For Pro Athletes and Vets, Denial is Still the Norm for Depression

The common reaction is usually laughter, followed by a certain sense of 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.

The guys will look at each other and laugh about it, thinking the pro athlete being portrayed is trying to get over on the media or the general public. It never seems to occur to them that what the athlete is going through is real—very real.

“It’s the way I used to feel,” said Taylor Buchholz, a pitcher for the New York Mets and a graduate of Springfield High in Delaware County. “You see these guys all of 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.”

“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,” 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.

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.

Studies show that persons between the ages of 45-64, women, African-Americans, Hispanics, persons with less than a high school education, the unemployed and persons without health insurance coverage tend to be most depressed.

The Disabled List

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

 “Growing up 15, 20 years ago, you maybe knew one or maybe two people who were seeing a psychologist," said Sacks, a Merion Station native. “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.

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

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

“Those are the extreme cases,” said Sacks, who also works for CAPE, the Center for Athletic Performance and Enhancement. “Depression is a sign. ... 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.”

Seeing 'The Wizard'

It’s incompatible with the blown-up images we have of pro athletes today, Sacks said. “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 advice for a depressed athlete or combat veteran was “to walk if off.” Peer pressure plays a role, which Sacks has witnessed in veterans and active-duty soldiers, when a soldier’s name comes up in reference in dealing with any military psychology. The saying, “He’s going to see the wizard” is typically used.

“It’s more amplified with men’s health,” Sacks explained. “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.”

One of the ways to treat depression, according to Sacks, is “behavioral activation”—something as simple as getting someone out of bed in the morning and walking. It’s a start, intended to trigger a response.

One of the most effective ways of treating depression, according to Sacks, is with a combination of anti-depressant medication and cognitive behavioral therapy (CBT). CBT provides the individual with tools to help actively cope with symptoms. Recent studies agree that CBT is at least as effective as medication alone, and several studies suggest that CBT helps people maintain their treatment gains more then medication treatment alone does. Sacks cites clinical studies showing a 30 percent relapse rate for cognitive-behavioral therapy, as opposed to a 60 percent chance of with medication alone.

“It takes courage to come in and sit down and put their face in front of a doctor,” Sacks 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. I don’t know Taylor Buchholz’s personal situation so I can’t comment on him individually.”

But Sacks said Taylor's decision to be open about having a problem, and then getting the help he needed, flew in the face of an older, slowly dying mentality that “a real man doesn’t have to ask” for help.

“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.”