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Battling Depression and Anxiety

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AP PHOTO/MARK SCHIEFELBEIN

By Dr. Tomi Wahlstrom |

Mood disorders have become quite prevalent among athletes. Recent cases such as Naomi Osaka and Simone Biles only highlight what we have known for a while. Mood disorders are the most common mental illnesses around the world. Out of them, anxiety disorders are the most common and depressive disorders the next common. Ironically, the symptoms of depression often include anxiety so separating these two is difficult. They often go hand in hand. They are both treatable but many struggle with them for a lifetime. Options for treatment include psychotherapy and psychotropic medication. Many do both. Some opt to do neither and find other methods effective. Many have found that exercise, for example, can help. Dietary choices also make a big difference. One can make overall lifestyle choices that can be very beneficial. Athletes may have even chosen sports as a way to exercise and improve their mood. However, competitive sports can be stressful and increase anxiety and depression.

For therapy, there are many different options. There are many different schools of psychology providing different theoretical frameworks. Some approaches work better than others do for some people. Behavioral therapy, for example, aims to change behaviors that may lead to depression and anxiety. Rational-emotive therapy, on the other hand, aims to change one’s rational thinking that lead to depressive emotions or anxiousness. Psychoanalytic approach, involves the analysis of the unconscious and exploration of childhood experiences that may have caused depression or anxiety. There is no consensus within the psychological community on what approach is ultimately the best. It is simply a matter of fit and preference.

Antidepressants and anti-anxiety medications are a complicated topic. For some, they are lifesavers while for others they are an endless rollercoaster. Most antidepressants work by altering the serotonin production in the brain. Psychiatrists also prescribe them to treat anxiety. These medications, called SSRIs or SNRIs, have many side effects that are particularly problematic to athletes. All of them cause weight gain, which can hinder the success of athletes in certain sports. Other side effects like fatigue can also be challenging to deal with. There is one medication, Bupropion, which works by altering dopamine production instead of serotonin. It does not promote weight gain like the serotonin-based alternatives. Use of it can actually result in weight loss. However, it has many other side effects that can be difficult to cope with. These medications do not permanently cure depression or anxiety although there is some support to the idea that relapses are less likely after their use even after one has stopped taking them.

Outside of therapy and medication, many lifestyle changes can help with mood disorders. Avoiding stress and maintaining a lifestyle low in stress is important. However, this may not always be possible to everyone. Life is stressful especially in these days of the pandemic. At the same time, we can control some aspects of our lives. We can make choices on what we eat and drink, and how much we sleep. Avoiding caffeine is important for those suffering from anxiety. Other foods, such as sugars and high fat content foods affect our brain chemistry. Sleeping sufficiently is essential to minimize depression and anxiety. Particularly, one needs to have enough of the REM sleep in order to stay mentally healthy. Alcohol and drugs influence REM sleep cycles and can lead to increased anxiety and depression.

Above are only some of the ways to prevent and minimize anxiety and depression. One could explore many more issues such as the benefit of certain philosophies, including existentialism and stoicism. The way we perceive the world around us influences our mood. As strange as it may sound, excessive use of positive psychology can actually lead to negative emotions. This is because life, essentially, is not always positive. Avoiding negative emotions and acting as if they do not exist is not the solution. However, many people do benefit from a positive outlook and attitude as well as positive affirmations.

Dr. Tomi Wahlstrom is the Provost at the United States Sports Academy.

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