A closer look: Dontrelle Willis, other players deal with anxiety

A closer look: Dontrelle Willis, other players deal with anxiety

BY JORGE L. ORTIZ • USA TODAY • June 26, 2009

ST. LOUIS — Khalil Greene endured such agony playing the game he loved, he had to get away from it.

Dontrelle Willis lost control to such an extent, his team put him on the disabled list twice.

Joey Votto found solace from his pain in baseball but was miserable elsewhere.

All three players were on or off the DL because of anxiety-related issues in the last eight days, an unusual confluence that underscores the mental challenges of playing baseball at its highest level.

"This is a source of a lot of joy, but it's also a source of a lot of frustration and sadness and fear," says Greene, an infielder for the St. Louis Cardinals. "It's difficult to deal with, because it is something I really enjoy doing, but it has become at times like a love-hate relationship.

"And the hate is not for the game necessarily but it's in the feeling that the game often tends to arise within me. It's not whatever you would consider to be normal. It's a different level of intensity."

Three years after leaving the team to deal with his social anxiety disorder, Kansas City Royals right-hander Zack Greinke has emerged as one of the majors' best pitchers. Now, in a sport rooted in a macho culture, others have felt compelled to acknowledge the rigors of the game can be too much to bear without help.

It's also a difficult experience for clubs grappling with how to help.

"You've dealt with Tommy John surgeries and rotator cuffs so many times that you get used to what the guidelines are," says Detroit Tigers general manager Dave Dombrowski, whose team has termed Willis' condition an anxiety disorder. "But I've never been involved with a situation like this, so everything you hear and deal with is new."

And conclusive answers are not always readily available.

Greene's constant battle

Greene, who won't go into specifics of his treatment, had to see a number of doctors and try different treatments until finding the right combination of medication and therapy.

He says he wages a constant, exhausting battle trying to push away negative thoughts and replace them with positive ones. In the last two seasons, that has been more difficult as his performance has declined, feeding into his fear of failure and leading to sudden outbursts.

Last season, while with the San Diego Padres, Greene broke his left hand punching a storage cabinet and missed the last two months. He was traded to the Cardinals in December and began the season as the team's clean-up hitter but was batting .200 on May 29 when the team put him on the DL as his condition worsened.

Greene, 29, says he has dealt with his anxiety for several years, though not to the extent the symptoms manifested themselves this season.

That information was not included in his medical records when the trade was made, Cardinals GM John Mozeliak says, adding he's not certain how much the Padres knew. San Diego GM Kevin Towers did not respond to calls seeking comment. For now, Mozeliak says the Cardinals do not intend to file a grievance, focusing instead on assisting Greene's return to full capacity.

They have tried to learn more about Greene's anxiety, exercised patience during his treatment and moved him from shortstop to third base, partly to reduce pressure. Greene homered in three consecutive games after being activated June 18.

"It's been a difficult ride," Mozeliak says, "but when you understand what's at stake, it's worth the time and energy."

For the most part, Greene's teammates have given him space while trying to remain supportive.

"I think it would be better to share it, speak with your teammates, because we might be able to help more than he thinks," said two-time MVP Albert Pujols, who has reached out to Greene. "When you're battling something inside, you want to get it out."

Besides playing for a new team, Greene is finishing a two-year, $11 million contract. That can be one factor that can cause anxiety, according to Greg Dale, the director of sports psychology at Duke University.

Dale, who has counseled college, Olympic and pro athletes, says heightened expectations, fear of failure and attention from the news media also can create anxiety.

"It can become very debilitating to where you begin to almost paralyze yourself and you can't perform something that comes very natural to you," Dale says. "It starts building upon itself."

'Still a great deal of stigma'

In the past, experts say, it's likely those pressures would have remained internalized.

Still, despite a greater societal awareness of mental health issues, seeking help takes a leap of faith for athletes, says Wes Sime, a sports psychologist who recently retired as a faculty member at the University of Nebraska.

"There is still a great deal of stigma," Sime says. "It's reassuring to know more and more are acknowledging it. It's very possible many who have had this in the past have been too afraid to suggest they had something of that nature."

On-field success stories might ease the stigma. With the club's blessing, Greinke left the Royals in spring training 2006 and didn't pitch until June that year, in the minor leagues. This season, he is 9-3, and his 1.90 ERA leads the American League.

"In recent years, (teams) dealt with it in a much more upfront manner," Sime says, "and (have) been more compassionate toward the player, rather than being so macho as in the past, expecting them to suck it up."


Rougher road for some

But the path to success is rarely so smooth; in Willis' case, it has been marked by fits and starts.

Willis missed the first six weeks of the season and is disabled again after going 1-4 with a 7.49 ERA in seven starts, during which control problems that initially sidelined him grew worse.

Willis has won one game in 14 starts for the Tigers, who acquired him in a December 2007 trade with the Florida Marlins.

The team doctors' diagnosis of Willis' condition stands at odds with his assessment.

The left-hander insists his problems are mechanical and that he feels fine on the mound.

"I don't feel like anything's wrong, other than me playing bad," says Willis, 27. "I feel great. I still have a good time on the field. I still love coming here. As far as people categorizing, they can say whatever they want to. The bottom line is whether you're playing well or not."

Given the unusual reason for placing Willis on the DL the first time, Dombrowski alerted the commissioner's office. The Tigers also had their doctors speak with MLB doctors to verify the diagnosis.

Willis remains upbeat and playful in the clubhouse — greeting a visitor heartily, shooting an empty bottle of a sports drink into a trash can basketball style — prompting teammates to wonder what exactly is wrong.

"No one knows what it is. Even Dontrelle doesn't 100% know," says center fielder Curtis Granderson, pointing out Willis shows no outward signs of stress.

"Why isn't he tearing up stuff?"

Votto, the Cincinnati Reds first baseman and top hitter, showed symptoms of distress when he had to leave three games in May, once being helped off the field by manager Dusty Baker.

The team put him on the DL on May 30 with what it called "stress-related issues." Upon returning to the lineup Tuesday, Votto revealed he had been having panic attacks while grieving the loss of his father, who died in August.

Votto says he was severely depressed during the offseason but found comfort in returning to baseball during spring training. When he missed several games in May because of an inner-ear infection, that comfort was no longer available.

"Baseball was my refuge," Votto told news reporters. "Then I went home and was miserable."

Eventually, Votto sought counseling.

Concerned about the stigma of succumbing to stress, he kept his condition private, even from his teammates, until doctors convinced him opening up would be therapeutic.

Sime and Dale think others will come forward as the stigma fades, but the stress inherent to the major leagues remains.

"There are more pressures going on right now, more insecurity about losing position, status," Sime says. "And it just makes players more vulnerable."