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When Does an Elite Athlete Need Mental Health Treatment?

0 2 years ago

Many athletes get the “jitters” — a feeling of anxiety — just prior to competing. For elite athletes, whether they’re participating in an individual event or as part of a team, whether on a track, court, rink, or field, this feeling can affect performance. It is a well-known, and not unexpected, phenomenon that comes with the territory. Nevertheless, specialists should keep a lookout for signs of more severe mental disorders — ones that may show up in other areas of the person’s life. These disorders may call for targeted psychotherapeutic treatment or the prescription of psychotropic drugs. This is the guidance put forth by session panelists at the Argentine Psychiatric Association’s XXXV Argentine Congress of Psychiatry (APSA 2022), which was held at the seaside resort town of Mar del Plata from April 27 to 30.

Ivanna Meloni Cafarelli, MD, a psychiatrist at Pirovano Hospital in Buenos Aires and a member of APSA’s anxiety disorders section, often works with athletes. “It’s usually said that elite athletes are not especially prone to developing depression, because all that exercise releases endorphins and neurotransmitters, like serotonin, which inhibit feelings of sadness,” she said. “But we also know that physical activity has positive effects on patients with anxiety disorders. And everyone’s allowed to have a moment, a crisis. We’ve seen this even in record-breaking Olympic athletes.”

Meloni Cafarelli told Medscape Spanish Edition that some mental health professionals who don’t work with athletes end up saying, “How could Messi and other top athletes get depressed? They’ve got all those endorphins going, they’re rich, they’re famous.”

Her answer? “It’s just not that straightforward. It’s not that simple. When someone is in the throes of anxiety or depression, there are more factors at play than just chemical imbalances. And we should never rule out family history or genetics. A psychiatric condition that has a significant genetic component — for example, schizophrenia, bipolar disorder, obsessive-compulsive disorder, an addictive disorder — this always has to be taken into account when we see athletes with symptoms that make us suspect that there’s something more going on. These are red flags that have to be looked into and evaluated — not so that we can slap on a label or diagnosis but so that we can be more attentive to the symptoms’ evolution.”

Preparing Mind and Body

Meloni Cafarelli mentioned that since the early 2000s, advances in neuroscience and sports psychology have been reinforcing the view that, when it comes to athletes, their mind and their body need to be prepared to improve performance.


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