Injured Athletes: Addressing Mental Health Risks

Dr. Shayla Sullivant, Child and Adolescent Psychiatrist

When a student athlete gets injured it can turn their world upside down and impact their emotional state. In our society, there’s an expectation that athletes need to be strong and hide emotion. That they need to play through pain, whether physical or mental. These athletes face other stressors too, which include family and college expectation, especially if playing a sport is going to help pay for college.

Add this to the other common teenage growing pains and it can be overwhelming. Injured athletes are not only at risk for depression, but suicidal thoughts, and parents, coaches and teachers need to know the warning signs.

Injury and Isolation

Suicide is the second leading cause of death for young people. We're losing more youth to suicide than cancer. It’s not just a problem on the national level, it’s a problem right here in our own backyard. Both Kansas and Missouri have higher suicide rates than the national average.

Studies show that social isolation increases the likelihood of suicidal thought and self-harm among adolescents. When athletes are sidelined they often become isolated from their peers, and the longer they’re away from normal activities the more isolated their world becomes. They may stop talking and texting with their teammates because they’re no longer part of the everyday moments. They could feel excluded and the entire dynamic changes.

To maintain a connection with their peers, I encourage my patients to go to practice or manage the team even when they’re not playing. Having a routine and participating in daily activities with their teammates will help their overall mental health.

Suicide Warning Signs

So how do you know if someone is having suicidal thoughts? There’s a misperception you can tell just by looking at them. That’s simply not true. There’s not a “look,” but there are risk factors, which include the following:

• Withdrawn or feeling isolated

• Poor grooming

• Appetite/eating changes

• Failing grades

• Discord with friends/parents

• Victim of bullying

• Frequent stomach/head complaints

• Sexual identity issues

• Gender identity issues

• Cutting back on activities

• Reckless behavior

• Substance abuse

• Shutting down

• Genetic predisposition to mental health problems

• Previous suicide attempt

It’s not unusual for teenagers to display a couple of these behaviors from time-to-time, but you need to be concerned if they have several of these risk factors at once.

What to Do

Teenagers often don’t want to talk to their parents when there’s a problem and instead may turn to a coach, teacher or another trusted adult for help. If someone confides in you, first make it clear you’re not in a hurry and thank them for sharing.

The first step in suicide prevention is identifying if the person needs help, and the severity and immediacy of that risk. You can do that by asking three questions.

1. Have you wished you weren’t alive anymore?

2. Have you had thoughts about killing yourself?

3. Have you ever done anything to try to kill yourself?

If they share specific thoughts, plans or actions you need to take action right away. Some teenagers may have vague thoughts about giving up from time-to-time, and they may not have any plans to harm themselves. Even so, it’s important to address this concern because it could progress to something more serious. If you talk to someone with a specific plan for suicide, especially if they have access to whatever is necessary to carry out the attempt, this is an emergency.

Always encourage that person to seek help and let them know you’ll need to tell their parents. The parents have a right to know and you should never keep thoughts of suicide confidential.

If your child is at risk for suicide, get them into counseling or take them to the emergency room if there’s a more immediate concern. Make sure make sure weapons are out-of-sight and locked up. Assure that your child doesn’t have access to prescriptions and over-the-counter medications such as Tylenol, Ibuprofen and Benadryl, as these medications can be just as dangerous as prescription medications.

Adolescence is a time of tremendous change, and impulsive decisions can have serious consequences. We need to remember that it takes a strong person to acknowledge that they need help, and we need our athletes to know it’s important to accept help when offered. The vast majority of people who face suicidal thoughts recover. We need to expand our focus, not only on how to identify those at risk, but on how recovery is possible. Many amazing athletes at one time faced tremendous struggles, and yet they got help and went on to thrive. We need our patients and families to know that recovery from mental health conditions is possible.

Note: If your child or someone you know is exhibiting signs of depression or suicide, if they are struggling with difficult thoughts and feelings, there is help available. Children’s Mercy social workers are available to connect you with services in your area. Need to talk to someone? Call (800) 273-TALK (8255). The Lifeline is available 24 hours a day, 7 days a week – and is free and confidential. 
 

Learn more about identifying suicide risks in teenagers.

Learn more about the Columbia-Suicide Severity Rating Scale.