When we think of an athlete's health, we think of ACLs, hamstrings and fractures.
Royce White reminds us that just as important is the health of the mind.
Of course, this presents immense challenges to a career in the NBA.
Perhaps the most difficult challenge is the inability of anyone but Royce White himself to understand the nature of his condition, as the manifestations of diseases such as generalized anxiety disorder are unique to each individual.
However, accepted criteria to make a diagnosis of generalized anxiety disorder have been determined. They are, according to the Diagnostic and Statistical Manual of Mental Disorders:
1. At least six months of excessive anxiety and worry regarding a number of different events or situations; this worry is more than would normally be expected for a particular event
2. The worry is difficult to control
3. Three of more of the following are present on most days:
- Feeling tense, wound-up or restless
- Easily becoming fatigued or worn-out
- Concentration problems
- Significant tension in muscles
- Difficulty with sleep
4. These symptoms are not part of another mental disorder
5. The symptoms cause clinically significant distress or problems functioning in daily life
6. The symptoms are not due to substance abuse
If a person meets all of these criteria, a diagnosis of generalized anxiety disorder is made.
Nevertheless, the similarities from one case of the disease to another end there.
Each case has its unique anxiety-producing triggers and situation-specific difficulties.
Unfortunately for Royce White, one of his primary sources of anxiety is air travel, a source that produces in White the overwhelming sense of worry that he experiences.
In addition to this overwhelming sense of worry, generalized anxiety disorder can also produce physical symptoms, such as a racing heart beat, hyperventilation, muscle tension, headaches and many others.
Fortunately, generalized anxiety disorder can be treated. Cognitive behavioral therapy, gradual and controlled exposure to sources of anxiety, antidepressants and sedatives can all help control symptoms.
But perhaps just as important may be avoiding known sources of anxiety when possible.
For White, the nature of playing in the NBA makes this extremely difficult, so difficult that White has now been demoted to the Rockets' D-team after disputes over how the organization has handled his disease.
While it may be easy to look at the situation and say it should have been managed differently, it is important to not pass judgment too quickly.
Generalized anxiety disorder is a very real disease, and it has very real symptoms and consequences.
No one can understand Royce White's situation other than Royce White.
And now, no one understands that better than Royce White.
The author of this article is a soon-to-be Family Medicine resident physician with plans to specialize in Primary Care (non-operative) Sports Medicine. The above information is based on the Diagnostic and Statistical Manual of Mental Disorders. Additional input is welcomed and encouraged.