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. Transition2. Stresses - relation3. 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 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