The Ashes 2013-14 November 25, 2013

The expert view - Big strides have been made


Jonathan Trott has been ruled out of the remainder of the Ashes tour with a stress-related illness. Brett Morrissey, a cognitive behaviour consultant, who has worked with professional sports people including Michael Yardy who left England's 2011 World Cup campaign in a similar situation, explains to ESPNcricinfo about the illness, the improved understanding of it and breaking down barriers.

What is a stress-related illness?

It's an all-encompassing phrase. It could mean several things. In one way it protects the person because the public do not need to know the specifics. When we see people from any walk of life you will make a more specific diagnosis based on the things they can tell you. It can include anxiety, depression and agitation as responses to the stress involved.

What strides have been made over recent years in the understanding and treatment?

The biggest stride was someone like Marcus Trescothick coming out in public, it makes everyone aware and also takes away the stigma. In sport, especially, there is a macho environment and you don't want to be seen to have what some people would term a weakness. You can tend to hide things away or bottle things up, put on a front and get on with it. Marcus did lots of people a favour.

You find that in any walk of life. If someone at work confides in a colleague then you will find others coming forward and saying they've been suffering or having treatment. Raising the awareness was key, within the sports teams themselves as well. Coaches and doctors are now spotting things earlier and there are procedures in place to form a support network.

Do cases vary from person to person?

Certainly, like any illness, they can be different from case to case. They'll be different types of problems and different intensities from one case to the next, from severe to milder episodes that you can go through. There is some thinking that there can be a genetic element, that some people are more predisposed than others, but there can also be a connection between life events. Also, people have a threshold where, up to a point, you can manage stresses - for example if they are spread out - but when they combine it goes beyond that point where normal coping mechanisms aren't effective

How has the thinking developed into the causes?

The current thinking is that there are two models. There's the mental model where the current thought is that there can be changes in levels of chemicals in the brain - usually serotonin - where you have a reduction, which can be treated with medication. The other model is the way people think, known as cognitive behaviour therapy, and how they interpret things. For example you may see something as threatening but it isn't, it's the way you've interpreted it. It's how we think, how we behave and how we feel. You can get a lot of automatic thoughts which aren't true and that's what we work on when trying to help a person.

Clearly it is not just an issue for those with high-profile lifestyles

I'm not aware of any figures about having a high-profile life making you any more prone. The current numbers suggest 5% of the population at any one time can be suffering from depression and with anxiety up to 10% at any one time. But, from a sporting point of view, what they found with the South African rugby union team after one World Cup was quite a high amount of depression among the players straight after the event; two years build up and all the emotion of the event put such physical and mental strain on them and then suddenly it's all finished. A similar process can happen in retirement, both within sport but also within any walk of life.

What is the recovery process?

It's hard to say without knowing the individual but over weeks or months people can make a very good or full recovery and can get back into their professional life, although it all differs from a case-by-case basis. Also, it isn't always the work itself that has caused the illness - even if it is where the problems has come to the fore - it can be many other things. Work can actually be somewhere you are comfortable with your role, know what you are doing and have support from friends and colleagues.

Sport can sometimes be slightly different because of the intensity you are under - it's not a normal job - and part of the recovery process will be looking to deal with that and any other causes of stresses. From Jonathan Trott's point of view he will have fantastic support and help from the ECB, who work very closely with the PCA and counties, and have an excellent system in place to help their players.

Andrew McGlashan is an assistant editor at ESPNcricinfo

Comments have now been closed for this article

  • Perry on November 27, 2013, 18:27 GMT

    Get well soon Test cricket. You are going down the tubes , but nobody whats to do anything about it.

  • Rajkumar on November 27, 2013, 5:46 GMT

    @Nutcutlet you have a very valid point and there definitley is relation between stress related illness and country.But the factor is neither culture nor society but the climatic conditions.Extreme cold and lack of sunlight or overcast and gloomy conditions for most part of the year can definitely foster mental illness.Researchers have proved this and this is a reason for finding more people with disorders like Bipolar in countries like Norway where it is extreme cold.Thanks a for starting off such a valid discussion and I hope someone to add much more to this...

  • ian on November 26, 2013, 17:53 GMT

    An interesting and informative piece. Now, I'd like someone to answer this question. Are these stress-related conditions more common, or even exclusively found only in certain cultures & societies, like UK, SA & NZ? A number of Indians have commented that they have never heard of any of their high-profile legends suffering from stress & I must admit there seems to be a valid point there. Does the subcontinental culture/society have some built-in immunity to the sort of condition that afflicted Trescothick & Yardy and has now halted Trott's career? Or is it that Indian society - or its cricketers at least - have developed an ethos that other societies need to know about, so that some learning-from-others can take place? I geninely would like an informed repsonse on this point, preferably from a professional practising in the subcontinent.

  • Michael Ponnudurai on November 26, 2013, 12:55 GMT

    Wish Trott a quick recovery and hope to see him back in the England team soon.

  • Dummy4 on November 26, 2013, 8:31 GMT

    In the context of a timely and well-informed article, I give the most kudos to Marcus Trescothick for being the pioneer in bringing mental illness in general out into the open - using his sporting profile. Odd that a player with an ankle or back injury would freely discuss it at length but one with an injury to another part of their physiology (their brain) was stigmatised. Thankfully this is starting to be broken down - thanks to Trescothick and others - they are sporting heroes for multiple reasons.

  • Perry on November 26, 2013, 2:58 GMT

    Herein lies cricket's problem. they are unable to recognize that an endless revolving door of months long tours played off in far off lands(which basically serve no purpose- there is no points sytem) will cause depression. Instead, it is considered a medical issue. Cricket is still being administered as an ameteur sport. They just dont see that the game is in desperate need of structure.

  • ESPN on November 26, 2013, 0:49 GMT

    Superb piece. Well-chosen questions to someone who knows their stuff and knows precisely how best to express themselves.

  • Dummy4 on November 25, 2013, 23:42 GMT

    Get well soon Trotty. An admirable career can be made into a legendary one if you can overcome this hurdle.

  • Paul on November 25, 2013, 23:40 GMT

    valvolux - stress-related illness and mental illness are *very much* interlinked.

    Your comment that is happens overnight and can be fixed overnight is also missing the point. Stress often happens for short periods of time, and then subsides. When it subsides, folk often don't think anything needs fixing. The fight-or-flight feeling is gone - and folk generally think they're now ok. Crisis over.

    However it can come back again, and over time can lead to subtle, but growing behavioural issues - OCD and suchlike.

    Stress-related illness is categorically something that can often lead to mental illness. It is excellent that Jonathan Trott has chosen to recognise this and even better that he is fully supported by ECB.

    It will take some time for him to combat this. I don't know about his chances of returning to test cricket. It really depends on how well he responds to cognitive therapy. I wish him all the very best.

  • Hassan on November 25, 2013, 18:38 GMT

    get well soon trotty. you will bounce back. Just hang in there!!