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REGISTER Representing the interest of 14 IPA’s, throughout South Africa

Sport & Mental Illness

Springboks, Bulls, Cheetahs, Lions… If you’re proudly South African you’ll know this is not a list of animals, but of rugby teams. South Africa’s rugby culture has elevated the sport to epic proportions, with stats available on every play and player in history. Something less available however, is the impact of every ruck and spear tackle. More and more evidence has surfaced in recent years drawing a link between contact sports like rugby, and mental illness.

Possible Causes

Mental illness can exist prior to brain injury, but studies have shown that repeated injuries to the brain can lead to mental illness in cases where none existed before. Causes have been attributed to the brain changing in structure and chemistry due to recurrent injuries. Zachary Y Kerr, et al. (2014) conducted a study that found an increased rate of severe depression among former professional sportsmen who experienced previous concussions while playing. Environmental and social factors also influence mental health, when a player is recovering from brain injury. Lack of a support system, adequate mental health care, and adjusting to life after the injury can all lead to the development of mental illness.

What Happens to the Brain?

It is believed that when players take hit regularly in high contact sports like rugby, football, soccer, and ice hockey, they unwittingly change the structure and function of their brains. Inflammation of the brain is known to lead to degenerative brain disorders and other forms of mental illness, like anxiety and depression. Repeated injuries to the brain, as with the recurrent concussions in Kerr’s study, affects the connective fibers within the brain. These are responsible for the way different areas of the brain communicates with each other, and once compromised, leads to reduced communication and function. People with this kind of condition will usually experience problems with motor function and vision.

Proof in the Numbers

Although observations have focused mainly on former professional athletes, and not on current sportspeople in high contact sports, the results are significant enough to pay attention to. The rate of severe depression is more than double among people who were involved in high contact sports like rugby, than with those involved in light- or no-contact sports like volleyball. With millions of sports-related head injuries being reported around the world annually, the number of people prone to developing mental illness is greatly impacted.

In many cases, these people show symptoms of both brain injury and mental illness – what is referred to as a dual diagnosis. About 42% of people with mental illness are dual diagnosis candidates, where their mental illness developed after they suffered a brain injury, or inversely, a brain injury was sustained due to mental illness. This happens when people with mental illness play high contact sports, but have impaired cognitive abilities, reaction times, etc.

What to do if You are Affected

Identifying the signs of mental illness can be difficult because symptoms are often so closely related to those of brain injury. However, a decline in the ability to perform everyday tasks, inability to cope with everyday stress, and an increase in behavioural issues, like anger and aggression are all red flags that require further investigation.
br>Living with the effects of both a brain injury and mental illness can be debilitating if proper care and management isn’t introduced. The most important first step is to seek an assessment from a specialist. Because the disciplines of brain injury and mental illness are very rarely treated as a whole, it’s best to work with a mental health professional with expertise in neuropsychiatry. Often patients are ushered between two points of treatment when they should have access to an integrated approach.

More than just Head Injuries

Head injuries aren’t the only kind that can lead to mental illness. A sportsperson’s response to injury – whatever that injury may be – plays a vital role in their mental health. The response is initially an emotional one, where feelings of sadness, anger, and frustration come to the fore. It becomes a psychological response when these emotions are entrenched in the player’s psyche, and problems with self-image, sleep, and depression will be prevalent.
br>The individual’s predisposition to mental illness prior to the injury and their level of support after the injury are major factors influencing the onset of problems with mental health. Other aspects to consider include the nature of the injury itself – serious injuries can end careers, and the level of coaching and medical care available to the player. The team’s medical staff should be appropriately trained in the emotional and psychological responses to injury, and take them into account when considering the player’s fitness to return to the game. When psychological symptoms are problematic in that they impair the player’s ability to perform, and present a risk to the player’s wellbeing, professional help should be recommended and made available. Severe depression can easily lead to suicide when not managed properly, and in sportspeople this consequence is too often a reality.

Getting Treatment

Professional athletes are celebrities in their own right. Their reputation is therefore worth more than they are in many instances. The stigma surrounding mental illness as a sign of weakness impacts sportspeople on this level, because seeking help would make them feel weak and unworthy of their status as a pro. Although the staff made available to the team covers a wide array of health specialists, mental health is very often overlooked because of this stigma, but also because athletes may seem physically strong and healthy. As a result, this area of a player’s life is neglected and doesn’t receive the attention it should, especially post-injury. It is important to change the discourse related to mental illness in sport, equipping team doctors with the tools they need to identify the signs and action the appropriate interventions. If you think you may need help, you can complete the free basic assessment on our website and one of our mental health professionals will contact you.

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