Practice makes perfect: Are athletes prone to OCD?
By Peter Aldhous, San Francisco Kelly MacDonald dreams of Olympic glory. But when her Canadian diving teammates competed at the Beijing games, MacDonald was absent. Her entry on the Diving Plongeon Canada website states that she has been “sidelined with injuries”. However, this week, MacDonald has spoken out for the first time about the real reason for her interrupted athletic career: obsessive-compulsive disorder, or OCD. Elite athletes often adhere to rituals and superstitions, which may help them control anxiety (see our round-up of sports star superstitions). An obsessive nature may also keep an athlete training after others call it a day. But when do these traits veer into illness? That was the question raised on 18 May at the annual meeting of the American Psychiatric Association, in a session held to raise awareness of what may be an unrecognised epidemic. OCD is a form of anxiety disorder, in which sufferers are compelled to perform time-consuming behaviours to control their sense of dread. In MacDonald’s case, what began as a brief series of actions to gain composure – clearing her throat, tapping her leg and blinking at certain steps on her approach – eventually left her stuck on the diving board, unable to calm down. “One by one, her dives went to pieces,” says Saul Marks, a psychiatrist at North York General Hospital in Toronto, and a member of Diving Plongeon Canada’s governing board. Worse, MacDonald was utterly miserable. “Nothing felt right to me,” she says. “I was always crying and never smiling.” Marks recognised the problem, and referred MacDonald first to a Canadian OCD specialist, and then to David Conant-Norville of Mind Matters, a psychiatric clinic in Beaverton, Oregon. Today, after treatment for both OCD and attention-deficit hyperactivity disorder, MacDonald is diving once more, and hopes to return to competition. “My future goal is the Olympics,” she says. “I want to try for 2012 in London.” Patients with OCD are taught to substitute their repetitive behaviours with relaxation techniques such as deep breathing, focusing on a soothing word, or envisioning a calming scene. Athletes work well at this, says Conant-Norville, although it is often hard to discuss where their anxiety comes from. “Athletes are really good at goal-setting,” he says. “They’re not generally very good at talking about their feelings.” Another of Conant-Norville’s patients is collegiate basketball player Sam Glasgow, whose obsessive traits have both enhanced and hampered his career. At 6 feet 3 inches, he is short for a basketball player. But what Glasgow lacks in aerial firepower he makes up for in shots from distance and free throws. This stems from an obsessive nature that makes it hard to walk away from the practice court. “I like to make a series of shots – maybe 10 in a row – before I leave,” he says. The downside to his behaviour is that Glasgow’s compulsive behaviour can consume up to 45 minutes each time he leaves home or the gym, as he checks and rechecks that he has all his belongings. When he joined the basketball squad of St Martin’s University in Lacey, Washington, last summer, these symptoms got so bad that he had to return home to Portland, Oregon, before the end of pre-season training – even though he was still performing well on the court. “When I came back I was just really a mess,” he says. Glasgow is also on the road to recovery, and hopes to return to St Martin’s later this year. But the psychiatrists behind this week’s session worry that other sufferers may be forced to leave the sports they love. Antonia Baum, a psychiatrist at George Washington University in Washington, DC, hopes that MacDonald and Glasgow’s stories will encourage other athletes to seek treatment – and stimulate research into the occurrence of OCD in sports. “There is a dearth of data,” she says. More on these topics: