Depression and overall mental health also opposed the hypothesis that elite and competitive athletes suffer most, despite studies suggesting they do . This is supported by a meta-analysis showing no difference in high-performance athletes and non-athletes with respect to depression. Competitive athletes are significantly less depressed than recreational athletes, irrespective of age. Despite this, they are susceptible to mental illness, just at a lower prevalence than the general population.
It is plausible that social networks buffer the effects of depression on mental health. Participation in sport, especially at top levels, implies parental involvement and a support team including coaches, psychologists and team-mates. Competitive elite athletes have greater perceived social connectedness , allowing identification with and comfort from those sharing similarities in appearance, experiences and talents, therefore profoundly protecting them from depressive symptomology and mental ill-health . Nixdorf et al. found higher depression in individual athletes compared to team sport athletes. Therefore, more accessible social support may be available within team sports compared to nonathletes and individual athletes, further justifying the need to assess mental health across sport types.
Over a third of young adults with mental health issues do not seek help; most commonly due to stigmatisation. Yet the significance of mental-ill health continues to be overlooked by sporting governing bodies. Stigma increases pressure to be physically and mentally ‘tough’, so disorders are often viewed as personal failures and character defects. Athletes are most affected by stigma so tend not to seek support due to its potential indication of inadequacy and weakness. Therefore, they may present themselves as ‘fine’, ignoring any depressive issues, hence a significant underreporting of depression is likely. Improving mental health literacy in elite sport personnel may help avoid presumptions that athletes are immune from mental ill-health. Future work should consider social desirability by measuring measures psychological distress more indirectly.
Similarly, throughout elite sport prioritising winning is socialised above all personal needs, further fuelling stigma and reducing the likelihood of elite athletes reporting mental ill-health. Admitting to needing help is perceived as risky, due to questioning of athletic performance capabilities. Unfortunately, this overlooks important associations between mental and physical health, where a positive, healthy mind helps increase successful performance and the likelihood of winning .
However, mental disorder concerns can be misdiagnosed as they overlap considerably with overtraining symptoms, thus approaching from a narrow physiological perspective may mean athletes are even more susceptible to underdiagnosis. This is worsened by elite sport professionals being under intense pressure to produce successful athletes compromising wellbeing and athlete treatment. Thus, implementing mental health screening programmes as well as physical health examinations may prevent underreporting of mental-ill health in athletes. However, again, the direction of this relationship is unknown implying individuals with symptoms may not develop physical skills or a desire to compete.