Cycling Through the Dark; Depression in the Pro Cycling Peloton

Photo of Graeme Obree via National Museums-Scotland

This article originally appeared in Velo Magazine(print and online) around 2016. As they’ve eliminated much of the Velo/Velo-news online back catalog, I have decided to share my work here.

·       If you or a friend is in crisis,

·       US - call 9-8-8, the Suicide and Crisis hotline.

·       UK - the National Suicide Helpline (0800) 689-5652

 

What’s the biggest compliment one bike racer can give another? “Dude knows how to suffer.” We applaud top cyclists for their ability to suffer. Suffering, on the bike, is good. Hinault, Merckx, Kelly – the images of these men as they push themselves beyond normal limits are a part of cycling’s history.

But what images do we have of Graeme Obree, Clara Hughes, Gillian Carleton, Tyler Hamilton, and Mauro Santambrogio? As depression stole huge chunks of their lives, these stellar cyclists suffered far more in their own heads than they did on the bike.

What should we make of Thierry Claveyrolet, Carlo Tonon, Luis Ocaña, Christophe Dupouey, Rene Pottier, Pantani, Franck Vandenbroucke, and Jose María Jiménez? Extraordinary champions, all suffered so with depression that suicide was their chosen alternative. What is it about cycling that attracts those prone to depression?

Turns out, it’s not just cyclists. Chronic clinical depression strikes eight people out of every one hundred. Twenty percent of us will experience a major depressive episode once in our lives (National Institute of Mental Health). Not the blues, not sadness – a time when merely getting off the couch can be impossible. A time when everything is hopeless and useless and joyless. Tyler Hamilton told Velo of the times when he was so depressed, he would tell his then-wife Haven that he was going out to train. Instead, he would end up downstairs in a little-used room and huddle on a couch in secret. You can’t just buck up and ride through it.

Depression, untreated, is the black hole of mental illness – it vacuums out the spirit and leaves scraps behind. For a variety of reasons, highly driven, perfectionist, goal oriented athletes are prime candidates for the disease.

What is it about cycling excellence that attracts those with depressive tendencies? What does depression look like? What has depression cost Tyler Hamilton, Gillian Carleton, and Graeme Obree? What factors contribute to depression? How do we identify it in ourselves and others? How does one get help? How do these three athletes work to raise awareness of depression?

Graeme Obree offered this on elite cyclists and depression: “Many of us with depression have obsessive personalities. Cycling gave me a place for my obsession. Tough to be well and truly successful in sport without it. We really don’t know where obsession comes from, do we? And many of us with depression feel so worthless, you ride and ride until you get successful, and you still don’t feel any better about yourself. At least, not for very long.”

“Most of the time, my training was like a monk’s penance. Just torture. I was desperate to be successful but it didn’t make me feel all that better. I mean, I tried to kill myself three times. Depression is like one of those spiral cones at mall where you toss in a coin and watch it spin round as it goes down the drain.”

                      Gillian doing a trail run in 2020

“Cycling breeds a culture of isolation and suffering,” said Canadian Olympic bronze medalist in team pursuit Gillian Carleton (Vanderkitten). “We’re out there for hours, often in horrible weather, and we hold it up as something noble. Endurance athletes, the depressed ones, a lot of us train to punish ourselves because we feel so little self-worth. A lot of us are riding to self-medicate, for sure. And a few of us get some self-esteem from our    success. The idea that I ride to punish myself just feeds into my depression issues. I have to fight the urge to see my training as punishment.”

Tyler with Graham Bensinger, Screen grab 2017.

Tyler Hamilton agrees. “It wasn't about punishment for me, but  when I realized I could really suffer and was good at pain, I wanted to see how far I could push myself. There’s something about the ability to push past your limits that’s attractive for athletes like me.”

Depression is not the blues. “Make sure you’re not just pissed off,” said Obree. “Pissed off is not depressed. You want something to be depressed about, be depressed that you’re depressed.”

 “Depression blinds you to the truth. You can’t fight against it,” he said. “If there’s a fire, the sprinklers go off in all the rooms, even if the fire’s in only one room. That’s what depression looks like. It’s everywhere in your life.”

Tyler Hamilton offered the following view of his depression during his career. “Cycling was my therapy and I think it allowed me to live with depression without treatment for a lot longer. Exercise helps depression. Your body produces endorphins and your mood improves.  I was on the bike for hours every day and because of that I felt I could deal with it, even though it reared its head every now and then. When it did, I used to think it was situational. I tried not make excuses so I never fully recognized it for what it was until I was officially diagnosed in 2003.”

For women cyclists, the issues are compounded by the link between depression and eating disorders (Adams, et al, 1993). Carleton said, “It can still be tough, even in 2014, to be a woman who is a professional athlete, especially in a sport so body-conscious. We should look like women, but we have to be as skinny as possible. That skinniness takes us away from an accepted view of femininity. Eating disorders are really common in the peloton, and I’ve learned in my University studies in psychology and working with my therapist that many depression issues are tied into food issues. As women, there's this back and forth between our self-worth, our self-image, our sense of control over our bodies, and our eating disorders. It's like they play against each other. I think this is very complex, and we’re just starting to come to grips with it.”

For Tyler, “when Haven first insisted I get help, I felt I couldn’t go anywhere with it. I never talked with anyone in charge. Not the team doctors or trainers or coaches, no one. Certainly not Andy Rihs or Bjarne Riis. We were alone with that.”

‘To a certain extent, my career and my depression are linked. I loved going out and training hard. Maybe it was the depression that drove me harder. Without knowing it at the time, it’s like I found a way to maintain a relationship with my depression. Today, I do it with yoga. I know depression will always be something I have to work on. It will always be there and that’s ok.”

Carleton’s experience, coming years after Hamilton’s, reflects an attitudinal change. “I first went public with my depression in an article in Bicycling.  The people at Cycling Canada and our new coach, Craig Griffin (long time US National team and Paralympian coach) were terrific. They called. We talked. Everything was on the table as far as making me comfortable and feeling supported. Cycling Canada is so great. We have the Mental Health Initiative-one of the first governing bodies to put this program into place for Canada’s athletes and I am very grateful.”

Obree’s experience was much different. “Yeah, when I was a kid, mental health was a thing for girls. Maybe I was already having issues about being gay. That was a lot bigger deal in 1980 than today. Men aren’t good about mental health anyway. We’d rather go ride 120 miles and hide from ourselves than analyze ourselves.”

“When I first started to sort this out, my doctor said I had an emotional age of 11. I was just hiding behind me bike. But that was pretty recently. Never really gave a lot of thought to getting help early in my career. It wasn’t done. Not in my part of the world.”

“My costs? I’ve been in institutions seven times. After my last suicide attempt, I was clinically dead. My specialist said she’d never seen anyone return from such a bad state to any kind of normalcy. When I started to sort things out after that, I told my doctor I felt like I had a 50/50 chance of survival. Much later on, the doctor told me it was more like 90/10 against.”

Depression is not to be taken lightly. Its economic costs are staggering.

• ·       In 2003, depression cost the US economy over $83 billion; lost productivity, mortality, and health care costs. (Greenburg, et al., 2003.)
• ·       Depression is the leading cause of medical disability for people ages 14-44. (Stewart, et al., 2003.)
• ·       Depression costs those affected about $16,000 in annual earnings. (Stewart, 2003.)

The ultimate costs of depression are heart-breaking.

• ·       Fifteen percent of those dealing with major depression will commit suicide. That’s 41,000 people per year. One person every thirteen minutes.
• ·       In the UK, suicide is the most common cause of death in men under 35. In the US, suicide is the tenth leading cause of death.
• ·       Men are four times more successful at killing themselves than women.

Dollars and cents aside, the costs of depression are incalculable.

Depression is a disease that can appear at any time, but the first symptoms are often seen in teens. For Gillian Carleton, her depression first manifested itself in 2003, at age 14. “I did drugs and alcohol and there were a lot of self-destructive behaviors to try and self-medicate. I was fortunate that I started doing triathlons, that helped a bit, but my depression didn’t go away. It wasn’t until 2012 that I sought help.”

Tyler Hamilton also noticed his depression early on.

“Depression runs in my family, but I never mentioned it, I just tried to cope. I’ve known that about my depression since I was a kid, but I didn’t want to rock the boat. Even on my worst days, I’d just hide, or ‘be sick.’ It wasn’t until Haven called me on it that I looked for help.”

Born in 1965, Graeme Obree’s teenage depression became so overwhelming that he attempted suicide by gassing himself. In 2001, at age 33, the Scotsman again tried suicide, despite a 1998 diagnosis of bipolar depression. These time frames are not uncommon. The average wait between awareness and treatment is ten years (NIMH).

Perhaps we might have a better handle on depression if the root causes were better understood. What is known is that depression can arise from a variety of sources. It has been demonstrated that depression does run in families amongst biological relatives. Currently, research is being focused on the identification of those genes which might contribute to depression.

With the advent of MRI-based research, neuroscientists also have noted that the brains of those with depression are physically different than those without. However, this work is in its nascence and applications of this knowledge which might help those with the disorder are still relatively untested.

In susceptible individuals, triggers can play a key role. These triggers are often major lifecycle events- death of loved one, divorce, prolonged and/or chronic illness. Financial and job stresses, and childhood trauma have also been shown to kick off a major depressive episode.

More frequently in women, but not exclusively, hormonal changes can also play a significant role in the onset of a depressive episode. This is seen following menopause, and amongst those with serious thyroid and adrenal gland issues.

Lastly, when people speak of depression, they often refer to it as a “chemical imbalance.” The brain uses a variety of chemicals, called neurotransmitters, for the exchange of information. Unlike your landline wires, nerves are not continuous strands. Instead, there are small gaps along the nerve called synapses. Little puffs of neurotransmitters jet across these gaps. When these chemicals are out of balance, depression may result.

Regardless of cause, the odds are good that at some time in your life, you’ll need to support a depressed friend or loved one. Should that need arise, the Mayo Clinic offers a few suggestions.

• ·       Talk to the person about what you’ve noticed and why you’re concerned.
• ·       Explain that depression is a medical condition; not a personal flaw or weakness.
• ·       Ask if the person has thought about harming themselves.
• ·       Suggest the person sees a professional.
• ·       Express your willingness to help by setting appointments, going with the person to appointments, helping out at home.

 If you fear that you may suffer from depression, examine the following symptoms.  While everyone has their down moments, if your symptoms are pervasive and persistent, you’ll want to consult your health care professional.

• ·       Feeling sad, guilty, down, or empty.
• ·       Feeling hopeless, worthless, or helpless.
• ·       Losing interest in activities that were once a source of pleasure – your daily ride has turned into a chore
• ·       Irritability and restlessness
• ·       Noticeable drop-off in performance- on and off the bike
• ·       Insomnia and/or fatigue, loss of energy and interest in the world around you
• ·       Thoughts of self-abuse or suicide

 

Whether you are wrestling with your depression, or you sense it in a loved one, it is often shame that keeps help at arm’s length. To fight the shame, it begins with a conversation.

“I do want to work for this cause,” said Gillian Carleton. “Ignorance is willful destruction. I want to start a conversation so that we can cultivate the ability to recognize depression in others, and in ourselves. I want people to learn from my isolation and to eliminate that sense of isolation in those who are depressed. If you’re reading this article, and you’ve thought “I am so alone,” you need to know you are not alone. Do not suffer in silence.”

“And if you think that someone you care about is suffering, don’t wait, start that conversation right now. You might help your loved one, you might help yourself, you might help a complete stranger in a way you hadn’t planned.”

Tyler Hamilton took a moment to look back as he talked about his work with depression awareness.

 “It’s like I’ve molted and have a whole new skin.  My life has changed a lot, but it was definitely a process. The book helped (The Secret Race, Bantam, 2012) because it gave me a chance to talk, tell the truth and eliminate a burden that had taken a huge physical and psychological toll on me. But it was also a difficult time and I had a lot of dark days during that period.  When I should have been happy that so many people were supportive of the book and my story, I was experiencing some of the most severe depressive episodes I’ve ever had. Even though a lot of people forgave me, depression wouldn’t let me forgive myself.

“It’s funny, I do a fair number of talks, but a lot of what is really meaningful is the one on one interaction. People will come up to me; in airports, restaurants, whatever, and just open up. I guess they feel that I’m a safe place.”

“The other thing I hear is, ‘Tyler, you’ve lived a life; the good stuff and the really bad stuff, all of it, while you were fighting this disease. If you can do all those things, then I can guess I can live a regular life.’ It feels good knowing some people find that inspirational. At the end of all this, I’ve finally learned to embrace who I am.”

Graeme Obree is succinct about his work with depression awareness. “I’m grateful. Incredibly grateful. I’ve been dead, literally dead. That’s given me purpose. I’m thankful for the journey. Part of what I do is speak out against our consumer culture. Billions of pounds are spent every year to make us all feel inadequate, the idea that you solve your problems if you only buy the right stuff.”

“It’s wrong and it’s sad, when our worth is measured from the outside. Our value system, our sense of self is out of whack. You come visit me on Christmas, give me a hug, not a gift. Make a phone call, don’t send a card.”

“I do speak with riders out on the road and I’m always amazed at what people will tell me should we meet up on a ride. But it is bigger than that. I’m a bit famous, especially here in my country, and that’s given me a platform. I’m intensely grateful for that platform, to get out and speak with groups-to kids, to adults – about my journey. I’ve suffered in a lot of ways, and that has paid off. My purpose is much bigger than racing a bike. I can reach others. Maybe when they hear my story, I hope someone they love won’t have to suffer.”

As befits a man who has looked death in the eyes too many times, Obree’s views are decidedly Zen-like. “You have to be careful about hope. Look at hope with a bit of suspicion. People living with their eyes to the future are really living in the past. That doesn’t work, to live in the past. Be grounded in the present. That’s what’s great about cycling. The bike keeps you in the moment. You have to appreciate the fact that you are in the moment. On the bike, you can see beauty. Be grounded in the now. That’s the secret.”

If you sense that you or a loved one is depressed, your first steps are always a conversation and a visit to a health care professional.

• If you think that you may harm yourself, or if you fear someone you know may harm themselves:
• ·       Do not leave your friend alone. Do not isolate yourself.
• ·       Call your doctor.
• ·       Call 911, or get to a hospital emergency room, or ask a trusted individual to help you do these things.
• ·       Call the toll-free 24 hour National Suicide Prevention Lifeline at 1(800)273-TALK to speak with a trained counselor.
• ·       Call 9-8-8, the newly established Suicide and Crisis hotline.

 

Jared Wood, Ph.D., consulted on this article. He holds a doctorate in sport and exercise psychology. He is also a Limited Licensed Psychologist in the State of MI. Dr. Wood specializes in working with athletes by enhancing athletic performance and mental health.