Tyrone GAA Youth Conference Date: M\arch 7th 2013 Venue: Tyrone GAA HQ at Garvaghey Time: 6.45pm – 9.30pm ‘The Winner Within’ Addressing the Emotional Health and Wellbeing of Young Players 7:00pm: Introduction Ciaran McLaughlin, Cathaoirleach / Stephen McHugh, Youth Committee Chairman. 7: 10pm: ‘Sports psychology: time to think beyond performance and acknowledge the presence of mental illness amongst athletes’ • Dr Lynette Hughes (BSC. MA. Ph.D) 8:00pm: Safeguarding in Clubs: promoting the ‘Code’ • Kathryn Anderson, OifigeachLeanaí (County Children’s Officer) 8:15pm: The role GAA can play in addressing suicide prevention through promotion of SafeTALK training for local Clubs. • Brendan Bonner Head of Health and Social Well-being Improvement (West) Public Health Agency. 8:30pm: Sharing Best Practice in Managing Youth Affairs at Club level • Stephen McHugh, Chairman Tyrone Youth Committee. 8:45pm: How to Develop Self - Empowerment in Young Players. • Brendan Harpur, Oiliúna & Forbartha (County Coaching Officer) 9:15pm: Plenary / Close BUFFET
Sports psychology: beyond performance, acknowledging mental illness amongst athletes Dr. Lynette Hughes
Concerns for athletes Variation in: • Diagnosis • Treatment Doctors in sports environment: • under intense pressure from management, coaches, trainers and agents to improve performance in the short term • Faced with a myriad of ethical dilemmas that compromise the well-being and treatment of the athlete.7 SAME SYMPTOMS
PRESSURE OF LIFE BALANCE i.e. Student, work, relationships ↑ public recognition & ↑ public scrutiny • Many athletes enjoy being recognised by the public BUT brings with it additional pressures. • Self-pressure to always be “the star” which is unrealistic when other factors like injury or illness are to be factored in. • ‘Homeostasis’ essential for performance and growth and repair. • Students pressures of exams, coursework, training and competing. • Recovery element of training compromised. • Additional teams to represent. • Athletes with a family, job, children, girlfriend etc. can find it hard to deal with the demands of intense training on top of everything else. • Self-pressure: high motivation and expectations • The pressure to be a role-model leaves it hard for athletes to make the mistakes their peers make without being under the scrutiny of fans, the media, coaches and managers. • Athletes who experience success very early in life can struggle with such a title. Role model status
Pressure to perform by coaches ↑Time constraints Dealing with injury/ career termination • Rest and recovery are essential components for athletic performance. • Coaches need to reinforce this to athletes. • Coaches also need to be aware when they are pushing for their own needs as opposed to the greater good of the athlete. • An athlete who feels understood and valued will ‘want to’ commit and make the sacrifices necessary for performance as opposed to feeling like they ’have to’ commit. • Experience of injury compared to experiencing a bereavement. • Athletes struggle with a body that does not perform or operate to its normal capabilities. • Can become very isolated within the sports setting and their team, left out. • Athletes are tested and pushed when injured which serves to fuel the psychological trauma experienced • An athlete needs to continually think of what they eat and drink, how much sleep they get and how they get themselves “into the zone” for optimal performance. • Physically striving to push the body. • Depression, body dysmorphia, anorexia and bulimia are just some of the documented conditions athletes suffer in trying to deal with the pressures that come with being a performer. mental and physical demands in terms of intense training
Current approach to mental illness in athletes Inaccurate and unhelpful = deprives the athlete of effective care (6)
Anxiety, panic and phobias: When these feelings become too strong they can stop us from doing the things we want to.
Stress Often the result of some event or trigger: • Negative (such as the death of a loved one (acute), redundancy, divorce or relationship ended (chronic), • Positive (a new partner, new job or going on holiday).
Causes of anxiety, panic and phobias • Genes - (trait anxiety). • Circumstances - (state anxiety) sometimes it's obvious what is making you anxious. When the problem disappears, so does the anxiety. However, some extreme situations are so threatening that the anxiety goes on long after the event (PTSD). • Drugs - recreational drugs like amphetamines, LSD or ecstasy can all make you anxious. • Life experience - bad experiences in the past or big life-changes such as pregnancy, changing job, becoming unemployed or moving house.
Depression in children: symptoms • Simply appearing unhappy much of the time, feelings so extreme or persistent they get in the way of normal activities. • Exhaustion • Headaches, stomach aches, tiredness and other vague physical complaints that appear to have no obvious cause. • Spending a lot of time in bed but sleeping badly and waking early in the morning. • Doing badly at school or not coping with things that used to be manageable • Major changes in weight. • Being unusually irritable, sulky or becoming quiet and introverted. • Losing interest in favourite hobbies. • Having poor self-esteem or recurrent feelings of worthlessness, hopelessness. • Contemplating suicide • At least 2% of children under 12 struggle with significant depression • By teenage years this has risen to 5% - i.e. at least one depressed child in every classroom.
Causes of depression Depression is also a feature of many other illnesses and conditions. ‘Organic' causes include: • An underactive or overactive thyroid gland • Vitamin B12 deficiency • Viral infections • Traumatic brain injury • Losing a loved one (or in children, a good friendship breaking up) • Illness, stress, family problems (marital disharmony or breakup) • Abuse • School problems (such as bullying, exam fears). Some children are more resilient to difficulties than others • Genetics and family tendencies: may also explain susceptibility and why the levels of certain brain chemicals become abnormal in depression.
Difficulties spotting it: • Children less capable of expressing feelings = often react to their moods in a more physical way. • Some are clearly sad, withdrawn and tearful, others may become hyperactive, troublesome bullies. • Symptoms for longer than 3/4 weeks = GP. • Talk about suicide should alwaysbe taken seriously = get expert advice.
Bipolar Disorder Bipolar (also known as manic depression) causes severe mood swings, that usually last several weeks or months and can be: • Low mood, intense depression and despair. • High or ‘manic’ feelings of joy, over-activity and loss of inhibitions. • A 'mixed state' such as a depressed mood with the restlessness and over-activity of a manic episode.
Causes of bipolar • Genes. • There may be a physical problem with the brain systems which control mood - so bipolar disorder can often be controlled with medication. • Stress can trigger mood swings. There are a number of types of bipolar disorder: • Bipolar I. There has been at least one high, or manic episode, which lasts for longer than one week. You may have only manic episodes, although most people will also have periods of depression. • Bipolar II. Where you have more than one episode of severe depression, but only mild manic episodes (called ‘hypomania’). • Rapid cycling. You have had more than four mood swings happen over a 12 month period. This affects around one in ten people with the condition.
Bipolar Symptoms Mania • General elation • Feeling more important than usual • Full of energy or ideas; moving quickly from one idea to another • Unable, or don't want to sleep • More interested than usual in sex • Making unrealistic plans • Overactive, talking quickly • Irritable with other people who can't go along with your mood or ideas • Spending money recklessly Depression • Feelings of unhappiness that won’t go away • Agitation and restlessness • Loss of confidence • Feeling useless, inadequate or hopeless • Unable to think positively • Can't concentrate or make even simple decisions • Loss of appetite • Sleeping problems including waking early in the morning • Lack of interest in sex • Avoiding other people • Thoughts of suicide
Bipolar Symptoms Psychotic symptoms If a mood swing becomes very severe, you may have 'psychotic’ symptoms. These include: • When depressed feeling guilty, worse than anybody else, or even that you don't exist. • When manic, feeling you’re on an important mission or you have special powers or abilities. • May also experience hallucinations - hear, smell, feel or see something that isn’t there.
Body dysmorphia Symptoms • Excessive worry about a part of their body which they perceive to have a defect, despite reassurances about their appearance. May: • Wear excessive make-up or heavy clothing to hide their perceived defect • Repeatedly look in the mirror and seek reassurance about their appearance • Frequently touch or measure the perceived defect • Repeatedly pick at their skin or pluck their hair and eyebrows • Feel anxious when around others • Diet and exercise excessively • Not be able to hold down a job and sometimes avoid socialising. • Find it difficult to have relationships. Causes • May be genetic or caused by a chemical imbalance in the brain. Who’s affected? • At least 1% of the UK population. • More common in people with a history of depression and/or social phobia. • Often occurs with obsessive-compulsive disorder or generalised anxiety disorder. • May also exist alongside an eating disorder. • It usually starts in adolescence when people are most sensitive about their appearance.
Eating disorders Is a broad name for a number of problems we face with food in our society. • Bulimia: comfort in feeling full but dreads taking on the extra calories. Induce vomiting, causing long-term problems for their throat and teeth on top of psychological problems. Common behaviour of someone affected by an eating disorder includes: • Mentally keeping a balance between calories taken in and calories used up • Deep-seated feelings of anxiety if they consume a few calories too many • Self-loathing, depression or panic if they haven’t lost any weight or put a little on • Many anorexics and bulimics know the damage they are doing to themselves but are still unable to stop. This increases feelings of despair and self-loathing, causing their condition to continue.
Causes of eating disorders • Evidence that eating disorders can run in families. • Socially: - Images of physical perfection - Encouragement to eat foods packed with calories made up of saturated fat and simple carbohydrates. Psychologically, at the root of an eating disorder: • Distorted body image • Low self-esteem • Anxiety for some control • An expression of deep emotions such as depression or trauma that can’t be put into words
Post-Traumatic Stress Disorder Symptoms of PTSD • Usually start within six months, and sometimes only a few weeks after the trauma. • After the traumatic event you can feel grief-stricken, depressed, anxious, guilty and angry. May also: • Have flashbacks and nightmares, reliving the event in your mind, again and again (forced to think about what happened and decide what to do if it happens again) • Avoid thinking and feeling upset about it by keeping busy and avoiding anything or anyone that reminds you (helps you not to become exhausted from remembering a trauma) • Be ‘on guard’ – you stay alert all the time, can’t relax, feel anxious and can’t sleep (helps react quickly to another crisis). • Vivid memories = adrenaline levels high = feel tense, irritable, unable to relax or sleep • Feel physical symptoms – aches and pains, diarrhoea, irregular heartbeats, headaches, feelings of panic and fear, depression. • Start drinking too much alcohol or using drugs (including painkillers). Causes • Getting diagnosed with a serious illness. • Having (or seeing) a serious road accident. • The unexpected injury or violent death of someone close. • Continuing physical or sexual abuse. • Conflict or war experiences
Schizophrenia • Schizophrenia is a disorder which affects thinking, feeling and behaviour. It usually starts between the ages of 15 to 35 and affects about 1 in every 100 people during their lifetime. Causes • Aren’t known for sure. It’s likely that several different factors may have an affect: • Genetic links - one in ten people with schizophrenia has a parent with the condition. • Damage to the brain during pregnancy or birth. • Use of recreational drugs, including ecstasy, LSD, amphetamines (speed), cannabis and crack. • Stress.
Schizophrenia symptoms “Negative” (represent loss of normal thoughts, feelings or actions) • Loss of interest, energy and emotions. You don't bother to get up or go out of the house. You don't get round to routine jobs like washing, tidying, or looking after your clothes. You feel uncomfortable with other people. • Some people hear voices without negative symptoms. Others have delusions but few other problems. “Positive” (represent a change in behaviour, or thoughts ): • Delusions - believing something completely even though others find your ideas strange and can't work out how you've come to believe them. • Difficulty thinking – finding it hard to concentrate, drifting from one idea to another. • Feeling controlled – feeling as though your thoughts are vanishing, that they‘re not your own, or that your body is being taken over and controlled by someone else. • Hallucinations - hearing, smelling, feeling or seeing something that isn’t there. Hearing voices is the most common problem. The voices can seem utterly real., they are more often rude, critical, abusive or annoying.
Personality disorder It’s thought 1 in 10 people has some form of personality disorder. You may have a personality disorder if: • Parts of your personality make it hard for you to live with yourself and other people • Experience doesn’t teach you how to change the unhelpful parts of yourself • You find it hard to make or keep relationships • You find it hard to control your feelings or behaviour • You find that you upset or harm other people because you’re distressed • Some evidence that, similar to other mental disorders, genes, brain problems and background can play a part.
Personality disorder: 3 sub-groups Emotional and impulsive • Antisocial (don't care about other people’s feelings, get easily frustrated and aggressive, find it difficult to develop close relationships, do things on the spur of the moment without feeling guilty and unable to learn from unpleasant experiences). • Emotionally unstable (do things without thinking and find it hard to control emotions, may feel empty inside or so bad they self-harm. Make relationships quickly, but easily lose them. Can also feel paranoid or depressed and may hear noises or voices. • Histrionic (are self-centered and over-dramatise events, emotions are strong, but change quickly, worry a lot about appearance and crave excitement). • Narcissistic (crave success, power and status, seek attention and tend to exploit others for self gain). Suspicious: • Paranoid, suspicious of other people, sensitive to rejection, tendency to hold grudges. • Schizoid (unable to make contact with other people, preferring your own company and developing a rich fantasy world). • Schizotypal (have odd ideas and difficulties with thinking, see n as eccentric and you may see or hear strange things).
Personality disorder Anxious • Obsessive-compulsive (perfectionist, worrying about the detail in everything, cautious, find it hard to make decisions, have high moral standards, worry about doing the wrong thing and judging other people, sensitive to criticism and may have obsessional thoughts and behaviours). • Avoidant (very anxious and tense, worrying about insecurities, feel inferior and want to be accepted, sensitive to criticism). • Dependent (rely on others to make decisions and do what others want to do, find it hard to cope with daily tasks, feeling hopeless and incompetent and easily feel abandoned by others).
Suicide • Approx 1 million people/year • Around 6,000 in the UK and Ireland. • Number of young men committing suicide has increased over the past couple of decades • Women may be better at expressing and dealing with their distress. • Current social, financial and economic issues have put more pressure on men.
Factors leading to suicide • There’s rarely one single trigger, although there may be an important 'last straw'. • Genetic predisposition, personality trait or lack of support. • A long history of mental health problems, the main ones being depression, eating disorders and schizophrenia. • Relationship problems • Other factors include physical illness (acute and chronic), alcohol and drug, social isolation, housing, money and job problems. • The final straw may be the end of an important relationship, having to face up to debt or a court case, losing one’s home or job, or simply an event that stirs the emotions.
Suicidal feelings in children and teenagers • Symptoms which may be due to depression include moodiness, irritability, poor concentration, tearfulness and being withdrawn. Loneliness, guilt and self-hatred can lead to a feeling of hopelessness and despair. • Changes in appearance, hygiene or health. • More tired, have sleep problems, poor appetite and have lost interest in their usual hobbies. • Children often feel isolated, afraid of talking to their family or friends and often don’t know who to turn to. • Young children especially may find it hard to put into words how they feel but instead act out their emotions in a way that their family may not understand.
Suicidal feelings in children and teenagers • They may have family problems – parents separating or who have problems of their own such as money problems which the child feels, inappropriately guilty about. Death of a grandparent or other family member, neglect, abuse, isolation, bullying and physical illness are all frequent triggers to teenage depression and suicide. • Drug and alcohol use are increasingly common in teenagers and also play a part in the development of depression and altered behaviour which can lead to a suicide attempt. • There were 1,722 adolescent and juvenile deaths by suicide in the UK between 1997 and 2003, almost all were young people were aged 15-19, three-quarters were male and overall, the most common methods of suicide were hanging, followed by self-poisoning. • Younger women are more likely to resort to deliberate self-harm and attempted suicide, rather than suicide itself.