Depression is a life threatening and disabling mental
health disorder comprising disturbed affective,
cognitive, and physiological components. The most
common type of depression is major depressive disorder
that is typically diagnosed on the basis of structured
clinical interviews through internationally recognized
tools such as the Diagnostic and Statistical Manual
(DSM-V) of the American Psychiatric Association
(American Psychiatric Association, 2013). Based on the
DSM-V, the clinical diagnosis of major depressive disorder
is based upon the following criteria: one of the
two symptoms, low mood or anhedonia (lack of interest
or pleasure) is necessary, in addition to no less than
four of the following symptoms: lack of concentration,
disturbed sleep, disturbed appetite or weight, fatigue,
psychomotor retardation or agitation, feelings of worthlessness,
and persistent thoughts of death or suicide.
The symptoms should be present for at least 2 weeks,
and cause impaired functioning.
Although no firm conclusions can be drawn at this
stage, the prevalence of increased scores of depression
among current or retired athletes seems to be ranging
from 15% to 35% showing no differences in comparison
to general population controls. Further, similarly to the
general population, females rather than males are more
likely to suffer from depression in athletic populations.
However, athletes show a number of unique risk factors
for depression in comparison to the general population.
Among current athletes, these factors are related to sport
performance, including unfulfilled expectations, fear of
failure, physical strain, injuries, and overtraining syndrome.
Among former athletes, self-reported concussions,
involuntary retirement, or high athletic identity at
the time of retirement appear to be associated with the
incidence of depression. However, depressed athletes are
typically underusing mental health services due to social
stigma concerns or time constraints. Increased treatment
needs, in particular, are seen in athletes from individual
sports attributable to their higher depressive severity
compared to peers from team sports. Similarly, younger
athletes, under the age of 21, mirror increased treatment
needs as they are affected by depression more frequently
in comparison to their peers aged higher than 21. Apart
from classical antidepressant treatment forms (psychotherapy,
medication, etc.), modification of individual or
social interplaying features with the relationship between
depression and sport participation may alleviate depression.
Individual features include negative self-criticism
or lack of coping skills about sport performance, no
insight about depressed thoughts and feelings, and building
up unrealistic public image (e.g., mental toughness).
Social features include unsupportive or suppressing
social networks in relationship to sport participation,
such as funding agents, family members, teammates or
coaches.
More systematic research is needed to provide robust
findings in terms of the prevalence of various types of depression and the identification of modifiable moderators
or mediators. To this extent, preventive strategies
and treatment effectiveness will be facilitated.
