No long winded introduction, this is important. Here's Andrew Thomas.

It's just over a year since Robert Enke, Hannover 96 and Germany goalkeeper, committed suicide at the age of 32. It emerged after his death that he had struggled with depression for years. To mark this bleak anniversary, BBC Radio 5live produced a half-hour special, featuring candid and illuminating interviews with, among others, Enke's biographer, agent, and therapist. It was an extraordinary half-hour of radio.


The distressing narrative of Enke's life, both footballing and personal, was illustrated with extracts from his diaries and notes for a planned autobiography. It was chilling to be given an insight into how Enke responded to what one might assume were just the vicissitudes of a sporting life: how he wept when he signed for Benfica; how he slumped after being overlooked at Barcelona in favour of a 19-year-old Victor Valdés; how he broke down after being abused by the fans following his disastrous debut for Fenerbahçe, a 3-0 loss.

"I want to get out of Istanbul and finally get myself on a proper course of therapy. There's no way it can go on like this. [...] I feel anxious, and helpless, and I haven't left the hotel room. I'm afraid of people's looks. If only I could live without fear and the nervousness."

The failure of sport to recognise that injuries of the mind are just as significant - if not more - than injuries of the body is an ongoing problem. Valentin Markser, Enke's therapist, told the BBC that mental health issues were just as prevalent in high-performance sports as in the general public, yet the suggestion that a footballer is struggling with mental illness is usually greeted by those within and without the game by a cocktail of scepticism and abuse. Consider the response of Ron Atkinson who, when asked if he had any sympathy for Stan Collymore, at the time recovering from depression in the Priory, remarked "Not on fucking 25 grand a week I don't".

Football is by no means alone in this problem. Looking across the Atlantic, the recent suicide of Denver Broncos wide receiver Kenny McKinley has been widely ascribed to depression following a knee operation. Another American footballer, Ricky Williams -- who struggled with social anxiety disorder to such an extent that he would conduct post-game interviews still wearing his helmet -- summed up the curious disparity at the heart of sport when he remarked to Sports Illustrated that "When it's a broken bone, the teams will do everything in their power to make sure it's OK. When it's a broken soul, it's like a weakness."

It is not uncommon for a footballer to attempt to conceal or to play with a physical injury; they will generally be found out when they're forced to limp from the pitch. But playing with a mental condition such as depression will generally manifest itself as a loss of form without any immediately obvious reason. It is here that it becomes crucial that a player is able to turn to his manager and tell him exactly what is going on.

Yet the barriers preventing this are legion. A lack of information about depression as an illness is commonplace not only within sport but throughout society. This is reinforced by the culture of extreme mental fortitude that permeates sport at the highest level, in which all perceived weakness is an opportunity to be exploited. The fact that such weakness might in fact denote illness is barely acknowledged. And when both Williams and Collymore overcame these blocks, and approached their bosses, they were told in varying but not uncertain terms: stop whining, get on with it.

It is no wonder that sportspeople suffering from depression are reluctant to come forward. Marcus Trescothick, Test cricketer and Ashes winner, famously withdrew from a tour of India citing "stress-related illness", and he subsequently retired from international cricket. Only later, in his autobiography, did he reveal that he was followed to and from the crease by "black wings" that threatened to overwhelm him. At the time, however, he was branded by some 'faint-hearted', while scurrilous rumours about the state of his marriage circulated.

What is odd is that the very institutions that sportspeople feel unable to approach - their managers, their clubs - are the very people who have the most to lose if depression isn't identified, treated, and managed. Taking the example above, Collymore can be a hard man to sympathise with, whether or not you understand his illness as an illness. But Atkinson's comment, not for the first time, seems spectacularly counterintuitive: if you're paying somebody silly money, why wouldn't you want to make sure they were sound in mind as well as body?

In Why England Lose, Stefan Syzmanski and Simon Kuper cite the example of a young Nicolas Anelka, who Real Madrid seemed to expect to be able to cope entirely on his own once he arrived in Spain, simply because they'd paid a fortune for him. They describe a young, lonely Anelka repeatedly trying to find a locker, only to be moved on time and again by dismissive senior players; eventually he became disillusioned with the club, and began his nomadic wanderings.

But to return to Enke. His was clearly an extreme case; his fears about revealing his depression were sharpened immeasurably by his concerns that it might somehow lead to his adoptive daughter being taken from him. Yet the pattern is familiar: an illness hothoused by an inability to tell those who had a vested interest - indeed, a duty of care - in ensuring his continued mental as well as physical wellbeing.

"I was always happy if I didn't have to play in games ... I'm also terrified of what the public thinks. The press, and people's stares. Anxiety cripples me. I don't know how long it's been since I was actually excited by a game."

The German Football League responded to his death by setting up the Robert Enke Foundation. A year on however, there is some concern as to how effective it has been. Former athlete turned academic Professor Dr. Gunter Gebauer recently told Bild that football remains as brutal as ever, and points to the national team's willingness to discard former linchpin Michael Ballack as an example of a latent callousness within the sport. René Adler, Enke's former Germany teammate, has echoed these concerns.

Perhaps an illustrative example of where football finds itself is that of Andreas Biermann, a former St. Pauli central defender, who saw Enke's struggle with depression revealed on television and immediately approached his club. He believes that the subsequent help he received may have saved his life but cost him his career; his contract was not renewed, and he is unable to find a club willing to employ him. And while nobody would disagree that it is better to save a life than a footballing career, it seems that the game is still some way from ensuring that those who suffer from depression can have both.

Andrew is on twitter @Twisted_Blood and to read more, head to his Twisted Blood blog.

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