This physician helps the Bay Area’s elite athletes navigate mental health challenges

Mental health was once considered a taboo topic in the fiercely competitive world of sports.

But as salaries soared, social media gave fans a platform to vent, and a global pandemic exacerbated the psychological toll, mounting pressure and scrutiny. So have a number of high-profile athletes who have spoken out openly about their struggles with anxiety or depression.

For insight into how the mental health landscape is evolving in the world of sports, The Chronicle reached out to Dr. Francesco Dandekar, associate director of sports psychiatry and clinical assistant professor at Stanford University. Dandekar participates in the school’s Sports Psychology and Sports Psychiatry Program, which evaluates and treats professional, Olympic and collegiate athletes from across the Bay Area.
This interview has been edited for clarity and brevity.

Q: How has the job of a sports psychologist changed in recent years?

From the perspective of psychology, it has been expanded a lot. Previously, people thought of visualization or breathing techniques, things limited to performance: “On the basketball court, I have to shoot free throws in front of a big crowd, how do I focus myself?” Historically, it has been more focused on how this is used for performance. Recently, there has been a shift if I am happier in general and can integrate my athletic self and me
I tend to do better in general. If you want to do something at the elite level for a long time, it has to be sustainable. Many athletes realize that if they want to do this long-term, they don’t know if the coping strategies they’ve used will be enough. They’ve talked about it like, “If I don’t rely on substances for my cognition, if I don’t feel depressed in my hotel room for two days, I’m going to feel better as a human being and I’m going to perform better.” So there’s more integration between the person and the athlete.

Q: Do you need different tools now than in the past?

It’s a little different from a psychiatric point of view. The people who provide the best services are able to do more than the psychology of sports performance. I think there needs to be better at a lot of things. People may say, “I want to do better,” but they may have PTSD from a childhood trauma. It is essential to realize that there are a bunch of things going on. There’s still a stigma, but I think it’s great that you have so many high-profile athletes speaking out (about mental health). In many cultures, athletes and actors can change the conversation.

Q: How effective is that? Many NBA players, such as DeMar DeRozan, Kevin Love, and John Wall, have spoken out publicly about their mental health challenges.

The sports world faces a mental health expense. This story is part of a series looking at the challenges faced by all levels of competition and how to address them.

I think one of the worst pains a human being can feel is isolation, and especially isolation in their own suffering. And when you have someone who has pulled it off by all external measures — you’re in the NBA and you’ve got all this money — and wait, were you really worried? And you don’t want to go to the grocery store because you’ll be seeing people? You want to kill yourself? You hear Michael Phelps talk about things, and the relevance factor is huge. You start thinking, “Maybe I’m not that different.” We all think that what we go through is unique. When we hear people we hold dear say they struggle with similar things, it allows us to feel less alone. That in and of itself can be beneficial – it encourages people to see it as another part of life. … It’s really brave and helpful that so many of these outstanding athletes are sharing their stories. They definitely drive the conversation.

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