“But I didn’t want to ask for help.”

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What happens when elite athletes suffer from mental illness as a result of head trauma? One answer to this question can be found in the August 2018 issue of Bicycling magazine, which features the first-person account of professional cyclist Alison Tetrick.

Before Tetrick transitioned from a successful road-racing career to her current role as a gravel-racing champion in 2017, she suffered two concussions. The first, which occurred in 2010 at the Cascade Cycling Classic in Bend, Oregon, was devastating. During the race’s first stage, another rider — who was trying to avoid a crash she could see ahead — accidentally clipped Tetrick’s front wheel. The pair were traveling downhill at an estimated 45 mph when Tetrick was launched from her bike and hit the tarmac.

In her words, “I didn’t slide, didn’t tear shorts, didn’t bleed. I just hit the ground. I landed on my hip and head, and shattered my pelvis” (p. 56). After spending over an hour on the ground while first responders arrived and stabilized her, the 25-year-old was airlifted to a hospital where she was quickly diagnosed with a concussion, a form of traumatic brain injury (TBI). The journey that commenced after she was released from the ER included daunting physical rehabilitation, and an even more challenging mental climb — a process that is still on-going.

While her body slowly healed over the months following her crash, Tetrick’s mind seemed perpetually in a “dense, never-ending fog” (p. 56). In both her relationships with friends and with family, she struggled to maintain a stable emotional state; she felt anxious and irritable at times, and emotionally vacant at others. Her marriage ended. And she struggled to determine how she would continue as a professional athlete in a sport where confidence is key. But despite these challenges and concerns, Tetrick fought on. Her body recovered and she made a comeback in 2011 at the Merco Cycling Classic in Merced, California. Despite winning the second-stage time trial, holding the leader’s jersey for three more days, and then winning the overall event, Tetrick knew something was wrong.

She writes: “Throughout my recovery from my broken pelvis, and after, I felt vulnerable and fragile, insecure and mentally frail…But I didn’t want to ask for help. I wanted to pull myself up by my bootstraps, cowgirl up” (p. 56). In language that testifies to the understandable fear of being an athlete who is perceived as weak or lacking in confidence, Tetrick says: “I didn’t want to admit I wasn’t okay [mentally] because if I admit that, and I’m leading a bike race, I’m going to get stuck in a corner because people know I’m going to have a panic attack…As a professional athlete, you hide your weaknesses….You can constantly find ways to tell yourself, ‘People like me. I’m normal. I’m okay'” (p. 56).

But, when dealing with a host of frightening symptoms that seem to indicate that your personality is morphing in strange ways, she admits that, “Deep down I was like, I don’t know if I’m okay” (p. 56). She continued forward, though, training and racing until disaster struck a second time in October 2011. At the Pan American Games in Guadalajara, Mexico, her front wheel got stuck in a storm drain during a pre-race warm-up. She “flew over the handlebar, and smacked [her] head” (p. 58). Despite this injury — a second head trauma in less than a year and a half — she raced that day. But her life began unraveling shortly thereafter. The once vibrant and outgoing young athlete was not okay.

Looking back on the period following her second concussion, Tetrick describes her situation this way: “I stared at the wall for weeks, couldn’t move, couldn’t stop crying. The depression wouldn’t go away. My parents sent me to psychologists…We were trying everything, because I couldn’t function. I couldn’t sleep — I had to go on sleeping pills” (p. 58). Again, she fought back. With the support of family, friends, and a neuropsychologist whom she works with today, Tetrick got back on the saddle and started racing again. For two years she did so while using the antidepressant Wellbutrin. She reflects: “During that time I didn’t really have emotional highs or lows, I just felt flat” (p. 60).

Tetrick continued racing until shortly after she and her team finished the 2016 Tour of Flanders in Belgium. The day after that Tour, she attended a smaller race where riders “were taking all of these [unnecessary] risks” (p. 78). There, she saw a rider “hit a light pole” — a collision that seemed entirely unnecessary. And that is when Alison Tetrick decided that her professional road-racing career was nearing its end.

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In 2017, Tetrick traded her skinny road tires for stouter off-road rubber and entered the 200-mile Dirty Kanza gravel race which is held in early June. It was her first time competing at that distance. And she ended up winning, sprinting to the finish line just ahead of reigning 2016 champion Amanda Nauman. Today, Tetrick seems to be on top of her game. Physically, she is performing better than she ever has before. However, she knows that the mental consequences of her concussions still follow her. She says: “Every day you have to make a choice for your mental health, and possibly deal with the physical side effects…I still get emotionally flooded. It’s an injury that you can’t see” (p. 79).

Despite the coverage that concussions receive in the press related to sports, military service, and workplace accidents, a stigma still exists around the psychological effects of traumatic brain injuries. Even though there is nothing shameful about being struck by a fellow cyclist and crashing to the pavement — or being tackled by a monstrous defensive lineman — we still seem to tread delicately around the emotional and mood-related consequences that those massive blows can impart. Physical injury caused by others’ actions can be interpreted as an sign of having performed courageously on the field of play, but mental anguish rarely receives equal respect. Both are tragic, to be sure, but it is the latter that is often darkened by shame.

I applaud Alison Tetrick for writing candidly about the physical and mental challenges that she has faced in the wake of her concussions. Speaking about broken bones can be easy, but talking about a flagging spirit or a troubled mind requires much greater resolve. Tetrick possesses a character made stronger by her willingness to be vulnerable.

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