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Tuesday, May 25, 2010

Depression in a High-Achieiving Athlete: An Encounter With Terry Bradshaw

In the mid '80’s, as a sport psychiatrist, I was fortunate enough to interview Terry Bradshaw for a cable TV show. The topic was “Why Super Bowl Champs Can’t Repeat." His Steelers of the '70’s had made that look easy, but at the time I did the interview, no other NFL team had been able to win the Super Bowl in successive seasons since.

Terry took the time to talk to me from the barn of his farm in Louisiana. He was accessible and generous with his time. He seemed to enjoy the fact that I was a psychiatrist and kidded me about it. His comments about the conservative mindset that can go along with defending something you’ve won, versus the attacking mindset when you are trying to take something from someone struck me as very insightful and intelligent.

Little did I realize then that the weight of defending all those championships probably laid more heavily on Terry’s shoulders than most. As he later publicly acknowledged, he had suffered from depression for years while playing. He described breaking into tears and sweating profusely after a game, not realizing what the problem was. Because of the prevailing myth that high-level athletes would not become depressed “like regular people,” and the stigma against admitting it if it did occur, none of his teammates, coaches or staff recognized that Terry had an illness. Terry became even more melancholy after retirement (a common phenomenon), sought psychotherapy, and was finally properly diagnosed and prescribed paroxetine, which helped him greatly. He then went on to talk about his depression and treatment publicly, becoming the first very high-profile athlete to do so.

Soon after Terry’s disclosure, the Hall of Fame jockey, Julie Krone, and the Olympic diver Wendy Williams came forward, notably at International Society for Sport Psychiatry Symposia here at the APA convention, which I had the pleasure to chair. Both Julie and Wendy openly discussed the fact that they had taken SSRI’s for anxiety and depressive disorders while competing. They shared with us that the SSRI’s had helped their conditions greatly, and had not negatively impacted their performance, though the illnesses certainly had.
Julie continued to use SSRI’s when riding and became an information source for jockeys and other athletes who were struggling with emotional disorders. Suddenly, there was less stigma to being prescribed a psychiatric medication, or to receiving psychotherapy while competing, and many other well-known athletes have since stepped forward to share their stories.

In my practice, these narratives had made it easier for my athlete patients to try a medication when it is offered. Another welcome benefit is that my non-athlete patients are more open to trying an antidepressant as well. As we discuss side effects, I mention that if Terry Bradshaw can take an SSRI and Julie Krone can compete on it, the medication must be fairly well tolerated, right?

Ronald L. Kamm, M.D.
Distinguished Life Fellow, American Psychiatric Association
Past-President, International Society for Sport Psychiatry

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