Depression Stigma Endures for Veterans, Pro Athletes

The common reaction is usually laughter, followed by sweeping disbelief. It doesn’t matter if it’s in a Major League clubhouse, NFL, NBA or NHL locker room. Pro athletes like to huddle around a TV, especially if it’s to catch a glimpse of a SportsCenter clip showing another athlete, maybe someone they know, enduring a rough public moment, in tears without any control of their emotions.

Guys will look at each other and laugh about it, maybe thinking the pro athlete portrayed is trying to get over on the media and general public. It tend not to occur to them that what the person is going through could be very real.

“It’s the way I used to feel,” said , a pitcher for the New York Mets and graduate. “You see these guys all the time and everyone in the clubhouse would think they’re making it up, trying to get over. I’ll admit, I used to think that, until it hits you.”

According to the National Institute of Mental Health, 18.8 million American adults (9.5-percent of the population) suffered from depressive disorders in 2010. Of that group, 2-percent of preschoolers are clinically depressed, or one in every fifty preschool student is chronically depressed.

Studies show that persons between the ages of 45-64, women, African-Americans, Hispanics, non-Hispanic persons of other races or multiple races, persons with less than a high school education, those previously married, individuals unable to work or unemployed and persons without health insurance coverage tend to be most depressed.

You won’t find multi-million pro athletes—like Buchholz, nor combat war veterans on that list, but they, too, suffer from depression. The glaring difference today as opposed to the past is that it’s gradually becoming more accepted to admit it in the testosterone-charged, if-you-cry-you’re-a-sissy, insular machismo culture of the military and professional sports.

“I think depression is well-recognized today in the general population, but when you’re talking about the military and pro athletics, it’s coming around much slower than regular society,” said Dr. Matthew Sacks, a 1991 Lower Merion High School graduate who is the staff psychologist for the Malcolm Grow Medical Center at Andrews Air Force Base in Maryland.

“Growing up 15, 20 years ago, you maybe knew one or two people who were seeing a psychologist. The national culture has changed with celebrity obsessions, and psychology has a pretty prominent place in society. What prompts me to speak out about pro athletes and vets is that we still are getting the word out. They’re still coming around when it comes to the debilitating nature of mental health illness.”

Sacks cited blaring newspaper and website headlines constantly filled with players behaving badly. What’s frequently missing is a deeper look into what actually might be going on, he said.

The tragic cases of Andre Waters and Dave Duerson, for example, come to mind. Both were successful, hard-hitting, driven football players. They also suffered from depression and, consequently, both committed suicide after their careers were over.

Last year, 25-year-old LPGA touring golfer Erica Blasberg committed suicide. More recently, 2010 Olympic silver medalist Jeret “Speedy” Peterson, an American freestyle skier, who battled his share of personal demons in his life, died of a self-inflicted gunshot wound on July 25. He was 29 years old.

“Those are the extreme cases,” said Sacks, who also works for CAPE, the Center for Athletic Performance and Enhancement. “Depression is a sign. The difference is you can see physical injuries that get played over and over again, like the Joe Theismann hit, where you can see the physical, debilitating damage. There is no highlight hit on a guy getting depressed; no shot of a guy sitting at home, or in his hotel room getting depressed before he gets to the stadium. It’s incompatible with the blown-up images we have of pro athletes today. Kids want to be like these athletes and the spotlight can be a lonely place. Research with pro athletes is just getting off the ground in terms of depression. You won’t find too many articles with pro athletes dealing with depression.”

In the past, Sacks maintains, the standard type of feedback for a depressed athlete or combat veteran was “to walk if off,” or it often broached peer pressure, like “the guy can’t hack it, he’s soft.”

Sacks has witnessed it in veterans and active-duty soldiers, when a soldier’s name comes up in reference in dealing with any military psychology, a saying “He’s going to see the wizard” is typically used.

“I don’t need convincing that it still goes on; I’ve seen it,” Sacks said. “It’s more amplified with men’s health. Like it or not, there’s still a double-standard and stigma with guys that come out and say they’re depressed. They’re supposed to be these tough guys. General managers are recognizing this. They’re realizing that their $17-million investment might not be right. They’re getting these guys to talk to someone. That’s in their best interest. They’ve been slowly coming to the table.”

One of the ways to treat depression, according to Sacks, is behavioral activation. That could be something as simple as getting someone out of bed in the morning to take a walk. It’s a start, though it’s intended to trigger a response.

One of the most effective ways of treating depression is with a combination of anti-depressant medication and cognitive behavioral therapy (CBT), Sacks said.

CBT provides the individual with tools to help them actively cope with their symptoms. Often times an instruction to get the patient “behaviorally activated” (getting them out of the house to walk or exercise) can help jump-start the treatment and put them on the right path.

Cognitive-behavioral therapy is a form of psychotherapy that emphasizes the important role of thinking in how one feels and what they do. Recent studies agree that CBT is at least as effective as medications alone and several studies suggest that CBT helps people maintain their treatment gains more then medication treatment alone.

Sacks said clinical studies also bear a 30-percent relapse rate for cognitive-behavioral therapy, as opposed to the 60-percent chance of relapse with medication.

“It takes courage to come in and sit down and put their face in front of a doctor, it really is an act of courage,” he said. “It’s so much easier not to pick up the phone, to pretend and go along and be just one of the guys. That takes guts to do what these athletes do in coming forward. Sometimes you need that face-to-face to get it.

“What Taylor [Buchholz] did, in speaking up, was a tremendous act of courage. To be open about having a problem and trying to get help flies in the face of an older, slowly dying mentality that a real man doesn’t have to ask for help. I look at Taylor as someone who has a tremendous of courage. He recognized there was a problem and that was a first step, regardless of whether you’re a professional athlete or a combat veteran. Get into treatment and finish the job; let the patient determine the pace, because you can’t push someone do to something until they’re ready. Like any regular person, a pro baseball player with depression can come back.”