Drexel Prof Finds Exercise Doesn’t Protect Student Athletes From Depression

Why are symptoms so prevalent in women's track and field and cheerleading?

The death by suicide of Penn freshman track athlete Madison Holleran in January 2013 rocked the local college sports world and jump-started discussions everywhere about the pressures faced by student athletes. But when Drexel Med professor and Drexel sports team physician Eugene Hong wanted to examine the issue of depression in college athletes, he found very little research on the subject. What there was instead was a general perception that participation in athletics had a protective effect. “Because of our societal and cultural idiosyncrasies,” says Hong, “we equate physical health with mental health.”

Whether that perception was true was what Hong and his fellow researchers wanted to find out. So they performed their own study of 465 athletes at a single East Coast D-1 university. The results, just published in the February issue of the British Journal of Sports Medicine, showed the same level of clinically relevant depressive symptoms in student athletes as in their non-athlete peers.

That result was surprising, says Hong, whose experience as a team physician dates back nearly two decades, not just because of that societal perception, but also because studies have shown that exercise is a clinically acceptable treatment for depression. Why wasn’t it protecting these college kids? 

Hong points to a number of stressors experienced by college athletes that could increase their risk of depression, including injuries, the performance expectations laid on them not just by themselves but by their families and coaches, and what he calls “the perception of failure” — the sense that they’re not performing as well as they should. Another factor could be the crushing time demands put on college athletes. A recent NCAA study showed a D-1 athlete puts in 30 to 40 hours a week at his or her sport — and that’s on top of schoolwork.

But the most eye-opening revelation of the study, Hong says, was the sharp variation in rates of depressive symptoms among athletes in different sports. Thirty-seven percent of female track and field participants showed such symptoms, compared to just 17.4 percent of field hockey players. A high percentage of cheerleaders also showed symptoms, at 34.3 percent; male lacrosse players had the lowest, at 12 percent. In the middle of the pack were those who rowed crew, participated in men’s track and field, or played tennis, basketball, soccer, baseball or softball, all coming in between 22 and 26 percent.

So what’s going on? Is women’s track and field that much more competitive? More stressful? “It’s a chicken-or-the-egg question,” says Hong. “We don’t know yet whether different sports attract types of students who are at higher risk, or if something about the sport itself makes symptoms more likely.” He speculates that further research will reveal some combination of the two. Since this was a study at a single university, he adds (and one that doesn’t offer football), something about its particular teams could be a factor. (In other words: It’s not yet time to point your pole-vault-loving middle-schooler toward basketball instead.)

When it comes to gender, 28 percent of female athletes showed depressive symptoms compared to 17 percent of the male athletes, a discrepancy that Hong says mirrors the gender difference found in studies of depression generally. The study, he adds, emphasizes the need for increased mental health screening for college athletes as part of standard student-athlete medical care. Hong points out, though, that while screening does raise awareness, “It isn’t really all that useful unless you have a system in place to deal with the findings.” Toward that end, just a few weeks ago the NCAA released new guidelines for colleges that are intended to make mental health care more accessible to student athletes. Hong says the NCAA guidelines will help, but adds, “We still have a lot of work to do.”

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For confidential support if you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Learn about the warning signs of suicide at the American Foundation for Suicide Prevention.