Research by sports scientists reveals that high-performance athletes face unique mental health challenges despite the well-established benefits of physical activity for depression prevention and treatment.
While moderate exercise is widely recognized for its positive impact on mental health, elite athletes experience specific pressures that can contribute to depression, including performance nerves, injury concerns and identity crises.
These findings are detailed in the comprehensive new book, Physical Activity, Physical Fitness and Depression, edited by researchers Adilson Marques and Élvio Rúbio Gouveia. The book brings together critical reviews examining the relationship between physical activity, fitness and depression, with contributions from more than two dozen academics across multiple disciplines.
Depression among elite athletes
Depression represents a significant global health burden, affecting over 264 million people worldwide, and elite athletes are just as susceptible.
In a chapter by authors Hugo Sarmento, Diogo Martinho and Pedro Teques, which specifically addresses mental health challenges in elite sports, the researchers explain: “Depression in high-performance sports is a complex phenomenon influenced by multiple factors.”
Their studies suggest that ‘young athletes and high-performance athletes can be vulnerable to depression’ despite their high levels of physical activity, and the standard self-reporting criteria used for the general population may not be sufficient in identifying depressive symptoms in athletes.
The scholars find several risk factors unique to elite athletes, including performance pressure, identity challenges and difficult career transitions. The researchers recommend that athletes get specific support upon retirement, as this period is a particularly vulnerable time when many athletes struggle with identity loss and purpose.
While physical activity generally serves as a protective factor against depression, the intense training regimens and competitive pressures of elite sports create a different dynamic. Although meta-analyses show the relative number of athletes experiencing depressive symptoms generally mirrors the wider population, it may be harder to identify using standard clinical methods as they might not fit the physical profile and could be more likely to underreport due to favoring traits like perseverance.
The authors explain: “The high prevalence of depression indicates that it constitutes a public health problem with potentially severe consequences.”
The researchers call for comprehensive mental health programs integrated into athletic training environments, and for sports organisations, coaches and health professionals to work collaboratively to develop effective screening tools and support systems specifically designed for high-performance athletes.
Physical activity and depression
For the general population, the book provides extensive evidence supporting moderate physical activity as an effective intervention for both preventing and treating depression. While antidepressant medications remain a cornerstone of treatment, their efficacy varies considerably among patients.
“Regular physical activity is associated with lower depressive symptoms and risk of depression in adults and older adults,” the authors suggest. Research cited in the book indicates that people engaging in higher levels of physical activity exhibit a 17% decreased risk of depression onset.
Physical activity offers substantial benefits for individuals with depressive symptoms by improving cognitive function and emotional regulation. The authors argue that physical activity should be considered as a complementary or alternative approach to traditional treatments, particularly when medication is not working.
Despite promising findings, the researchers emphasize that physical activity, exercise and depression research has a ‘long way to go’, and they call for more investigation, including looking at how to translate trials into clinical practice to enable clinicians to give specific advice on how much exercise, what type and for how long.
The authors conclude that tailored approaches are key, whether a high-performance athlete or member of the general public, but add: “Given its numerous benefits, physical activity should be integrated into clinical settings as a standard component of depression treatment.”