A recent study from Lund University in Sweden indicates that elite ice hockey players with a history of concussions are experiencing increased mental health problems. Furthermore, it was found that one in five female players reported symptoms of burnout, while both genders engaged in alcohol consumption at levels considered risky.
The researchers conducted their study focusing on Sweden’s top hockey leagues, including the SHL and Hockeyallsvenskan for men, as well as the women’s league, SDHL. They gathered responses from a total of 648 players, which included 180 women, through an online questionnaire targeting alcohol use, mental health, and concussion history.
Extensive research is being done on the impact of concussions on mental well-being both in Europe and the United States.
“We aim to explore the long-term effects on top Swedish players at least six months after a concussion. The players’ feedback has shed light on the relationship between concussion and mental health issues,” explains Mitchell Andersson, a doctoral candidate in psychiatry at Lund University.
His study, now published in the journal BMC Sports Science, Medicine and Rehabilitation, was co-authored with Anders Håkansson, a consultant physician and professor of addiction medicine at Lund University. When the researchers reviewed reported mental health symptoms among players, they observed that male players showed significantly fewer symptoms of depression, anxiety, and burnout compared to other men, including elite athletes in different sports and the broader Swedish male workforce. Nevertheless, 30% of male hockey players reported hazardous levels of alcohol consumption, which was considerably higher than in the comparison groups.
For female hockey players, the findings presented a different scenario. Their symptoms of depression and anxiety were similar to those of the average Swedish woman; however, the occurrence of burnout was significantly higher, with over 19% reporting clinical symptoms—almost double the average among Swedish women. Female players also indicated high levels of alcohol consumption, with 36.4% reaching what is classified as at-risk levels, also notably above average.
When it comes to concussions, both male and female players who reported experiencing more concussions were more likely to indicate an increase in various mental health issues, such as depression and anxiety. The link was particularly strong after three or more concussions, with the risk of developing depressive symptoms doubling, and the chance of experiencing burnout increasing by three and a half times. More than a quarter of male players and nearly one in five female players reported having had at least three concussions.
“Previous research has indicated that women may experience more immediate symptoms following a concussion than men, but it’s intriguing that the connection between concussion and the increased prevalence of depression, anxiety, and burnout is similarly strong for both genders. This might suggest that the long-term neuropsychiatric recovery process is more alike for men and women compared to the short-term process,” says Mitchell Andersson.
To meet the criteria for burnout, a person must have been under prolonged stress for at least six months and have developed several physical and mental health symptoms. However, according to Andersson, distinguishing between long-term concussion symptoms and burnout can be challenging since both may exhibit similar signs like cognitive issues, irritability, trouble with concentration, and sleep disturbances.
The research findings open up several pathways for further investigation, according to Mitchell Andersson, one of which involves exploring why alcohol consumption rates are so high among elite players.
“Hockey players tend to be physically larger, potentially allowing them to consume more alcohol. They, and those around them, may perceive them as tougher, which can create a sense of pride associated with their subculture. This romanticized view of alcohol consumption can be prevalent among both male and female players,” Andersson speculates, drawing from his own experience playing hockey at a non-elite level.
This self-perceived toughness could lead male players to underreport mental health challenges. The noticeable prevalence of burnout symptoms in women, even without concussions, might point to an ongoing issue within women’s sports at high levels: they often earn less than their male counterparts and may need to balance hockey with other jobs or academic commitments. Managing these responsibilities alongside late-night games can be incredibly taxing.
“Elite-level Swedish hockey players need to be informed about where and how they can seek help. Resources exist specifically for this demographic. Consider the scenario of being an elite athlete who trains diligently, maintains a nutritious diet, and earns a good income from a beloved sport—yet still struggles. The feeling of isolation in such a situation can be daunting. Feeling supported in one’s mental health state is crucial,” concludes Mitchell Andersson.
