For some, the picture of depression can often be summed up by one of those infomercials for medications like Zoloft or Paxil, an individual going through life lethargic and expressionless amidst a black-and-white backdrop. While not completely false, the reality is that many living with depression are high-functioning individuals. This truth has been brought to light amidst the recent news of Naomi Osaka’s withdrawal from the 2021 French Open. On Monday, May 31, the professional tennis player (and 2018 U.S. Open champion) announced on Instagram that she was stepping away from the competition, citing “long bouts of depression” she’d been experiencing for years.
“Anyone that knows me knows I’m introverted, and anyone that has seen me at tournaments will notice that I’m often wearing headphones as that helps dull my social anxiety,” explained Osaka in her Instagram announcement. “The tennis press has always been kind to me (and I wanna apologize especially to all the cool journalists who I may have hurt), I am not a natural public speaker and get waves of anxiety before I speak to the world’s media.”
According to reporting by the Wall Street Journal, the announcement came after three days of Osaka’s participation in the French Open, at which she won her first match but also opted out of news conferences due to mental health concerns. In her Instagram announcement, the tennis star explained that, in Paris, she was already starting to feel “vulnerable and anxious so I thought it was better to exercise self-care and skip the press conferences.” Despite her reasons, Osaka was still fined $15,000 for failing to appear for her press duties.
In their story, WSJ reporters Joshua Robinson and Rachel Bachman say Osaka’s exit “highlights the rising but complex question of how the sports world should handle mental-health issues.” It also highlights the often misunderstood complexities of depression (and the idea of “high-functioning depression”), which impacts more than 264 million people of all ages around the world, according to the World Health Organization (WHO).
“There are so many factors that influence how depressive symptoms manifest and no one symptom determines depression,” says licensed clinical psychologist Dr. Ayanna Abrams to TZR. “While ‘high functioning’ depression is not an actual clinical diagnosis, it typically means that how a person presents socially or occupationally doesn't match what society assumes a depressed mood would look like [...] Individuals who are functioning ‘well’ by society's standards are still moving through tasks that are expected of them personally and professionally. What is different is what is happening for them internally as they move through their day; the battles that no one can see or hear about unless a person trusts you and is willing to be vulnerable with you. The dissatisfaction, hopelessness, emotional disconnection as they interact with the world may be an experience that they hold onto tightly out of fear, shame, confusion, or many other emotions that underscore feeling depressed.”
Abrams explains that Osaka’s decision, as a young woman of color at the top of her game, to withdraw from an event like the French Open was important on multiple levels. “She displayed a number of behaviors that are not only beneficial to her own confidence and clarity about her needs, but that also serve as a modeling of the benefits and difficulties of setting a boundary to do what's best for you while others do not approve or understand,” says Dr. Abrams. “Naomi Osaka displayed courage, vulnerability, and compassion in her narrative. She also displayed an ongoing commitment to continue preserving her peace and a challenge to the WTA to update its antiquated ideas about athletes, mental health, performance, and autonomy. What we saw from WTA, in response to a healthy practice of autonomy, was a reaction wrought with privilege, financial power, and defensiveness, when a young woman of color showed her own power and refused to be pushed around by hierarchy and history.”
The psychiatrist is also quick to note that, in reality, most people living with depression (both diagnosed and undiagnosed) function, meaning that they maintain their day to day lives of work, love, play and sport. “Depression doesn't necessarily have a ‘look’ and given social and personal shame that is a result of mental health stigma, the majority of people who may be struggling with depressive symptoms work actively to conceal their struggles, for fear of being perceived as weak, attention-seeking, or incapable of managing their lives,” says Dr. Abrams. “As a psychologist, I know this is far from true, but society still has a ways to go in offering respect, compassion, and autonomy for those who are managing depressive symptoms.”