0 Female Athlete Triad: Sport Gone Bad

By Claudia L. Reardon, M.D.

Psychiatrists encourage nearly everyone to participate in sports and exercise. Sports not only improve physical health but also can greatly improve mental well-being. However, if girls and women take involvement in sports too far, they can suffer a well-described triad of symptoms. The so-called female athlete triad consists of the following three inter-linked health problems:

1. Insufficient caloric intake/disordered eating


2. Menstrual problems


3. Weak bones

Girls and women who participate in “leanness sports” that emphasize thinness (running, ballet, gymnastics, figure skating, and others) are particularly at risk. If they receive the message that being thinner could result in greater athletic success, they may try to cut down on their caloric intake to levels too low to support their levels of physical activity. This can result in full-blown eating disorders, irregular menstrual cycles, and weak bones (including osteoporosis at young ages).

Some common myths about the female athlete triad include the following:

• If an athlete’s performance has not started suffering, then she must not have a problem. FACT:  Even if an athlete’s performance has not started suffering, it eventually will.  Not taking in enough calories to match activity level is not sustainable in the long-run.


• It is normal for female athletes to stop menstruating. FACT:  It is never normal for a female athlete to stop menstruating. There are serious health risks, especially bone loss, to not menstruating. Studies show that after three years of not menstruating, bone loss is likely to be permanent. Loss of future reproductive function could also occur.


• If an athlete is not eating enough to match activity level, she is aware of what she's doing. FACT: Denial is powerful. Athletes will very often feel that they are being as healthy as possible, and that meticulous attention to diet is a sign of dedication to sport. Coaches, parents, and professionals will need to help the athlete see the problems with the behaviors.


• An athlete who eats “healthy," is a top performer on the team, and excels in class is unlikely to have an eating disorder. FACT: Traits that are desirable in an athlete can make them more at risk of developing an eating disorder. Mental toughness, pursuit of excellence, performance despite pain, commitment to training, and being a team player are very similar to excessive exercise, perfectionism, denial of discomfort, and being self-less.

What can you do if someone you know might be suffering from the female athlete triad?

1. Share your concerns with the athlete.


2. Talk with the coach, athletic trainer, or school counselor.


3. Encourage the athlete to see a physician and dietitian. Not all health care professionals are familiar with the details of the female athlete triad; to help them out, you can send along this brochure with the athlete to the appointment.

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0 Seeing Stars is a Serious Deal - Sports-Related Concussions

By Claudia L. Reardon, M.D.

Concussions in athletes have received increased media attention recently.  More and more evidence shows that there can be serious short- and long-term consequences of concussions if athletes return to physical activity too soon.  A concussion is a brain injury and must be treated very seriously. 

How do you know if someone has sustained a concussion?  Signs and symptoms of a concussion after an athlete hits his/her head include:

• Headache


• Nausea/vomiting


• Dizziness


• Vision changes


• Sensitivity to light and sound


• Feeling confused or groggy


• Concentration difficulties


• Inability to remember events before or after the hit


• Mood, behavior, or personality changes

Importantly, most athletes with concussions won’t experience all of these signs and symptoms.  Some of them might not appear for hours or even days.  If you, a coach, a game official, or medical provider suspect a concussion, take the following steps:

• Remove the athlete from the game/practice immediately.


• Seek medical attention.


• Do not return to physical activity until cleared by a physician.  Returning to activity too soon can cause long-term physical and psychiatric problems and even death.


• When returning to play, do so gradually, under the guidance of your health care provider.

Sports participation has many positive physical and mental health benefits for children and adults alike.  In the spirit of competition, athletes and coaches often want to do everything they can to win.  However, if a concussion is suspected, it is not worth it to risk long-term brain damage to stay in the game to help the team.   

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Detail: Seeing Stars is a Serious Deal - Sports-Related Concussions

0 Concussion: Getting Back in the Game?

American Psychiatric Association Healthy Minds blogger and sports psychiatriy expert Claudia Reardon, M.D., discusses concussions in young athletes in this video blog:

Detail: Concussion: Getting Back in the Game?

0 Athletes Suffer from Depression Too

By Claudia L. Reardon, M.D.

Athletes don’t get depressed, right? After all, they are so physically fit and healthy that they must be equally emotionally healthy. Unfortunately, this is not true. Just like the rest of us, athletes can be at risk for depression. This is the case all the way from the school-aged child playing on a recreational team, up to the professional athlete who makes a living playing his or her sport.



Whenever we see a news story about a famous athlete with depression or an athlete who has committed suicide, it tends to come as a big surprise since athletes tend to be glamorized and admired in our society. However, here are some things we know about the reality of depression in athletes:



1. Athletes seem to be at least as likely as the general population to suffer from depression.

2. Athletes who suffer multiple concussions are up to four times as likely as other athletes to suffer depression. Athletes in some sports, including football, hockey, and soccer, are especially likely to suffer concussions.



3. Overtraining syndrome can occur in athletes who are seriously training for an event and do so beyond the body’s ability to recover. Overtraining can look very similar to depression and can actually lead to full-blown depression. Like depression, overtraining can include fatigue, insomnia, appetite change, weight loss, difficulties with motivation, and poor concentration. Overtrained athletes usually notice that their sports performance worsens. They may develop more injuries; experience muscle and joint pain, and lose enthusiasm for their sport. If an athlete is overtrained, the treatment is usually to cut back on physical activity or do cross training at a lower intensity until the symptoms start to improve. If overtraining leads to full-blown depression, medication and/or talk therapy may also be helpful.



4. Besides concussions and overtraining, other common factors that can lead to depression in athletes include injuries, competitive failure, aging, retirement from sport, and the same daily stressors that can lead to depression in the general population.



5. In recent years, athletes across several sports have started to open up about their struggles with depression. Hopefully this will help athletes with depression to feel better about seeking help for this disorder.

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