Discover Mental Health 5th Anniversary: Reflections from Guest Editor – The Mental Health of Athletes

Hear from the Guest Editor of the Topical Collection, The Mental Health of Athletes: Challenges, Insights, and Innovations. This Collection shines a light on the complex and often underexplored mental health challenges faced by athletes at all levels.
Discover Mental Health 5th Anniversary: Reflections from Guest Editor – The Mental Health of Athletes
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The care episode of a young elite-level female cyclist with major depressive disorder and comorbid eating disorder: A sports psychiatry case report from Switzerland

Elite-level athletes can experience mental illnesses as frequently as the general population. In professional cycling, distinctive psychosocial risk factors and inadequate formal support may heighten psychiatric vulnerabilities, yet treatment case examples remain scarce. Consequently, we outline the care episode of a 20-year-old female elite-level cyclist in Switzerland, who ceased competing and was thereafter diagnosed with major depressive disorder and a continuing diagnosis for a comorbid eating disorder, likely exacerbated by sport-specific stressors. Whilst psychopharmacological outpatient treatment yielded initial progress, the patient’s persistent suicidality necessitated voluntary inpatient admission. Her mental health improved post-discharge, though reintegration into cycling entailed difficulties, prompting a transition to a team with a less demanding schedule that allowed for a better balance between sporting and personal commitments. At the time of writing, the patient’s symptoms had stabilised and she was engaging in advocacy to raise awareness about athlete mental health. Accordingly, this case adds to the therapeutic evidence-base on elite-level athletes, demonstrating the importance of individualised psychiatric interventions that prioritise sustainable and holistic wellbeing.

This post is part of the “Celebrating Five Years of the Discover Journals” series, highlighting Discover journals and the people who have played a key role in shaping their development. The series aims to spotlight the leadership, values, and vibrant communities behind the journals. 


We invited the Guest Editor of the Topical Collection, The Mental Health of Athletes: Challenges, Insights, and Innovations, to share insights into the complex and often underexplored mental health challenges faced by athletes at all levels.  

Dr. Takao Yamasaki (M.D., Ph.D.) is the Executive and Medical Director of Minkodo Minohara Hospital in Fukuoka, Japan. He also serves as Executive Director and Head of Research and Development at the Kumagai Institute of Health Policy, and as a Part-time Lecturer at the International University of Health and Welfare. He holds an M.D. from Saga Medical School (1997) and a Ph.D. from Kyushu University (2005), and previously served as an Assistant Professor and academic researcher at Kyushu University. As a neurologist and clinical neuroscientist, his academic work focuses on brain and mental health research, particularly through the study of human brain function. 

Figure - Dr. Yamasaki’s workspace. Framed photographs of his children playing judo and table tennis are displayed on the desk. Watching their dedication to competitive sports inspired Dr. Yamasaki’s interest in athlete mental health. 

“My interest in the mental health of athletes has been shaped by experiences across three domains: clinical and occupational medical practice, research, and everyday life. As a physician - particularly as a neurologist - I have long been involved in the care of patients with neurological disorders, including neurodegenerative diseases, dementia, and developmental conditions, as well as their families. In these fields, psychological burden and everyday struggles are deeply intertwined with physical symptoms, and I have consistently observed that mental health issues are inseparable from clinical care. 

In addition, through my work as an occupational physician, I have engaged with individuals exposed to significant stress across a wide range of workplaces, including hospitals, long-term care facilities, and law enforcement settings. Furthermore, through ongoing discussions with my spouse, who works as an occupational physician in the transportation and aviation industries, I have come to recognize the presence of shared psychological challenges that transcend specific professions and environments. 

Alongside these clinical and occupational experiences, my academic work has focused on human brain function. As part of this research, I have also investigated the effects of physical activity on cognitive function. Although this work has not directly targeted mental health, it has deepened my interest in the relationship between physical activity and cognitive and psychological processes. 

Through these combined experiences in clinical practice, occupational health, and research, I have repeatedly encountered the psychological burdens and conflicts that arise within the contexts of roles and environments in which people live and work. From this perspective, my interest in the mental health of athletes gradually developed. 

In my personal life, I have also observed this issue from another perspective. My two children have both been engaged in competitive sports since early childhood—one in judo and the other in table tennis—and they continue to pursue their respective sports. They have trained under coaches with experience at both national and international levels. Watching their sustained efforts in such highly competitive environments, I began to notice a common pattern: regardless of sport or level, the psychological challenges faced by athletes closely resembled those I had encountered in clinical and occupational settings. 

This realization led me to view athlete mental health not merely as a sports-related issue, but as a broader and more universal concern. In recent years, issues surrounding athlete mental health have increasingly gained attention in both the media and society. As training environments become more demanding and expectations for performance intensify, psychological burdens appear to be becoming more visible. At the same time, however, systems of support and societal understanding remain insufficient. 

The questions that emerged through both personal observation and professional experience converged with these broader societal developments, strengthening my conviction that this topic should be examined in a more systematic and structured way. Around that time, I received an invitation from Discover Mental Health to serve as a Guest Editor. This invitation marked a turning point for me. The role extended beyond simply compiling manuscripts; it involved shaping the theme, identifying contributors, and managing the peer review process, thereby contributing to the overall development of the Collection. 

At the outset, I felt a certain degree of tension, given both the responsibility involved and the fact that this theme represented a new challenge compared to my previous editorial experiences across multiple academic journals. At the same time, however, I was strongly drawn to the possibility of integrating fragmented knowledge within this field and creating a platform that connects researchers from diverse disciplinary and cultural backgrounds. I therefore decided to take on this role as an opportunity to expand the questions that had emerged from my clinical and everyday experiences into a broader academic dialogue. 

One of the most striking aspects of editing this Collection was witnessing how diverse perspectives from different countries and disciplines came together under a shared theme. Ultimately, contributions were received from 16 countries, covering a wide range of topics, including the athlete lifecycle, performance pressure, recovery from injury, and support systems. Although each topic addressed a distinct issue, they were deeply interconnected, collectively illuminating the complex landscape of athlete mental health. 

Among the contributions, a case report of an elite female cyclist left a particularly strong impression on me. This case described a young athlete balancing high-level competition with academic commitments, who developed major depressive disorder and an eating disorder under the combined pressures of performance demands and family dynamics, eventually requiring inpatient care due to persistent suicidal ideation. Following multidisciplinary treatment and environmental adjustments, her condition improved, and the process of reconstructing her relationship with sport was carefully documented. This article attracted considerable attention, receiving over 47,000 accesses and reaching a wide readership. 

However, what is most important is not the number of accesses itself, but the implications of the case. It highlights that mental health challenges in athletes are not confined to specific individuals or exceptional circumstances, but rather represent a universal issue that can arise across sports and competitive levels. At the same time, it demonstrates that with appropriate support and environmental adjustments, it is possible to establish a sustainable way of engaging with sport. 

Through this Collection, I was strongly reminded that athlete mental health is a multifaceted and cross-disciplinary domain that cannot be fully understood within a single field of expertise. Bringing together diverse perspectives in an integrated and meaningful way is essential for advancing our understanding of this area. 

The support I received from the editorial team at Discover Mental Health throughout the process was also highly impressive. The submission, review, and decision-making processes were both efficient and attentive, with careful consideration given to authors at each stage. In particular, the clear assignment of a Managing Editor at the outset provided a strong foundation for the operation of the Collection. Questions regarding editorial decisions were addressed promptly and accurately, contributing to a sense of confidence throughout the process. Moreover, the team went beyond administrative support by actively suggesting submissions that aligned with the theme of the Collection, reflecting a collaborative engagement with the content itself. Practical resources, such as the Guest Editor information pack and invitation templates, were also systematically provided, serving as an important infrastructure for facilitating international collaboration among diverse researchers. Through these experiences, I came to clearly appreciate how the journal’s stated commitment to an efficient submission and review process, high-quality author support, and community-oriented academic exchange is genuinely realized in practice. 

Looking ahead, I believe that the field of athlete mental health needs to be redefined beyond the context of athletic performance, within a broader social and clinical framework. Considering its continuity and shared characteristics with the mental health of working populations, the question of how to support the well-being of individuals across diverse backgrounds will become increasingly important. I hope that this Collection will contribute to deepening our understanding of these challenges, while also serving as a starting point for interdisciplinary dialogue and future research. I also strongly hope that the Discover journals will continue to evolve as a platform that connects diverse perspectives and sheds light on areas that remain underexplored.” 

Please stay tuned for more posts from our anniversary celebrations! 

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