Top eSports stars may not end their battles with the same bumps, bruises and breaks as other top-level athletes do, but the games still take a toll on even the best players.

As eSports continues to transform into a major industry, with top competitions filling major arenas around the world, the industry is starting to look at how hours and hours of high-pressure competitive gaming is affecting its top players. A panel at the PAX West game conference in Seattle this weekend dove into the issue this weekend, featuring prominent players, gaming company officials and team representatives.

The consensus: any push for better mental health in eSports has to start with leagues and game publishers because most players and teams are in it to win as many games as they can.

Most panelists mentioned their experiences playing a game they were really into for 16 hours in a day. But for top eSports competitors, that is the norm.

“For the longest time it’s been feast or famine,” said Devin Nash, CEO of eSports organization Counter Logic Gaming. “If you don’t perform you die. There’s no other way out of it; you have to go as fast and as hard as you can for as long as you can. I think that the entire ecosystem of eSports has been set up to grind players into the ground, and we need to address this systemically to solve it.”

The charge to fix this problem isn’t likely to come from the players, panelists said. Steph Loehr, a Twitch broadcaster and highly ranked player in Heroes of the Storm, said a couple extra hours practice, or something as small as mousepad, can give that little advantage to put them over the top, so asking players to cut back is likely to be a non-starter.

“When you are streaming and playing you only get what you put in,” Loehr said. “Any day off you feel like you’re making no progress.”

Loehr went on to say that the best way to get players to buy in to mental health initiatives is to pitch them as a competitive advantage. For example, the argument could be made that a rested player would have an advantage over someone who has been practicing too much.

Ryan Morrison of New York law firm Morrison & Lee, who is also known online as the “video game lawyer,” said eSports needs programs like the NBA and other professional leagues have for young players. Handling the competitive pressure, knowing how to manage their money and life outside gaming is crucial to help players adjust to the spotlight and continue to succeed in future phases of life.

The conversation eventually moved away from the general concept of mental health to focus on abuse and the toxic culture that often comes with gaming, and not just on the professional level. Some panelists favored harsher penalties for people who use racist or sexist language.

Some panelists argued that there will always be negative people, and negative aspects of gaming. Nash and Loehr both advocated for focusing more on positivity, compassion and sportsmanship within the community, while still keeping healthy levels of competition.

Melissa Mok, senior partnerships manager at game maker Bluehole Ginno Games, said there is only so much banning a game publisher can do. One way to push back against abusive behavior in gaming, panelists said, is to start with the players.

Mok said her company encourages players from competing teams to hang out when they aren’t facing each other. Players also need to remind fans to keep their feedback positive and refrain from invading other channels with negative and abusive comments, she said.

“We’re part of this community whether we have differences in culture, or religion or gender whatever,” Mok said. “We’re all in this together, we all love this game, so why do we have to fight each other?”