Sports Medicine Handbook - NCAA

78
Depression: Intervention for Intercollegiate Athletics
Available online at NCAA.org/
health-safety.
Depression affects approximately 19
million Americans, and for many,
the symptoms first appear before or
during college.
Early identification and intervention
(referral/treatment) for depression
or other mental illness is extremely
important, yet may be inhibited
within the athletics culture for the
following reasons:
• Physical illness or injury is more
readily measured and treated
within sports medicine, and often
there is less comfort in addressing
mental illness.
• Mental wellness is not always
perceived as necessary for
athletic performance.
• The high profile of studentathletes
may magnify the
attention paid on campus and in
the surrounding community when
an athlete seeks help.
• History and tradition drive
athletics and can stand as barriers
to change.
• The athletics department may
have difficulty associating mental
illness with athletic participation.
Enhancing knowledge
and awareness of
depressive disorders
Sports medicine staff, coaches and
student-athletes should be
knowledgeable about the types of
depression and related symptoms.
Men may be more willing to report
fatigue, irritability, loss of interest in
work or hobbies and sleep
disturbances, rather than feelings of
sadness, worthlessness and
excessive guilt, which are
commonly associated with
depression in women. Men often
mask depression with the use of
alcohol or drugs, or by the socially
acceptable habit of working
excessively long hours.
Types of Depressive
Illness
Depressive illnesses come in
different forms. The following are
general descriptions of the three
most prevalent, though for an
individual the number, severity and
duration of symptoms will vary.
Major Depression, or “clinical
depression,” is manifested by a
combination of symptoms that
interfere with a person’s once
pleasurable activities (school, sport,
sleep, eating, work). Studentathletes
experiencing five or more
symptoms as noted in Table 1 for
two weeks or longer, or noticeable
changes in usual functioning, are
factors that should prompt referral
to the team physician or mental
health professional. Fifteen percent
of people with major depression die
by suicide. The rate of suicide in
men is four times that of women,
though more women attempt it
during their lives.
Dysthymia is a less severe form of
depression that tends to involve
long-term, chronic depressive
symptoms. Although these
symptoms are not disabling, they do
affect the individual’s overall
functioning.
Bipolar Disorder, or “manicdepressive
illness,” involves cycling
mood swings from major depressive
ep i sodes to mania. Depressive ep isodes
may last as little as two
weeks, while manic episodes may
last as little as four days. Manic
signs and symptoms are presented
in Table 2.
In addition to the three types of
depressive disorders, studentathletes
may suffer from an Ad justment
Disorder. Adjustment
disorders occur when an individual
experiences depressive (or anxious)
symp toms in response to a specific
event or stressor (e.g., poor