Depression and chronic fatigue in athletes.

For the most part, the competitive athlete is a well-adjusted individual who demonstrates considerable vigor and well-being, as well as less depression, anxiety, and fatigue than nonathletic counterparts. The well-trained athlete, however, may also have a personality that is somewhat rigid, strongly goal oriented, and perfectionist. It is not unrealistic to expect that when confronted with diminished performance or success, such an athlete may be compelled to drive himself or herself harder to succeed. Such behavior typically leads to the phenomenon of overtraining, which can express itself in the form of chronic fatigue and depression. There are a number of other organic causes of chronic fatigue and depression, however, which must be excluded by careful evaluation and appropriate diagnostic testing. Although the evaluation of the athlete who presents with chronic fatigue and depression can be somewhat complex, a diagnostic framework has been outlined here to assist the clinician in the assessment of an athlete who presents with such complaints.