Athletes and mental health - a need for increased awareness


Photo: Dr. Daniel Rafie (l) and Brandon Bostick (r) prepare for the BrainSPORT podcast

Former NFL player Brandon Bostick joins UCLA BrainSPORT podcast to stress dual treatment of the brain and the mind.

Christopher Giza, MD, director of the UCLA Steve Tisch BrainSPORT Program, knows that mental health and brain health are connected and that both should be treated together.

Yet they are often viewed as separate and distinct.

“When people ask me are you going to do neurological treatment or psychiatric treatment, I tell them the last time I checked, it’s all one brain,” Dr. Giza said. “To have overall good brain health, you can’t just treat the neurological and you can’t just treat the mental health. You have to treat them both.”

BrainSPORT conducts research and works with athletes to diagnose and treat brain health and – in tandem – mental health.

Former NFL player Brandon Bostick understands the need for the dual approach.

BrainSPORT podcast addresses mental health

On a new episode of The BrainSPORT podcast, Bostick sat down with Dr. Daniel Rafie, sports neurologist and Dr. Doug Polster, sports neuropsychologist with the Tisch BrainSPORT program, to discuss his battle with depression since leaving the game of football.

Bostick, a tight end with the Green Bay Packers from 2012-2015, talked about a mistake he made in a game that played a key role in his team not reaching the Super Bowl in 2015. In trying to recover an onside kick with roughly two minutes left in the NFC Championship game – a play that likely would have sealed the victory – Bostick mishandled the ball and allowed the Seattle Seahawks to gain possession.

From there, the game spiraled out of control and the Packers lost 28-22. The Packers season was abruptly over.

It was the beginning of the end for Bostick’s NFL career. He soon was cut by the Packers and like most NFL players who are let go, Bostick immediately began looking for his next team. He was picked up by the Minnesota Vikings only to ask the team for his release due to lack of playing time.

Bostick received interest from a few other teams but admitted it was hard for him to focus mentally because his costly mistake in the NFC Championship game still haunted him, leading him to believe he wasn’t good enough to play anymore.

“I didn’t know I was dealing with anything mental health related,” Bostick said. “I knew what I was feeling because I was living it. I just couldn’t describe what it was.”

Bostick said he was unaware of possible mental health issues because he was too focused on his career.

“When my agent asked me if I wanted to see a therapist. I told him I wasn’t interested. I was just focused on getting back to football,” Bostick said during the podcast.

Bostick turned to partying and drugs as a coping mechanism, he said. A random NFL-sanctioned drug test further derailed Bostic’s career after MDMA was found in his system. The drug, also known as “Molly” or “Ecstasy,” is a psychoactive drug that causes a high.

“A lot of it had to do with the social media aspect,” Bostick said of his post-career struggle, which was exacerbated by public criticism over his play in the NFC Championship game. “Just seeing the comments, the memes, and people saying what I couldn’t do just brought me down even lower.”

Listen to the BrainSPORT podcast featuring Brandon Bostick.

Psychological trauma and its effect on the brain

Dr. Polster said Bostick’s story is similar to what many people go through when experiencing a traumatic event.

“In life, we go through traumatic experiences and the mind does things to protect us from those experiences,” Dr. Polster said. “One of the ways we treat traumatic experiences is to remember them and go through them, but in the moment, the brain has a way of trying to protect you from being overwhelmed.”

Dr. Polster explained there are many types of traumatic experience. It could be a physical attack, a car accident, or, as in Bostick’s case, a traumatic mental health event.

“Certainly when it comes to our patients, mental health is on our minds when we’re trying to treat someone or diagnose them with the most debilitating thing they have going on,” Dr. Polster said on the podcast.

Lack of mental health awareness

Bostick said few NFL players or former players are focused on their mental health because their mind is on so many other things.

“I wasn’t thinking about my mental health after I was cut,” Bostick admitted. “You have to play in the league three years to get your pension. I wasn’t a vested player at the time. I was just trying to get back on the field.”

Dr. Rafie said many pro players are at risk of mental health challenges beyond the game – some in part related to head injuries, but also due to factors such as deciding when to retire, a significant change in income once they leave the game, or being trained to fight through pain.

“The reason it’s so difficult is because it’s not as simple as saying, ‘Hey dude, be vulnerable,’” said Dr. Rafie. “These guys have thrived on that psychological resilience in pushing past pain in order to be successful. So why wouldn’t that be the case with your mental health, your emotions or your feelings? They’ve been taught to suppress that pain and just push past it.”

It took Bostick time and work to get to this place of vulnerability. And Dr. Giza and Dr. Rafie said it will take more players like Bostic to help other athletes reach that same psychological state.

“We need more Brandon Bosticks,” Dr. Rafie said. “If you have guys like Brandon coming on, doing podcasts, and being vulnerable and transparent about their mental health journey, it’s going to trickle down and it’s going to affect the college guys and then ultimately the high school and Pop Warner (youth league) kids too.”

A long way to go

Though great strides have been made in the area of mental health care among athletes, Dr. Giza said, there is still quite a way to go. There are big hurdles to overcome.

“It’s a real challenge in our medical system because even though I talked about brain health and mental health being associated with one brain, our medical system doesn’t always see it that way,” Dr. Giza said in an interview. “Mental health is often covered by a different insurance and sometimes it’s not even covered at all.”

Dr. Giza said mental health programs are needed for collegiate, high school and youth sports but lack of resources and funding make it difficult. He says having an athletic trainer on site for high school and youth sports can at least help with the mental and physical health component.

In May of 2019, the NFL Players Association and the league mandated that each team appoint a behavioral health team clinician. This is a step in the right direction, but Bostick believes more can be done.

“I think the NFL is doing the best they can, but players have to hold themselves accountable too,” Bostick said. “Just being an athlete in the pros, a lot of those players have the mindset of ‘I can handle it’ or ‘I just have to push through the pain.’ But, you can’t handle mental health like that.”

Bostick added he thinks the NFL can do a better job of transitioning players out of the sport by putting a program in place that helps them mentally with the idea of retirement and finding purpose outside of football.

Similar programs would be beneficial for collegiate and high school athletes who don’t go on to a pro career, he said.

Victory in life beyond football

For Bostick, 2019 was a critical year. It was the year he realized he had to do something about his mind.

“That was when I was diagnosed with major depressive disorder and social anxiety,” he said on the podcast.

Bostick committed to getting his mind and life under control. Now he’s paying it forward by coaching youth football in Arizona.

“Because of the journey I have been on, I coach a little differently,” Bostick said. “I’m all about showing love and teaching. I want to help the kids who are struggling.

“I’m not just trying to be the best coach to these kids, but the best man to them as well, because they need a leader and they look up to me.”

Bostick also has a message for those still playing in the NFL and those who are considering retirement: “Become more educated with mental health and how others operate emotionally and physically. Also, speaking up and being vulnerable with what you’re going through will definitely help you with your own personal struggles.”

Learn more about the BrainSPORT Program.