The Prevalence of Failure-Based Depression Among Elite Athletes

Objective: To assess the prevalence of diagnosed failure-based depression and self-reported symptoms of depression within a sample of elite swimmers competing for positions on Canadian Olympic and World Championship teams. Design: A cross-sectional design. Setting: Assessments were conducted after the conclusion of the qualifying swimming trials. Participants: The sample consisted of 50 varsity swimmers (28 men and 22 women) based at 2 Canadian universities who were competing to represent Canada internationally. Main Outcome Measures: Diagnosed depression was assessed using a semistructured interview, and symptoms of depression were also assessed by the Beck Depression Inventory II. Performance was measured by changes in swimming time and athlete ranking. Results: Before competition, 68% of athletes met criteria for a major depressive episode. More female athletes experienced depression than their male peers (P = 0.01). After the competition, 34% of athletes met diagnostic criteria and 26% self-reported mild to moderate symptoms of depression. The prevalence of depression doubled among the elite top 25% of athletes assessed. Within this group, performance failure was significantly associated with depression. Conclusions: The findings suggest that the prevalence of depression among elite athletes is higher than what has been previously reported in the literature. Being ranked among the very elite athletes is related to an increase in susceptibility to depression, particularly in relation to a failed performance. Given these findings, it is important to consider the mental health of athletes and have appropriate support services in place.