Tuesday, 26 November 2013

"Stress Related Illness"

I really enjoyed the recently completed Brisbane Ashes Test, especially since Australia won so convincingly after such a long drought.  I certainly enjoyed seeing the Australians dominate Jonathan Trott, a player who has scored plenty of runs against them in previous series.

However, I'm not enjoying the aftermath, with Trott returning home with a "stress-related illness".  Naturally I feel sad that Trott is unwell, and hope his recovery is swift and complete.  I also feel disturbed by the euphemistic description of his illness and the hush-hush way in which everyone seems to talk about it.


Cricketers, like other elite sportspeople, are prone to frequent physical injuries.  It's the nature of elite sport, where people push themselves to the limit of their physical capabilities.  We hear about these injuries in forensic detail.  Everyone who cares about cricket knows all about Michael Clarke's degenerative disc, Kevin Pietersen's chronic knee problem, Shane Watson's dodgy calves and hamstrings and the struggles of teams the world over to manage fast bowlers' risk of back injury.  We know when the injuries happen, the dates and times of their scans, the grading of the tear or sprain, the treatment process and the expected recovery time.  It's all out there in the public realm.

Of course opponents are not slow to try and exploit any weakness.  England bowlers know that Clarke's back can make playing the short ball more difficult and so he was peppered with bouncers in both innings.  It was spectacularly successful in the first innings, a failure in the second.

The same seems to apply to mental health problems.  Players certainly seem aware when their opponents are struggling psychologically and don't hesitate to exploit it.  Hence before, during and after the Brisbane Test Trott was sledged mercilessly on and off the field.  It worked.  He was out cheaply in both innings and now he's gone home. 

That's the ruthlessness of sport, win at all costs and all that.  It's ugly, but it's the same for everyone.  What I find more problematic is that elite sporting organisations seem to be so far behind the rest of society in the way they deal with mental illness.  Now that Trott has gone home, the English hierarchy reveals that he has been "struggling with a stress-related condition for some time".  In other words, he probably brought it to Australia with him, and was possibly also suffering from it in the mid-year series in England when his performances were definitely below par. 

Yet unlike Clarke's back, Peterson's knee or Watson's hamstring, it was never mentioned.  Even now we don't know for sure what the illness is.  Journalists writing about the event have referred back to similar events involving England players Marcus Trescothick and Michael Yardy, both of whom suffer from depression, so that's where I'd be putting my money. 

In a perceptive article written for Cricinfo in 2011, Australian batsman and occasional author Ed Cowan shone the spotlight on the issue.  Estimates vary, but perhaps 5-10% of the population at any time is suffering from depression or anxiety, and up to 20% will at some point in their lives.  Cowan suggests that this figure is far higher for elite sportsmen, including cricketers - perhaps twice as high.  If this is true, it is almost certain that other members of both teams are currently struggling with similar conditions. 

There are various reasons why sports people are more prone to mental illness than other people.  Elite sports tend to attract people who are driven and obsessive, and OCD is strongly linked to depression.  Elite sportsmen and women operate in high pressure environments where their performance can be judged vary harshly and opponents exploit any weakness.  International cricketers travel constantly and hence are separated from their families for long periods.  Professional sport can be an emotional roller-coaster ride and the emptiness that comes after success can tip people over the edge just as much as the self-doubt brought on by failure.

However, Cowan laments the lack of openness about these issues.

Sadly, despite growing awareness about mental health issues outside of the change room, it is still something of a taboo topic within. While cricketers know there is a fantastic support network available through the players' associations, these issues are rarely, in my experience, openly discussed among the players themselves.

The consequence of such secrecy is also clear - players often don't seek treatment, and attempt to self-diagnose and self-medicate.  I don't know about cricketers, but former rugby league star Andrew Johns and former AFL star Ben Cousins have both attributed their cocaine addictions to misguided attempts to self-medicate for chronic anxiety. 

It is telling that Cowan himself only names two cricketers who suffer from depression - former West Australian wicketkeeper Ryan Campbell, and former New Zealand fast bowler Ian O'Brien.  Neither are team-mates of Cowan, and both have spoken publicly about their depression.  Cowan must know many more - otherwise why write the article? - but he is obviously not free to name them.  Maybe naming would be seen as equivalent to shaming.

I long for the day when cricket captains and coaches will feel comfortable saying, "He's suffering from depression.  He was first diagnosed about two months ago and has been taking antidepressants and having weekly counselling sessions.  We're confident the problem is being well managed and he's not in doubt for the game".  Or whatever.  It's not shameful, and it need not be a secret, any more than it's shameful to strain your hamstring.  It just happens, it's the way humans are made. 

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