EXPERT ANALYSIS FROM THE ANNUAL MEETING OF THE AMERICAN PSYCHIATRIC ASSOCIATION
HONOLULU--They're not sports psychologists. And they're not neurologists. Sports psychiatrists have their own position to play in the care of athletes.
A neurologist deals with memory and function after concussion, for example, but a sports psychiatrist also diagnoses and treats the short- and long-term psychiatric sequelae of traumatic brain injury (TBI) or other injuries, Dr. Ira D. Glick said at the meeting.
A sports psychiatrist in general might diagnose and treat psychopathology, symptoms, or disorders within an athlete or problems related to the athlete's family, significant other, team, or the sport.
Just as a private-practice psychiatrist's job is to help bring patients to their highest quality of life, "our job as sports psychiatrists is to bring athletes to optimal mental health and athletic performance," said Dr. Glick, professor of psychiatry and behavioral sciences at Stanford (Calif.) University, who coauthored a paper with Dr. Claudia L. Reardon on the subject.
Treatment might target attention-deficit/hyperactivity disorder, anxiety disorders, depression, psychotic disorders (rarely), or substance abuse problems (frequently). Symptoms can interfere with performance, as in the athlete who develops so many obsessive-compulsive rituals before a game that he can't get on the field in time.
Aggression, cheating and gambling, and suicidal ideation and behavior all might occur less frequently in athletes than in the general population. However, there are always some who will engage in these behaviors.
In fact, Dr. Glick recently traveled to Germany to consult with psychiatrists in that country on the suicide of Robert Enke, the goalkeeper for Germany's national soccer team who took his life by train in 2009 after concealing many years of depression. The athlete's 2-year-old daughter had died 3 years earlier of a heart ailment.
At the time of his suicide, Mr. Enke apparently was in line to play for the national team at the 2010 World Cup.
Female athletes in particular face family problems that don't get enough attention. "It's almost impossible to have a life if you're a professional woman athlete. You're always on the move; you can't raise kids; you have to have your husband around to have a relationship," said Dr. Glick, who is on the board of directors of the International Society for Sports Psychiatry.
"These are tremendous family problems that have hardly been addressed. If somebody wants to make a career, focus on sports psychiatry now and carve out a niche" specializing in helping female athletes, Dr. Glick suggested.
Sports psychiatrists also look at systemic issues, such as the impact on athletes of the "posse" of people surrounding them, including agents, coaches, trainers, and others. Sports psychiatrists also might focus on problems in a particular sport, such as TBI in football, doping in cycling, or brain damage in boxing.
Once psychopathology is identified, the sports psychiatrist helps set goals. "One of the special characteristics of our field is deciding: goals for whom? The athlete? …