The cognitive costs of the game: athletics contribute to rates of depression

CLARIFICATION: Due to a reporting error, the original version of this story was not clear enough in representing the sample of the British Journal of Sports Medicine's study. The study found that 24 percent of Division I athletes have depression. The story has been updated to reflect these changes.

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UNC junior Stephanie Davis sustained her first of four concussions during a middle school soccer tournament in Charlotte when a midfielder slammed heads with her as they leaped for the ball.

She doesn’t remember if she blacked out. Her ears were sensitive to sound and her eyes to light. Then she was led off-field and asked if she remembered the score of the game and where she was.

Now Davis asks those questions as she helps train athletes in UNC Football, Capital Area Soccer League in Raleigh, Garner Magnet High and UNC Women’s Soccer. She has grown to love rehabilitating athletes even as she remains on the sidelines, shadowed by symptoms like depression.

Davis said in an email she is sure sports injuries like concussions can cause depression.

“Not only can brain injuries adjust neurotransmitter levels in your brain, the secondary effects of concussions can be very significant,” she said.

She said concussion recovery can mean avoiding lights and noise as well as reducing exercise.

“When you consider D-1 athletes — competitive, driven, strong hard-workers that want to be the best in everything they do — losing their reason, purpose and desire can be very depressing for them,” Davis said.

Destinee Grove, a UNC junior and research assistant at the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, said in an email the link between brain injuries and depression should be explored.

“A brain injury alters the way a brain functions, leaving one susceptible to cognitive, motor and psycho-social deficits. How strong is that correlation?” Grove said. “More research needs to be done before we have a definitive answer.”

A British Journal of Sports Medicine study published this month found 24 percent of Division I athletes have depression — a rate similar to their peers in school and higher than the general population.

Study co-author Andrew Wolanin said the study is the most comprehensive to date, following 465 athletes across nine sports over three consecutive years.

He said risk factors for depression could be academic and psychological pressures common to all students, compounded by demanding schedules, performance pressures and injuries.

“It could be socioeconomic issues,” he said. “The sample we had was predominately Caucasian. We didn’t have any differences between racial groups, but there’s a potential of that as well. There was a significant gender difference as well.”

Wolanin said researchers are looking into why women’s track and field fell on the higher end of the depression curve and men’s lacrosse on the lower end.

The study highlighted the need for community awareness of athletes’ vulnerability as well as adequate treatment and prevention resources, he said.

At UNC these resources include athletic trainers, sports psychologists, coaches and doctors, Davis said.

“We are up-to-date on the latest research and possible preventative measures,” she said.

Allen O’Barr, director of UNC’s Counseling and Psychological Services, said in an email he would like to provide students with more resources.

“CAPS will occasionally do an outreach to groups of students, including athletes, about how to identify depression and anxiety in self and others,” he said. “However, a more routine and comprehensive approach to education in this area would be great to have.”

Mario Ciocca, director of Sports Medicine at UNC, said the University’s two sports psychologists are trained for mental aspects of performance improvement and general one-on-one counseling.

“The athletic department increased the time our sports psychologists are at UNC this past year, and one of the psychologists is present from Monday to Thursday; they also do team talks,” he said. “This is helpful as a group session, but it also familiarizes our athletes with them and may make them feel more comfortable coming in if they need one-on-one counseling.”

Ciocca said trust within the athletic department plays an important role in mental health.

“The athletes may have their best relationship with a coach or an athletic trainer and may confide in them,” he said. “They can then get the athlete referred for treatment.”

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