At the biggest fighting game tournament in the world, Justin "Plup" McGrath experienced his first panic attack.

Considered a favorite to win the title at the Smash Bros. Melee event at Evolution Championship Series in early August at the Mandalay Bay Events Center, McGrath was defeated right before the final, and he finished in third place. What was at first seen as a moment of anguish -- a title contender bowing out before even having a chance at a title -- quickly turned into a concerning scene.

Thousands of social media messages rolled in as people wondered whether McGrath was OK. Juan "Hungrybox" Debiedma, also a Melee player from the Florida region and former duos partner with McGrath, put his arm around his fellow competitor and tried to help him the best he could.

Watching from the front row of the Las Vegas tournament, I tensed up. As someone who was diagnosed with social anxiety and clinical depression as a child, the situation seemed bizarrely akin to past experiences I've had, even though I've never competed on as large of a stage as McGrath. The thousands of eyes peering at your every movement. The pressure to succeed or become awash with the split-second feedback of your onlookers. The fear of failure. The sense of loneliness despite the crowd.

McGrath, following the event, announced on Twitter that it was the "first time in my life" that he had experienced a panic attack during an event. In the same tweet, he said although this new obstacle added another wrinkle to competing professionally, he had started taking medication that was noticeably helping.

"I've been a mess ever since," he wrote after his elimination from the tournament. "It's quite disconcerting knowing I could start spazzing out any time I get on stage. It's one more thing to worry about for tournaments, and just writing this is making my heart race."

In the world of competitive video games, mental health issues loom so large and come up so often that the problem somehow becomes invisible. When a player or team fails at a large event, one of the first things fans harp on is "mental toughness." We make a point of analyzing whether a team or player, win or lose, has the fortitude to ever become a champion. The best video game players are not only lauded for their specific skills on a controller or mouse, but also for their steely minds, which are purportedly capable of withstanding the harsh judgment and pressure that seems to emanate from every angle of their lives.

That's the lie we tell ourselves, both as spectators and as victims of mental health issues: The best competitors, the greatest people among us, are unbreakable.

In North America, while some League of Legends teams have moved to get their players their own apartments and have rented separate spaces for training, the old practice brought over from South Korea -- team houses -- is still prevalent. In team houses, players wake up, eat together, practice together, eat together again, practice together again and then sometimes even share rooms with their teammates without any time to themselves. On average, during a competitive season, players will get maybe one day off a week to themselves, with the rest littered with scrimmages and individual practice.

Team Liquid support Kim "Olleh" Joo-sung suffered from a mental health incident during the Mid-Season Invitational and has since been working with a mental health specialist to cope with the stress of competitive play. Provided by Riot Games

"I've seen so many players have these key 'aha' moments that have completely changed their career trajectories," Summer Scott, Counter Logic Gaming's head of player development, told ESPN. "One of my favorite players to work with started out with a really poor reputation in the community. He was known for having a really poor attitude, and not many were willing to take the risk to have him on their team. After working together with me, we learned that all of that negativity was just him trying to protect himself from failure.

"Once he learned that he was acting out of fear, he was able to combat those thoughts and feelings. By the time we were done, his coach told me that he was the only player he'd want to work with again. So the biggest change I've seen in players since more focus has been put on the mental side of things is truly realized potential."

But even if individual players mesh, making friends outside of the gaming world is challenging. Trying to find someone to date or have a long-lasting relationship with when 95 percent of your time is dedicated to your craft is another mountain to climb entirely. It can be suffocating even without the microscope of playing on stage and having every mistake toxically scrutinized on Reddit, Twitter and other online forums.

When someone who lives a life in a box can't meet someone outside that box, what do they do? They use the computer, an extension of their work, to communicate with the outside world. Unlike traditional professional athletes who can get away from their stress after a bad stretch of games, competitive video game players, especially those who play computer games such as League of Legends, can't turn off the screen and walk away. When that monitor is the only place where you can go to talk to the world, the avalanche of hate messages, from trolls to people calling themselves "real fans," can't be avoided.

Players try their best, going as far as to block message boards and Reddit, and filter their social media to only accept messages from people they trust, but sometimes that's not even enough.

Unlike traditional sports, one of the charms of esports is how close a fan can feel to their favorite player: conversing with them on Twitter, talking and donating money to them while they stream on Twitch, going to fan meetings after a regular-season game. While that's an amazing experience for the fan, at times it can be anything but for the player.

Kim "Olleh" Joo-sung is a South Korean player who plays on Team Liquid, one of the best League of Legends teams in the Western Hemisphere. Olleh, outwardly and in interviews, is the most upbeat and kind player you can meet, with a cheeky smile that forms on his face as he ponders the correct phrase to answer a question. But he, just like anyone, can crumble.

At the second-biggest tournament in League of Legends, the Mid-Season Invitational that was held in Europe this year, Olleh did the unthinkable: Following a disastrous start to the tournament, he benched himself. Olleh didn't feel like he was in the right state of mind to play. Although he would return a day later and help Team Liquid make a late run at the event, the damage was already done.

Olleh was criticized online for not being strong enough mentally to play, and even though he attempted to be transparent on Twitter about what happened, the backlash only grew. When the team was eliminated from the tournament without making it to the knockout rounds, the brunt of the blame fell on Olleh. He was too weak. He was too soft.

If you make a living playing a video game, something most of the world has to pay hard-earned money to enjoy as a luxury, why do you have any reason to complain about hardship?

"I used to get [offended] by their words," Olleh said. "I face my fans. I don't avoid what they say. I truly open my mind, and my tweets still have my [thoughts]. After MSI, I learned a lot and am going to take criticism seriously. Instead of being fake, I decided to be a real person to my fans. Even in our YouTube videos, I talk about my weakness, my trauma, and now people can see I'm getting better."

A few years ago, Olleh's trauma would have been brushed aside by his team, treated like a distraction too unimportant to fix. If he couldn't get better on his own, he would be replaced, another fresh-eyed teenager with probably the same underlying issues thrust into his spot. If that player didn't have the mental toughness, he'd be replaced as well, and the cycle would continue: Kids, living their dream of playing video games as a profession until they become too mentally drained to function. That attitude has changed in recent years. Added investment in the esports scene has brought this issue to the attention of team owners, but more often than not, it's mental health issues, not physical ability, that ends a pro player's career.

"I've seen so many players have these key 'a-ha' moments that have completely changed their career trajectories. ... The biggest change I've seen in players since more focus has been put on the mental side of things is truly realized potential." Summer Scott, Counter Logic Gaming head of player development

"We treat mental health just like any and every other medical issue," said Sebastian Park, vice president of esports for the Houston Rockets and the North American LCS' Clutch Gaming. "We provide our players with the access to the resources they need and encourage them to seek any and all medical help they need or want."

In basketball, a player's prime can extend well into his mid-30s. Jaromir Jagr is 46 years old and still playing top-flight professional hockey in his home country of the Czech Republic. For esports, especially a game like League of Legends, a player nearing his mid-20s is considered ancient in most titles, someone far removed from their prime.

With the added emphasis on esports teams getting mental health coaches and moving away from the archaic team house format that has shown to be a source of burnout, the hope for longer and, more importantly, healthier careers is an ongoing effort.

Olleh, who has been working with a mental health professional to understand himself better, sees this year's world championships, in his home country of South Korea, as an opportunity for redemption.

He has changed his outlook outside of the game, as well.

"If you have a friend who never talks about your problem, they're not a real friend," Olleh said. "Maybe they can be kinda a good friend, but they're not a best friend. Always put some friends next to you that will [help] you with your problem.

"In the short term, you'll [hate] the people who bring up your problem; but in the end, you'll cherish it every day."

Video games are often a form of escapism. Playing as characters in fantastical worlds, with swords and guns and magic, seems fun, not overly stressful. But when that fantasy is intertwined with a profession, it becomes a job, not an outlet. At their best, games make us happy and offer relief from a harsh outside world. At their worst, games do the opposite.

There is no other sport in the world in which one day you can be a teenager playing a game by yourself, and the next day, because someone scouted you from your online account, you're thrown onto a stage for millions to criticize. There's little to no assimilation period. There's no road map for how to deal with the criticism. There's just you, on the stage with four teammates, facing down the biggest moment of your life with no lifeline. And the next day, and almost every day that follows, you do it all over again.

That's the reality of esports. It's frightening, and it's lonely, and it can make a mess of anyone.