Mental Health and the Athlete

Objectives Fatigue/Staleness/Overtraining/Burnout Psychology of Injury and Rehab Mental Illness: Mood Disorders Depression Bipolar disorder Seasonal Affective Disorder Anxiety Disorder Panic Attacks Phobias Obsessive Compulsive Disorder (OCD) Post-traumatic Stress Disorder Attention Deficit Hyperactivity Disorder (ADHD) Performance Enhancement Imaging Self-Talk Relaxation Mental Health Professionals

Mechanism for Fatigue/Depression Poor performance ↓ Frustration Increased effort Increase fatigue Risk Factors for Athletes: 1. Transition 2. Stresses - relation 3. Injury

Psychology of Injury Self-Worth/Athletic ID How does Psychology affect athletes? Initial Injury Assessment Loss of self-ID Decrease self-esteem Isolation Anxiety Helplessness TX:

Psychology of Rehabilitation Secondary Gain Malingering Compliance

Psychological RED FLAG S/S Family Hx Change in sleep patterns Change in cognitive status and function Change in weight/appetite Change in mood Physical exams that don’t make sense

Mood Disorders Depression; 10-20% prevalence Definition Causes: medical vs. other Dx: Must have above definition plus 5 of 7 s/s S/S: Distr. Sleep, unhappy, can’t concentrate, fatigue, suicidal thoughts, weight loss/gain, worthlessness, incr. in medical problems, sudden change in academic/athletic performance, isolation from family/friends

Mood Disorders Depression: cont Tx: Meds: Tricyclic Antidepressants (TCADs) or Selective Seratonin Reuptake Inhibitors (SSRIs) Citalopram (Celexa) Escitalopram (Lexapro) Fluoxetine (Prozac, Prozac Weekly) Paroxetine (Paxil, Paxil CR) Sertraline (Zoloft)

Mood Disorders Bi-polar Disorder: Characterized by sequential periods of major depression and manic episodes that last for 1 week or require hospitalization Associated S/S: Tx:

Mood Disorders Seasonal Affective Disorder Depression that occurs only during particular seasons and is completely resolved during other time frames S/S: Tx:

Anxiety Disorders: Excessive worry that occurs in multiple Anxiety Disorders: Excessive worry that occurs in multiple settings creating difficulty in social functions Panic Attacks: period of intense fear, discomfort or terror accompanied by thoughts of impending doom or loss of control Panic Disorder: defined by recurrent episodes of unexpected panic attacks followed by worry about future attacks S/S: ANXIETY VS. PANIC DISORDER

Anxiety Disorders Phobias: Abnormal fear of a specific object or situation that does not cause anxiety in the average person s/s:

Anxiety Disorders Phobia List

Anxiety Disorders Obsessive Compulsive Disorder (OCD) Definition: recurrent obsessions/compulsions that can be time consuming or cause significant impairment Washing and cleaning Counting Checking Demanding reassurances Repeating actions over and over Arranging and making items appear orderly

Anxiety Disorders Post-Traumatic Stress Disorder Reaction to exposure to life-threatening events or similar stimuli outside of normal life events

Attention Deficit Hyperactivity Disorder ADHD: neuro-behavior condition that impairs a persons ability to sustain attention or control activity and impulses in at least 2 settings Types: Tx:

Performance Enhancements Imagery: Purpose is to rehearse action Technique: Self-talk: Athlete repeats aloud what is ideal Relaxation: 2 Types

Mental Health Professions/Referral 5 Mental Health Disciplines (US gov. recognized) Psychiatry Psychiatric Nursing Psychology Marriage and Family Therapy Social Work Other: Professional counselors Clergy members

Role of ATC Recognize and referral (1st line of defense) Know the professionals in your area Can always start c primary MD

ATC – What can I do Athlete Approaches you: Be Approachable Their approach indicates a need to talk Give TOTAL attention & Listen Ask clarifying questions only, not judgmental Indicate you want to help Ask if there is anything they need Ask - “are you thinking about hurting yourself” Ask – “do you have a plan” Make a referral – knowing your limits