Sport psychiatry: How to keep athletes in the game of life, on or off the field
Some athletes’ toughest opponents are depression, addictions, and eating disorders. Managing these patients’ mental illnesses is a new niche for psychiatry
The use of performance-enhancing drugs is not unique to baseball15 or to professional athletes. A significant percentage of high school athletes also is believed to be using anabolic steroids,16 which cause psychiatric symptoms ranging from depression to psychosis (“roid rage”) to suicide. Other commonly used performance-enhancing drugs include caffeine, human growth hormone, and erythropoietin.16
Alcohol and drugs. For some professional athletes, alcohol and drug abuse is as much a part of sports culture as sweat and fame. Former Major League Baseball outfielder Darryl Strawberry spent more time in treatment for alcohol and cocaine addiction than he did playing baseball toward the end of his career. He was sentenced in April 2002 to 18 months in prison after 3 years of repeated drug-related offenses and probation violations.
Psychiatric therapy for athletes
Psychotherapy. A range of psychotherapeutic techniques—from cognitive-behavioral and family therapy to insight-oriented psychotherapy—can help the troubled athlete.
Drug therapy. When prescribing psychotropic medications to an athlete, remember that the physiologic effects of exertion—such as fluid loss, increases in VO2 max, and cardiac output—can alter drug metabolism and distribution. These effects need to be assessed case by case.
Psychotropic side effects to avoid in the athlete include sedation, extrapyramidal symptoms, orthostasis, tremor, and cardiac arrhythmias. We know little about the potential for psychotropic drugs to enhance athletic performance, and research is needed.1\7
Related resources
- Mind Body and Sports (promotes sportsmanship and addresses the emotional needs of athletes of all ages). www.mindbodyandsports.com
- USA Gymnastics Athlete Wellness Program. www.usa-gymnastics.org/wellness
- Fuentes RJ, Rosenberg JM (eds). Athletic drug reference. Durham, NC: Clean Data, Inc., 1999.
Drug brand names
- Alprazolam • Xanax
Disclosure
The author reports no financial relationship with any company whose products are mentioned in this article, or with manufacturers of competing products.
