THE WORD is MLSsoccer.com's regular long-form series focusing on the biggest topics and most intriguing personalities in North American soccer. In honor of World Mental Health Day, MLSsoccer.com takes a look back at an article written by former senior editor Nick Firchau that examined Landon Donovan's stance on one of the sports world's oldest taboos: mental health. The article was originally published on January 4, 2015.

Photo illustration by Gabriel de los Rios

WHEN LANDON DONOVAN STROLLED TO THE STAGE at StubHub Center in Carson, California, in August and unveiled what would become one of the biggest stories of the year in North American soccer, it didn’t exactly come as breaking news.

Donovan’s teammates on the LA Galaxy knew it was coming. The good friends he’d made through decades of playing soccer knew it, too, and so did the media members who somehow managed to mute their gasps in the audience. In fact, just about anyone who’d followed the past 18 months of Donovan’s career could have reasonably expected he would retire after this year, his 15th as a professional soccer player.

What Donovan said that day offered a candid glimpse into a mind that had matured and changed greatly even in just the past two years, perhaps one of the most tumultuous stretches of his career. The end result of all that transpired in that time – career burnout following the 2012 MLS Cup, a curious but cathartic trip to Cambodia, his fallout with United States national team head coach Jurgen Klinsmann and his eventual snub from the 2014 World Cup team – left him tethered to his career but not enjoying it, playing at times out of obligation, and dispassionate about his day-to-day life.

The decision, he said, freed him up to enjoy the game as if he were a kid again, and allowed for him to exit on his own terms, even if some considered it more of an escape than anything else.

In a refrain Donovan has used many times throughout his career, he summed it all up so simply: “I have to live the life I want to live.”

But as telling as his comments in August may have been, there were revealing signs long before that indicated he’d been doing some serious thinking. When he returned from his offseason trip to Southeast Asia in March 2013, Donovan took a very public -- and rare -- stance on the topic of mental health among athletes in the United States, and he’s revisited his thoughts on the subject numerous times since. Citing mental exhaustion that he said forced him out of soccer for roughly four months, Donovan took aim at the stigma surrounding those who struggle with psychological issues and questioned the overly macho aura that permeates professional sports.

Since then he’s said that he battled depression at times during his career, that he’s found respite in meditation and, for the past six years, sought help from a therapist. He’s also hinted at the idea that whenever his career ends – he's hoping it lasts as long as Dec. 7, when the MLS Cup final takes place – he’d like to become some sort of advocate for those struggling with the same issues he’s had for years.

All of this begs two questions as daylight fades on Donovan’s career. Will Donovan’s outspoken stance on mental health really become a lasting part of his legacy, or is the stigma too great even for the most accomplished player in American soccer history to break down?

LANDON DONOVAN STRETCHES OUT AN ARM, offers a wide smile, and beckons his latest guest into his office -- a sparsely decorated administrative office in the catacombs of StubHub Center.

Despite a steady slog of media interviews, he's clearly in a good mood. The field where Donovan and the Galaxy will host the Seattle Sounders in the first leg of the Western Conference Championship in a few days is roughly 50 yards down the hall to the right. It’s also close enough to Galaxy ground zero that if you were in this office when the club won the 2011 or 2012 league titles, you probably would've heard the locker-room celebration.

On this day in late October, Donovan is being shadowed by a two-person camera crew recording his every move for a documentary series for ESPN's Grantland, par for the course during a farewell tour. In the past month he’s given a string of interviews touching on everything from his glory days during the 2002 World Cup in Korea to his stunning omission from the US roster in Brazil, all combining to serve as a collage of career accomplishments all other American players can only gaze at from the other side of the glass.

Today's interview, though, is not about his on-the-field legend, but instead about those comments from March 2013, when Donovan first laid himself bare following the Cambodia trip.

He said at the time: “We have a sort of stigma that being in a difficult mental place is not acceptable. We should 'pull ourselves up by the bootstraps' and 'fight through it,' and all this, and it's a little peculiar to me, that whole idea, that if someone's physically hurt, we're OK with letting them take the time they need to come back, but if someone's in a difficult time mentally, we're not OK with letting them take the time they need to come back. Hopefully, there's at least a few people out in the world that can relate to this and can somewhat be inspired.”

Donovan says now that he never planned to go public with his thoughts on mental health the way he did. His monologue was spontaneous, though he’d certainly spent time thinking about the subject. He says that he, like most athletes, had once been critical of players who missed time or quit their respective sports because of psychological issues, but that his thinking on the issue changed as he began dealing with problems himself.

“A big tenet in my life is trying to have compassion for people, and I think we really lack that, in the sports world especially. And I think it’s disgusting,” he says. “I was probably defensive when I said those things (in 2013), but it really bothered me because I was a relatively young guy and I was going through a really hard time. And I decided that for my well-being, for my family’s well-being and for my professional well-being, I needed a break.

Donovan says that his public comments on mental health in 2013 were spontaneous, but he's long been bothered by a lack of compassion for athletes and their psychological issues. Says Donovan: "I think it's disgusting." (USA TODAY Sports)

“And all of a sudden I’m getting criticized for it?”

Not by everyone. His message was received loud and clear by other players who reached out via text or email to thank him for such a public outcry. He says he was surprised to get such positive feedback from players who he suspects otherwise might never have said a word.

Being remarkably candid about his emotions, however, is not a new phenomenon for Donovan. While at times during his career he could appear reluctant, preoccupied or even skittish with the media, he matured into an articulate, thoughtful and introspective player during the latter part of his career.

It came as no surprise to those who know him best, then, that Donovan took the opportunity to touch on something that clearly struck a chord.

“Things that mean something to Landon, he’s willing to talk about,” says Galaxy associate head coach and former USMNT assistant Dave Sarachan, who’s known Donovan for more than a decade. “We all do this when we get older – we gain perspective. Clearly Landon has that.”

Added a Galaxy staffer: “Sometimes Landon is completely willing to put himself on the couch.”

That might be true, but it didn’t dampen the message, or the rarity of an athlete of Donovan’s stature making such a salient point. Consider the iconic athletes of Donovan’s era when it comes to other North American sports – figures like Derek Jeter in Major League Baseball, Kobe Bryant in the NBA or Tom Brady in the NFL – and try to remember when any of them openly discussed an issue like the fragility of an athlete’s psyche or, as Donovan has done on more than one occasion this fall, the cultural perceptions of sadness.

“We don’t live in a world where it’s okay to admit that we’re not perfect,” Donovan says. “Everybody wants to take a picture where we’re smiling and we’re so happy. Sadness is not okay in our world.

“In other cultures, sadness is accepted as a part of life. There’s beauty in sadness. People are compassionate. In America we say, ‘Don’t be sad, cheer up!’ It’s ‘Don’t cry kid, here’s a toy!’ We actually learn it at a very young age, and I see that with parents all the time. You have a parent telling a kid, ‘Don’t cry!’ Well, crying is how kids express themselves. Sadness is a way kids express themselves. And we try to get rid of it as quickly as we can.”

It’s unclear at what point in his career Donovan started thinking this way, or if he’s felt like this all along. But it’s well known that he’s been celebrated in some circles for having such a refreshingly honest personality and criticized in others for revealing too much, exposing a soft underbelly that may have affected his reputation.

“He showed weakness at times, and as athletes you’re taught not to think, just act,” says former MLS player and current ESPN analyst Taylor Twellman. “Landon Donovan is not the only athlete to wake up in the morning and feel tired of going to training. But he’s the only athlete who’s been open about it, and in many people’s minds, he was weak. “

Donovan told ESPNFC.com last month that he’s well aware his introspective personality has both helped and hurt him during his career, but with little time left on the field and his legacy assured, he has no need to hold back now.

“I obviously have no problem being honest about these things,” he says. “I think it’s important. Forget athletics – we’re all human beings, and if someone is struggling, let’s be compassionate.”

Asked if he thinks other players in the Galaxy locker room down the hall feel the way he does or could possibly benefit from a psychological support system like Donovan has, he is succinct.

“I think the whole world needs therapy,” he says. “Maybe the better way to say it, because of the way we view therapy, is that everyone needs someone to talk to. But yes, everyone in our locker room needs someone to talk to.”

STUDIES SHOW DONOVAN KNOWS WHAT HE'S TALKING ABOUT, and soccer is starting to take notice.

The findings of a study commissioned by the International Federation of Professional Footballers (FIFPro) were released in April and showed some striking results, namely, that one in four professional players suffer from symptoms of anxiety and depression.

Roughly 300 current and former players from Major League Soccer and five other international leagues were surveyed in the study, which concluded that "mental illness among former professional footballers cannot be underestimated and should be a subject of interest for all stakeholders in football."

Five months after the results of the study were released, FIFA announced it was launching a mental-health research project to generate more data on the subject and so that its players could "feel more comfortable coming forward to talk about issues and in order to ease access to treatment."

Retired German professional footballer and three-time FIFA World Player of the Year Birgit Prinz, who currently works as a sports psychologist for a Bundesliga club, is heading up the project.

"From my experience and in my opinion it is important to see and to openly demonstrate that it is 'normal' for professional football players to experience mental stress and that this does not automatically result in failure of a professional career," Prinz says in FIFA's announcement of the program. "But it can be prevented, treated and cured. We have to overcome the myth that professional football players are invulnerable."

The latest initiatives come on the heels of the suicide of German player Andreas Biermann, who battled depression before he killed himself in July at the age of 24. Five years earlier, Biermann's countryman Robert Enke, a 32-year-old goalkeeper for Hannover 96, was expected by some to make Germany’s 2010 World Cup squad before he committed suicide roughly seven months before the tournament.

New England Revolution forward Charlie Davies says he visited a Boston-area therapist earlier this year and was told he has "a lot of things to deal with." Says Davies: "There are always things in people’s lives that come up that need to be talked about." (USA TODAY Sports)

Major League Soccer has felt it, too. Former Kansas City defender and Nigerian international Uche Okafor committed suicide in his home outside Dallas in January 2011 at the age of 43, though Okafor’s family has since said they suspect foul play was involved.

But it doesn’t take tragic events like these to realize other players have been in need of help at points in their career, too, and they’ve received it from therapists willing to listen.

Take Charlie Davies, who in October 2009 was nearly killed in a car accident outside Washington, and has spent every day since trying to become the player he was before the accident. Now in his second season with the New England Revolution after a brief spell with D.C. United in 2011, Davies says that while he’s tried to keep his emotional struggle internal, he’s found in recent years that therapists can provide additional help if he’s willing to accept it.

While with D.C. three years ago, for example, he sought out Tom Perrin, a Virginia-based sports psychologist who worked with the US national team during the 2002, 2006 and 2010 World Cup cycles. The two spoke in person and over the phone during a layoff for D.C., and Davies scored his first hat trick since 2007 in his first game back from the break.

“I was thinking, ‘Ah, I’m good, I’m fixed,’” he says now. “But the truth of the matter was that it’s never something that can be fixed. There are always things in people’s lives that come up that need to be talked about."

In fact, Davies says he met with a Boston-area therapist earlier this year who was taken aback by the level of trauma Davies had endured in his life.

“He was like, ‘Whoa, you got a lot of things to deal with,’” Davies says with a laugh. “’How do you practice every day with these things? This isn’t normal to go day-to-day with these things and not talk about them.’”

Robbie Rogers knows this, too. Last year the LA Galaxy left back became the first openly gay male athlete to play professional team sports in the United States, a burden he says weighed heavily on him when he arrived in Los Angeles last summer. After coming out in February 2013, he sought counsel from other openly gay men as well as therapists who could help him with “the levels of shame” that had built up inside him, and he set up a lunch meeting with Donovan almost immediately after arriving home in Los Angeles.

Robbie Rogers has enjoyed a career rebirth in his second season with the LA Galaxy, but not without hard work on his body and his mind. He says he still visits a private therapist whenever he feels the need. (USA TODAY Sports)

Rogers says that at the time he was scared to go back into a professional locker room after his announcement, and that Donovan and his therapist helped him deal with what would come next: Not just a return to the sport he loved, but a crush of attention that proved both positive and negative.

“Last year was crazy for me,” says Rogers, who adds that he still sees a private therapist occasionally. “I quickly realized it was not something you can get over by talking with someone over a two-week period, a number of months or even years.”

There are others. Colorado Rapids veteran Brian Mullan sought therapy after he was involved in a tackle that broke the leg of then-Seattle Sounders winger Steve Zakuani in 2011, and Mullan’s former teammate and current Rapids head coach Pablo Mastroeni made his return from a scary concussion in 2012 with some help from a Denver-area psychologist who asked Mastroeni to share his free-flowing and sometimes gloomy journal entries in hopes that it would help the healing process.

“They were about how comical my life can be, given that it’s perceived from the outside that I have everything. But on the inside I’m just a roller coaster,” Mastroeni told MLSsoccer.com in 2013. “You live across the street from some people and they see you on the street: ‘Hey, how’s it going?’ Everything seems great. But we all have our demons to battle.”

As researchers spend more time on the subject of athletes and mental health, however, it’s becoming clear that players who have experienced trauma aren’t the only ones struggling.

JOHN O'BRIEN STILL HAS A FEW YEARS TO GO, but his career mantra goes something like this: By the time I’m 40, I’ll be a sports psychologist.

That’s a far cry from where he thought his future would be when he was in his 20s, when, O’Brien says, he never thought twice about teammates who might be struggling with personal issues.

"I was bad. I was like, ‘That guy’s dealing with something, alright, that’s too bad for him. He’ll have a tough time at practice keeping his spot,'" O'Brien recalls. "That competitive attitude is really something I look back on and regret a little bit.”

O'Brien played for famed Dutch club Ajax and was an integral member of the United States’ 2002 World Cup team. Donovan once called him "the best soccer player in the USA" and Bruce Arena has said O’Brien was "as talented a midfielder as US soccer has ever had," but his career never quite came to the fruition most expected.

Much of that is due to injuries suffered during his career and the inability to fully recover, a result of a scoliosis diagnosis when he was young. The rotation of his spine and his left hip, he told MLSsoccer.com in 2011, functioned differently than with his right hip, often inhibiting him from recovering from injuries and eventually leading to the end of his career.

John O'Brien broke through with storied Dutch side Ajax in the late 1990s and went on to star for the United States at the 2002 World Cup. Since his retirement he's delved into psychology, and says that "there’s a depth to psychology that’s pretty beautiful. We’re all here on this planet for a short amount of time, and psychology is another way to look at our experience and what’s going on with us and society." (Reuters)

But those struggles during his soccer career taught him one simple lesson he still carries today: The more balance you have, the better you can handle the load of being a professional athlete.

“There’s a depth to psychology that’s pretty beautiful,” he says. “We’re all here on this planet for a short amount of time, and psychology is another way to look at our experience and what’s going on with us and society. Think of the valuable people in your life. Being able to connect with other people in our lives is something of value.”

O’Brien has spent the past year immersed in the field of sports psychology, and is currently a graduate student in clinical psychology at Alliant International University in the San Francisco Bay area. He works with middle school children in the East Bay suburb of Richmond. He still follows the game of soccer, but his main focus now is on the mental health of athletes and their challenges with identity, confidence, and self-worth when their careers come to an end.

What he has learned sounds familiar to his own case, and to that of many players he’s known throughout his career. Studies focused on the psychological struggles of retiring athletes typically illustrate the idea that during a player’s career he or she is myopically tied to the athlete identity, and that when that identity is lost, trouble ensues.

“The idea that very high-level athletes have it all together psychologically, I would say that’s not at all true,” says Perrin, the sports psychologist for the United States national team. “Many do, but high-level athletes struggle with confidence just as much as my teenaged daughters did when they played in high school. Confidence ebbs and flows depending on the experience a person is having, and there are a lot of issues that come from that.”

Studies regularly show that athletes facing the end of their careers – either by choice or because of injury or de-selection – face a wealth of issues dealing with self-perception, social death, or exclusion, a sense of betrayal and ultimately a loss of identity. There’s also proof that those players who forged a strong athletic identity at the time of their sport career – frequently the most successful ones – need a longer period of time to adjust to their post-athletics career.

Sometimes these athletes also find themselves without a wealth of professional options because of a lack of non-sporting life experiences, or a lack of personal development during their sport careers.

Numerous studies have shown, meanwhile, that any form of psychosocial support during the athlete’s career – via spouses, family members, coaches, professional therapists or elsewhere – can have a tangible and positive effect on the athlete’s transition from the field to civilian life, if you will. If players can plan ahead and discuss with others what it will mean to no longer be an athlete, O’Brien says, they can better deal with painful issues of confidence or identity when things go bad.

“When you’re younger in your career, you are really focused and your path is very uniform,” he says. “You’re totally into it. At some point – especially if you have a longer career – things come up. That’s how life is. You reach this developmental age where you begin dealing with very real things.

“I was on a path where I thought nothing would take me off of it. And then life starts to happen, and you have to learn how to bend a little bit.”

Former MLS player and current NBCSN analyst Kyle Martino is close friends with O’Brien and underwent his own career crisis after his career ended in 2007, truncated by injury. He sought a therapist’s help to deal with the same issues that plague most players whose careers end abruptly: a loss of identity and bouts of self-denial.

Current NBCSN analyst Kyle Martino says he sought the help of a therapist when his playing career ended earlier than he expected, and believes players should be offered help early in their careers. "A guy should be able to dip into a room and be able to talk to someone." (USA TODAY Sports)

“It’s so strange to have your identity for your entire life be intertwined with something that’s going to end one day,” Martino says. “The Peter Pan life of being a professional athlete – you push off a lot of emotional issues. Sometimes you’re left at the latter parts of your career, and you find yourself realizing you’re falling out of love with the thing that’s maybe been the most important part of your life to that point.”

Different players deal with different issues in every locker room. While younger players might struggle with the acclimation to the professional ranks or the pressure of living up to their first professional contract, mid-level players are constantly battling confidence issues that might come from a lack of playing time. Older athletes facing de-selection and the twilight of their careers struggle most with the creeping loss of identity.

Unfortunately for current athletes, however, it might be difficult to reach out for help. O’Brien says that since he made his debut in 1998 the stigma surrounding mental health in professional locker rooms has changed, but it’s still something of a radioactive topic for most players. Instead of reaching out for professional help, he says, players are more inclined to share their problems with a small group of players on the team, or maybe just their domestic partner.

“There’s no impetus for a player to tell another player, ‘Hey, I’m dealing with this problem, let me get your help on it,’” he says. “People don’t feel comfortable bringing it up, or sometimes the people they’re talking to don’t know how to respond in a beneficial way.”

Martino likens the new attention on players’ mental health to the gradual awareness in recent years of concussion safety, and both Rogers and Davies say the stigma surrounding mental health has improved during their careers.

All of those interviewed, however, concede there’s a long way to go before the topic becomes mainstream inside the locker room.

“It shouldn’t be left to young players to seek advice out,” Martino says. “It has to be as fluid and as normal as getting your ankle taped up or your hamstring looked at. A guy should be able to dip into a room and be able to talk to someone.”

BACK IN DONOVAN'S MAKESHIFT OFFICE at StubHub Center, it’s not so easy to come up with a solution to the problem.

When asked by MLSsoccer.com, all current MLS teams said that their players have access to mental health professionals via either a sports psychologist who visits the team regularly or a referral to a private, external psychologist.

The Galaxy, for their part, currently work with Dr. Ken Ravizza, a sports psychologist who has also worked with the Los Angeles Dodgers and various US Olympic teams over the past two decades. Donovan says he’s had many conversations with Ravizza since he was added to the staff ahead of the 2014 season, and that Arena and Sarachan have been two of the more progressive coaches in MLS when it comes to incorporating mental health awareness into the team’s approach.

MLS Technical Director of Competition Jeff Agoos, a longtime MLS and USMNT standout who played with Donovan on the San Jose Earthquakes, recognizes that the players’ mental health is an important aspect of the modern game, one that will become more relevant over time.

“The mental side of the game is deservedly getting more attention,” Agoos told MLSsoccer.com. "It’s still in the nascent stages, but if you look at the most progressive clubs around the world, they’re committing resources to studying and optimizing players' mental performance in hopes of a competitive advantage.”

Said Donovan: “It’s almost laughable that this has to be coined as 'progressive,' but it’s true. Big-picture-wise, I’m constantly shocked at how little attention is paid to the emotional and mental side of sports. Forget about how it affects people in their personal lives for a second. It could massively help your team as a coach, or a GM or an owner. If you really invested in this and helped people, you’re going to get so much more out of your players.”

That can be a hard sell, however, considering the results are not readily tangible. For example, Rogers can say he’s enjoyed a career rebirth in large part because of the psychological help he’s received in the past 18 months, but a skeptic can just as easily shrug it off as anecdotal. How can we know for sure that healthier minds in the locker room will translate to more success on the field?

Donovan says that helping athletes with their mental health issues would mean more points in the standings: "You're going to get so much more out of your players." (USA TODAY Sports)

That question, at this point, makes it difficult for a club – or a league – to mandate any type of psychological intervention for its players.

“Can you force your players to go see a therapist? Probably not,” Donovan says. “ You can certainly hold a team meeting with a sports psychologist, but I don’t know that there’s a way that the league could [require psychological intervention for individual players].”

Ultimately, Donovan says, like so many other things in professional sports, the results on the field will be the determining factor of the entire debate.

“If you could convince the teams that this is worthwhile – which I certainly could do – then they would do it,” Donovan says. “If it added up to one more point and meant making the playoffs instead of missing the playoffs, they would do it.”

“Once someone figures that out, it will be a windfall,” he adds. “Everyone will realize they should have been doing this years ago.”

Will Donovan be the one to convince everyone? Despite all his openness and discussion, he's given no clear indication of what role he wants to play next. At this point, he does not have any formal education in psychology, and it remains to be seen if other players will seek him as someone to talk to.

But he's willing to listen.

“I’ve seen a lot in my career and in my life,” he says. “And if I can help one more person to not go through some of the hard times I’ve gone through and I’ve seen others go through, it’s totally worth it.”