Athletes we cheer for are people first. Some of them, even in their best years, are also in their hardest. The least we can do is stop assuming that a good stat line means everything is fine.
Every season, fans watch an athlete play through something, a sprained ankle or a shoulder issue. We celebrate it, and often we should. But what we rarely see is an athlete who is playing through high-functioning depression. The reason is simple: it’s hiding in plain sight.
I am a licensed clinical social worker, not a former athlete, and I work with high performers whose careers depend on looking steady. The pattern I see in executives and physicians shows up in sport too, and sport may be where it hides best. When the stat line is strong, nobody asks how the person is doing.
What High-Functioning Depression Looks Like
High-functioning depression is not a formal diagnosis. It is a plain-language description of someone who meets their obligations while carrying real depressive symptoms underneath. They show up, they perform, they say the right things in the postgame interview. Then they go home flat, exhausted, and unable to enjoy any of it.
In athletes, the signs are easy to misread as dedication:
1. Training harder after a win instead of enjoying it, because the next game is the only thing that quiets the noise.
2. Losing interest in the parts of the sport they used to love, while still executing every rep.
3. Sleep problems that get blamed on travel, early practices, or late games.
4. Irritability with teammates and family that gets written off as competitiveness.
5. Withdrawing from friends outside the sport, because explaining how they feel would mean admitting something is wrong.
None of these show up on a scoreboard. Some of them even look like the qualities coaches and fans admire.
Numbers Aren’t Small
This is not a rare problem at the elite level. A 2019 systematic review and meta-analysis in the British Journal of Sports Medicine, led by Vincent Gouttebarge, pooled studies of current and former elite athletes. Among current elite athletes, the prevalence of anxiety and depression symptoms reached 34%. Among former elite athletes, it was 26%.
Think about a 25-man roster. By that estimate, several players in any clubhouse could be carrying symptoms right now, and some of them are probably having a very good year.
Why Winning Makes it Harder to See
Performance is the gauge everyone uses, including the athlete. If the numbers hold up, the logic goes, the person must be fine. But output is usually the last thing to fail.
An athlete can keep producing for months while sleep, mood, and relationships quietly fall apart behind the scenes.
There is also the identity problem. For many athletes, the sport is more than a job. It is who they are. Admitting to depression can feel like admitting weakness in the one area of life where they have always been strong. So they push harder, and it works, until it doesn’t.
Why the Usual Therapy Model Can Miss Athletes
Athletes who do make contact often run into a practical wall. Standard therapy centers on one 50-minute appointment a week. That rhythm doesn’t fit a road trip, a tournament schedule, or a season that runs most of the year.
A 2026 CEREVITY report, Why Standard Therapy Fails: The Case for Longer Therapy Sessions (American Psychologist, 1986), cites classic dose-response research. In the article, Kenneth Howard and colleagues found that improvement increases with total therapy, rising from about 30% of patients improving after two sessions to about 75% after 26 sessions. A 2012 meta-analysis by Joshua Swift and Roger Greenberg reviewed 669 studies and 83,834 clients and found that about one in five clients drop out early.
The point for athletes is simple. What matters is getting enough steady care, not squeezing it into the same weekly slot as everyone else.
One-on-one therapy that flexes around a schedule, whether that means telehealth on the road or longer sessions during the offseason, is far more likely to stick than an appointment an athlete misses every third week.
An Alternative Approach
We cannot diagnose anyone from the stands, and should not try. But the people around athletes can change the culture that keeps high-functioning depression hidden.
1. Ask how the person is doing, not just how the season is going.
2. Treat mental health the way the sport treats a hamstring: something you address early, not something you play through until it tears.
3. Notice withdrawal, not just performance. The teammate who stops showing up to dinners may need more attention than the one in a slump.
4. Talk about therapy as part of training. The best athletes already work with strength coaches, nutritionists, and film staff. A therapist belongs on that list.
The athletes we cheer for are people first. Some of them, even in their best years, are also in their hardest. The least we can do is stop assuming that a good stat line means everything is fine.
If you are an athlete reading this and recognizing yourself, you do not have to wait for a bad season to ask for help. The best time to start is while you are still playing well.
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Martha Fernandez, LCSW, is a licensed clinical social worker and co-founder of CEREVITY, a private-pay concierge network of independent licensed clinicians built for high achievers. She is the author of Wired to Burn: A Therapist’s Guide for High Achievers Running on Fumes (2026). Learn more about one-on-one therapy at cerevity.com
