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MENTAL HEALTH IN BASEBALL: FEAR STRIKES OUT?
By Jim Bloch
Community Relations, St. Clair County CMH

Say you’re a professional baseball pitcher. How would it be possible to pitch in front of tens of thousands of fans if you had a social anxiety disorder? According the DSM-IV, a social anxiety disorder is a “marked and persistent fear of social or performance situations in which embarrassment may occur.” Frequently, people with social anxiety disorders fear being judged as weak, stupid or “crazy.” They often try to avoid the situations that cause them anxiety. Being exposed to such a situation can trigger panic attacks involving palpitations, tremors, sweating, diarrhea and confusion. The answer is that you probably cannot pitch under such conditions. In the world of pro sports, where physical and mental invulnerability are paramount, it would be difficult to admit to having a mental illness. But it’s getting easier, thanks to advances in Major League Baseball and the The continuing struggles of former Detroit Tiger Dontrelle Willis provides an interesting starting point for a look at mental health in professional sports. Dontrelle in Detroit
Dontrelle Willis, known as the D-Train, electrified the baseball world in 2003, winning Rookie of the Year and propelling the Florida Marlins to a World Series championship. The lefty, known for his high leg kick and magnetic personality, led the National League in victories in 2005 with 22. He has barely equaled that number of victories in the subsequent five seasons. This year, he has one victory playing with three teams. After two years of trying to get Willis back on track, the Detroit Tigers traded him to the Arizona Diamondbacks on June 1. For Arizona, Willis had a 1-1 record with a 6.85 ERA. He walked 27 men in 22 1/3 innings. Arizona released him on July 6. On July 14, the San Francisco Giants signed him to a minor league contract. Detroit paid him – and is still paying him with the Giants – about $29 million to make 22 starts over parts of three seasons, pitching 101 innings in which he won What’s up? According to a number of news reports, Willis battled social anxiety disorder during his stay with the Tigers over the past two seasons. Why would two teams jump at the chance to acquire him after the Tigers First, a lefty with a record of past success like Willis’ is always enticing. Second, Detroit is paying the tab – Willis is in the last year of a $29 million contract in which he’s making $12 million this year. Third – and this is pure hunch – the front offices of the Arizona and San Francisco ball clubs might not fully believe Willis’ mental health diagnosis. If Willis really has social anxiety disorder, the likelihood is that there is no quick fix. It won’t go away like a cold. Cognitive behavioral therapy is effective in improving the symptoms in 75 percent of individuals with social anxiety disorder, according to the Mayo Clinic. Medications, especially selective serotonin reuptake inhibitors, such as paraxetine (Paxil), sertraline (Zoloft), fluvoxamine (Luvox) and fluoxtine (Prozac, Sarafen) are the safest and most effective medications available for social anxiety disorder. Most individuals who live with social anxiety disorders can expect, with proper treatment, a dramatic decrease in symptoms, but not their full disappearance. Chances are that they will need to continue their therapy and medication to manage their symptoms successfully. Without treatment, as the social anxiety escalates, the individual will tend to isolate himself, creating the conditions for other mental illnesses, such as depression. If Giants and Diamondbacks found Dontrelle’s diagnosis to be credible, they probably would realize that a quick fix is unlikely. But a quick fix seems to have been their goal. How many times have you heard that a “change of scenery” might get a faltering “The Diamondbacks are hoping that Dontrelle Willis benefits from a change of scenery,” wrote Nick Piecoro in the Arizona Republic on June 1. There was hardly a mention of Willis’ social anxiety disorder in the Arizona media. Listen to Bobby Evans, VP of baseball operations with the Giants, the team that claimed him: “You’ve got an arm like that, you get him in our system the way we prepare our pitchers, and maybe he’ll have some success.” You can’t blame the D’backs or the Giants for taking a shot with the D-Train on Further, there has been plenty of speculation in the media over the past two years about whether Willis really had a social anxiety disorder. Willis himself seemed to deny it. “Even when I went on the DL (disabled list), I felt fine,” Willis told NBC reporter Josh Alter on May 13, 2009, as he was about to make his first start of the season with Tigers after spending most of 2008 on the disabled list. “You can ask anybody in here. I’m not a depressed guy. Maybe I’m hard on myself, but I wouldn’t have gotten here if I wasn’t… As far as how I feel, I don’t have a condition. My condition is me going out there and playing baseball and having fun.” In the end, we don’t know if Willis really has a mental illness – his right to medical privacy seems to have withstood prying – or what role it played in the Tigers trading him and the D’backs giving up on him. On the other hand, if teams and players are strong enough to stand up in the face of the stigma that surrounds mental illness, it appears that baseball is the best professional sport in which to begin the road to recovery. MLB’s Disabled List for Emotional Disturbances
On April 1, last year, MLB formally instituted a disabled list for emotional disorders, according to a June 21 story in Sport Illustrated, thus becoming the most forward-thinking of all major professional sports when it comes to mental health Teams could now place players on the DL for emotional disorders if they were “evaluated and diagnosed by a mental health professional as suffering from a mental disability that prevents a player from rendering services.” Last season, after MLB sent letters to all teams advising them of the so-called “mental DL,” teams placed five players on the list, including Dontrelle: Oakland starter Justin Duchscherer for clinical depression; Cardinals shortstop Khalil Greene for social anxiety disorder; former Diamondback reliever Scott Schoeneweis for clinical depression; and Reds first baseman Joey Votto for clinical depression and anxiety attacks. Votto is a candidate for Most Valuable Player this year in the National League. Of course, baseball players are not the only pro athletes with mental health problems. In the NFL, we can think of Ricky Williams, social anxiety disorder, Barrett Robbins, bipolar disorder, Pittsburgh’s Terry Bradshaw, depression, or the Detroit Lions Eric Hipple, depression, who works with the Depression Center at the University of Michigan to educate the public about depression and its link to suicide. In pro hockey, former Toronto star Ron Ellis speaks about his experience with depression. Ron Artest thanked his psychiatrist after helping the Lakers win the NBA championship in June. Baseball, however, is alone in its commitment to the mental health of players. MLB has a long history of tackling the personal problems of players. In 1981, largely in response to drug and alcohol problems, MLB mandated that every team establish an Employee Assistance Program. As concerns shifted from drugs to an array of personal issues, the EAPs laid the groundwork for the DL for emotional issues, according to the SI story. At this point, we don’t know if the baseball players listed above, including Willis, received appropriate mental health treatment. So we cannot definitively say that But it appears that the stigma surrounding mental illness in baseball is lessening, thanks in large part to Zack Greinke. Greinke, the Kansas City Royal pitcher who won the Cy Young award last year, spent most of the 2006 season being treated for clinical depression and social anxiety disorder. For Greinke, therapy and anti-depressant medication laid the groundwork for his “The medicine is unbelievable,” Greinke told SI this spring. “I’m still the same person, but my attitude about everything is different.” From Greinke’s point of view, a change of scenery would probably be insufficient “I hate to make this comparison,” said former teammate Mike Sweeney, a DH after years of catching, in the SI story, “but Zack was like Jackie Robinson. Whether he likes it or not, he’s the guy who really paved the way for the modern player to come out about these types of issues.” To read the Sports Illustrated story “A Light in the Darkness: Mental Health in Baseball” by Pablo S. Torre, visit or click on http://sportsillustrated.cnn.com/vault/article/magazine/MAG1170866/1/index.htm

Source: http://www.macmhb.org/PR_Committee/Mental_health_in_baseball%20_2_.pdf