Scores of athletes may be hiding mental health problems because they feel it may harm their career, research suggests.
One in three sports stars suffer from mental illnesses, such as depression, due to the fierce demands placed upon them, according to estimates.
But experts say they are choosing not to seek help over fears it'll be seen as a sign of weakness to their competition, peers and the public.
They also worry it'll scare-off potential sponsors and harm their chances of signing a professional contract.
Researchers analysed 52 studies that included 13,000 elite athletes at professional, Olympic, or university level from 71 sports around the world.
They conducted the review as part of a special issue of the British Journal of Sports Medicine devoted to the topic.
The most common mental illnesses were sleep disorders, depression and anxiety, eating disorders, substance misuse, gambling and other addictions.
In many cases, depression and anxiety were the direct result of injuries and concussion.
'Athletes fear, possibly rightly so, that disclosing mental health symptoms or disorders would reduce their chances of maintaining or signing a professional team contract or an advertising campaign,' the research team noted.
'Coaches and sports governing bodies have a crucial role in helping to de-stigmatise mental ill health and promote a culture of mental wellbeing.'
The team claims that elite sports culture, with its heavy training demands and constant drive to improve performance, heightens the risk of mental health issues arising.
Other factors influencing mental health included difficulties accepting women as athletes in some cultures because of societal expectations of the female role; black and minority ethnicity; financial considerations; and keeping quiet about religious beliefs.
But the team conceded their review was so broad that many elite athletes come from countries where there are few, if any, mental health services, meaning access to help was unavailable.
While it is normal to feel down from time to time, people with depression may feel persistently unhappy for weeks or months on end.
Depression can affect anyone at any age and is fairly common – approximately one in ten people are likely to experience it at some point in their life.
Source: The Daily Mail
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