Do you want to know what a panic attack in the middle of an NBA game feels like? Kevin Love of the Cleveland Cavaliers tell us: “Everything was spinning, like my brain was trying to climb out of my head… the air felt thick and heavy. My mouth was like chalk. I remember our assistant coach yelling something about a defensive set. I nodded, but I didn’t hear much of what he said. By that point, I was freaking out. It was like my body was trying to say to me: you’re about to die.”

Love is one of a number of athletes who have recently spoken about their battle with mental health issues, and is sharing his experience, firstly as catharsis for himself, but also, in an effort to get more athletes to break the silence that surrounds this subject and share their own stories.

Despite some progress (the NBA recently announced a Mind Health campaign to better support players), there is a still very much a culture of silence and denial in elite sports when it comes to mental health issues – especially in South Africa. The perceptions of mental illness as weakness – the antithesis of what mentally tough athletes are “supposed” to be – makes it very difficult for athletes to seek help and support when they are at their most vulnerable.

Also, many people think elite athletes are living the dream while getting paid to play, and so really have nothing to complain about. The lens of elite sport therefore unfortunately magnifies the stigma that still sticks to this issue, which can have devastating consequences. Suicides, attempted suicides or suicidal ideation of prominent athletes such as boxer Mike Tyson, footballers Andreas Biermann and Frantisek Rajtoral, Rugby player Dan Vickerman, NFL star Junior Seau, former swimming world record holder Liesel Jones and former UFC world champion Ronda Rousey, stand as testament to the problem.

The list of Olympic athletes who have battled with mental health issues reads like a who’s who of great athletes. Sydney and Rio 50m Freestyle gold medallist Anthony Ervin suffers from Tourette’s Syndrome. Multiple swimming World Record holders and Olympic medallists Ian Thorpe and Michael Phelps battled depression and alcohol abuse. Gold medallists, swimmer Amanda Beard and gymnast Shawn Johnson, both battled with an eating disorder while competing. Dame Kelly Holms, Athens double gold medallist on the track, admitted to suicidal thoughts and self-harm while competing. Rio long jump silver medallist and current World Champion, Luvo Manyonga, has also been open about his past difficulties with substance abuse.

Other sports don’t fare so well either. Two of Australia’s greatest cricketers, Ricky Ponting and Shane Warne developed gambling problems and ex-New Zealand player Craig Spearman admitted to a full-blown gambling addiction while still competing internationally. At one point the world best all-rounder, England’s Freddie Flintoff, suffered from depression and drinking problems.

Boxing’s’ Oscar de la Hoya said of his struggle with depression: “I could put all my opponents in one ring and battle them, but this monster is going to be the toughest of my life.”

Former All Black rugby great, Sir John Kerwin said: “I don’t wish it (depression) an anyone. It was my worst nightmare.”

The list goes on and on, and the message is clear: being the best athlete in the world – and yes, being mentally tough, as all the athletes above clearly are when you consider their achievements – doesn’t exempt you from metal health difficulties. Our minds are complex and toughness and mental illness are two different concepts.

The problem is that many athletes only open up and share their stories once they have retired. Almost all the athletes mentioned above revealed this “secret” in biographies or interviews long after they had stopped competing. Thorpe admitted that he only felt he could talk about these issues after his retirement because of the “macho” culture of Australian sport, and Phelps revealed his battle only after been caught for a DUI. We need to de-stigmatise mental health issues if we have any hope of helping athletes that suffer in silence both during their careers and in life after sport, and this will only happen if we encourage more athletes to share their challenges, especially while still competing.

We then need to offer compassion and support rather than victimising or stigmatising them further. If we make jokes about “weakness” or “being crazy” or even comments such as “what do they have to be sad about?” when an athlete is brave enough share their difficulties, we are colluding with the system that exists and perpetuating the barriers athletes face in seeking the help they need.

In the end, athletes, for better or worse, are also role models to many, and by courageously speaking out, will send a message to ordinary boys and girls, men and women, that mental health issues are not shameful secrets, but very real human conditions that, with support and help, can be overcome. DM