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From Steroids to SSRIS: What Do We Really Mean By "Performance-Enhancement?"

Much hay has been made in the past few months over the use of performance-enhancing drugs in sport, but the question remains: what makes a drug performance-enhancing?

According to the World Anti-Doping Code, three substance categories govern the chemistry of cheating—1) It has the potential to enhance or enhances sport performance 2) It represents a potential or actual health risk 3) It is contrary to the spirit of sport—with a score of two-out-of-three being enough to earn a drug a place on the dreaded Prohibited List.

But what does it mean to “enhance sport performance?” Talk to most professional athletes and you’ll find them in agreement: the mental aspects of the game are significantly more important than the physical aspects. How important? Well, in Michael MacCambridge’s America’s Game: The Epic Story of How Pro Football Captured a Nation, Marty Shottenheimer, the winningest coach in the history of football, says that 75 percent of all the mistakes made in the NFL draft would be eliminated if someone could develop a psychological test to measure how incoming players deal with three pressures: a) more adoration and recognition than they’ve ever received before b) more unsupervised time than they’ve ever had in their lives c) more money than they’ve ever had in their lives.”

And Shottenheimer’s list is only one set of psychological factors. There are others, with mood foremost among them. In fact, in the past twenty years, there have been hundreds of studies done by hundreds of researchers linking a positive emotional state to superior athletic performance. Everyone from volleyball players to basketball stars to tennis players to cross country runners have been tested and with few exceptions more happiness equals more winning. And more happiness is now available in pill form.

Which brings us to Ricky Williams. In 1999, the New Orleans’ Saints traded eleven draft choices for a chance to select the star University of Texas running back. Williams, if the rumors were to be believed, would revolutionize the position, bringing glory and championships to a team sorely in need. Instead, he merely destroyed the team. How bad was Williams? Three years later he was traded away to Miami for draft picks. In Florida, he finally lived up to the hype. In his first year as a Dolphin, Williams rushed for a league-leading 1,853 yards and made the Pro Bowl. So startling was his turn-around that rumors of drug abuse soon followed. And those rumors were true. Williams was taking drugs. He was strung out on the antidepressant Paxil.

And he’s not the only one. Athlete depression has long been a closet issue, but with the big money to be made in the antidepressant market, that issue is being forced into the open. Along these lines, it is GlaxoSmithKline who manufactures Paxil and it is Glaxo who hired legendary Pittsburgh Steelers’ quarterback Terry Bradshaw to be their spokesman (he is currently touring the country on "The Terry Bradshaw Depression Tour”). So while no hard numbers exist, we can assume that a healthy portion of the ten million Americans taking their daily dose belong in the pro-athlete category. And all of these legally-obtained SSRIs are boosting their performance on the field (how this boost is occurring will be a topic for my next blog), right alongside their mood off of it.

Which raises another question: If steroids ruin careers, why does no one have a problem with Prozac Nation making the team?

Comments

Brain Injury and Depression

Interesting and exciting piece. Makes one think about the nature of the word "enhance." We always think of enhancement as a physical thing. As you point out, mental enhancement seems a whole other, perhaps overlooked, issue.

Only tangentially related but also very interesting are the studies on brain injury and depression. A notable study is the one done on retired NFL players, linking concussion to depression. Of course, this is a departure from what you've discussed here. But does suggest possible connectives that are interesting.


Depression and Concussions

I am a Professor (and psychologist) at University of South Florida where - among other topics - I conduct research on psychological factors affecting performance among combat sport athletes. I currently have a study underway with more than 400 mma fighters, grapplers, boxers, etc. Most specific aims of the study focus on sport performance, but I also am examining the effect of repetitive concussive injury on depression risk among these athletes.

As Mr Brodsky points out in the post above, in April of 2007 Kevin Guskiewicz and colleagues published in JSSM the results of their study on retired NFL players showing that multiple concussions were associated in a linear pattern with increased depression risk. In my study, I am using the same measure of concussion they used, but I incorporated a more specific measure of depression and the sample is much younger. My preliminary findings, however, are very consistent with the NFL study. Interestingly, though, I am also finding that some positive mental skills moderate that risk.

Is Mr Kotler suggesting that when athletes used standard practice guideline pharmacological treatments for their depressive disorders that this should be considered "doping" or "cheating"?


Maybe/Maybe not

Good comment. Interesting study. Scary stuff.

About SK: I think he's asking us to question what we mean by "enhance." I don't think he's saying anti-depressants= cheating.

Hey, another question. Is there any evidence to suggest that there's a correlation between depressive tendencies and extreme sport? I've heard a good amount on the exploration of sport (esp. brain injury) leading to depression. I'm also interested in the exploration of sport as self-medication. There has been plenty of discussion of all the positive pain killers released etc etc. I'm wondering if that line of inquiry has gone further in the direction I'm discussing. ?


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right on

This is absolutely true. I am a college baseball athlete and I can with out question say that antidepressants like zoloft and prozac help your performance.


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