Skip to main content

Major Depressive Disorder and Depressive Symptoms

  • Chapter
  • First Online:
Mental Health Care for Elite Athletes
  • 905 Accesses

Abstract

In professional sport, the mental health of elite athletes is a major concern. Given its high prevalence and the potential for multifaceted and severe consequences, major depressive disorder is one of the greatest concerns with respect to the mental health of elite athletes. The purpose of this chapter is to provide a review of major depressive disorder and depressive symptoms within the elite sport research literature. Along with information on the epidemiology of depressive symptoms, risk and protective factors will also be examined. Strategies to enhance diagnosis, treatment, management, and recovery, including culturally situated mental health literacy, will also be discussed. The chapter will conclude with suggestions for future research and clinical and organizational intervention. Collective action amongst mental health researchers and practitioners, as well as athletes, coaches, staff, and their families, can help drive continual improvements in the prevention and treatment of major depressive disorder and depressive symptoms.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Reardon CL, Hainline B, Miller Aron C, Baron D, Baum AL, Bindra A, et al. Mental health in elite athletes: International Olympic Committee consensus statement. Br J Sports Med. 2019;53(11):667–99. https://doi.org/10.1136/bjsports-2019-100715.

    Article  PubMed  Google Scholar 

  2. Swann C, Moran A, Piggott D. Defining elite Athletes: issues in the study of expert performance in sport psychology. Psychol Sport Exerc. 2015;16(1):3–14. https://doi.org/10.1016/j.psychsport.2014.07.004.

    Article  Google Scholar 

  3. Currie A, Gorczynski P, Rice SM, Purcell R, McAllister-Williams RH, Hitchcock ME, et al. Bipolar and psychotic disorders in elite athletes: a narrative review. Br J Sports Med. 2019;53(12):746–53. https://doi.org/10.1136/bjsports-2019-100685.

    Article  PubMed  Google Scholar 

  4. Golding L, Gillingham RG, Perera NKP. The prevalence of depressive symptoms in high-performance athletes: a systematic review. Phys Sports Med. 2020;48(3):247–58. https://doi.org/10.1080/00913847.2020.1713708.

    Article  Google Scholar 

  5. Gorczynski PF, Coyle M, Gibson K. Depressive symptoms in high-performance athletes and non-athletes: a comparative meta-analysis. Br J Sports Med. 2017;51(18):1348–54. https://doi.org/10.1136/bjsports-2016-096455.

    Article  PubMed  Google Scholar 

  6. Gouttebarge V, Castaldelli-Maia JM, Gorczynski P, Hainline B, Hitchcok M, Kerkhoffs GM, et al. Occurrence of mental health symptoms and disorders in current and former elite athletes: a systematic review and meta-analysis. Br J Sports Med. 2019;53(11):700–6. https://doi.org/10.1136/bjsports-2019-100671.

    Article  PubMed  Google Scholar 

  7. Rice SM, Gwyther K, Santesteban-Echarri O, Baron D, Gorczynski P, Gouttebarge V, et al. Determinants of anxiety in elite athletes: a systematic review and meta-analysis. Br J Sports Med. 2019;53(11):722–30. https://doi.org/10.1136/bjsports-2019-100620.

    Article  PubMed  Google Scholar 

  8. Rice SM, Purcell R, De Silva S, Mawren D, McGorry PD, Parker AG. The mental health of elite Athletes: a narrative systematic review. Sports Med. 2016;46(9):1333–53. https://doi.org/10.1007/s40279-016-0492-2.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Mountjoy M, Brackenridge C, Arrington M, Blauwet C, Carska-Sheppard A, Fasting K, et al. International Olympic Committee consensus statement: harassment and abuse (non-accidental violence) in sport. Br J Sports Med. 2016;50(17):1019–29. https://doi.org/10.1136/bjsports-2016-096121.

    Article  PubMed  Google Scholar 

  10. Vella S, Sutcliffe J, Swann C, Schweickle M. A systematic review and meta-synthesis of mental health position statements in sport: scope, quality and future directions. Psychol Sport Exerc. 2021;55(4):101946. https://doi.org/10.1016/j.psychsport.2021.101946.

    Article  Google Scholar 

  11. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5). Washington, DC: American Psychiatric Publishing; 2013.

    Book  Google Scholar 

  12. Schaal K, Tafflet M, Nassif H, Thibault V, Pichard C, Alcotte M, et al. Psychological balance in high level athletes: gender-based differences and sport-specific patterns. PLoS One. 2011;6(5):e19007. https://doi.org/10.1371/journal.pone.0019007.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Hammond T, Gialloreto C, Kubas H, Hap Davis H. The prevalence of failure-based depression among elite athletes. Clin J Sport Med. 2013;23(4):273–2777. https://doi.org/10.1097/JSM.0b013e318287b870.

    Article  PubMed  Google Scholar 

  14. Kuettel A, Larsen CH. Risk and protective factors for mental health in elite athletes: a scoping review. Int Rev Sport Exerc Psychol. 2020;13(1):231–65. https://doi.org/10.1080/1750984X.2019.1689574.

    Article  Google Scholar 

  15. Bronfenbrenner U. Toward an experimental ecology of human development. Am Psychol. 1977;32(7):513–31. https://doi.org/10.1037/0003-066X.32.7.513.

    Article  Google Scholar 

  16. McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Q. 1988;15(4):351–77. https://doi.org/10.1177/109019818801500401.

    Article  CAS  PubMed  Google Scholar 

  17. McLaren L, Hawe P. Ecological perspectives in health research. J Epidemiol Community Health. 2005;59(1):6–14. https://doi.org/10.1136/jech.2003.018044.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Reupert A. A socio-ecological framework for mental health and well-being. Adv Ment Health. 2017;15(2):105–7. https://doi.org/10.1080/18387357.2017.1342902.

    Article  Google Scholar 

  19. Schinke RJ, Stambulova NB, Si G, Moore Z. International society of sport psychology position stand: Athletes’ mental health, performance, and development. Int J Sport Exerc Psychol. 2018;16(6):622–39. https://doi.org/10.1080/1612197X.2017.1295557.

    Article  Google Scholar 

  20. Scarneo-Miller S, Kerr Z, Kroshus E, Register-Mihalik J, Hosokawa Y, Stearns R, et al. The Socioecological framework: a multifaceted approach to preventing sport-related deaths in high school sports. J Athl Train. 2019;54(4):256–360. https://doi.org/10.4085/1062-6050-173-18.

    Article  Google Scholar 

  21. Purcell R, Gwyther K, Rice SM. Mental health in elite athletes: increased awareness requires an early intervention framework to respond to athlete needs. Sports Med Open. 2019;5:46. https://doi.org/10.1186/s40798-019-0220-1.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Stambulova N, Wylleman P. Athletes’ career development and transitions. In: Papaioannou AG, Hackfort D, editors. Routledge companion to sport and exercise psychology: Global perspectives and fundamental concepts. New York: Routledge; 2014. p. 605–20.

    Google Scholar 

  23. Wylleman P, Reints A, De Knop P. A developmental and holistic perspective on athletic career development. In: Sotiaradou P, Bosscher VD, editors. Managing high performance sport (foundations of sport management). New York: Routledge; 2013. p. 159–82.

    Google Scholar 

  24. Appaneal RN, Levine BR, Perna FM, Roh JL. Measuring postinjury depression among male and female competitive athletes. J Sport Exerc Psychol. 2009;31(1):60–76. https://doi.org/10.1123/jsep.31.1.60.

    Article  PubMed  Google Scholar 

  25. Schuring N, Kerkhoffs G, Gray J, Gouttebarge V. The mental wellbeing of current and retired professional cricketers: an observational prospective cohort study. Phys Sports Med. 2017;45(4):463–9. https://doi.org/10.1080/00913847.2017.1386069.

    Article  Google Scholar 

  26. Du Preez EJ, Graham KS, Gan TY, Moses B, Ball C, Kuah DE. Depression, anxiety, and alcohol use in elite rugby league players over a competitive season. Clin J Sport Med. 2017;27(6):530–5. https://doi.org/10.1097/JSM.0000000000000411.

    Article  PubMed  Google Scholar 

  27. Junge A, Prinz B. Depression and anxiety symptoms in 17 teams of female football players including 10 German first league teams. Brit J Sport Med. 2019;53(8):471–7. https://doi.org/10.1136/bjsports-2017-098033.

    Article  Google Scholar 

  28. Schuring N, Aoki H, Gray J, Kerkhoffs GMMJ, Lambert M, Gouttebarge V. Osteoarthritis is associated with symptoms of common mental disorders among former elite athletes. Knee Surg Sports Traumatol Arthrosc. 2017;25(10):3179–85. https://doi.org/10.1007/s00167-016-4255-2.

    Article  PubMed  Google Scholar 

  29. Yang J, Peek-Asa C, Corlette JD, Cheng G, Foster DT, Albright J. Prevalence of and risk factors associated with symptoms of depression in competitive collegiate student athletes. Clin J Sport Med. 2007;17(6):481–7. https://doi.org/10.1097/JSM.0b013e31815aed6b.

    Article  PubMed  Google Scholar 

  30. Beable S, Fulcher M, Lee AC, Hamilton B. SHARPSports mental health awareness research project: prevalence and risk factors of depressive symptoms and life stress in elite athletes. Aust J Sci Med Sport. 2017;20(12):1047–52. https://doi.org/10.1016/j.jsams.2017.04.018.

    Article  Google Scholar 

  31. Frank R, Nixdorf I, Beckmann J. Analyzing the relationship between burnout and depression in junior elite athletes. J Clin Sport Psychol. 2017;11(4):287–303. https://doi.org/10.1123/JCSP.2017-0008.

    Article  Google Scholar 

  32. Jensen SN, Ivarsson A, Fallby J, Dankers S, Elbe AM. Depression in Danish and Swedish elite football players and its relation to perfectionism and anxiety. Psychol Sport Exerc. 2018;36:147–55. https://doi.org/10.1016/j.psychsport.2018.02.008.

    Article  Google Scholar 

  33. Gerber M, Holsboer-Trachsler E, Pühse U, Brand S. Elite sport is not an additional source of distress for adolescents with high stress levels. Percept Mot Skills. 2011;112(2):581–99. https://doi.org/10.2466/02.05.10.PMS.112.2.581-599.

    Article  PubMed  Google Scholar 

  34. Nixdorf I, Frank R, Beckmann J. Comparison of athletes’ proneness to depressive symptoms in individual and team sports: research on psychological mediators in junior elite athletes. Front Psychol. 2016;7:893. https://doi.org/10.3389/fpsyg.2016.00893.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Nixdorf I, Frank R, Hautzinger M, Beckmann J. Prevalence of depressive symptoms and correlating variables among German elite athletes. J Clin Psychol. 2013;7(4):313–26. https://doi.org/10.1123/jcsp.7.4.313.

    Article  Google Scholar 

  36. Foskett RL, Longstaff F. The mental health of elite athletes in the United Kingdom. J Sci Med Sport. 2018;21(8):765–70. https://doi.org/10.1016/j.jsams.2017.11.016.

    Article  CAS  PubMed  Google Scholar 

  37. Reardon CL. Psychiatric comorbidities in sports. Neurol Clin. 2017;35(3):537–46. https://doi.org/10.1016/j.ncl.2017.03.007.

    Article  PubMed  Google Scholar 

  38. Sanders G, Stevinson C. Associations between retirement reasons, chronic pain, athletic identity, and depressive symptoms among former professional footballers. Eur J Sport Sci. 2017;17(10):1311–8. https://doi.org/10.1080/17461391.2017.1371795.

    Article  PubMed  Google Scholar 

  39. Sullivan PF, Neale MC, Kendler KS. Genetic epidemiology of major depression: review and meta-analysis. Am J Psychiatr. 2000;157(1):1552–62. https://doi.org/10.1176/appi.ajp.157.10.1552.

    Article  CAS  PubMed  Google Scholar 

  40. Bigdeli T, Ripke S, Peterson R, Trzaskowski M, Bacanu S-A, Abdellaoui A, et al. Genetic effects influencing risk for major depressive disorder in China and Europe. Transl Psychiatry. 2017;7:e1074. https://doi.org/10.1038/tp.2016.292.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Gouttebarge V, Frings-Dresen MH, Sluiter JK. Mental and psychosocial health among current and former professional footballers. Occup Med. 2015;65(3):190–6. https://doi.org/10.1093/occmed/kqu202.

    Article  CAS  Google Scholar 

  42. Prinz B, Dvořák J, Junge A. Symptoms and risk factors of depression during and after the football career of elite female players. BMJ Open Sport Exerc Med. 2016;2:e000124. https://doi.org/10.1136/bmjsem-2016-000124.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Wippert PM, Wippert J. The effects of involuntary athletic career termination on psychological distress. J Clin Sport Psychol. 2010;4(2):133–49. https://doi.org/10.1123/jcsp.4.2.133.

    Article  Google Scholar 

  44. Mountjoy M, Brackenridge C, Arrington M, et al. International Olympic Committee consensus statement: harassment and abuse (non-accidental violence) in sport. Br J Sports Med. 2016;50:1019–29. https://doi.org/10.1136/bjsports-2016-09612.

    Article  PubMed  Google Scholar 

  45. Tesh S. Disease causality and politics. J Health Polit Policy Law. 1981;6(3):369–90. https://doi.org/10.1215/03616878-6-3-369.

    Article  CAS  PubMed  Google Scholar 

  46. Doherty S, Hannigan B, Campbell MJ. The experience of depression during the careers of elite male athletes. Front Psychol. 2016;7:1069. https://doi.org/10.3389/fpsyg.2016.01069.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Gouttebarge V, Aoki H, Verhagen E, Kerkhoffs G. Are level of education and employment related to symptoms of common mental disorders in current and retired professional footballers? Asian J Sports Med. 2016;7(2):e28447. https://doi.org/10.5812/asjsm.28447.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Birrer D. Rowing over the edge: Nonfunctional overreaching and overtraining syndrome as maladjustment-diagnosis and treatment from a psychological perspective. Case Stud Sport Exercise Psychol. 2019;3(1):50–60. https://doi.org/10.1123/cssep.2019-0006.

    Article  Google Scholar 

  49. Gabbett TJ. The training-injury prevention paradox: should athletes be training smarter and harder? Br J Sports Med. 2016;50(5):273–80. https://doi.org/10.1136/bjsports-2015-095788.

    Article  PubMed  Google Scholar 

  50. Halson SL, Jeukendrup AE. Does overtraining exist? An analysis of overreaching and overtraining research. Sports Med. 2004;34(14):967–81. https://doi.org/10.2165/00007256-200434140-00003.

    Article  PubMed  Google Scholar 

  51. Meeusen R, Duclos M, Foster C, Fry A, Gleeson M, Nieman D, et al. Prevention, diagnosis, and treatment of the overtraining syndrome: joint consensus statement of the European College of Sport Science and the American College of Sports Medicine. Med Sci Sports Exerc. 2013;45(1):186–205. https://doi.org/10.1249/MSS.0b013e318279a10a.

    Article  PubMed  Google Scholar 

  52. Roy B. Overreaching/overtraining. ACSMs Health Fitness J. 2015;19(2):4–5. https://doi.org/10.1249/FIT.0000000000000100.

    Article  Google Scholar 

  53. Armstrong LE, Van Heest JL. The unknown mechanism of the overtraining syndrome—clues from depression and psychoneuroimmunology. Sports Med. 2002;32(3):185–209. https://doi.org/10.2165/00007256-200232030-00003.

    Article  PubMed  Google Scholar 

  54. Kreher JB. Diagnosis and prevention of overtraining syndrome: an opinion on education strategies. J Sports Med. 2016;7:115–22. https://doi.org/10.2147/OAJSM.S91657.

    Article  Google Scholar 

  55. Richardson SO, Andersen M, Morris T. Overtraining athletes: personal journeys in sport. Champaign: Human Kinetics; 2008.

    Book  Google Scholar 

  56. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Facts about suicide. https://www.cdc.gov/suicide/facts/index.html. Accessed November 26, 2021.

  57. Rao AL. Athletic suicide. In: Hong E, Rao AL, editors. Mental health in the athlete. London: Springer Nature; 2020. p. 39–56.

    Chapter  Google Scholar 

  58. Cai H, Xie X-M, Zhang Q, Cui X, Lin J-X, Sim K, et al. Prevalence of suicidality in major depressive disorder: a systematic review and meta-analysis of comparative studies. Front Psych. 2021;12:690130. https://doi.org/10.3389/fpsyt.2021.690130.

    Article  Google Scholar 

  59. Rao AL, Asif IM, Drezner JA, Toresdahl BG, Harmon KG. Suicide in National Collegiate Athletic Association (NCAA) athletes: a 9-year analysis of the NCAA resolutions database. Sports Health. 2015;7(5):452–7. https://doi.org/10.1177/1941738115587675.

    Article  PubMed  PubMed Central  Google Scholar 

  60. National Institute of Mental Health. Suicide. Available from https://www.nimh.nih.gov/health/statistics/suicide#part_2557. Accessed November 26, 2021.

  61. Mann JJ, Apter A, Bertolote J, Beautrais A, Currier D, Haas A, et al. Suicide prevention strategies: a systematic review. JAMA. 2005;294(16):2064–74. https://doi.org/10.1001/jama.294.16.2064.

    Article  CAS  PubMed  Google Scholar 

  62. Patel V. Talking sensibly about depression. PLoS Med. 2017;14:e1002257. https://doi.org/10.1371/journal.pmed.1002257.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Hirsch JK, Barton AL. Positive social support, negative social exchanges, and suicidal behavior in college students. J Am Coll Heal. 2011;59(5):393–8. https://doi.org/10.1080/07448481.2010.515635.

    Article  Google Scholar 

  64. Schroeder PJ. Changing team culture: the perspectives of ten successful head coaches. J Sport Behav. 2010;33(1):63–88.

    Google Scholar 

  65. Macalli M, Tournier M, Galéra C, Montagni I, Soumare A, Côté SM, et al. Perceived parental support in childhood and adolescence and suicidal ideation in young adults: a cross-sectional analysis of the i-Share study. BMC Psychiatry. 2018;18(1):373. https://doi.org/10.1186/s12888-018-1957-7.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Tahtinen RE, Shelley J, Morris R. Gaining perspectives: a scoping review of research assessing depressive symptoms in athletes. Psychol Sport Exerc. 2021;54:101905. https://doi.org/10.1016/j.psychsport.2021.101905.

    Article  Google Scholar 

  67. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4(6):561–71. https://doi.org/10.1001/archpsyc.1961.01710120031004.

    Article  CAS  PubMed  Google Scholar 

  68. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401. https://doi.org/10.1177/014662167700100306.

    Article  Google Scholar 

  69. Kroenke K, Spitzer RL. The PHQ-9: a new depression diagnostic and severity measure. Psychiatr Ann. 2002;32(9):509–15. https://doi.org/10.3928/0048-5713-20020901-06.

    Article  Google Scholar 

  70. Baron DA, Baron SH, Tompkins J, Polat A. Assessing and treating depression in athletes. In: Baron DA, Reardon C, Baron SH, editors. Clinical sports psychiatry: an international perspective. Chichester: Wiley; 2013. p. 65–78.

    Chapter  Google Scholar 

  71. Polat A, Cakir U, Karabulut U, Tural U, Baron D. Reliability and validity of Turkish form of baron depression screener for athletes. Bull Clin Psychopharmacol. 2015;25(1):134.

    Google Scholar 

  72. Hagiwara G, Iwatsuki T, Isogai H, Van Raalte JL, Brewer BW. Relationships among sports helplessness, depression, and social support in American College student-athletes. J Phys Educ Sport. 2017;17(2):753–7. https://doi.org/10.7752/jpes.2017.02114.

    Article  Google Scholar 

  73. Gouttebarge V, Bindra A, Blauwet C, Campriani N, Currie A, Engebretsen L, et al. International Olympic Committee (IOC) Sport Mental Health Assessment Tool 1 (SMHAT-1) and Sport Mental Health Recognition Tool 1 (SMHRT-1): towards better support of athletes’ mental health. Br J Sports Med. 2021;55(1):30–7. https://doi.org/10.1136/bjsports-2020-102411.

    Article  PubMed  Google Scholar 

  74. Stillman MA, Glick ID, McDuff D, Reardon CL, Hitchcock ME, Fitch VM, et al. Psychotherapy for mental health symptoms and disorders in elite athletes: a narrative review. Br J Sports Med. 2019;53(12):767–71. https://doi.org/10.1136/bjsports-2019-100654.

    Article  PubMed  Google Scholar 

  75. Stillman MA, Farmer H. Psychotherapeutic approaches to addressing mental health problems among elite athletes. In: Taiar R, editor. Contemporary advances in sports science. London: IntechOpen Limited; 2021. https://doi.org/10.5772/intechopen.96978.

    Chapter  Google Scholar 

  76. Glick ID, Kamis D, Stull T. The ISSP manual of sports psychiatry. New York: Routledge; 2018.

    Book  Google Scholar 

  77. McDuff DR, Garvin M. Working with sports organizations and teams. Int Rev Psychiatry. 2016;28(6):595–605. https://doi.org/10.1080/09540261.2016.1212820.

    Article  PubMed  Google Scholar 

  78. Baier AL, Kline AC, Feeny NC. Therapeutic alliance as a mediator of change: a systematic review and evaluation of research. Clin Psychol Rev. 2020;82:101921. https://doi.org/10.1016/j.cpr.2020.101921.

    Article  PubMed  Google Scholar 

  79. Humer E, Stippl P, Pieh C, Schimböck W, Probst T. Psychotherapy via the internet: what programs do psychotherapists use, how well-informed do they feel, and what are their wishes for continuous education? Int J Environ Res Public Health. 2020;17(21):8182. https://doi.org/10.3390/ijerph17218182.

    Article  CAS  PubMed Central  Google Scholar 

  80. Hays KF. Working it out: using exercise in psychotherapy. Washington: American Psychological Association; 2009.

    Google Scholar 

  81. Fenn K, Byrne M. The key principles of cognitive behavioural therapy. InnovAiT. 2013;6(9):579–85. https://doi.org/10.1177/1755738012471029.

    Article  Google Scholar 

  82. Stillman MA, Brown T, Ritvo EC, Glick I. Sport psychiatry and psychotherapeutic intervention, circa 2016. Int Rev Psychiatry. 2016;28(6):614–22. https://doi.org/10.1080/09540261.2016.1202812.

    Article  PubMed  Google Scholar 

  83. McDermut W, Miller IW, Brown RA. The efficacy of group psychotherapy for depression: A meta-analysis and review of the empirical research. Clin Psychol. 2006;8(1):98–116. https://doi.org/10.1093/clipsy.8.1.98.

    Article  Google Scholar 

  84. World Anti-Doping Agency. List of prohibited substances and methods. 2021. Available from https://www.wada-ama.org/sites/default/files/resources/files/2021list_en.pdf. Accessed November 27, 2021.

  85. Reardon CL, Creado S. Psychiatric medication preferences of sports psychiatrists. Phys Sports Med. 2016;44(4):397–402. https://doi.org/10.1080/00913847.2016.1216719.

    Article  Google Scholar 

  86. Reardon CL. Managing psychiatric disorders in athletes. In: Hong E, Rao AL, editors. Mental health in the athlete. London: Springer; 2020. p. 57–67.

    Chapter  Google Scholar 

  87. Patel K, Allen S, Haque MN, Angelescu I, Baumeister D, Tracy DK. Bupropion: a systematic review and meta-analysis of effectiveness as an antidepressant. Therap Adv Psychopharm. 2016;6(2):99–144. https://doi.org/10.1177/2045125316629071.

    Article  CAS  Google Scholar 

  88. Davidson J. Seizures and bupropion: a review. J Clin Psychiatry. 1989;50(7):256–61.

    CAS  PubMed  Google Scholar 

  89. Gorczynski P, Gibson K, Thelwell R, Harwood C, Papathomas A, Kinnafick F. The BASES expert statement on mental health literacy in elite sport. Sport Exerc Sci. 2019;59:6–7.

    Google Scholar 

  90. Gorczynski P, Currie A, Gibson K, Gouttebarge V, Hainline B, Castaldelli-Maia JM, Mountjoy M, Purcell R, Reardon CL, Rice S, Swartz L. Developing mental health literacy and cultural competence in elite sport. J Appl Sport Psychol. 2021;33(4):387–401. https://doi.org/10.1080/10413200.2020.1720045.

    Article  Google Scholar 

  91. Jorm AF, Korten AE, Jacomb PA, Christensen H, Rodgers B, Pollitt P. “Mental health literacy”: a survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Med J Aust. 1997;166(4):182–6. https://doi.org/10.5694/j.1326-5377.1997.tb140071.x.

    Article  CAS  PubMed  Google Scholar 

  92. Canadian Alliance on Mental Illness and Mental Health (CAMIMH). Mental health literacy in Canada: phase one report mental health literacy project. Ottawa: CAMIMH; 2007.

    Google Scholar 

  93. Kutcher S, Wei Y, Coniglio C. Mental health literacy: past, present, and future. Can J Psychiatr. 2016;61(3):154–8. https://doi.org/10.1177/0706743715616609.

    Article  Google Scholar 

  94. Jorm AF. Mental health literacy: empowering the community to take action for better mental health. Am Psychol. 2012;67(3):231–43. https://doi.org/10.1037/a0025957.

    Article  PubMed  Google Scholar 

  95. Breslin G, Shannon S, Haughey T, Leavey G. A systematic review of interventions to increase awareness of mental health and well-being in athletes, coaches and officials. Syst Rev. 2017;6:177. https://doi.org/10.1186/s13643-017-0568-6.

    Article  PubMed  PubMed Central  Google Scholar 

  96. Chow GM, Bird MD, Gabana NT, Cooper BT, Swanbrow Becker MA. A program to reduce stigma toward mental illness and promote mental health literacy and help-seeking in National Collegiate Athletic Association Division I student-athletes. J Clin Sport Psychol. 2021;15:21.

    Article  Google Scholar 

  97. Bu D, Chung PK, Zhang CQ, Liu J, Wang X. Mental health literacy intervention on help-seeking in athletes: a systematic review. Int J Environ Res Public Health. 2020;17(19):7263. https://doi.org/10.3390/ijerph17197263.

    Article  PubMed Central  Google Scholar 

  98. Oftadeh Moghadam S, Gorczynski P. Mental health literacy, help-seeking, and mental health outcomes in women rugby players. Women Sport Phys Act J. 2021. https://doi.org/10.1123/wspaj.2020-0066

  99. McCabe T, Peirce N, Gorczynski P, Heron N. Narrative review of mental illness in cricket with recommendations for mental health support. BMJ Open Sport Exerc Med. 2021;7:e000910. https://doi.org/10.1136/bmjsem-2020-000910.

    Article  PubMed  PubMed Central  Google Scholar 

  100. Porta M. A dictionary of epidemiology. 6th ed. New York: Oxford University Press; 2014.

    Book  Google Scholar 

  101. Merikangas KR, Nakamura EF, Kessler RC. Epidemiology of mental disorders in children and adolescents. Dialogues Clin Neurosci. 2009;11(1):7–20. https://doi.org/10.31887/DCNS.2009.11.1/krmerikangas.

    Article  PubMed  PubMed Central  Google Scholar 

  102. Gorczynski P, Webb T. Developing a mental health research agenda for football refees. Soccer Soc. 2021;22(6):655–62. https://doi.org/10.1080/14660970.2021.1952695.

    Article  Google Scholar 

  103. Gorczynski P, Fasoli F. LGBTQ+ focused mental health research strategy in response to COVID19. Lancet Psychiatry. 2020;7(8):E56. https://doi.org/10.1016/S2215-0366(20)30300-X.

    Article  PubMed  PubMed Central  Google Scholar 

  104. Bahr R, Clarsen B, Derman W, Dvorak J, Emery CA, Finch CF, et al. International Olympic Committee consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport 2020 (including STROBE Extension for Sport Injury and Illness Surveillance (STROBE-SIIS)). Br J Sports Med. 2020;54(7):372–89. https://doi.org/10.1136/bjsports-2019-101969.

    Article  PubMed  Google Scholar 

  105. Coyle M, Gorczynski P, Gibson K. “You have to be mental to jump off a board any way”: elite divers’ conceptualizations and perceptions of mental health. Psychol Sport Exerc. 2017;29:10–8. https://doi.org/10.1016/j.psychsport.2016.11.005.

    Article  Google Scholar 

  106. Chang C, Putukian M, Aerni G, Diamond A, Hong G, Ingram Y, et al. Mental health issues and psychological factors in athletes: detection, management, effect on performance and prevention: American Medical Society for Sports Medicine Position Statement-Executive Summary. Br J Sports Med. 2020;54(4):216–20. https://doi.org/10.1136/bjsports-2019-101583.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Paul Gorczynski .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Gorczynski, P. (2022). Major Depressive Disorder and Depressive Symptoms. In: Reardon, C.L. (eds) Mental Health Care for Elite Athletes. Springer, Cham. https://doi.org/10.1007/978-3-031-08364-8_6

Download citation

Publish with us

Policies and ethics