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Mental Illness and the Athlete. Objectives. Fatigue/Staleness/Overtraining/Burnout Psychology of Injury and Rehab Mental Illness: Mood Disorders Depression Bipolar disorder Seasonal Affective Disorder Anxiety Disorder Panic Attacks Phobias Obsessive Compulsive Disorder (OCD)
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Objectives • Fatigue/Staleness/Overtraining/Burnout • Psychology of Injury and Rehab • Mental Illness: • Mood Disorders • Depression • Bipolar disorder • Seasonal Affective Disorder • Anxiety Disorder • Panic Attacks • Phobias • Obsessive Compulsive Disorder (OCD) • Post-traumatic Stress Disorder • Attention Deficit Hyperactivity Disorder (ADHD) • Performance Enhancement • Imaging • Self-Talk • Relaxation • Mental Health Professionals
Patients in General • Less: • More: • They usually know how to deal with failure, adversity & pressure
Mechanism for Fatigue/Depression Poor performance ↓ Frustration ↓ Increased effort ↓ Increase fatigue
Staleness • Fatigue • Irritability • Depression • Related to an ↑ in training volume & intensity • Associated with a depletion of glycogen stores on muscle biopsy
Overtraining & Fatigue • Most common cause of fatigue • Overtraining can lead to fatigue & depression • Monitor mood states • Overtraining Syndrome:
Training Stresses • Intensive interval workouts • Short recovery time • Sudden increase • No periodization training • Other stresses
Overtraining Management • Diet • Training
Burnout • Presentation: • At risk: • Factors:
Psychology of Injury • Self-Worth/Athletic ID • How does Psychology affect athletes? • Initial Injury Assessment • Loss of self-ID • Decrease self-esteem • Isolation • Anxiety • Helplessness • TX:
Psychology of Rehabilitation • Secondary Gain • Malingering • Compliance
Psychological RED FLAG S/S • Family Hx • Change in sleep patterns • Change in cognitive status and function • Change in weight/appetite • Change in mood • Physical exams that don’t make sense
Mood Disorders • Depression; 10-20% prevalence • Definition • Causes: medical vs. other • Dx: Must have above definition plus 5 of 7 s/s • S/S: Distr. Sleep, unhappy, can’t concentrate, fatigue, suicidal thoughts, weight loss/gain, worthlessness, incr. in medical problems, sudden change in academic/athletic performance, isolation from family/friends
Mood Disorders • Depression: cont • Tx: • Meds: • Tricyclic Antidepressants (TCADs) or Selective • Seratonin Reuptake Inhibitors (SSRIs) • Citalopram (Celexa) • Escitalopram (Lexapro) • Fluoxetine (Prozac, Prozac Weekly) • Paroxetine (Paxil, Paxil CR) • Sertraline (Zoloft)
Mood Disorders • Bi-polar Disorder: Characterized by sequential periods of major depression and manic episodes that last for 1 week or require hospitalization • Associated S/S: • Tx:
Mood Disorders • Seasonal Affective Disorder • Depression that occurs only during particular seasons and is completely resolved during other time frames • S/S: • Tx:
Anxiety Disorders: Excessive worry that occurs in multiple settings creating difficulty in social functions • Panic Attacks: period of intense fear, discomfort or terror accompanied by thoughts of impending doom or loss of control • Panic Disorder: defined by recurrent episodes of unexpected panic attacks followed by worry about future attacks • S/S:
Anxiety Disorders • Phobias: Abnormal fear of a specific object or situation that does not cause anxiety in the average person • s/s:
Anxiety Disorders • Phobia List
Anxiety Disorders • Obsessive Compulsive Disorder (OCD) • Definition: recurrent obsessions/compulsions that can be time consuming or cause significant impairment • Washing and cleaning • Counting • Checking • Demanding reassurances • Repeating actions over and over • Arranging and making items appear orderly
Anxiety Disorders • Post-Traumatic Stress Disorder • Reaction to exposure to life-threatening events or similar stimuli outside of normal life events
Attention Deficit Hyperactivity Disorder • ADHD: neuro-behavior condition that impairs a persons ability to sustain attention or control activity and impulses in at least 2 settings • Types: • Tx:
Performance Enhancements • Imagery: Purpose is to rehearse action • Technique: • Self-talk: Athlete repeats aloud what is ideal • Relaxation: 2 Types
Mental Health Professions/Referral • 5 Mental Health Disciplines (US gov. recognized) • Psychiatry • Psychiatric Nursing • Psychology • Marriage and Family Therapy • Social Work • Other: • Professional counselors • Clergy members
Role of ATC • Recognize and referral (1st line of defense) • Know the professionals in your area • Can always start c primary MD