By By Sandro Angulo Rincón
– Journalist: Danny, congratulations. There were so many questions before this fight, moving up in weight, the long break, the defeat before the break, and you’ve already had detractors. But did you ever doubt yourself?
– Boxer: I’ve been a bit dark. I went through some anxiety and depression. And I just tried to do my best to stay strong. That’s it (cries).
– Journalist: You know, the public rarely sees this in athletes. They only hear it. Can you describe what it’s like and how you try to overcome it?
– Boxer: Not just the pressure of life, the pressure of boxing, being a good father. I’m letting it all go right now. I’m letting it go because it weighed on me for a year and a half. And I know the only way to improve is to fight and win. I am a fighter. This is what I do. And I love doing it. And I noticed that if you bet against anxiety and depression, you can overcome them.
– Journalist: And is it an ongoing process?
– Boxer: I still struggle some days. Yes, I have some dark days. But I try to do my best to stay positive. But now I feel good. As you can see, it depends on a great show like tonight’s.
– Journalist: So, is the goal to become a champion again, or is the goal just that, to be okay?
– Boxer: People ask me daily: “You make good money in boxing; why do you keep fighting?” I am a fighter. This is what I do. I like to fight.
This is the summary of the interview that Danny García, an American boxer of Puerto Rican origin, gave to Jim Gray, an American journalist, after defeating José Benavídez Jr. by majority decision on July 30, 2022, at the Barclays Center in Brooklyn, New York (see video).
García, 35, a former super lightweight (140 pounds) champion of the World Boxing Association (WBA) and welterweight (147 pounds) of the World Boxing Council (WBC), was not talking about the fight, the decisive round, or the knockout blow, but about his depression. He openly described it in front of the live audience and those watching through the ESPN channel, despite the stigma that weighs on elite athletes – especially boxers – expected to appear strong and determined.
This scenario results from a double paradox: on the one hand, the athlete is expected to demonstrate vitality, strength, clarity, and a positive mood (the usual social representation of their figure), but never weakness. On the other hand, he engages in physical activity, which is part of the treatment doctors suggest for people suffering from depression since it activates neurotransmitters like serotonin, endorphins, oxytocin, or dopamine that produce pleasure, relaxation, and balance in the brain. However, for these athletes, exercise is precisely the activity that can trigger mental illness.
The expression “elite athlete” refers to professional sportspeople in a continuum of competition, starting with semi-elite in highly competitive youth programs, college sports, and professional leagues, and reaching the group of world-class athletes, frequent participants in the Olympic Games, World Championships, and Pan American, Pacific, European, Pan-African, and Asian Games. As sports psychologist María Cabrera Bolufer says, being in this category implies a very high mental demand, forcing them to face adversity and adapt to the changing high-performance scenarios. They also begin to deal with the pressure from their fans, sponsors, family members, media, and the nations they represent, as well as comments from their followers on social media.
Although we are accustomed to calling the daily contingencies of life depression, the truth is that specialists differentiate deep sadness from depression. According to psychiatrist Luis Rojas Marcos, co-author of the book “Heart and Mind,” normal sadness has three characteristics: (1) “It is an appropriate and coherent emotional response to a painful situation or a complete loss,” such as a romantic breakup or an unexpected job dismissal; (2) the intensity of normal sadness is proportional to the magnitude and duration of the event that causes it, meaning “the person perceives and values the circumstance that afflicts them correctly and does not distort or exaggerate it” and (3) this feeling eases or disappears when the cause ceases or the individual overcomes it emotionally. However, it is true that under some conditions or in vulnerable people, these griefs and internal sufferings can prolong and turn into major depressive disorder.
Depression, adds Dr. Rojas Marcos, implies a mental alteration with constant and noticeable symptoms for a minimum of 14 consecutive days. The usual symptoms are profound feelings of sadness, bitterness, and demoralization, with a prevalence of irrational thoughts of self-loathing and guilt, devaluation of life, and suicidal ideas. Other symptoms include:
– Slowness of movements, loss of energy, decreased appetite, difficulties in falling asleep, and loss of sexual libido.
– Limits the ability to enjoy occupations, leisure activities (anhedonia), and relationships with loved ones.
– Undermines the ability to adapt to changes and increases the tendency to say “no” to various opportunities, even if they are favorable.
In elite athletes, depression has other manifestations, detected by Pablo del Río, a sports psychologist: problems with sleeping and resting, changes in character, irritability, difficulty smiling, and deterioration in their physical appearance. Brais Méndez Portela, a Spanish football player, remembers how, on one occasion, he woke up vomiting at 4 in the morning in his home due to disturbing comments from his followers on social media, whistles from the stadium stand, and pressure to achieve good results for the Celta de Vigo team, where he was a midfielder.
The World Health Organization estimates that 3.8% of the population, about 280 million individuals, experiences depression. The percentages among elite athletes are ambivalent. According to research by Sebastian Harenberg and his colleagues, published in the International Review of Sport and Exercise Psychology, when athletes answer questionnaires anonymously to identify the presence of depression, that is when they are not required to give their name, nationality, and sport, the prevalence is high (23%), but when the questionnaires request open information about their profiles (name, sport, nationality), the percentage is reduced by half (11.4%). The researchers conclude that there is still a stigma among elite athletes regarding depression, leading them to hide the illness to avoid exposing themselves and it publicly, which prevents early treatment of this condition.
The causes of this illness among high-performance competitors are diverse. Psychologist Pablo del Río assures perfectionists are more prone to suffer from it because they experience more fear and overwhelm, as well as those who practice individual sports since introspection is more recurrent than those who practice team sports, where social interactions among teammates and colleagues alleviate stressful situations. Female athletes have a higher rate of depression. Being away from family, misunderstanding due to language and culture, and setting overly ambitious goals for one’s preparation and current fitness level are also triggers for this condition.
Another relevant variable is the current society, characterized by labeling them as superheroes, elevating them, and discarding them when they make mistakes or stop winning. This was the case with the fantastic Italian cyclist Marco “Il Pirata” Pantani, winner of the 1998 Tour de France and Giro d’Italia. When he was in his prime, the Italian society called him “the people’s pedaller.” Still, when he was disqualified in the 1999 Giro d’Italia for suspected doping with EPO (erythropoietin), drivers who saw him training on the roads of his country shouted “doper” at him. Although he always defended his innocence, his already devalued image became a reason to abuse drugs and antidepressants, leading to his death at 34. This story is featured in the documentary “The Accidental Death of a Cyclist,” directed by James Erskine and released in 2014 (watch it here).
Sports psychologist Pablo del Río states that when there is mental training parallel to physical exercise in any sports discipline, the rate of depression is low in elite athletes. This strategy should be implemented in the children’s and youth categories when the competition for medals and podiums begins. The coach, del Río adds, is a crucial person because, with primary mental health literacy, they can provide “first aid” to their pupil and then refer them to a specialist.
According to Paul Gorczynski, co-author of the book Health Care for Elite Athletes, when depression appears, it can be treated with psychotherapy and medication. Individual, couple/family, and group psychotherapies are available. The most used approach is cognitive-behavioral because it can explore the connections between thoughts, emotions, and behaviors. It is designed to help people identify and change their thoughts, beliefs, attitudes, and behaviors to improve emotional regulation. For example, making the athlete aware that goals must be realistic, teaching them to live with the anxiety and everyday stress of competition, and preparing them for achieving and not achieving their objectives.
Psychiatric medication must be administered with knowledge of its side effects, any deterioration in physical performance (decreased exercise intensity and increases in body weight), and the athlete’s safety (drowsiness). The most commonly used include norepinephrine-dopamine reuptake inhibitors (NDRIs), selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs). Care must also be taken to ensure that the medications are not included in the list of substances banned by the World Anti-Doping Agency.
If, at the end of reading this article, you have wondered about the health of Danny García, the latest news from Agon&Areté is that this boxer – who has a record of 37 wins, 3 losses, and 21 knockouts – is remarkably recovered. He even began to venture as a boxing promoter and could fight at 154 pounds (super welterweight) against the English Connor Benn (23-0-14 KOs). The fight would be disputed in the United Kingdom in 2024.
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