Sports psychiatry is a

medical specialty A medical specialty is a branch of medical practice that is focused on a defined group of patients, diseases, skills, or philosophy. Examples include those branches of medicine that deal exclusively with children (paediatrics), cancer (oncology), ...

that aims to treat and prevent

mental disorder A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...

s in athletes and helps them use different techniques to enhance their performance. First mentioned in literature in 1967, it is a developing area that relies on other fields, like

sports psychology Sport psychology was defined by the European Federation of Sport in 1996, as the study of the psychological basis, processes, and effects of sport. Otherwise, sport is considered as any physical activity where the individuals engage for competi ...

History

The first publication on sports psychiatry was written in 1967 by Arnold R Beisser, a doctor and tennis player. It was brought up in literature again twenty years later by JH Rick Massimino, MD, and mentioned again in 1992 by California-based psychiatrist Daniel Begel, who is known for officially launching the specialty. As the field developed, the

World Psychiatric Association The World Psychiatric Association is an international umbrella organisation of psychiatric societies. Objectives and goals Originally created to produce world psychiatric congresses, it has evolved to hold regional meetings, to promote profess ...

eventually created a section on Exercise and Sports Psychiatry, giving way for interest in other countries, including Britain and Germany.

International Society for Sports Psychiatry

In 1994, Begel founded the International Society for Sports Psychiatry (ISSP). The organization aims to spread the benefits of the field to the entire athletic community and promote mental health in sports. ISSP membership in 2020 is open to medical students, residents, psychiatrists, and other clinicians at times.

Requirements

The requirements to be a sports psychiatrist as of 2018 are the same as for any psychiatrist. However, in addition to that, they must be aware of individual and team culture as well as approach the prescription of medication with a perspective on

doping in sports In competitive sports, doping is the use of banned athletic performance-enhancing drugs by athletic competitors as a way of cheating in sports. The term ''doping'' is widely used by organizations that regulate sporting competitions. The use of ...

Professional differences

Differences between

sports psychologist Sport psychology was defined by the European Federation of Sport in 1996, as the study of the psychological basis, processes, and effects of sport. Otherwise, sport is considered as any physical activity where the individuals engage for competi ...

s and psychiatrists, according to Antonia Baum, are that although both areas aim to enhance athletes' performance, psychiatry also focuses on

psychopathology Psychopathology is the study of abnormal cognition, behaviour, and experiences which differs according to social norms and rests upon a number of constructs that are deemed to be the social norm at any particular era. Biological psychopatholo ...

and tries to uncover deeper issues than performance problems. Additionally, psychiatrists are able to prescribe

psychotropic medication A psychoactive drug, psychopharmaceutical, psychoactive agent or psychotropic drug is a chemical substance, that changes functions of the nervous system, and results in alterations in perception, mood, consciousness, cognition or behavior. Th ...

Common areas of study

Some of the most commonly found mental disorders in athletes that sports psychiatrists may come in contact with include

mood disorder A mood disorder, also known as an affective disorder, is any of a group of conditions of mental and behavioral disorder where a disturbance in the person's mood is the main underlying feature. The classification is in the ''Diagnostic and Stat ...

s (such as

major depressive disorder Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. Introdu ...

bipolar disorder Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and periods of abnormally elevated mood that last from days to weeks each. If the elevated mood is severe or associated with ...

anxiety disorders Anxiety disorders are a cluster of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal function are significantly impaired. Anxiety may cause physi ...

(including

social anxiety disorder Social anxiety disorder (SAD), also known as social phobia, is an anxiety disorder characterized by sentiments of fear and anxiety in social situations, causing considerable distress and impaired ability to function in at least some aspects ...

, obsessive-compulsive disorder,

eating disorders An eating disorder is a mental disorder defined by abnormal eating behaviors that negatively affect a person's physical or mental health. Only one eating disorder can be diagnosed at a given time. Types of eating disorders include binge eating ...

attention deficit hyperactivity disorder Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inap ...

(ADHD), and

substance abuse Substance abuse, also known as drug abuse, is the use of a drug in amounts or by methods which are harmful to the individual or others. It is a form of substance-related disorder. Differing definitions of drug abuse are used in public health, ...

), and more sport-specific ones such as

concussions A concussion, also known as a mild traumatic brain injury (mTBI), is a head injury that temporarily affects brain functioning. Symptoms may include loss of consciousness (LOC); memory loss; headaches; difficulty with thinking, concentration, ...

body dysmorphic disorder Body dysmorphic disorder (BDD), occasionally still called dysmorphophobia, is a mental disorder characterized by the obsessive idea that some aspect of one's own body part or appearance is severely flawed and therefore warrants exceptional meas ...

traumatic brain injuries A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. TBI can be classified based on severity (ranging from mild traumatic brain injury TBI/concussionto severe traumatic ...

(TBI), and

chronic traumatic encephalopathy Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease linked to repeated trauma to the head. The encephalopathy symptoms can include behavioral problems, mood problems, and problems with thinking. The disease often gets worse o ...

(CTE). Eating and body dysmorphic disorders have higher incidence in women in sports that emphasize appearance, like gymnastics or figure skating. Substance abuse is commonly found in the athletic community. College athletes have been reported to use alcohol at higher levels than the general public despite its detriment to performance.

Anabolic steroids Anabolic steroids, also known more properly as anabolic–androgenic steroids (AAS), are steroidal androgens that include natural androgens like testosterone as well as synthetic androgens that are structurally related and have similar effects t ...

are also a widely abused substance among athletes. These aid athletes in faster training and recovery time, but may also have psychiatric side effects like irritability and mood swings. Substance abuse is a concern among elite athletes.

Commonly used techniques

The treatments of choice for many mental illnesses experienced by athletes include psychotropic medication as well as, depending on the specific situation and life of the athlete,

psychotherapy Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome pro ...

psychoeducation Psychoeducation (a portmanteau of psychological education) is an evidence-based therapeutic intervention for patients and their loved ones that provides information and support to better understand and cope with illness. Psychoeducation is most oft ...

counseling Counseling is the professional guidance of the individual by utilizing psychological methods especially in collecting case history data, using various techniques of the personal interview, and testing interests and aptitudes. This is a list of co ...

, and

family therapy Family therapy (also referred to as family counseling, family systems therapy, marriage and family therapy, couple and family therapy) is a branch of psychology and clinical social work that works with families and couples in intimate relationsh ...

Psychotropic medication

Usually, sports psychiatrists choose non-sedating medications because they are less likely to cause side effects such as an increase in weight and body fat, sedentary behavior, a decrease in insulin sensitivity, cardiac issues. The effect on athletes' performance must also be taken into consideration, as well the anti-doping guidelines of different sports leagues. The

World Anti-Doping Agency The World Anti-Doping Agency (WADA; french: Agence mondiale antidopage, AMA) is a foundation initiated by the International Olympic Committee based in Canada to promote, coordinate, and monitor the fight against drugs in sports. The agency's key ...

(WADA) provides a list of generally banned substances, and it is left to each leagues' discretion to add a more strict code. Widely used medications include

antidepressants Antidepressants are a class of medication used to treat major depressive disorder, anxiety disorders, chronic pain conditions, and to help manage addictions. Common side-effects of antidepressants include dry mouth, weight gain, dizziness, heada ...

(e.g.

bupropion Bupropion, sold under the brand names Wellbutrin and Zyban among others, is an atypical antidepressant primarily used to treat major depressive disorder and to support smoking cessation. It is also popular as an add-on medication in the case ...

mood stabilizers A mood stabilizer is a psychiatric medication used to treat mood disorders characterized by intense and sustained mood shifts, such as bipolar disorder and the bipolar type of schizoaffective disorder. Uses Mood stabilizers are best known for th ...

anticonvulsants Anticonvulsants (also known as antiepileptic drugs or recently as antiseizure drugs) are a diverse group of pharmacological agents used in the treatment of epileptic seizures. Anticonvulsants are also increasingly being used in the treatment of b ...

(e.g.

lithium Lithium (from el, λίθος, lithos, lit=stone) is a chemical element with the symbol Li and atomic number 3. It is a soft, silvery-white alkali metal. Under standard conditions, it is the least dense metal and the least dense solid el ...

anxiolytics An anxiolytic (; also antipanic or antianxiety agent) is a medication or other intervention that reduces anxiety. This effect is in contrast to anxiogenic agents which increase anxiety. Anxiolytic medications are used for the treatment of anxie ...

(e.g.

benzodiazepines Benzodiazepines (BZD, BDZ, BZs), sometimes called "benzos", are a class of depressant drugs whose core chemical structure is the fusion of a benzene ring and a diazepine ring. They are prescribed to treat conditions such as anxiety disorders, i ...

Psychostimulants Stimulants (also often referred to as psychostimulants or colloquially as uppers) is an overarching term that covers many drugs including those that increase activity of the central nervous system and the body, drugs that are pleasurable and inv ...

/ ADHD medications (e.g.

dextroamphetamine Dextroamphetamine is a central nervous system (CNS) stimulant and an amphetamine enantiomer that is prescribed for the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy. It is also used as an athletic performance and ...

), and sometimes sedative hypnotics and

antipsychotics Antipsychotics, also known as neuroleptics, are a class of Psychiatric medication, psychotropic medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia but ...

Mental health stigma

In professional sports more than others, seeking assistance to improve one's mental health is often stigmatized. Athletes will most commonly seek help from psychologists first or not go for help at all, and serious mental health-related issues might go unrecognized. Hence, another role of sports psychiatrists is to help de-stigmatize and promote mental health among athletes.

History

International Society for Sports Psychiatry

Requirements

Professional differences

Common areas of study

Commonly used techniques

Psychotropic medication

Mental health stigma

See also

References

Further reading