Helenius interview casts light on football's depression problem

In his time at Aston Villa, Nicklas Helenius battled severe depression that left him with, among other things, suicidal thoughts. Reading the interview he gave to Danish TV3 today was heartbreaking, but it was hardly shocking. Depression is a significant problem in football, and it's one that is receiving far too little attention. Every single week players are pushed to their physical extremes and are asked to perform under incredible (in the most literal sense of that word) pressure. It's nice to think of footballers as lucky folks who have it all going for them, but the toll it takes on the mind is immense.

A survey of 300 current and former professional footballers released this spring revealed that one in four players suffered from symptoms of depression or anxiety. I'm inclined to think that the numbers may actually be higher than that, as the lack of information about mental health means that many probably don't realize that they are suffering as well. The survey showed that footballers were more likely to have issues with mental illness, and that the likelihood increased immediately after retirement. That makes sense given that those who have just retired have seen the almost singular purpose of the entire life disappear. And this usually happens at a (relatively) young age. Imagine working for something for your entire life and having that structure suddenly gone.

Perhaps the most visible example of depression's effects on footballers is the case of Gary Speed. The former player had retired and gone on to manage Wales when in 2011 he hanged himself. At an inquest into his death afterwards, testimony was heard from a number of medical professionals in Speed's life:

"The hearing was told by the Welsh national team's GP, Dr Mark Ridgewell, that Speed had showed no signs of stress and depression.

Dr Bob Muggleton, the medical officer at Sheffield United - the club Speed managed before taking on the Wales job - told the inquest in Warrington that he had worked with him until 2010 and no mental health issues were raised during that time."

But the generally accepted understanding has been that Speed suffered from depression and that his death was, at least tangentially, a result of that. Even Speed's sister, though, had no idea that her brother was struggling with mental illness: "He hid it from us and it stopped him asking for help."

That quote comes from an article by Clarke Carlisle, a former centre back who had a promising career that was, in part, hampered by depression. He presented a documentary on suicide in football for the BBC, and even tells of his own story of attempting suicide only to be saved. In Carlisle's telling, it becomes apparent that mental illness is as hard to detect for those suffering from it as for those around them.

"I didn't actually realise I was depressive until a few years ago, when my wife was diagnosed with post-natal depression. I'd told her to 'get a grip' and reminded her that we had a great house, great car, lovely kids etc etc.

Then I was told about Goldberg's depression test. I looked at the checklist and soon understood what she was going through. I also realised 'that's me'. When I took the test, the result came through that I was suffering from severe depression."

It's striking, reading that statement, that his own depression was so difficult for Carlisle to detect. But it's also interesting to see that such a simple test could help diagnose what can be a far-from-simple problem.

Carlisle's statement also emphasises another problem with depression: even when the symptoms are seen, people tend to make light of them. In Carlisle's case it was towards his wife. In football, it has prevented players from getting help. Carlisle talks about former Aston Villa midfielder Lee Hendrie and former Norwich striker Leon McKenzie. The former twice tried to take his life after having to declare bankruptcy, clearly showing that the help he needed was not given. The latter also tried to kill himself in the midst of a depressive breakdown after injury and a crumbling relationship. Carlisle writes:

"As chairman of the Professional Footballers' Association, I was shocked to hear that Leon had phoned my organisation to talk about his depression yet had not been given an understanding response.

It was very telling that neither Lee nor Leon felt they could talk to anyone about their problems."

Another area in which depression is a significant problem is with foreign-born players. For many, they have left their homes at a young age, traveled to a country where they don't speak the language, and been tasked with playing football at the very highest level possible. Helenius' problems seem to have abated fairly quickly after returning to Aalborg in Denmark for his loan this year. It's easy to understand that the mental health issues faced by all footballers would be amplified by the feelings of isolation that must come from seemingly being alone in a foreign land.

Things are being done, thankfully. Vincent Pericard, a former striker for, among others, Juventus, Portsmouth, and Stoke, has set up the Elite Welfare Management group to help players. In his career, Pericard suffered from depression, and retired because his "passion had gone." The group he set up is dedicated to providing confidential support for players in many areas. Their focus is on foreign-born players, and their approach to mental health is refreshing:

While clubs have seen considerable advances in their physiological and technical knowledge, subsequently producing previously unattainable physical performances, there is a significant increased awareness that unless the player is psychologically healthy and socially satisfied all of the other physical and technical gains are lost.

Players, coaches and support staff are beginning to understand that players' psychological and social well-being is actually as important as their physical health and strong mentalities are necessary in order to achieve maximum potential both on and off the field of play.

Our team comprises of Doctors, Clinical Psychologists, Psychological Coaches, CBT and NLP Practitioners, which are geographically placed throughout the United Kingdom.

But despite efforts by some, there is still not enough being done. The aforementioned study of current and former players made a sweeping claim from its results: "mental illness among former professional footballers cannot be underestimated and should be a subject of interest for all stakeholders in football." That means you, me, players, owners, and back room staffs. This is an issue that needs more focus, and it's one that needs to be handled in a shame-free way. There is nothing anyone can do to prevent depression. Those who are depressed haven't done anything wrong, and the macho culture in football that stigmatizes something "minor" like mental health is one that could (and likely already has) lead to serious damage.

Let's start changing that now.