Team Liquid support Matthew "Matt" Elento wouldn’t strike you as a person who struggles with anxiety.

It’s difficult to imagine what he was going through just a few weeks ago: his gratefulness for having a substitute to step in for him when he dreaded playing on stage or to take his place during scrims when he couldn't sleep through the night — his fear at not understanding what his own body was doing to him.

"There was just some really scary times where I just didn't know what was going on," he explained. "It felt like I was trapped or felt like I was really stuck in a cycle I couldn't escape."

Matt has played with TL for two years, originally joining Team Liquid Academy in 2015 before being bumped up to the big leagues in 2016, replacing Andy "Smoothie" Ta as the team's starting support.

But by the time the spring split started, his anxiety was at a fever pitch. The anxiousness and insomnia were made all the worse by the fact that he didn’t know enough about anxiety to realize that he was suffering from it until Team Liquid brought in a sports psychologist to help him through his issues.

“Before that, I had no idea about anything. About mental health or panic attacks. I had zero clue about any of that stuff until it started happening to me. So I had to learn about that,” he said. “Because it was kind of like just terrifying because I didn't know what was going on. There was obviously something wrong, but I had no idea because no one just told me about any of those things.”

Though Matt is very open about his battle with anxiety, he’s far from the only esports player who struggles with mental illness. For instance, Fnatic AD carry Martin “Rekkles” Larsson has spoken out about his own troubles in interviews and social media posts, and has touched on how he is working with a therapist and has chosen to sit out his team’s Korean bootcamp so that he can rest before the summer split.

RELATED: Rekkles: 'I was about to sign a three-year contract [with FNC], which I've actually put on hold for now because...I haven't been feeling that well personally'

In a subculture where players, fans and pundits are all around the same age, it’s easy to forget just how young esports players are and how vulnerable they are to the problems that plague young adults. According to the National Alliance on Mental Illness, one in five youths aged 13-18 live with a mental health condition and 50 percent of all lifetime cases begin by 14 with 75 percent beginning by 24. They say that suicide is the third leading cause of death for young adults between the ages of 10 and 24.

Matt says the mental health issues that plague a number of players are but a microcosm of issues he thinks run rampant in the gaming community as a whole. He says it’s important for more pros and industry leaders to open up about their private struggles and show others that they aren’t alone.

‘Where does life take me from here?’

Jason Docton is intimately familiar with the pain and struggle of dealing with mental illness. Nearly a decade ago, Docton was an honors student gearing up for med school while working as an EMT. But before graduating from university, he began suffering from panic attacks.

“I quit going to school and I quit going to work and then in my mind I was kind of like, ‘Oh maybe just being out in general. Maybe I should just be home in case something happens. Then I'll for sure be safe,”’ he said. “So I stopped leaving home all together. And before I even knew it, I looked up three years later and realized I hadn't left home in all of that time."

Trapped in his own home because of his panic disorder and agoraphobia, Docton began to feel he had no alternatives save suicide.

"I told myself, ‘I've been dealing with this for the past three years, I haven't left home, I haven't had contact with anybody,’” he said. “All I really was doing at the time was playing World of Warcraft and I figured I would commit suicide. It just made sense to do that.”

Before ending his own life, Docton wanted to balance the scales by preventing someone else from doing the same. He began to ask people on his WoW server if they needed someone to talk to and soon somebody took him up on his offer. Soon after, a friend of the first person he helped contacted him. That request was followed by another, then another, and before Docton could carry out his own plans, his goal was no longer justifying his own suicide, but preventing others from taking their own lives.

Today, Docton is the head of Anxiety Gaming, a non-profit organization he founded that has helped over 20,000 gamers with mental illness find therapists, subsidies to help them cover the costs of treatment or lend them an ear to listen to their problems.

In recent years, they’ve expanded their services to esports pros through their partnership with Counter Logic Gaming whose esports director, Matt “Trinitiii” Nausha, is a therapist. Docton often visits CLG’s offices throughout the week, assisting players with anything they may need.

According to Immortals’ coach and trained sports psychologist Robert Yip, providing support to players is a constant effort as they need to dedicate a substantial portion of every day to it as part of their training.

“They're separated so far from their families, in some cases in different countries, not just even in the States,” he said. “...And they invest so much time into League of Legends that they don't really have hobbies, they don't have things to do outside of the game because the day starts at 10 but it might not finish until 10 or 12 in the night time. So their entire day is filled up with League of Legends related activities, training.”

Since coming into the space, Docton says he’s seen esports pros struggle privately with a variety of issues, everything from stress and burnout to depression and social anxiety.

“There's a lot of performance anxiety. Depression seems to be a staple part just in mental health in general, but this kind of depression usually relates to the struggle of what comes next and trying to figure out in this very fast-paced arena, where does life take me from here? Am I going to hopefully become like an analyst or a coach? Or is this it? Trying to work through the pain that that can cause internally is really critical and then social anxiety always seems to be on the back burner,” Docton said.

With greater awareness of the mental strain their players are under and its impact on their performance, a number of orgs have started to fill the gap with psychological trainers and sports psychologists.

However, not everyone agrees that such practitioners are enough to help players with their out-of-game issues, as well as their in-game ones.

Sports psychology

On Jan. 29, Astralis took down Virtus.pro to win the ELEAGUE Major. Coming off the heels of a win at ECS Season 2 and a second-place finish at ELEAGUE Season 2, the victory solidified Astralis as a top-tier CS:GO team.

Always a Top 8 contender, the only thing that held Astralis back from reaching their full potential was a bad habit of tilting at clutch moments. Astralis’ Peter “dupreeh” Rothmann credits the addition of sports psychologist Mia Stellberg as a game-changer for the squad and calls it a key reason for their ELEAGUE win.

“We have a huge advantage above a lot of teams mentally now, and it’s funny when people think it doesn’t make a difference having a sports psychologist and they feel they don’t need one,” he told theScore esports’ Dennis Gonzales. “Well, sure, go ahead and believe that, but look where it took us. We’ve learned so much about professionalism and how to function as a team in such a short time. I’m confident that a lot of teams will pick up this method.”

dupreeh wasn’t wrong. Since their victory, CS:GO’s awareness of the benefits of sports psychology has increased and many players say they’re interested to see whether such a specialist could help their own team.

“We're very open for it at the moment and we're thinking about hiring a person for it, we just need to find someone that understands us. I'm one of the people that's very open to it and I really want to talk to that person to see if they can help my issues on my side of the game,” said Ninjas in Pyjamas’ Christopher "GeT_RiGhT" Alesund.

“Take Astralis. They've had, for many years, mental blocks and look where they are now, it looks like a big positive thing ... It's also opened up the conversation on psychologists in the esports scene, because I think a lot of teams or players were kind of, I guess, ignorant on the subject.”

According to Nausha, with top-tier esports players reaching a level of parity mechanically, every little bit of an advantage starts to count, especially when it comes to mentality. However, he says making players comfortable is more important than having a dedicated sports psychologist.

According to Docton, while such practitioners can help players improve their gameplay, they don’t necessarily help players deal with their deeper, personal issues.

“I've watched as sports psychologists and very specific, niche providers come in and try and figure out some of the micro-work that we can do to improve gameplay," he said. "…But not really addressing the reality that a lot of these players are facing huge levels of stress. That they have to get up on stage and if they don't perform well that their career's on the line."

‘I used to love living in a gaming house’

Team houses are a mainstay in professional esports, but some have questioned the rigorous grinding players as young as 17 are expected to endure, including Team SoloMid’s Yiliang “Doublelift” Peng.

"It just seems so bad," Doublelift said in a November interview with Yahoo Esports’ Travis Gafford. "It's such a bad life to scrim 10-12 hours a day for 10 months, 11 months in a row, and then at the end of it... 99 percent of pro players don't win. So at the end of it, to feel empty and disappointed."

However, when Matt moved from his home in Hawaii to his first team house in Los Angeles in 2015, it was a dream come true.

“I used to love living in a gaming house,” he said. “That first year was like, a blast. I never went to college — I came out right after I graduated from high school — so I never had the dormitory experience, but I can definitely say it was the most fun I've had. Just having a bunch of people around your age just playing games, liking the same hobby that you do and the same kind of food you like to eat, doing all the same kind of things that you've always wanted to do as a kid growing up, just play video games all day. That's like, the life.”

But as he’s gotten older, Matt says the harder it’s been to put in the dozens of hours of training a week necessary to remain at the top of the game. “I feel like the more that you grow up as a person, or the more you expand your horizon, the more you realize how grindy things seem,” he said.

Like many pro players, Matt started his career climbing the ladder, knocking out game after game after game. According to Immortals’ coach Robert Yip, himself a trained psychologist, one of the roadblocks he and his staff encounter when helping players like Matt work through their issues is that they haven’t developed the life skills that others take for granted.

While athletes in traditional sports advance through regimented structure from their little league games to college and the pros, most esports players are scouted out form high Elo solo queue matches. They don’t receive the guidance of coaches and benefits of infrastructure until much later in life.

“These guys are pretty young, they have a lot less life experiences than people that let's say went to college and are like paving their way,” Yip said. “So their ability to communicate or be aware of how stressed they are or how frustrated they are is kind of difficult.”

Despite living the dream of thousands of gamers, Matt says he’s acutely aware of what he had to sacrifice to get there.

Looking back on the grinding he did in school just to reach the level where he could join the pro scene, Matt says he wouldn’t advise anyone else to follow in his footsteps.

“Playing video games throughout high school is not something that I would ever suggest to someone,” he said. “That would just be for any hobby, you can’t just devote all your time and slack in everything else. Especially during your development stages.”

While Matt says team houses are a necessity with the current state of esports, he thinks with time and a greater level of professionalism, they will eventually lose their effectiveness. However, that doesn’t change the fact that expecting today’s players to eat, sleep, live and breathe their esport to the exclusion of all else is unrealistic after a certain point.

“It’s more like I was changing. The schedule didn't fit me anymore,” Matt said. “Like, I couldn't happily sit in front of a screen for 18 hours a day.”

Twenty-six days later

Despite his ordeal over the last several months, Matt says that he’s made tremendous progress since the end of the spring season.

“Twenty-six days ago, I was extremely struggling to do the basic things in my life. But now, 26 days later — which is a relatively short amount of time — I'm like already back to normal,” he said. “Like, I'm back to how it was. My operational level in the day-to-day is extremely high and I'm making pretty big strides. So that leads me to be very optimistic for the next split.”

Nonetheless, conditions like anxiety and depression are lifelong struggles. While esports players might be surrounded with support staff who can help manage their personal demons, they don’t have access to many of the same treatments normal people do.

According to Docton, one issue Anxiety Gaming has faced when working with esports pros is that many of the avenues of treatment traditionally available to people suffering from mental illness are simply unfeasible in a strictly-regimented, 10-12-hour day.

“If I was to sit down with somebody who wasn't dealing with these issues, I would say, ‘Hey, you should go outside, you should take some time away from this, you should see a therapist,’” he said. “And almost that first initial advice isn't applicable here. Because I can't say, ‘Hey, you should take a break,’ because if they take a break, it could cost them their career.”

At 19, Matt is still in the prime of his playing years. Despite Team Liquid’s roster turbulence over the last split, he says getting kicked was never one of his primary concerns. He was too deep in his own turmoil to be care too much.

“When all the roster stuff was happening, I was in the worst of my anxiety issues and insomnia. So my worries were not in-game,” he said. “Like, it sucks to lose but honestly I didn't really care if we were losing. I was just really stressed out all the time because… I had anxiety, there's no other way to put it.”

Even with the stress and the grind and the disappointment their profession often entails, he recommends fellow players struggling with mental illness to take the time to seek the help they need.

“The best thing is professional help, obviously,” he said. “If you're struggling to the point where you feel incredibly drained, depressed or anxious all day — it's normal — but it's not meant to be that way. You aren't meant to be panicked all day.”

Sasha Erfanian is a news editor for theScore esports. You can follow him on Twitter.