Zach Colletti

ENC 2135
Tanya Grae
12/11/16
Football Fever
When it comes to big pay days, not many people make out quite like professional athletes do,
NFL players in particular. It is strange to note, then, that there are many cases of retired NFL players
(some boasting very long and lucrative careers) falling under severe amounts of debt, being forced to
file for bankruptcy, or being plagued by any number of financial problems. While financial
irresponsibility is already a daunting issue in and of itself, it is a common symptom of much more deep
rooted psychological problems. Psychological disorders are more common among retired NFL players
due to high exposure to head and neck injuries, prescription medications, steroids, and the general high
pressure of the job. These factors can all contribute to the formation of disorders over time, which can
then be detected by noting behavior in the ex-players consistent with that of someone with a
psychological disorder. To gain a perspective on how the cultivation of these disorders work, it is
necessary to observe examples of ex-NFL players showing these behaviors.
One of the most current and prevalent issues among retired NFL players is suicide. Attempting
suicide is already a red flag for spotting mental health issues among the general population, let alone
when it is among retired NFL players. This is because NFL players are subject to many other independent
variables ( for example: head trauma, high pressure, easy access to prescription/performance
enhancing/recreational drugs) that are known to produce strong positive correlations with many
psychological disorders. Suicide is six times more likely among retired NFL players than it is among the
general population (qtd. In Karimipour 51). For instance, between January of 2012 and July of that same
year, there were five reported ex-NFL player suicides (Karimipour 53). One thing that each suicide had in
common with the previous and the next was that each death was caused by a gunshot wound to the
head (Karimipour 53). Given this information, it becomes time to investigate this apparent correlation
and attempt to identify some possible causal mechanisms for this relationship. One noteworthy thing to
take a look at is the idea of masculinity rooted into football. "Hegemony permeates many facets of
society, particularly in sports. Within the sports arena, hegemony comes into play in situations in which
athletes establish themselves as dominant and powerful and subsequently exert their power through

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various methods" (Karimipour 51). In the United States in particular, masculinity and hegemony have
been praised for many years, especially within the realm of sports. Due to the prevalence and popularity
of the NFL in American culture, many people are exposed to the form of masculinity presented in
professional football. This is stated in the following quote: "...commercial sports are a focus of media
representations of masculinity..." (qtd. In Karimipour 51). When one takes this idea into account, they
can begin to see how, for example, a retired NFL player suffering from depression could be pushed
further into self-deprecating behavior because they feel that their current emotional state shows
weakness, and that they no longer live up to the ultra-masculine leader they were on the field. During
their time in the league, players are idolized for their toughness, athleticism, and leadership, among
other intangibles crucial for preforming on the gridiron. During this period, demonstrations of
dominance and masculinity are the high points of their careers (big hits, scoring on the opponent,
outplaying your matchup, etc.). After years of reliance on the capability to physically dominate their
opponent in order to move ahead in their careers, the change to a more sedentary lifestyle out of the
public eye (or at least further from it) can be difficult on many. This feeling is common among all
retirees, not just football players. Consider the career of litigator. After years of using their sharp
analytical minds and savvy tongues to win cases, they often retire to a life of much less stress. While this
may not be a bad thing, many people lose their sense of worth during this time. The American
Psychological Association brings into question the issue of "loss of career identity, replacing support
networks... finding new and engaging ways to stay active" (Chamberlin, "Retiring Minds Want to Know").
While this is a possible explanation for retirees among the general population, there are other factors at
play in the post-retirement depression of ex-NFL players.
Another possible contributor to this depression is head injuries. "According to the Center for
Disease Control and Prevention (CDC), approximately 1.6-3.8 million sports and recreational concussions
occur each year. Whereas a vast majority of individuals who sustain mild traumatic brain injury (mTBI)
show good recovery within several weeks, some continue to experience lingering somatic, cognitive,
and/or mood symptoms." (qtd. in Didehbani 418). How, one could ask, does this statistic relate directly
to ex-NFL players? Plenty of people not involved in the NFL (or any form/level of sport) are subject to
concussions. A study found that, through the 2012-2013 and 2013-2014 NFL seasons, 306 players
combined to sustain 323 concussions (Breslow). The ratio of concussed NFL players per year over the
total number of players in the NFL is much greater than that of the total number of concussed people on
the planet over the total world population. Results from a study show that retired athletes are 16%
more likely to experience chronic or lifelong depression than retired males from the general population

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(Didehbani 419). Further evidence shows that NFL players who reported 3 or more concussions were 3
times more likely to suffer from post-retirement depression (qtd. In Didehbani 419). The clear
correlation between concussions and depression displayed through these studies, combined with the
increased likelihood of NFL players to sustain concussions shows, by proxy, a correlation between
playing in the NFL and post-retirement depression. Of all of the symptoms tested for in this study, the
ones that saw the largest spikes among retired NFL players were concentration problems, changes in
appetite, low energy, changes in sleep patterns, and decreased sexual interest (qtd. In Didehbani 424).
The information provided by this study shows yet another possible explanation/contributing factor to
the post-retirement depression felt by many athletes. Concussions and head injuries definitely play a
role, but there is still much more to take into account when considering this topic.
While head and neck injuries may be the most hotly debates topics of discussion when talking
about the mental health of retired NFL players, there is another very closely related factor that does not
receive nearly the same level of attention. Injuries of nearly any degree (bruises, sprains, tears,
fractures, and breaks, among others) to every other part of the body besides the head and neck may
have more of an effect on mental health than one could assume at first consideration. When a player
receives a serious concussion or injury of similar nature, they typically are put through treatments and
sit out until they are deemed recovered and fully able to play. However, when they sustain an injury to
another part of their body the protocol changes. If the injury is not deemed to be too serious, they are
many times prescribed painkillers and medications of varying strength depending on the nature of the
injury.
A study of 644 retired NFL players showed that, of the 644, 52% used opioids during their
careers (Cottler et al. 190). Of those 52%, 37% obtained their pills only from a doctor (family doctor or
team doctor), 12% obtained their pills from only non-medical outside sources (family, friends, other) and
the remaining 51% obtained theirs via a combination of both (Cottler et al. 190). Here we can already
see a trend of players side-stepping their doctors to get opioids, which is a red flag for misuse. Of the
players who used opioids during their careers, a staggering 71% admitted to misuse during their time in
the league (Cottler et al. 191). Now things begin to get interesting. Of those who reported misuse in the
league, 17% reported use as per their prescription within the last 30 days, 68% reported no use at all,
and the remaining 15% reported misusing opioids within the last 30 days before completing the survey
(Cottler et al. 191) Of the percentage of players who admitted to misuse in the last 30 days, 78% of them
reported a history of chronic misuse during their time in the NFL, and had significantly higher odds of

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experiencing poor health in the future than those that used as prescribed or did not report any opioid
use during their careers (Cottler et al. 191). "Misusers were at increased odds of having a career ending
injury and nearly 8 times as likely to be using a cane, walker, or wheelchair compared to their non-using
teammates" (Cottler et al. 192) This shows some very hard empirical evidence of a correlation between
opioid misuse and use of a cane, wheelchair ,or walker; each of which being a tool designed to assist
someone with limited use/no use of their legs. What this means is that players who received injuries to
or harbor chronic pain in their legs are at a significantly increased risk of opioid use.
Opioid addiction sets in quickly relative to other drugs, and the addiction itself is very intense
(Effects of Opiate Use). Somebody who is in the beginning stages of their misuse can expect, along with
the desired "high": drowsiness, lethargy, paranoia, respiratory depression (making them more prone to
illness), and nausea (Effects of Opiate Use). While these may come in small waves and go virtually
unnoticed by some, the effects of long-term use are much more severe. Chronic abusers are likely to
experience lifelong episodes of nausea and vomiting, abdominal dissention and bloating, constipation,
permanent liver damage (even more likely when coupled with alcohol abuse, which is a common trend
among lifelong opioid abusers), hypoxia and other damage to the brain, permanent respiratory
depression, and eventually complete dependence on the drug (Effects of Opiate Use). It is clear now that
chronic opioid abuse leads to brain damage, which in turn leads to mental disorders. Now, by tracing
this information back and connecting it to the previously discussed research, we see a clear pattern.
Bodily injuries (highly common among NFL players) lead to opioid prescriptions. Opioid prescriptions,
according to previously cited research, can likely lead to misuse (Cottler et al. 188-194). Misuse then
leads to chronic misuse, which leads to addiction, an effect of which is lifelong brain damage. In short,
bodily injuries can lead to factors which lead to mental disorders. This proves that bodily injury
sustained during their career can have a significant impact on the mental health of retired NFL players
later in life; ultimately contributing to post-retirement depression.
Another one among the myriad of controversial NFL-related topics of discussion is steroids.
Steroids, when being discussed under nearly any context, will likely spark some form of disagreement.
Whether it people are discussing the fairness of using them, whether they are "ruining the sport" or not,
or any thing related to them, a difficult aspect of steroids to look past is their side affects. While the
physical consequences of taking steroids are fairly easy to cite, there are effects that are much less
observable. One of the largest drawbacks of steroid use is the psychological effects that long-term use
can yield. Illicit anabolic-androgenic steroids (AAS) have been used by professional athletes all around
the world since the 1950's (Kaufman et al. 48) "AAS are known to cause acute psychiatric effects such as

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aggression, violence, including increased partner violence, and impulsive behaviors including risky sexual
and other behaviors" (qtd. in Kaufman et al. 48). According to the fifth edition of the Diagnostic and
Statistical Manual of Mental Disorders (DSM-5), aggression and violent behavior and outbursts are
prime symptoms of Intermittent Explosive Disorder, which happens to be comorbid with a number of
depressive disorders as well as personality disorders (Intermittent Explosive Disorder). What that means
is that these disorders tend to be diagnosed together due to the fact that they tend stem form the same
causes and show the same symptoms. A study of 150 ex-weight lifters yielded results consistent with the
clam that AAS cause the aforementioned effects. After MRI and fMRI scanning, a series of memory and
cognitive ability tests, and self-reported surveys and screenings, the subjects that reported long-term
AAS use showed to have altered amygdala structures among other neurochemical abnormalities,
especially when coupled with reported opioid, alcohol, and/or other illicit substance abuse (Kaufman et
al. 55). Change in the structure/size of the amygdala is consistent with the formation of many
psychological disorders, including both depressive and personality disorders alike (Kaufman et al. 49-50).
While this information provides some evidence that steroid use may be causally linked to some
psychological disorders, how then does this relate to retired NFL players?
While virtually anyone is capable of getting their hands on them, and their use is by no means
restricted only to NFL players, steroid use is a concerning issue in the NFL today. One current starting
player in the NFL (who wished to remain anonymous) claimed that ten to fifteen players on each team
regularly use steroids on average (Arthur, "HGH Use"). That being said, if we know that there are fiftythree players on each team in the NFL, and that there are thirty-two teams, we can do the math and see
that approximately twenty-three percent, or nearly a quarter, of the NFL uses steroids. Citing previously
discussed information, we know that there is substantial evidence to show that association between
steroid use and, ultimately, psychological disorders. Knowing now that nearly one out of every four
players in the NFL will likely use steroids at some point; the increased likelihood for a retired NFL player
to show signs of psychological disorders becomes apparent. It is unfortunate to note, then, that due to
the high number of players currently using steroids in the league, it seems unlikely that the NFL will do
more than its minimum requirement to try to decrease (if not completely eradicate) use of steroids in
the NFL. Because of the relatively large amount of players currently using, it is highly plausible that a
sizeable proportion of those using could be some of the leagues more marketable players; one's whose
absence from sport could cause the league to lose substantial amounts of money. It is for this reason
that decreased steroid use in the NFL is unlikely to be observed in the near future.

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Determining factors that could causally contribute to psychological disorders among retired NFL
players is one way to attempt to detect them, but not the only way. It is important to not only look at
what causes these disorders, but also to observe their effects in action among the population in
question. In order to detect a disorder one must first be able to cite behavior consistent with it.
Engaging in risky behavior, which is oftentimes also illegal, is a commonality among people with
disorders. Criminal/ felonious behavior has historically been an issue among both current and retired
NFL players alike. It is worth noting that crimes committed by NFL players tend to be more publicized
and receive more media attention than those committed by others, which some could argue would give
the illusion of a more serious issue than actually exists. With that being said, only true empirical data can
give the answer. Statistics on all U.S. males age 25 to 29 (the highest age concentration in the NFL) and
all NFL players of that age group revealed the relationship between each group's criminal habits. The
NFL players' arrest rates relative to those of the general population were as follows: Domestic violence
arrests at 55.4%, nonviolent gun-related at 45.2%, sexual offenses at 38.2%, murder at 27.8%, DUI at
27.7%, prostitution at an even 20%, disorderly conduct at 18.5%, nondomestic assault at 16.7%, drugrelated at 11.4%, nonviolent domestic at 8.6%, theft at 5.5%, burglary at 2%, and fraud at 1.1%
(Benjamin, "Rate of Domestic Violence"). As can be observed from the statistics above, NFL players
account for a relative majority of domestic violence arrests, nearly half of gun-related arrests, and over a
third of disorderly conduct arrests within the previously laid-out age parameters relative to their total
population versus that of the general population. This shows some strong empirical evidence of an
affinity for risky, aggressive, and criminal behavior among these players, which is consistent with
psychological disorders. Another study shows that, while NFL players are less likely to commit crime in
general than the general population is, they are significantly more likely to commit violent crimes
(Strachan, "NFL Violence"). Violent crime includes murder, manslaughter, DUI manslaughter, robbery,
any kind of assault, rape, battery, domestic violence, child abuse, and kidnapping, ad crimes of the same
nature. It is also worth noting that many occurrences of this behavior does not end in arrest. Rape
allegations faced by Steelers quarterback Ben Roethlisberger, as well as multiple domestic abuse
allegations facing Ravens running back Ray Rice, Cowboys defensive end Greg Hardy, and Giants kicker
Josh Brown are just a few of the recent instances that, while causing a huge media frenzy, never ended
in an arrest or in criminal charges. Each of these instances, as well as many others that received no legal
attention, where handled internally by the NFL. After observing the above data, it is easy to see that
there is a significant trend of violent and aggressive criminal behavior among NFL players when
compared relative to the general population. It is through observing such behavior that detecting

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psychological disorders among retired NFL players becomes easier, which can in turn make it easier try
to come up with remedies and/or solutions to solve the problem at hand.
After observing and contemplating the information provided, it becomes clear that retired NFL
players are at a higher risk of having psychological disorders than the general population is. This is
shown through empirical evidence from a variety of scientific studies, physical evidence obtained via
mapping techniques (MRI/fMRI), analyses from doctors and experts in psychology, and self-reported
surveys and screenings. Through continued research, the knowledge gained regarding psychological
disorders from the study of retired NFL athletes can be used to better understand these disorders and ,
by proxy, become better suited to treat them.

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Works Cited
Arthur, Kenneth. "HGH Use Is 'rampant' in NFL." SBNation.com. Vox Media, 01 May 2013.

Web. 01

Nov. 2016.
Breslow, Jason M. "FRONTLINE." PBS. PBS, 19 Sept. 2014. Web. 22 Oct. 2016.
Carlson, Kyle, Joshua Kim, Annamaria Lusardi, and Colin F. Camerer. "Bankruptcy Rates among NFL
Players with Short-Lived Income Spikes." American Economic Review 105.5 (2015): 381-84. Web.
Casson, I. R., D. C. Viano, E. M. Haacke, Z. Kou, and D. G. Lestrange. "Is There Chronic Brain Damage in
Retired NFL Players? Neuroradiology, Neuropsychology, and Neurology Examinations of 45
Retired Players." Sports Health: A Multidisciplinary Approach 6.5 (2014): 384-95. Web.
Chamberlin, Jamie. "Retiring Minds Want to Know." American Psychological Association. American
Psychological Association, Jan. 2014. Web. 22 Oct. 2016.
Cottler, Linda B., Arbi Ben Abdallah, Simone M. Cummings, John Barr, Rayna Banks, and Ronnie
Forchheimer. "Injury, Pain, and Prescription Opioid Use among Former National Football League
(NFL) Players." Drug and Alcohol Dependence 116.1-3 (2011): 188-94. Web.
Didehbani, N., C. Munro Cullum, S. Mansinghani, H. Conover, and J. Hart. "Depressive Symptoms and
Concussions in Aging Retired NFL Players." Archives of Clinical Neuropsychology 28.5 (2013):
418-24. Web.
Gagliardi, Jane P., MD, Andrew J. Muzyk, PharmD, and Shannon Holt, PharmD. "When Steroids Cause
Psychosis." The Rheumatologist. N.p., 01 Oct. 2010. Web. 04 Oct. 2016.
Karimipour, Nicki. "Suicide on the Sidelines: Media Portrayals of NFL Players Suicides from June 2000 to
September 2012." Journal of Sports Media 11.1 (2016): 49-80. Web.

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Kaufman, Marc J., Amy C. Janes, James I. Hudson, Brian P. Brennan, Gen Kanayama, Andrew R. Kerrigan,
J. Eric Jensen, and Harrison G. Pope. "Brain and Cognition Abnormalities in Long-term Anabolicandrogenic Steroid Users." Drug and Alcohol Dependence 152 (2015): 47-56. Web.
Kelly, Daniel F., Charlene Chaloner, Diana Evans, Amy Mathews, Pejman Cohan, Christina Wang, Ronald
Swerdloff, Myung-Shin Sim, Jihey Lee, Mathew J. Wright, Claudia Kernan, Garni Barkhoudarian,
Kevin C.j. Yuen, and Kevin Guskiewicz. "Prevalence of Pituitary Hormone Dysfunction, Metabolic
Syndrome, and Impaired Quality of Life in Retired Professional Football Players: A Prospective
Study." Journal of Neurotrauma 31.13 (2014): 1161-171. Web.
King, S. "Beyond the War on Drugs? Notes on Prescription Opioids and the NFL." Journal of Sport &
Social Issues 38.2 (2013): 184-93. Web.
Marshall, Brandon. "Brandon Marshall: Athletes Struggle to Identify with Mental Illness." Interview by
Chris Smith. Guardian 08 Sept. 2015: n. pag. Web.
Morris, Benjamin. "The Rate of Domestic Violence Arrests Among NFL Players." FiveThirtyEight.com.
N.p., 31 July 2014. Web. 02 Nov. 2016.
Sheaffer, Heather. "Intermittent Explosive Disorder." Therapedia. Theravive, n.d. Web. 01 Nov. 2016.
Strachan, Maxwell. "Why Aren't We Talking About What This Study Discovered About NFL Violence." The
Huffington Post. The Huffington Post, 1 Sept. 2015. Web. 02 Nov. 2016.

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