The abiding irony is that athletes—our indestructible gladiators, our iron-clad warriors—might be more prone to mental illness than the population at large. "Athletes are so paradoxical because physically they are so much healthier than the average person," says Murray, "but from the clinical side of things, they are very much an at-risk population." Among the reasons why:
After heredity, the biggest risk factor for depression is stress. Performing in front of thousands of fans, having your work scrutinized and judged regularly, laboring in a field where success and failure are so clear-cut—all that can exact a huge psychic toll. There's also the stress of knowing that your career, and thus the window of opportunity to make millions, is narrow. The stress can be equally intense in the less prominent sports. An athlete such as Shea might not perform nightly in front of multitudes, but he spent four years preparing for a single event. "I knew, one mistake and it was over," he says. "That's a lot to bear." Not for nothing does the USOC have a phalanx of full-time psychologists on staff.
Social stability and a solid home life improve mental health. And athletes, regardless of the sport, live out of a suitcase for months on end.
Researchers know that exposure to trauma at a young age can lead to an increased likelihood of depression and mental illness later in life. (Studies have also shown that growing up in a single-parent household can increase the risk.) The sports world is awash with athletes who have endured circumstances that are deeply abject. "Think of how many athletes you read about who grew up in terrible poverty, or had relatives who were murdered, or don't know their dads," says Joe Schrank, a former practice-squad defensive tackle at USC who is pursuing a master's degree in social work with an emphasis on clinical issues associated with athletes. "It's off the charts." For instance, Leon Smith, a former Chicago hoops star, was raised in a world inconceivable to most of us. A ward of the state, he was shuttled among group homes, and he talks of having slept in cars. In 1999, after he was drafted out of high school by the San Antonio Spurs and immediately traded to the Dallas Mavericks, he suffered a breakdown that doctors say was caused by depression. After slathering green paint on his face, he threw a rock at a car, then swallowed 250 aspirins in an apparent suicide attempt. Smith never played for Dallas and most recently appeared in the L.A. Pro Summer League, more than a long jump shot from the NBA.
Athletes are at a far greater risk than the general population to suffer cranial injuries, which can alter brain chemistry. Studies show that someone who has endured multiple concussions is up to four times more likely to suffer depression. Not surprisingly, anecdotal evidence suggests that depression is common in hockey, a sport in which there are nearly as many concussions as dislodged teeth. This off-season alone, two professional players have committed suicide. Pat LaFontaine, the former NHL All-Star, suffered a nasty concussion in 1996, and virtually overnight, hockey lost all significance to him. Team doctors puzzled over his lack of passion. Only after a trip to the Mayo Clinic was his condition diagnosed as depression, the result of postconcussion syndrome.
What about the notion that the incidence of mental illness in sports should be lower because the weak have been winnowed out? Wouldn't anyone battling an incapacitating case of depression simply fail to make it to an elite level? Not necessarily. "Depression often doesn't kick in till someone hits his early or mid-20s," says Dennis Charney, chief of the Mood and Anxiety Disorders Research Program at the National Institute of Mental Health. "So you could grow up fine, then have your [onset] once you've made it to the pros."
Take Bradshaw, who led four Pittsburgh Steelers teams to Super Bowl titles and won the NFL's MVP Award in 1978. He was the picture of calm on the field, but when the game ended, he would hemorrhage sweat and dissolve into tears. "People say, 'You couldn't have been depressed—I saw you throw for all those touchdowns,' " says Bradshaw. "Shoot, the football was the easy part. I could concentrate for three hours, and the games were an escape. It was the rest of my life that was going to hell in a hand-basket." Despite a jovial public persona that splinters the stereotype of how someone who's depressed acts, Bradshaw grew more melancholy after retiring from football. Finally he sought help. After going to counseling and taking Paxil (an antidepressant he is now paid to endorse), he stopped experiencing the inexplicable lows. "And the rest," he says, commencing his familiar cackle, "is history, baby."
Although it's commonly thought that physical activity and the pursuit of goals have a salutary effect on mental health, those alone don't necessarily reduce athletes' risks. While exercise in conjunction with therapy and medication can help elevate mood, alone it is no match for depression. "Anyone who has had depression will tell you, it's not the kind of thing where you can go for a run and suddenly feel all better," says Charney. "That's a big misconception."
Athletes also have at their disposal a raft of handlers, apologists and other sycophants who help excuse behavior that would otherwise seem pathological. Consider Ricky Williams, who struggled for years with social anxiety disorder before finally seeking successful treatment. When he was a high school football star in San Diego, he sensed that he was "wired differently" from classmates. He would recoil from social situations, even from speaking in class. He believes that because he was a football star, his extreme introversion was shrugged off as behavior typical of a coddled athlete. "It was always, 'Oh, Ricky's just aloof,' or 'Ricky's moody,' or 'Ricky's arrogant,' when it was really so much more," he says.
As Williams developed a national profile at the University of Texas, he turned further inward. As his anxiety worsened, he enlisted what he wryly calls "a support system" to run interference. "If I didn't want to honor an obligation," he says, "I knew someone would cover me. If I didn't want to do something, they said, 'Don't do it.' " Boosters, for example, would be waiting to meet Williams only to have an athletic department flack explain that Williams's car had broken down, or that he was sick, or that his mom was sick. "A lot of people made it easy for me to hide," he says.