sharply into focus
and the team was given a crash course in mental illness, players'
statements of support seemed forced at best. "I've heard his
teammates saying things like, 'The ball's in his court,'" says
Bradshaw. "The ball's in his court? The guy's brain chemistry
needed to be regulated. Can you imagine if a diabetic had
suffered from insulin shock and the response was 'Hey, the ball's
in his court'?"

Robbins is uncomfortable talking about both his Super Bowl
weekend episode and his bipolar disorder. During the off-season
he turned down numerous opportunities to speak publicly about his
condition. When groups sought his services in campaigns to raise
awareness and even when pharmaceutical firms offered endorsement
deals, he politely demurred. Profusely apologetic, Robbins
declined a request to be interviewed one-on-one for this story.
"I just want to move on," he said through his agent, Drew
Pittman.

Not that insensitivity toward mental illness is confined to
football. When pitcher Pete Harnisch, then with the New York
Mets, suffered what he later learned was a depressive episode
around Opening Day 1997, he discovered just how clueless teams
can be. First he told Mets manager Bobby Valentine that he had
not slept in five days, and Valentine responded, "Good April
Fools' [joke]." Harnisch then complained to other team personnel,
and according to multiple sources, a trainer offered him
Benadryl, a drug usually administered to counteract allergies, to
help him get some rest. The Mets then speculated that Harnisch
was experiencing severe tobacco withdrawal and then Lyme disease
before concluding that he suffered from depression, an illness
that figured prominently in his family history. Later in the
season Harnisch accused Valentine of, in effect, calling him
"gutless" in front of the team and says he angrily confronted the
manager in the lobby of the team hotel. (Valentine denies having
talked about Harnisch in front of the team.) Valentine told
reporters he was instructed not to address Harnisch's situation
because "I was told by Dr. [Allan] Lans [the Mets' team
psychiatrist at the time] that he might be suicidal." Several
days later Harnisch was traded. (Harnisch was released by the
Cincinnati Reds this season.)

The media are not always helpful in burying stereotypes, either.
When Shayne Corson, an enforcer for the Toronto Maple Leafs,
suffered panic attacks last spring that caused him to leave the
team--and surrender millions of dollars of his salary--midway
through a playoff series, members of the press unsheathed their
daggers. PRIDE HAS BIG PRICE TAG: SHAYNE CORSON'S WALKOUT WILL
COST HIM DEARLY, AND HE KNOWS IT screamed the headline of one
column. Likewise, a thoughtful article on Robbins that recently
ran in the San Jose Mercury News was accompanied by an online
poll asking readers how they would handle him. One of the four
choices presented: Robbins "should be tied up and stoned."

Even teams and leagues with the best intentions often fall short
in their efforts to help athletes. Though sports psychologists
are now in vogue, there's a world of difference between glorified
performance coaches who help athletes "enter the zone" and "reach
peak performance," and psychiatrists or clinical psychologists
trained to diagnose and treat mental illness. While the players'
associations in all four major sports have programs to aid
athletes with mental health issues, those, too, can be
inadequate. When he played for the Seattle SuperSonics, forward
Vin Baker was perpetually melancholy and took the brave step of
acknowledging his depression. He contacted the NBA Players
Association for guidance, and it arranged for counseling sessions
not with a mental health professional but with former players
Dirk Minnifield and Cliff Robinson.

Apart from simply doing the right thing, teams would benefit
financially if they were more attentive to players' mental
health. Just ask the NFL franchise that recently lavished
millions on a high-profile quarterback without, a team source
says, giving him a basic psychiatric evaluation. When the player
acted erratically--behavior subsequently attributed to untreated
bipolar disorder--he was released, and the team swallowed the
bulk of his contract. "We're not nearly as thorough [as we should
be] about mental history," says the general manager of a team in
the NBA's Eastern Conference. "We--and I think we're like most
teams--interview guys and give a personality test [which is not
intended or able to diagnose depression or anxiety disorders],
but we're probably not comprehensive enough. Maybe if we get
burned, that will change."

The wheels of change do turn in sports, however slowly. In
interviews, nine mental health experts who treat athletes
unanimously asserted that disorders of the mind are gradually
shedding their stigma in sports. In some cases the shift in
attitude is merely a matter of semantics. When Murray was doing
his doctoral work, he approached the soccer coach at one
university and asked if he could consult the team on matters of
sports psychology. "He wouldn't even listen to me--I had said the
magic word, psychology," says Murray. "Then I came back a while
later and called what I was doing 'mental coaching,' and he got
all excited." Similarly, Lardon stresses to his athlete-patients
that depression is "an imbalance in brain chemistry," so it is
less abstract and subjective. When appropriate, he shows patients
their brain scans, giving them tangible evidence of a problem,
not unlike an X-ray revealing a cracked rib.

When Lardon diagnosed Shea's depression, the athlete went on the
defensive. "Prove to me that I'm depressed," Shea snapped. But it
was a facade. He was relieved to hear what Lardon told him.
Lardon said that in three out of four cases, depression is
treatable with medication. After some trial and error, they
settled on Effexor XR, which inhibits the reuptake of serotonin
and norepinephrine, neurotransmitters that affect mood. "Right
away," says Shea, "I noticed a big change in achieving general
day-to-day happiness."

The big test came in January 2002. The Salt Lake City Games were
less than three weeks away, and Shea was trying to treat a
nagging injury to his left leg. Late one night he received word
that his 91-year-old grandfather had been killed by a drunken
driver. Lardon knew that such news could plunge Shea back into
depression. He and Shea spoke often in the days before the Games
and were able, as Lardon puts it, "to integrate Granddad's death
in a positive way instead of catastrophizing it." Which is to
say, Shea put a photo of his grandfather in his helmet. During
the Olympics, Jack Shea wouldn't be in the stands, as the family
had planned, but he could ride down the mountain with his
grandson.

The rest became the stuff of Olympic lore. Shea was chosen by his
U.S. teammates to take the Athletes' Oath at the opening
ceremony, just as Jack had done 70 years earlier, and Jim went on
to win the gold by .05 of a second. In one of the enduring images
of the 2002 Games, Shea's first reaction after looking at his
winning time was to pluck Jack's photo from his helmet and,
obscured by falling snow, wave it tearfully. It was as if all the
joy and emotion that he had missed in his first 33 years of life
had suddenly flooded him.

Basking in the afterglow of Olympic victory, Shea figured he had
also defeated his depression, so he stopped taking his Effexor
XR. Literally overnight, his feelings of despondency came
screaming back. He promptly went back on his medication, and now,
before going to bed every night, he pops a small beige capsule.

As Shea prepares for the 2006 Games, he marvels at how different
the experience is this time around. Part of it is his status as
the defending gold medalist. But that pales in comparison to the
change in his mental health. The fog that enshrouded him? It's
lifted. The jock culture that had long considered depression an
earmark of weakness? "Listen, unless you've been there, you have
no idea," Shea says. "Winning a gold medal is the ultimate. But I
wouldn't trade happiness for it. Not in a million years."

COLOR ILLUSTRATION: ILLUSTRATION BY ROB DAYCOLOR PHOTO: AL TIELEMANSCOLOR PHOTO: PETER READ MILLERCOLOR PHOTO: HEINZ KLUETMEIERCOLOR PHOTO: MIKE BLAKE/REUTERS
"Winning a gold medal is the ultimate," Shea says. "But I
wouldn't trade happiness for it. Not in a million years."
"In sports," Williams says, "when it's a broken bone, teams will
do everything in their power to make sure it's O.K. When it's a
broken soul, it's like a weakness."
"Football was the easy part," Bradshaw says. "I could concentrate
for three hours, and the games were an escape. It was the rest of
my life that was going to hell."
Robbins engendered scant sympathy from his teammates after he
missed the Super Bowl. "Whatever rock he came up from," one said,
"he can stay there."