Recently I was saddened to hear that the NRL legend Greg Inglis had entered himself into a mental health facility suffering from depression. Inglis at 30 years of age had hit rock bottom and made comments that he felt “completely lost”. Whether it was the ACL injury that finished Inglis for the season that led to his breakdown or other pre-disposing factors is not entirely clear.
The story has lingered in my mind since the news broke. Depression is a problem for many Australians and anyone who struggles with its torment knows the pain. I am not writing as a psychologist or a doctor, I am writing this article as a practitioner who sees the demands that professional sport places on its stars and how some just can’t cope.
Depression in athletes is not just isolated to contact sports such as league and union it is often the illness that finishes careers of swimmers, gymnasts and any other highly competitive sports.
In a contact sport such as rugby league, players need to be “fired up”. The adrenaline runs high and they play as if it is real life battle. As in any stressful situation, our adrenal glands secrete our stress hormones: adrenaline and nor-adrenaline, therefore increasing cortisol levels.
GENERAL ADAPTATION SYNDROME IN ATHLETES:
It could be said that we all require stress. Stress is what motivates us to achieve and stay on top of life. In athletes it makes them hungry to compete and win, however in the long term this can really deplete their performance as they cannot rise to the challenge as they once did.
The term GAS (General Adaptation Syndrome) is commonly used to explain the progression of exhaustion caused by continual stress. (6) This concept was developed by Hans Selye, briefly this is how the body responds to stress over an extended period.
Alarm Phase (reaction): this is the stage where our body produces stress hormones, adrenaline and nor-adrenaline.
Resistance Phase: when the reaction to stress becomes so sustained that stress becomes the new normal. This is new equilibrium is known as allostatic load.
Exhaustion Phase: after prolonged periods of stress the adrenals cannot continue to produce the hormones required to continue responding to the situation of constant stress. This phase of exhaustion often leads to a range of physical and mental illnesses.
Elite athletes they are under constant stress to win and preform. In the case of rugby league the brain must respond in a way that if you don’t play like you are being chased by a brown bear you are going to end up being tackled by the league equivalent of a brown bear. As with many athletes along with the exhaustion comes the endless trail of injuries to add to the body’s inability to adapt. It comes as no surprise that athletes at this level are just falling apart mentally not just physically.
SUPPORTING STRESS IN ATHLETES:
Preventing burnout in athletes is vital to the longevity of their career and they overall well being. It does not solve the problem of physical injuries but supporting their mental well being they return after injury in a better place than if all the focus being only their physical fitness.
Supporting stress in athletes is not much different to how I would support any normal person in times of extreme stress. The only difference is that they have more physical stress to accompany the mental stress.
Supporting stress in athletes focuses on reducing the allostatic load of stress. Reducing cortisol levels in athletes requires shifting the nervous system from the Sympathetic (fight or flight) state to the Para-Sympathetic (rest and digest) state. The Para-sympathetic state is the condition where the athlete can cease responding as if they are being chased by huge front row forward constantly.
Supporting stress in athletes makes sense not just for their mental well being but also to aid their recovery. Elevated levels of adrenaline increase inflammatory cytokines, this leads to oxidative stress. Consequently, a constant state of stress in athletes is more likely to cause injury and impair their recovery time.
It is could be understood that stress is vital for a league player to stay on top of his game. Stress would keep his reflexes fast and make him fearless in his efforts to perform. However once they are off the field balancing the nervous system may be key to keeping them not burning out.
SUPPLEMENTATION FOR ATHLETES:
There are dozens of different concoctions that could be recommended for athletes to perform better and recover faster. The following recommendations are aiming more towards mental well being than increased performance. However supporting mental well being in the long term will improve an athletes output.
B-Group Vitamins: in times of stress the body’s demand for B vitamins increase, in particular B5 (Pantothenic Acid). Vitamin B5 has a vital role in producing adrenal hormones and lowering cortisol levels. B-group vitamins are collectively involved in the metabolic pathway known as methylation which is produces serotonin and adrenaline. (1)
Vitamin C: naturally lowers cortisol levels in athletes. In times of stress our adrenal glands require significantly more vitamin C.(2)
Magnesium: as well as aiding muscle recovery in athletes, magnesium is recommended for reducing the allostatic load in athletes without impairing their performance. Magnesium is crucial is supporting adequate rest and recovery in healthy athletes. (1)
Essential Fatty Acids: Omega-3 fatty acids not just reduce inflammation in athletes but support the nervous system. (2)
Zinc: is depleted in athletes due to excessive perspiration and urine. Zinc is required for various human functions including mental health. Zinc deficiency is indicated in cases of depression and anxiety. (3)
WHAT HAS GABA GOT TO DO WITH IT?
GABA or Gamma-aminobutyric acid is a neurotransmitter produced to reduce stress. GABA reduces the allostatic load associated with constant stress. (4) GABA allows the brain to switch off after intense training or a tough game. GABA supports the parasympathetic nervous system, therefore it balances the fight and flight stress associated with competitive sport. The brain and requires various nutrients to produce GABA; magnesium, B6, B12, folate, Vitamin C, zinc and the amino acid glutamine.
Supporting GABA production in athletes may be the key to supporting their adrenal load and preventing premature burnout.
GUT HEALTH AND ATHLETES:
Even though many athletes are in top physical condition their digestive health may be suffering. This can be due to diets that cycle high carbohydrate and high protein. High carbohydrate diets can cause dysbiosis (imbalance of flora) in the small intestine. A high protein diet for extended periods may cause constipation and other digestive complaints.
Due to injuries, many athletes may be prescribed strong anti-inflammatory drugs to reduce inflammation and pain. These drugs have harsh side effects on the digestive system, such as constipation and ulceration.
When the digestive system is not working harmoniously this can lead to mood related conditions such as anxiety and depression. (5)
Supporting digestive health in athletes with adequate fibre, probiotics, digestive enzymes and fermented foods may assist their physical and mental wellbeing.
DOES THIS ONLY APPLY IF YOU ARE AN ATHLETE?
Many people who experience stress and are at risk of burnout would benefit from many of the recommendations I have made. Supporting stress, anxiety and depression is always a multi-faceted treatment protocol. Nutritional medicine supports mental health by recommending changes to diet, lifestyle and correcting nutrient imbalances.
(2) Braun L & Cohen M, 2010.“Herbs and Natural Supplements, 3rd Edition. Chatswood: Elsevier Australia
(3)Chu A, Samman S (2014) Zinc Homeostasis in Exercise: Implications for Physical Performance. Vitam Miner 3:e132. doi:10.4172/vms.1000e132
(4)Boonstra, E., de Kleijn, R., Colzato, L. S., Alkemade, A., Forstmann, B. U., & Nieuwenhuis, S. (2015). Neurotransmitters as food supplements: the effects of GABA on brain and behavior. , , 1520. http://doi.org/10.3389/fpsyg.2015.01520
(5) Trivedi, M. H. (2004). The Link Between Depression and Physical Symptoms. , (suppl 1), 12–16.