C02. Depression/depressed state

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Depression, which is thought to be experienced by nearly one-third of elite athletes, occurs in approximately 3% of cases per year in Japan and approximately 5% to 6% of cases in the United States, according to the World Health Organization.

As shown in the table, symptoms include depressed mood and loss of interest or pleasure, as well as appetite abnormalities, sleep disorders, mobility disorders, fatigue, loss of energy, difficulty thinking and concentrating, self-deprecating thoughts, suicidal thoughts, etc. Early detection and early intervention are important for recovery.

By the way, there is a type of depression with atypical features. Symptoms include being able to temporarily stay active even during periods of depression if there are fun things or things that need to be done, and being able to sleep and eat. This often leads people to misunderstand, "Are you really depressed?" Another thing is that my body feels heavy like lead. I tell my patients, " It's like a car with bad oil. Even if it looks like you're driving normally from the outside, when you step on the gas, it will run out of gas in no time."

They also often worry about what others think of them, thinking that they are seen in a negative light. Thy are a very considerate person when they are in good spirits, but when they become depressed, they feel like everyone thinks they are no good, and this feeling of victimization becomes stronger.

This type of depression is most common in people in their teens and twenties, starting from the upper grades of elementary school, and often manifests as school refusal or social withdrawal. It also often appears as part of bipolar disorder, a condition in which both mania and depression appear. The average age of onset of bipolar disorder is reported to be 20 years old. Since athletes often reach their peak in their teens and twenties, their depression often has atypical characteristics and is likely to be bipolar disorder .

As for treatment, drug therapy is used along with rest and psychotherapy such as cognitive behavioral therapy. It is important to note that antidepressants should be administered with extreme caution in young people, as they can worsen depression, intensify suicidal thoughts, or cause the patient to swithch to mania . Rather, medications used to treat depression in bipolar disorder are often more effective .