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• Time to think. Pitchers and hitters alike have an enormous amount of time to sit and stew in their mistakes. For many—such as Snell—the stretches of idleness can be torturous. "God wanted to give males something to do to keep them occupied and make them crazy, other than war, [and] he came up with baseball," says Karesky, who has counseled Vietnam vets and firemen, is EAP director for the Blue Jays and the Padres, and works with the Diamondbacks. "So much time to think is likely to produce problems, especially if you're a perfectionist." Indeed, studies by University of Chicago psychology professor Sian L. Beilock suggest a correlation between increased conscious thought and choking under pressure—something that has long been obvious to major leaguers. (As Giants pitcher Barry Zito sums it up, "Sometimes it's better just to go out there and be ignorant.")
• Solitude. Baseball players have 81 away games in a season; travel-weary NBA players have 82 games, period. Thus baseball players' personal support structures—whether friends or relatives or a church group—aren't nearby for at least half of the most stressful time of year. "Most people get stability from the families they go home to every night," says Karesky. "That's not the world of baseball." Because teams are away so much, a player on injury rehab, a fertile time for depression in any occupation, is isolated even from his teammates. Duchscherer, whom Karesky treated, felt his depression surge while recovering from arthroscopic surgery on his elbow. "[Players are] cut off from the team, worrying about their careers, scared of losing their positions," says professor Ronald Smith, director of the University of Washington's clinical psychology training program and a former counselor for the Astros and the Mariners.
But the specific provenance of a disorder, whether it's on the field (a drawn-out slump, say) or off it (an unexpected death, like that of Votto's father, Joe, in 2008), may not even matter. Emotions tend to spill over into every area of a player's life. "It's one tank," says David R. McDuff, professor of psychiatry at Maryland's medical school and team psychiatrist for the Orioles and the Ravens. "We can artificially break it down, but there's no actual partitioning in the mind." A player's skills are at the mercy of his emotional condition, but as Bradley discovered, the reverse can also be true. "An athlete's self concept is so anchored to his ability to do these wonderful things on a field," says Smith. "I've seen problems develop in well-functioning people with no prior issues. Then they have to deal with constant questions, booing. It's a pressure cooker."
Asking for help has never been easy, either. In the mid-'90s Bill Pulsipher, then a top pitching prospect for the Mets, tried to convince team management that his loss of control—a recurring baseball mystery known by names such as the Creature and White Line Fever and, yes, Steve Blass Disease—had metastasized into a larger, all-encompassing illness, only to have the conversation keep returning to his mechanics. "They showed me my delivery in a 30-picture sequence," says Pulsipher, who would eventually be diagnosed with general anxiety disorder and clinical depression. "I'm going, 'You guys aren't listening to what I'm saying.'"
Blass, now 68, believes he suffered from undiagnosed performance anxiety. "I can say anxiety now," he says. "Back in the day there was a stigma. There were a lot of issues that guys never revealed." He relates his own stories of emotional torture: nights like the one following a terrible relief appearance on the road against Atlanta when he walked the streets for hours, as aimless as one of his sliders. "I was devastated," says Blass. "I had begun feeling very, very alone."
In the late 1980s a researcher at the University of Southern Maine named Loren Coleman studied the suicide patterns of MLB players—77 current or former big leaguers had taken their own lives, more than half of them between their late 20s and late 40s—and called for an improved counseling program for retirees. The recommendation resonated loudly on July 18, 1989, when Angels reliever Donnie Moore, 35, shot his wife (who survived) and killed himself at their home. Moore, a former All-Star who had been released from Triple A the previous month, had given up a series-turning homer to the Red Sox' Dave Henderson in the top of the ninth inning in Game 5 of the 1986 ALCS. Friends say that Moore was forever haunted by that one pitch.
More than a year after his bout with suicidal thoughts, and more than two decades after Moore took his own life, Snell has yet to seek professional counseling or therapy. But after a team win last June, he tried something that was brave in its own right. Snell, whose ERA had jumped from 3.72 to 5.36 in the eight weeks since that heartbreaking loss in Milwaukee, asked Pirates G.M. Neal Huntington to send him down to Triple A for the good of "this team, my career, and me, so I don't harm myself or do anything stupid." Huntington obliged. Fans seemed skeptical or baffled. In his first start for the Indianapolis Indians, the pitcher struck out 17 Toledo Mud Hens, including 13 in a row. "It was a big weight off my shoulders," says Snell, who would welcome being traded to the Mariners that July. "I could finally enjoy the game."
One day three years ago at the Royals' spring training facility in Surprise, Ariz., Mike Sweeney was hanging around the weight room when Kansas City G.M. Dayton Moore quietly approached with a question. "There was a deal on the table for a high-profile shortstop that another team wanted to trade, straight up, for Zack Greinke," Sweeney says. The shortstop may not have been a future Hall of Famer, but he had, in Sweeney's words, a "huge upside." So Moore asked his veteran first baseman, "Would you do it?"
The facts: Greinke, then 23, was a prized prospect whose ERA had been trending in the wrong direction (3.97 in '04, 5.80 in '05). He had thrown only 61/3 major league innings in '06, in relief. And—most troubling—Greinke had spent months on the DL that year with a mental illness.
Sweeney's answer: "Heck, no," he recalls with a chuckle.