Athletes in Recovery: Thanksgiving Football Edition

If you and your family are planning to watch one of the three NFL games scheduled for Thanksgiving Day or one of the twelve NFL games scheduled for the Sunday following Thanksgiving, your thoughts may turn to players’ health.

Physical trauma including concussions on the field can cause progressive cognitive disorders including Chronic Traumatic Encephalopathy (CTE). CTE and other slow-developing brain diseases may cause behavioral health problems in the present. Players may also struggle with mental health conditions and addiction issues that predate their careers and/or that worsen once they leave the league. Four retired athletes use their platforms to talk about mental health:

““When I first heard the term “mental health,” the first thing that came to mind was mental toughness. Masking pain. Hiding it. Keeping it inside. That had been embedded in me since I was a kid. Never show weakness. Suck it up. Play through it. Live through it. Now, I realize that mental health means the total opposite.””

— Brandon Marshall

Brandon Marshall, former wide receiver for the Seattle Seahawks, wrote in a 2017 essay for the Players Tribune, “When I first heard the term “mental health,” the first thing that came to mind was mental toughness. Masking pain. Hiding it. Keeping it inside. That had been embedded in me since I was a kid. Never show weakness. Suck it up. Play through it. Live through it. Now, I realize that mental health means the total opposite.” After receiving a diagnosis of Borderline Personality Disorder in 2011, Marshall felt relief. After years of suffering, being able to name the disorder helped him understand it, and understanding it helps him manage it. He wrote, “I always say that football is my platform, not my purpose. I believe my purpose is to serve as an example for people who are suffering from mental illness — to show them that it’s O.K. to seek help.”

““And I think that’s why I didn’t want to go to the hospital that night…It wasn’t the help that scared me. I was afraid that if I told somebody what was happening to me, they would confirm my biggest fear. That I was crazy.” ”

— Gerald McRath

Retired linebacker Gerald McRath wrote about his struggles with depression, anxiety, and substance use after an injury pushed him out of the league: “And I think that’s why I didn’t want to go to the hospital that night…It wasn’t the help that scared me. I was afraid that if I told somebody what was happening to me, they would confirm my biggest fear. That I was crazy.” For him, depression led to increased substance use, which contributed to increased anxiety and panic attacks. McRath received 30 days of inpatient care to address his substance abuse issues and mental health, and offered the following advice: “If you’re struggling, don’t wait for something bad to happen. Don’t wait for a wake-up call. Talk to somebody. It’s not as scary as you think. There is hope. There is light. Just talk to somebody. Because fighting alone is the worst way to fight.”

““It just felt like my body was deteriorating more and more, and I couldn’t understand why. I kept asking myself, “Why was I thinking this way, why am I not happy, why am I depressed?””

— Lauvale Sape

Former Oakland Raiders defensive tackle Lauvale Sape pushed through a traumatic childhood using football as an outlet, but found that the feelings returned once he retired. After he left the league and he and his wife suffered a stillbirth, he wrote “It just felt like my body was deteriorating more and more, and I couldn’t understand why. I kept asking myself, “Why was I thinking this way, why am I not happy, why am I depressed?” I didn’t know anything about depression and anxiety and I didn’t know that I had gotten really angry at the world, and I was very suicidal. I didn’t care about what was going on around me, it didn’t matter anymore.” Describing the way he views depression today, he explained, “It’s not that it’s “bad,” it’s just that we have to understand where we’re at and where we stand with our illness.”

““Over time, I grew more isolated and more distant from Courtney and the kids — from everybody, really — while I tried to sort myself out and deal with whatever the hell was going on with me. I thought a lot about the way I was acting, and I just chalked it all up to being fresh out of the NFL and not being in tune with “real life” yet. I figured I was just in a funk because I missed the game, and everything that came along with it.” ”

— Jermichael FInley

Former Green Bay Packers tight end Jermichael Finley suffered a devastating spinal cord concussion that ended his career. But even before that injury, other concussions and injuries had caused trauma. In an essay for the Players Tribune, he wrote, “Over time, I grew more isolated and more distant from Courtney and the kids — from everybody, really — while I tried to sort myself out and deal with whatever the hell was going on with me. I thought a lot about the way I was acting, and I just chalked it all up to being fresh out of the NFL and not being in tune with “real life” yet. I figured I was just in a funk because I missed the game, and everything that came along with it.” Jermichael’s accumulated concussions affected his mood and his memory, leading him to seek treatment from a neurological clinic. After starting meditation, therapy, and cognitive retraining programs, he wrote, “I’m as happy and healthy as I’ve ever been, and it’s all because I was able to swallow my pride and go get help.”

Megan Mulvaney is an MA, MPH Candidate and Public Health researcher at Workit. She’s committed to delivering evidence-based addiction treatment and brings over 11 years of experience in healthcare operations to the WorkIt team.

Profession-Specific Addiction Recovery Resources

Addiction affects people from all walks of life and in all professions. However, employees in certain fields report higher rates of substance abuse than others.

According to SAMHSA’s 2012 report on Substance Use and Substance Use Disorder by Industry, the five fields with the highest rates of substance use disorder are accommodations and food services (16.9% prevalence); construction (14.3% prevalence); arts, entertainment, and recreation (12.9% prevalence); mining (11.8% prevalence); and utilities (11.5% prevalence).

Figure 3. Past year substance use disorder among adults aged 18 to 64 employed full time, by industry category: combined 2008 to 2012

* The full title of this category is “Management of companies and enterprises, administration, support, waste management, and remediation services.”Source: SAMHSA (2012), Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health (NSDUHs) 2008 to 2010 (revised March 2012) and 2011 to 2012. Retrieved from https://www.samhsa.gov/data/sites/default/files/report_1959/ShortReport-1959.html

You may find that you have access to addictive substances including alcohol and prescription drugs through your everyday job responsibilities (including serving drinks or dispensing controlled substances), that addictive substances are provided to you as a perk (including in green rooms or after a shift at work), or that workplace injuries introduce you to addictive substances. The following recovery resources were developed for and/or by professionals in a variety of fields. This is not an exhaustive list – if your profession is not represented on this list, let us know in the comments!

  • Union members including autoworkers, trade professionals, and construction workers may find resources and support through their locals or Employee Assistance Programs, and union reps can help coordinate time off work for treatment and other needs. Families may also have access to these resources.

  • Lawyers and judges, first responders, and licensed healthcare professionals can find 12-step meetings and inpatient or outpatient treatment programs specific to members of their fields. State licensing boards and Physician Health Programs in Michigan, California, New Jersey, and other states also have programs for healthcare professionals to seek treatment, maintain their employment and licenses, and ensure public safety.

  • Food and beverage and hospitality industry employees can find support from other industry workers at Ben’s Friends meetings in multiple states.

  • Touring musicians can find local support and resources through Detroit, MI-based Passenger Recovery.

Megan Mulvaney is an MA, MPH Candidate and Public Health researcher at Workit. She’s committed to delivering evidence-based addiction treatment and brings over 11 years of experience in healthcare operations to the WorkIt team.

Substance Use Recovery Within the LGBT Community

Members of the LGBT+ community can find themselves relying on coping mechanisms like drinking to handle discrimination and harassment. So what happens when you get sober?

Lots of people in recovery from addiction talk about always knowing they were different from their peers, or being able to find belonging and peace only through substance use.

For members of the LGBT+ community, these feelings can be magnified. Long-term experiences of discrimination and harassment or exposure to specific traumatic events can increase reliance on coping mechanisms like drinking, while internalized homophobia or transphobia can cause cognitive dissonance and discomfort. Gay bars and clubs promise fun, community, and safety, and many networking and social events within the LGBT+ community involve alcohol.

“Deciding to get sober felt like cutting the rope to an anchor that sometimes kept me safe but more often held me back.”

In my experience, deciding to get sober felt like cutting the rope to an anchor that sometimes kept me safe but more often held me back. Restructuring ways of spending time and developing new habits was a big task. Many friends had no idea how bad my use and my health actually were. Years removed from the crises that first led me to sobriety, I offer the following suggestions to my queer peers: it’s important to build new networks and find new tools to help you reach your health and wellness goals.

If you are part of the 12 Step recovery community, try an LGBT meeting. Look for resources to help you quit at LGBT community centers in your state. If you attend therapy, evaluate whether you are comfortable being open about all aspects of your life with the clinician you’re working with. At pride events, seek out dedicated sober spaces. Investigate whether medication like buprenorphine or naltrexone could be a tool for harm reduction that would help you meet your goals.

Most importantly, know that this is not something you have to do alone.

Megan Mulvaney is an MA, MPH Candidate and Public Health researcher at Workit. She’s committed to delivering evidence-based addiction treatment and brings over 11 years of experience in healthcare operations to the WorkIt team.

Men’s Health: Athletes In Recovery

June is Men’s Health Month. In honor of all the great male athletes we wanted to focus in on four different mental health struggles and discuss how these men were able to overcome obstacles during their careers.

From the archives of the Players’ Tribune: current and former professional athletes get real about experiencing mental illness, overcoming stigma, and how they got help.

On Depression and Substance Abuse:

““This is real life. As real as it gets. Guys are suffering. In some cases, people are dying. And it simply doesn’t have to be like that.” ”

— Nick Boynton, NHL (Retired)

Retired NHL player Nick Boynton experienced multiple concussions on the ice, suffered pre-game anxiety, developed drug and alcohol addiction, and was traded by the first team he asked for help. After getting sober, he found that he still struggles with crushing depression. Seeking help for mental health issues has meant, for Nick, recognizing that addiction and mental illness co-exist, and that they require separate treatment. In a 2018 Players’ Tribune essay, he wrote, “For me individually, nothing is guaranteed at this point. I’ve still got lots of issues to try and fight through, and every day presents new challenges. But one thing I know for certain is that I’m done lying and pretending that everything’s O.K…”

To read more from Nick Boynton (June 13, 2018): https://www.theplayerstribune.com/en-us/articles/nick-boynton-everythings-not-ok

On Panic Disorder:

““It was like my body was trying to say to me, You’re about to die.” ”

— Kevin Love, NBA

Cleveland Cavaliers center and power forward Kevin Love suffered an on-court panic attack in November 2017. Kevin began challenging the messages he had absorbed as a child, as a young man, and as a professional athlete about how to handle emotion, stress, and grief. Writing about the experience in the Players’ Tribune in March 2018, he said, “I’d thought the hardest part was over after I had the panic attack. It was the opposite. Now I was left wondering why it happened — and why I didn’t want to talk about it…I know you don’t just get rid of problems by talking about them, but I’ve learned that over time maybe you can better understand them and make them more manageable. Look, I’m not saying, Everyone go see a therapist. The biggest lesson for me since November wasn’t about a therapist — it was about confronting the fact that I needed help.”

To read more from Kevin Love (March 6, 2018): https://www.theplayerstribune.com/en-us/articles/kevin-love-everyone-is-going-through-something

On Obsessive-Compulsive Disorder:

““I am not insane. I am not a bad person. I am not weak. I have an illness, and there is a treatment.” ”

— Corey Hirsch, NHL (Retired)

Corey Hirsch could only find relief from his dark, frightening intrusive thoughts while he was on the ice. Eventually, though, even his games were affected. After being diagnosed with Obsessive-Compulsive Disorder, which can cause intrusive thoughts, Corey was relieved to learn that his experiences were not caused by a moral failing or a personal weakness. In his 2017 Players’ Tribune essay, he credits a therapist with helping him understand the disorder and how to manage it, and credits his former teammates, managers, and team psychologists for their support: “When I think back on those years in the NHL, when I was lost completely lost in the darkness, it is painful. But I will never, ever forget the teammates who tried to protect me. I will never forget the guys who went out of their way to make sure I had somebody to talk to, even though I never told them what was really wrong. For all they knew, I was just an arrogant kid. But they were there for me anyway.”

To read more from Corey Hirsch (February 15, 2017): https://www.theplayerstribune.com/en-us/articles/corey-hirsch-dark-dark-dark

On Depression and Childhood Trauma:

““So, What the hell happened to Darius Miles? Man, a lot. A lot happened to Darius Miles. But it’s 2018 now — and I’ll tell you one thing. He alright.” ”

— Darius Miles, NBA (Retired)

Darius Miles went from high school in East St. Louis to playing for the LA Clippers at age 18. The neighborhood trauma he experienced as a child was compounded by personal losses while playing in the NBA. He recounted this experience in the Players’ Tribune: “My whole life, I used basketball as an escape. When you grow up how I grew up, I think you’re probably bound to have some kind of PTSD. I ain’t a doctor, but when you grow up running from gunshots all the time, I think there’s something inside you that never leaves…My people were dropping like flies when I was in the league ― homies, cousins, my grandmomma ― and I never cried, not one damn time.” After Miles’ mother died, he suffered a 3-year depressive episode, compounded by anxiety and paranoia. Today, his mental health is improving, and he surrounds himself with friends and support.

To read more from Darius Miles (October 24, 2018): https://www.theplayerstribune.com/en-us/articles/what-the-hell-happened-to-darius-miles

Mental illness, substance abuse, and trauma, are all difficult to overcome. Especially while in the spotlight because with these illnesses comes great stigma. If you are struggling, remember to take things one day at a time and to not be ashamed. We are all here to support you!

Megan Mulvaney is an MA, MPH Candidate and Public Health researcher at Workit. She’s committed to delivering evidence-based addiction treatment and brings over 11 years of experience in healthcare operations to the WorkIt team.

What You Need to Know About Non-Opioid Advance Directives

When in recovery from opioid addiction, what if you get sick or injured? How will medical teams know your own wishes around opioids?

Michigan residents may now place an opioid-specific advance directive in their medical files. Advance directives tell doctors and other medical staff what your wishes are in the event that you are unable to communicate or advocate for yourself, and this form will tell doctors not to prescribe opioids except in limited circumstances.

Advance directives are not perfect. Although there is a statewide electronic repository for these forms, there is no guarantee that every hospital or medical center will check it for every patient. When possible, patients or caregivers should provide copies of advance directives before a patient undergoes a medical procedure or when changing healthcare systems. Don’t forget to share this information with dentists and oral surgeons as well.

Michigan’s non-opioid advance directive tells doctors that they should only prescribe opioids for hospice care and for medication-assisted treatment for substance use disorder. Alaska, Connecticut, Louisiana, Massachusetts, Pennsylvania, Rhode Island, and West Virginia have similar opioid-specific forms, but patients in every state can write in instructions regarding opioids to a general advance directive document.

If amending an existing advance directive in any state or creating a new one in a state without an opioid-specific form, it may be wise to review non-opioid advance directive forms from the states that do offer them: make sure that the opioid prescribing preferences you write will cover any exceptions you may need.

If you are in recovery from addiction of any kind, you may find that a non-opioid advance directive becomes part of your toolkit to protect your sobriety.

Check out Michigan’s non-opioid advance directive, and the state’s advance directive electronic repository.

Megan Mulvaney is an MA, MPH Candidate and Public Health researcher at Workit. She’s committed to delivering evidence-based addiction treatment and brings over 11 years of experience in healthcare operations to the WorkIt team.