In the second of a three-part series on the realities of professional tennis, Charlie Eccleshare meets players who are battling with depression.

Nicole Gibbs was once the 68th best women’s tennis player on the planet. She reached the third round of the Australian Open last January and is still within sight of the top 100. She is mid-way through an economics degree at Stanford University, a charming, highly intelligent, globe-trotting sportswoman - and still only 24 years old.

But Gibbs has also been carrying a heavy burden: she suffers from clinical depression. Having first displayed symptoms when she was an aspiring professional at secondary school, the American - speaking for the first time about her illness - believes tennis has exacerbated them in adulthood.

“When you’re not inside the top 50 tennis is a constant identity crisis,” she says. “You ask yourself questions all the time: what can I be doing to do better? Am I doing everything I can? How do I get to that next level where I really want to be? There were times when the up and down elements of tennis made things almost unbearable for me.”

Part of Gibbs’ struggle stems from the sense that, while many sports are finally talking openly about mental health issues, depression remains a taboo subject in the unforgiving environs of the tennis locker room. The American Mardy Fish is one of the relatively few high-profile players to admit to struggling with mental health issues while still active on the circuit. The young Australian Ashleigh Barty meanwhile only spoke publicly about suffering with symptoms of depression once the illness had forced her to take a sabbatical from tennis at the age of just 18. She is thankfully now back playing and ranked No 19.

The fact that others, such as Andre Agassi, Pat Cash and Cliff Richey, have all spoken about mental health issues post-retirement confirms that the problem, rather than not existing at all, simply goes unspoken.

Nicole Gibbs in action against world No 1 Simona Halep in the first round of the Shenzhen Open on January 1 credit: AFP

Gibbs has only discussed her depression with a few close friends on the tour, but she is sure she is not alone in grappling with these demons.

“I totally think it’s prevalent,” she says. “When people hear this I think there will be a lot of solidarity for me, and people saying ‘good for you’. A lot of times with these things, people can be so guarded and fearful of what others might think that they won’t share and that creates this stigma about it. But I think the more people talk about it, the more comfortable they'll be confronting it.”

That tennis could be harbouring a silent mental health crisis is hardly surprising. It is a particularly unforgiving sport, and some of its defining moments revolve around players collapsing mentally on court - whether it be the late Jana Novotna weeping on the Duchess of Kent’s shoulder following an agonising Wimbledon final defeat to Steffi Graf, or Grigor Dimitrov forfeiting a final in Istanbul two years ago after an on-court meltdown that included smashing his racket in frustration on three separate occasions.

According to the Centre for Health and Human Performance sports psychologist Andy Lane, tennis is an especially difficult sport to deal with emotionally because of how often players have negative information rammed down their throats. One can imagine the agony Novotna must have felt against Graf as the umpire continually reminded the world that her Wimbledon dream was slipping away from her, with every score announcement. Even club players can identify with the feeling that everything is unravelling, and there is nowhere to hide.

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Then there is the practical reality that life at the sharp end of the tour - with players constantly travelling from tournament to tournament, staying in faceless hotels and with precious little time at home - is hardly conducive to maintaining a positive state of mind.

One of the few other players to reveal the depth of their struggle with mental health, Canada's Rebecca Marino - once ranked as high as No 38 in the world - revealed in a TED Talk how the lifestyle simply became too much to bear.

"I was homesick a lot of the time, and missing milestones in people’s lives and in my life,” she said. “I was also sad. I didn't know what it was and I hid it from everyone. I didn't want to be a burden because I mean as an athlete you're supposed to be strong right?

"But I distinctly remember when I was travelling in Birmingham, England and I was on the bus going to the tennis centre, and I started crying. I don't know why I was crying. There was no reason - nobody had died, nobody was sick - I was just sad and I couldn't contain it."

Marino quit, five years ago, at the age of 22.

Mardy Fish battled with anxiety struggles towards the end of his career credit: Getty Images

That feeling of despair, brought about by an unforgiving and antisocial schedule, is shared by Gibbs. ”I haven’t had a normal family life since I was about 10. I’ve barely had a Christmas at home since then. When I was young I used to have Christmas in Tucson, Arizona because that’s where the nationals were. Usually now I fly to Australia on December 24 which means I land on December 26 because it's around $500 (£370) cheaper.

“Certainly all of these factors - the unpredictability of your life, whether you’re making money or not, money being dependent on your results - all of these really volatile aspects of tennis are terrible for your mental health.

“Things like that can mess with your brain even if you’re the most normal and well-adjusted human alive, so for me it's a really big battle. If I was living a more standard life at home then maybe I wouldn’t need medication but as it stands I do. If anyone is at risk of depression then tennis is going to amplify it for sure.

“It’s going to make all your symptoms more dramatic and make it something you have to deal with. I have actually felt very fortunate that I got confronted very early with my symptoms which wouldn’t have happened were it not for tennis.”

The Women’s Tennis Association (WTA) is acutely aware of cases like these, and is encouraging players to be open about any mental health issues they have. Kathy Martin, Senior Director Athlete Assistance and a qualified mental health counsellor, meets new players on the tour to educate them about the challenges professionals face.

“As well as the usual life problems that can befall anyone - a relationship breaking down, loss of a loved one - players are often in the public eye in a big way,” she says.

“They need to be emotionally and mentally resilient to cope with this environment. It’s extremely challenging.

“It’s also stressful for tennis players managing their life, managing their competition, travelling round the world, their budgets, managing their own and other people’s expectations of their performance level. Athletes have to learn how to deal with that.”

To assist them, players under the age of 18 attend compulsory interactive on-line and face-to-face education sessions with the WTA’s Athlete Assistance Department on how to deal with mental health issues, while the WTA also endeavours to hold a face-to-face conversations with players throughout the year.

On the men’s side, the Association of Tennis Professionals’ (ATP) Chief Player Officer Ross Hutchins encourages meetings with players and oversees a compulsory university programme that includes discussions of mental health challenges. Tournament physicians and physiotherapists are in regular contact with players, and can refer them to the appropriate consultant where necessary. “If they see any warning signs they would take action in getting the player the appropriate help,” said ATP spokesman Simon Higson.

Gibbs says she is now much better equipped to deal with her depression credit: Rupert Thorpe

The International Tennis Federation (ITF) meanwhile offers mental health support online and over the phone.

Is that enough? Marcus Willis, the British player who became a minor celebrity when he reached Wimbledon’s second round in 2016, losing to Roger Federer, thinks not.

“We get no support, unless you look for it,” he says. “No-one comes forward, no-one helps you especially at the age I’m at now [27]. After Wimbledon I didn’t receive one call from the federation or anyone to say how are you doing, can we help you in any way? Absolutely nothing. I think everyone just gets on with their job, and that’s life. It’s a lonely world.”

At a national level, Britain’s Lawn Tennis Association (LTA) has substantially increased its investment in the mental health and player wellness area, and says there will be “significant investment” this year in the education of young players to best prepare them for tour life.

The LTA also employs two mental health ambassadors, who from 2018 will have a more active role in helping manage the wellbeing of British youngsters. They will work alongside two full-time performance lifestyle coaches and a team of psychologists.

Ashleigh Barty is back playing professional tennis after taking time off partly due to suffering from depression credit: AFP

It suggests that attitudes may be changing for the better. Marino is taking her first tentative steps towards a comeback and Gibbs, too, is finding some peace.

"I do a lot of meditation and mindfulness practice now, a lot of yoga,” she says. “Anything to centre me, and a lot of those skills will be very very useful when actual tragedies happen in my life, not just losing a tennis match.

"I feel much better equipped to deal with it, and much better about not falling into habits like not getting out of bed. My boyfriend’s been great in reminding me to keep active and work through this stuff and not wallowing in it. If I’m ever labouring or seem like I’m down, he’ll drag me out and make me go the beach and hang out or something.”

And what of the future? Gibbs give a laugh, but her voice is steady and determined.

"I think I will eventually work myself into a place where I’m not on medications but for now, while I’m competing, certain things have to be in place just to make sure I can handle everything that comes my way."

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Case study, Naomi Cavaday

Naomi Cavaday, the former British No 3, was 22 when she first retired in 2011 after suffering bouts of depression. After a brief comeback in 2014, she quit for good a year later. She now works as a mental-health ambassador for the LTA

Tennis naturally attracts children who are pre-disposed to mental-health issues. Anything where you can get success young does that, plus it is an individual sport. There are lots of kids who mistake their parents’ praise as love. People can crave that.

But being a tennis player is very tough, especially when you are younger. By the end, I was hating every second of it. I loved the matches – but I could not bear the life of a tennis player. The constant travel and loneliness.

If you are going to spend a lot of time by yourself, you really have to like yourself a lot. For me as a teenager, I did not like myself at all. When I played, there was a lot of mistrust of anyone who suffered with mental-health issues.

Naomi Cavaday is a former British No 3 credit: Getty Images

I saw a psychiatrist and some people were like “right, she’s obviously not cut out for this”. It is better now and there is a lot more acceptance, but it is still nowhere near where we need it to be.

What does not help is that, as a tennis player, you are permanently jet-lagged. I had not spent more than four weeks in the same time zone for six years when I was a pro so, when I retired, I suddenly felt grounded, and normal. It was amazing.

The relentlessness of it also takes its toll. When I was 17, my dad suggested taking a few months out, and I accused him of trying to sabotage my career because it seemed so ludicrous, and it was just not acceptable in the tennis world. Plus I did not want to show any weakness. You are fighting against everyone else constantly – fighting for ranking points, money, sponsorship.

I became totally blinkered. I did not just reduce socialising and having fun, I totally cut them out. I even stopped resting properly because I did not think I could afford to. That’s what tennis can do to you if you are not careful.

Part three of the series goes online Thursday and focuses on tennis's social media abuse problem that's spiralling out of control