Train Tracks of Life

We travel along life’s paths with enthusiasm, intensity, ambition, happiness and sadness, depression and exhilaration. Which track are you on? And can you switch?

All athletes experience each of these mental mindsets at different times. They are enabled by those emotions that are helpful, but not usually disabled by those that aren’t.

While all athletes get injured, the best of them use the injury as an opportunity. A critical part of what we do as doctors is help athletes take an unexpected injury and turn it into an occasion to reframe their lives, their training programs, and their goals. When we succeed, we become their partners in a lifetime of sports activities. When we fail, we all suffer.

Athletes who are challenged by this transition are our greatest responsibility, and often our biggest opportunity. To turn a depressed athlete into an enthusiastic participant in meeting their new goals is thrilling and satisfying. Having the optimal surgical techniques designed to let athletes optimize their return— combined with nursing care that supports their healing and a rehabilitation team that creatively assesses their state of fitness, their injury, and their potential for total body recovery—is what makes our professional lives exciting.

The newest tool in the public’s toolbox, though, is currently outside our expertise. During recent months, we are hearing (and actually seeing) remarkable stories of athletes on the wrong track—depressed, anxious, and without goals—being shifted with the help of mind-altering drugs like psilocybin and MDMA. These therapies are being offered by well-trained therapists, lessening or even eliminating the need for lengthy talk therapy and chronic medications. 

This is a game changer. All of us have treated athletes whose careers have been upended; who are resistant to all of our caregiving tools; who suffer severe depression, and even suicidal thoughts. Some are actually made worse by anti-depressant medications (not everyone, of course, since these medications have been a godsend to many). But for athletes accustomed to the thrill of endorphins, adrenaline, testosterone, and pheromones, the leveling effect seen by many of the classic anti-depressant drugs—which replace the highs and lows with a middle-of-the-road mindset—such therapy is just not productive. Psychedelics, on the other hand, appear to work by permitting athletes to see themselves both as they are and as they hope to be, re-opening neurologic gates and pathways that have been closed by injury, failure, and depression. Recent studies have documented this phenomenon and current research is focused on how to reliably repeat the process.

We recognize that the field of psychedelic therapy is new and that there is an enormous need for expert guidance for any drug therapy to work. And we understand that finding and training such experts is still very daunting.

Despite all this, we are deeply encouraged that our saddest athletes—once superstars in their own right—have another lever with which to switch the train tracks of the mind and get back on the route to performance happiness.