James Donaldson on Mental Health - Learning Disabilities and Depression

Why kids with LDs often develop depression, and need emotional support, too

Writer: Molly Hagan

Clinical Experts: Laura Phillips, PsyD, ABPdN , Helene Omansky, LCSW

https://www.youtube.com/watch?v=4uIAhuvwFIk

What You'll Learn

- Why are kids with LDs more likely to be depressed?
- How does school affect a child's self-esteem?
- How can parents and teachers emotionally support kids with learning disabilities?
- Quick Read
- Full Article
- School and self-worth
- Academic challenges get tougher
- Comparisons with peers
- Hiding the signs
- A vicious cycle — how depression impacts learning
- Classroom safety
- Combining academic and emotional supports
- Learning Disabilities and Depression
- How Depression Affects Kids in School

Quick Read

Research shows that children with learning disabilities run a higher risk of developing depression than other kids — and that this risk increases as they get older.

Depression comes from feelings of hopelessness and low self-worth. And the struggles kids have at school play a big role in how good or bad they feel about themselves. These challenges include more difficult work in the classroom as kids get older but also social problems.

When kids turn 8 or 9, they begin to compare themselves to their friends and peers. Kids with LDs might feel embarrassed by their learning challenges and want to hide them. Some kids will act out. Others, including many girls, will withdraw at school, and from friends  — which makes it much harder for parents and teachers to know that they have a learning disorder in the first place.

Dealing with undiagnosed learning disabilities can make kids anxious and depressed. And depression and anxiety, in turn, can affect the brain, making it harder to remember things and concentrate. Because being anxious or depressed makes it hard to learn, schools are beginning to teach social and emotional learning (SEL) skills to kids with LDs, to help them cope with difficult feelings. Learning support by itself is not enough to help kids succeed.

But while SEL skills are very helpful, kids showing signs of depression — like being tired all the time, seeming sad, or losing interest in things they usually enjoy — should see a medical professional for treatment.

We think of learning disabilities as affecting kids in school, but challenges in skills like reading, writing, math, and language affect all aspects of life, not just academic performance. We are using them all the time — reading street signs, counting change, playing games, and following conversations with friends.

Struggling with skills that appear to come easily to others, inside the classroom or out, can take an emotional toll starting at an early age. Research shows that children with learning disorders are at higher risk for developing depression. This risk increases as children enter their teenage years.

“Kids spend the majority of their waking hours in school,” says Laura Phillips, PhD, a neuropsychologist. “When you spend eight hours a day engaged in something that’s challenging for you it has a very significant impact on your self-concept — meaning your idea about who you are as a person — and your ability to feel successful.”

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

School and self-worth

Depression can manifest in different ways:

- Appearing sad or irritable
- Trouble sleeping
- Losing interest in things you once enjoyed 
- Being tired all the time
- Gaining or losing a lot of weight

But at its root are feelings of hopelessness and low self-worth. Studies show that for kids with learning disorders, the school environment can contribute to and breed these feelings.

A child with an undiagnosed learning disability is particularly at risk for depression because they don’t understand why they struggle with things that others don’t. Frustration and failure create a sense that something must be wrong with them. A diagnosis can be reassuring and offer them the support they need — but success will still be a struggle. When it comes to a child’s emotions, an LD diagnosis is not a magic bullet.

??“It doesn’t always feel better right away,” notes Helene Omansky, LCSW, a senior social worker at the Child Mind Institute. “It will get better, but newly diagnosed kids need time to adjust to their support system, and to develop confidence in skills that they may have lacked.”

If you think your child might be depressed, consult a medical professional for help — but know there are ways parents and teachers can offer support, too.

Academic challenges get tougher

The requirements of school change as you get older, and there’s one shift that can be particularly tough for kids, especially those with reading and language deficits. “From kindergarten through second grade, you’re learning how to read,” Dr. Phillips explains. “By third grade, the emphasis shifts to reading to learn.”

In other words, reading becomes incorporated into every class. Kids who struggled in language arts classes but prided themselves on their math skills are suddenly confronted with math word problems. “And then they lose that confidence in the thing that might’ve been maintaining their sense of self and self-esteem,” Dr. Phillips explains.

This change is the first of many. Kids will continue to wrestle with their challenges in unexpected ways, and this can be discouraging.

“The impact of alearning disorder becomes more widespread as you move through school,” Dr. Phillips says.

It’s important for parents to understand the depth of frustration a child may be feeling and acknowledge it, says Omansky. We’re naturally inclined to dispel negativity with encouragement — “You’re so smart!” — but this can make a child feel isolated and unheard. If a child is saying they feel dumb because they can’t figure out how to solve a word problem, Omansky says, “It’s okay to validate that by saying something like, ‘I can see how frustrating this is for you.’”

Comparisons with peers

Around 8 or 9 years old, kids become less self-focused and begin to understand themselves in the context of — and in comparison, to — their peers. Where before school was merely frustrating, now kids may wonder why certain things appear to come easily to others. They may feel like they’re working twice as hard as those around them, and understandably, they may think this is unfair.

Kids also become more self-conscious at this age and might feel like their deficits are on display. This can look like a kid who doesn’t want to raise their hand in class, but it can also look like a kid who plays by themselves at recess. When a child can’t solve a math problem or gets called out for not finishing an assignment, it’s easy for them to go from “I feel dumb” to “Nobody is going to like me,” Omansky notes.

Kids with learning challenges can also struggle with social skills, such as following the thread of a conversation or finding the right words to respond. They sometimes fumble social cues, and given enough negative feedback, might avoid socializing altogether.

Some kids draw attention away from their challenges by acting out. Being perceived as funny or rebellious might even bolster your self-esteem. But avoiding your challenges doesn’t make you feel any better about them, it just makes you more determined to hide them.

Hiding the signs

Rates of learning disorders are not significantly different among genders, but boys are more likely to be diagnosed because of their tendency to be disruptive in class — an obvious red flag. Girls, meanwhile, tend to withdraw, making identification harder.

“Girls are much more likely to quietly sit in the back of the class and try to sink into the ground,” Dr. Phillips says.

This translates to girls not receiving a learning disorder diagnosis or being diagnosed late. When LDs are overlooked, a child’s anxiety or depression can be the first recognized signs that they need help. “They might become highly anxious or more academically demoralized,” says Dr Phillips. “So, it might be the anxiety or depression that first brings them to clinical attention.”

It’s important for adults to empathize with this experience, too. “Well-intended parents and teachers don’t want to put a spotlight on a kid unnecessarily, but they may not be asking the right questions that would allow for further intervention or exploration,” says Omansky. When a child is anxious, unmotivated, or depressed, the adults in their lives should investigate if they might be struggling, she adds. “Kids don’t always have the skillset to know how to self-advocate and say, ‘I don’t understand.’”

A vicious cycle — how depression impacts learning

Depression can actually impact cognitive functions, making learning challenges more acute.

Research shows that depression can:

- Slow information processing
- Slow memory consolidation, or how your brain transforms the things you learn into long-term memories
- Make it harder to pay attention and concentrate
- Interfere with sleep, which can also be bad for your brain

It’s a vicious cycle — learning challenges contributing to depression, contributing to more challenges — but there are ways to interrupt it.

Classroom safety

How a child relates to their school environment can also affect how they learn and how they see themselves. This is a particularly important factor for Black children and other children of color, especially if they attend predominantly white schools. “If there’s a difference in skin color between kids and their teachers, they might enter the classroom with a different level of anxious arousal that they have to overcome in order to be fully engaged,” Dr. Phillips says.

If the school environment already makes you anxious, you’re more likely to shut down if learning is also a challenge. You might even develop a fear of going to school at all. Teachers should be aware that kids don’t experience school in a vacuum. They should understand the racial, cultural, demographic factors that impact kids, so kids feel safe enough to learn and ask for help if they need it.

Combining academic and emotional supports

Schools are beginning to embrace emotional supports for children with learning disorders. When kids feel defeated by their challenges, and resist learning because it makes them feel bad about themselves, academic support alone is not enough.

Increasingly, schools are using  social and emotional learning (SEL) techniques to help kids develop an awareness of the emotions that drive their behaviors — whether they are acting out, trying to disappear, or simply avoiding the tasks that are most difficult for them.

Kids can be taught strategies to manage big emotions around learning. Take kids with math learning disorders, who become anxious when asked to solve math problems. They tend to engage in negative self-talk — “I’m so bad at math. I’m going to fail this math test. I’m so stupid, I’m not going to get into college.”

The negative self-talk interferes with problem solving. “It taxes your working memory to the point where you can’t effectively problem solve,” explains Dr. Phillips. “So, you do poorly and then you see yourself as a bad math student.”

But kids can interrupt the cycle with a simple trick: saying the steps of the math problem as they do them. “If you’re verbally working through the steps, you can’t engage in negative self-talk and so you can’t tax the working memory system,” she adds.  “It’s very effective.”

The ability to embrace this kind of creative problem-solving is the secret weapon of having a learning disorder — but when a child shows signs of depression, it’s important to seek professional treatment. Understanding that emotional challenges and learning challenges are intertwined can help parents get kids the support they need.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-learning-disabilities-and-depression-2/

Why kids with LDs often develop depression, and need emotional support, too

Writer: Molly Hagan

Clinical Experts: Laura Phillips, PsyD, ABPdN , Helene Omansky, LCSW

https://www.youtube.com/watch?v=4uIAhuvwFIk

What You'll Learn

- Why are kids with LDs more likely to be depressed?

- How does school affect a child's self-esteem?

- How can parents and teachers emotionally support kids with learning disabilities?

- Quick Read

- Full Article

- School and self-worth

- Academic challenges get tougher

- Comparisons with peers

- Hiding the signs

- A vicious cycle — how depression impacts learning

- Classroom safety

- Combining academic and emotional supports

- Learning Disabilities and Depression

- How Depression Affects Kids in School

Quick Read

Research shows that children with learning disabilities run a higher risk of developing depression than other kids — and that this risk increases as they get older.

Depression comes from feelings of hopelessness and low self-worth. And the struggles kids have at school play a big role in how good or bad they feel about themselves. These challenges include more difficult work in the classroom as kids get older but also social problems.

When kids turn 8 or 9, they begin to compare themselves to their friends and peers. Kids with LDs might feel embarrassed by their learning challenges and want to hide them. Some kids will act out. Others, including many girls, will withdraw at school, and from friends  — which makes it much harder for parents and teachers to know that they have a learning disorder in the first place.

Dealing with undiagnosed learning disabilities can make kids anxious and depressed. And depression and anxiety, in turn, can affect the brain, making it harder to remember things and concentrate. Because being anxious or depressed makes it hard to learn, schools are beginning to teach social and emotional learning (SEL) skills to kids with LDs, to help them cope with difficult feelings. Learning support by itself is not enough to help kids succeed.

But while SEL skills are very helpful, kids showing signs of depression — like being tired all the time, seeming sad, or losing interest in things they usually enjoy — should see a medical professional for treatment.

We think of learning disabilities as affecting kids in school, but challenges in skills like reading, writing, math, and language affect all aspects of life, not just academic performance. We are using them all the time — reading street signs, counting change, playing games, and following conversations with friends.

Struggling with skills that appear to come easily to others, inside the classroom or out, can take an emotional toll starting at an early age. Research shows that children with learning disorders are at higher risk for developing depression. This risk increases as children enter their teenage years.

“Kids spend the majority of their waking hours in school,” says Laura Phillips, PhD, a neuropsychologist. “When you spend eight hours a day engaged in something that’s challenging for you it has a very significant impact on your self-concept — meaning your idea about who you are as a person — and your ability to feel successful.”

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

School and self-worth

Depression can manifest in different ways:

- Appearing sad or irritable

- Trouble sleeping

- Losing interest in things you once enjoyed 

- Being tired all the time

- Gaining or losing a lot of weight

But at its root are feelings of hopelessness and low self-worth. Studies show that for kids with learning disorders, the school environment can contribute to and breed these feelings.

A child with an undiagnosed learning disability is particularly at risk for depression because they don’t understand why they struggle with things that others don’t. Frustration and failure create a sense that something must be wrong with them. A diagnosis can be reassuring and offer them the support they need — but success will still be a struggle. When it comes to a child’s emotions, an LD diagnosis is not a magic bullet.

??“It doesn’t always feel better right away,” notes Helene Omansky, LCSW, a senior social worker at the Child Mind Institute. “It will get better, but newly diagnosed kids need time to adjust to their support system, and to develop confidence in skills that they may have lacked.”

If you think your child might be depressed, consult a medical professional for help — but know there are ways parents and teachers can offer support, too.

Academic challenges get tougher

The requirements of school change as you get older, and there’s one shift that can be particularly tough for kids, especially those with reading and language deficits. “From kindergarten through second grade, you’re learning how to read,” Dr. Phillips explains. “By third grade, the emphasis shifts to reading to learn.”

In other words, reading becomes incorporated into every class. Kids who struggled in language arts classes but prided themselves on their math skills are suddenly confronted with math word problems. “And then they lose that confidence in the thing that might’ve been maintaining their sense of self and self-esteem,” Dr. Phillips explains.

This change is the first of many. Kids will continue to wrestle with their challenges in unexpected ways, and this can be discouraging.

“The impact of alearning disorder becomes more widespread as you move through school,” Dr. Phillips says.

It’s important for parents to understand the depth of frustration a child may be feeling and acknowledge it, says Omansky. We’re naturally inclined to dispel negativity with encouragement — “You’re so smart!” — but this can make a child feel isolated and unheard. If a child is saying they feel dumb because they can’t figure out how to solve a word problem, Omansky says, “It’s okay to validate that by saying something like, ‘I can see how frustrating this is for you.’”

Comparisons with peers

Around 8 or 9 years old, kids become less self-focused and begin to understand themselves in the context of — and in comparison, to — their peers. Where before school was merely frustrating, now kids may wonder why certain things appear to come easily to others. They may feel like they’re working twice as hard as those around them, and understandably, they may think this is unfair.

Kids also become more self-conscious at this age and might feel like their deficits are on display. This can look like a kid who doesn’t want to raise their hand in class, but it can also look like a kid who plays by themselves at recess. When a child can’t solve a math problem or gets called out for not finishing an assignment, it’s easy for them to go from “I feel dumb” to “Nobody is going to like me,” Omansky notes.

Kids with learning challenges can also struggle with social skills, such as following the thread of a conversation or finding the right words to respond. They sometimes fumble social cues, and given enough negative feedback, might avoid socializing altogether.

Some kids draw attention away from their challenges by acting out. Being perceived as funny or rebellious might even bolster your self-esteem. But avoiding your challenges doesn’t make you feel any better about them, it just makes you more determined to hide them.

Hiding the signs

Rates of learning disorders are not significantly different among genders, but boys are more likely to be diagnosed because of their tendency to be disruptive in class — an obvious red flag. Girls, meanwhile, tend to withdraw, making identification harder.

“Girls are much more likely to quietly sit in the back of the class and try to sink into the ground,” Dr. Phillips says.

This translates to girls not receiving a learning disorder diagnosis or being diagnosed late. When LDs are overlooked, a child’s anxiety or depression can be the first recognized signs that they need help. “They might become highly anxious or more academically demoralized,” says Dr Phillips. “So, it might be the anxiety or depression that first brings them to clinical attention.”

It’s important for adults to empathize with this experience, too. “Well-intended parents and teachers don’t want to put a spotlight on a kid unnecessarily, but they may not be asking the right questions that would allow for further intervention or exploration,” says Omansky. When a child is anxious, unmotivated, or depressed, the adults in their lives should investigate if they might be struggling, she adds. “Kids don’t always have the skillset to know how to self-advocate and say, ‘I don’t understand.’”

A vicious cycle — how depression impacts learning

Depression can actually impact cognitive functions, making learning challenges more acute.

Research shows that depression can:

- Slow information processing

- Slow memory consolidation, or how your brain transforms the things you learn into long-term memories

- Make it harder to pay attention and concentrate

- Interfere with sleep, which can also be bad for your brain

It’s a vicious cycle — learning challenges contributing to depression, contributing to more challenges — but there are ways to interrupt it.

Classroom safety

How a child relates to their school environment can also affect how they learn and how they see themselves. This is a particularly important factor for Black children and other children of color, especially if they attend predominantly white schools. “If there’s a difference in skin color between kids and their teachers, they might enter the classroom with a different level of anxious arousal that they have to overcome in order to be fully engaged,” Dr. Phillips says.

If the school environment already makes you anxious, you’re more likely to shut down if learning is also a challenge. You might even develop a fear of going to school at all. Teachers should be aware that kids don’t experience school in a vacuum. They should understand the racial, cultural, demographic factors that impact kids, so kids feel safe enough to learn and ask for help if they need it.

Combining academic and emotional supports

Schools are beginning to embrace emotional supports for children with learning disorders. When kids feel defeated by their challenges, and resist learning because it makes them feel bad about themselves, academic support alone is not enough.

Increasingly, schools are using  social and emotional learning (SEL) techniques to help kids develop an awareness of the emotions that drive their behaviors — whether they are acting out, trying to disappear, or simply avoiding the tasks that are most difficult for them.

Kids can be taught strategies to manage big emotions around learning. Take kids with math learning disorders, who become anxious when asked to solve math problems. They tend to engage in negative self-talk — “I’m so bad at math. I’m going to fail this math test. I’m so stupid, I’m not going to get into college.”

The negative self-talk interferes with problem solving. “It taxes your working memory to the point where you can’t effectively problem solve,” explains Dr. Phillips. “So, you do poorly and then you see yourself as a bad math student.”

But kids can interrupt the cycle with a simple trick: saying the steps of the math problem as they do them. “If you’re verbally working through the steps, you can’t engage in negative self-talk and so you can’t tax the working memory system,” she adds.  “It’s very effective.”

The ability to embrace this kind of creative problem-solving is the secret weapon of having a learning disorder — but when a child shows signs of depression, it’s important to seek professional treatment. Understanding that emotional challenges and learning challenges are intertwined can help parents get kids the support they need. https://standingabovethecrowd.com/?p=16422

Understanding suicide, identity, and collective loss in sport.

Tess M. Kilwein PhD, ABPP, CMPC

Reviewed by Jessica Schrader

THE BASICS

- Suicide Risk Factors and Signs

- Take our Depression Test

- Find a therapist near me

Key points

- Grief in sport settings affects identity, performance, and psychological safety.

- Athlete suicide risk is shaped by pressure, identity foreclosure, injury, and barriers to care.

- Teams need proactive suicide response protocols before a crisis occurs.

When a death occurs in a sport environment, particularly a death by suicide, its impact can ripple through entire organizations. Athletes, coaches, and sport staff, including those tasked with supporting organizations through crises (e.g., sport psychologists, athletic counselors), often experience collective waves of shock, grief, and unanswered questions.

This reality was central to a recent conversation with professional soccer player for RC Strasbourg Sierra Enge and adolescent mental health and suicide expert Dr. Kimberly O’Brien. Together, Sierra and O’Brien bring both lived and professional experience to the intersection of grief, suicide prevention, and athlete mental health. Throughout our discussion, their perspectives underscored a critical truth: we still do not fully understand the weight or complexity of grief and loss within sport environments, especially when that loss is due to suicide.

Athlete Identity and the Pressure to Perform

For many athletes, sport is not just something they do. Over time, it becomes central to who they are. Sierra described growing up excelling in soccer and receiving external reinforcement that her value was directly tied to performance. Social media, increased visibility, and constant evaluation intensified this dynamic over time. She continues to navigate these same pressures as a professional athlete today.

When performance declines, injury occurs, or life circumstances disrupt sport participation, many athletes experience a significant rupture in identity. In these moments, the internal message can quickly become, “If I am not performing, I am not valuable.” This belief can fuel social and emotional challenges, including anxiety, withdrawal from sport, and social isolation.

With time, peer and professional support, and meaningful shifts in perspective, Sierra learned that she functions best when she invests in multiple parts of herself, not solely soccer. While she continues to train intensely and care deeply about her sport, the difference is that performance alone no longer determines her self-worth.

O’Brien observes this same pattern in her work with athletes across the lifespan, particularly adolescents and young adults. She emphasized that overidentification with sport can limit coping flexibility when adversity hits. To support both mental health and long-term performance, athletes need identities that extend beyond their role on the field.

Why Today’s Athletes Are Carrying More

Athletes today are navigating higher stakes and broader demands than many prior generations. Dr. O’Brien emphasized the convergence of academic and athletic pressures, while Sierra highlighted the growing expectations tied to NIL deals, public scrutiny, and constant social media comparison.

A recent systematic review examining suicide risk among college student-athletes identified several contributors, including the convergence of academic and athletic pressures, toxic or psychologically unsafe team cultures, barriers to accessing confidential mental health services, identity foreclosure tied to sport, and injury-related stressors (Anton-Lotruglio & O’Brien, 2025). These factors accumulate over time, increasing vulnerability when coping resources are already strained.

Evidence suggests that this stress exposure begins well before college. One study of high school athletes revealed that 91% reported experiencing sport-related stress, with 27% endorsing moderate to extreme levels of stress associated with athletic participation (Ward et al., 2023). This chronic stress becomes normalized long before youth athletes enter elite or collegiate sport environments.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Remembering Katie Meyer

The reality of grief in sport is best understood through the experiences of those most closely impacted. Sierra and Katie Meyer were best friends, teammates, and co-captains at Stanford University. Katie’s death by suicide in 2022 shook the college sport world and brought renewed attention to athlete mental health.

When I asked Sierra what she would say to Katie now, her message was simple and urgent: Tell someone. Make one call. Hold on a little longer. Even one trusted person can change the trajectory of a life.

At the same time, Sierra acknowledged how difficult this can be for student-athletes who are taught to be tough from a young age. “It’s not going to be an easy road,” she shared, “but if you open up to one person, maybe they can walk with you.”

Sierra speaks openly about her own mental health and her use of therapy, encouraging others to do the same. She reflected that while she had developed many independent coping skills over the years, she came to recognize how essential asking for help became as she worked through the loss of Katie.

O’Brien emphasized that suicidal crises distort perception. Emotional pain overwhelms the brain’s ability to generate alternatives. In moments of extreme distress, suicide can feel like the only option, not because others do not exist, but because the brain under intense stress cannot access them. This is why both O’Brien and Sierra emphasize the importance of social connection and accessing support before distress reaches a critical point.

Both also stress that therapy should not be a last resort for athletes. Instead, it should be treated as a protective resource. Building a relationship with a mental health professional when life feels stable creates a safety net for when it does not. “It can’t hurt,” Sierra emphasized.

Supporting Teams After Suicide

When a suicide affects a sports team, grief becomes collective, carried through the hallways, fields, and offices of athletic departments. O’Brien’s work centers on restoring psychological safety so teams and organizations can function, communicate, and ultimately heal.

This includes psychoeducation about suicide-specific grief, facilitating conversations about support needs, and helping teams navigate decisions related to memorials, daily routines, and returning to play. O’Brien emphasizes that there is no single correct response. Athletes grieve differently, and flexibility within structure is essential.

Sierra echoed this sentiment, noting that returning to structure supported her healing, while pressure to adhere to that structure when more time was needed to process caused long-term harm for one of her teammates.

Both Sierra and O’Brien emphasized that external consultants are often critical in moments of tragedy, particularly when loss involves suicide. Internal staff and coaches are grieving as well. Outside support offers containment, neutrality, and guidance at times when decision-making feels overwhelming or impossible for those closest to the loss.

Why Institutions Must Prepare in Advance

One of the clearest takeaways from my discussion with Sierra and O’Brien is that sport systems too often wait until tragedy strikes to develop a response. Suicide response protocols must exist before they are needed, especially when emotional resources are limited and decision-making capacity is compromised.

Effective institutional responses include:

- Clear suicide and crisis response protocols.

- Flexible attendance and training expectations without retaliation.

- Multiple layers of support for athletes, coaches, and staff.

- Centering survivors and respecting varied grief timelines.

Routine with flexibility allows athletes to re-engage at their own pace. “If you can come, come. If you cannot, do not,” stated Sierra.

Carrying Forward What Matters

At the end of our conversation, Sierra reflected on her friend Katie Meyer’s capacity to love deeply and consistently show up for others. Her legacy challenges sport communities to do the same. “Soccer is a sport. It’s not that serious,” Sierra shared. She expressed hope that it will not take another loss for teams to recognize this truth.

Grief and loss will continue to enter sport spaces. The critical question is whether those environments are prepared to meet it with humanity, structure, and care. Mental health support for athletes is not only a performance asset. In moments of profound loss, it is life-saving.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 dial 988 for the 988 Suicide & Crisis Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory. https://standingabovethecrowd.com/?p=16419

James Donaldson on Mental Health - When Grief Enters the Locker Room

Understanding suicide, identity, and collective loss in sport.

Tess M. Kilwein PhD, ABPP, CMPC

Reviewed by Jessica Schrader

THE BASICS

- Suicide Risk Factors and Signs
- Take our Depression Test
- Find a therapist near me
Key points
- Grief in sport settings affects identity, performance, and psychological safety.
- Athlete suicide risk is shaped by pressure, identity foreclosure, injury, and barriers to care.
- Teams need proactive suicide response protocols before a crisis occurs.

When a death occurs in a sport environment, particularly a death by suicide, its impact can ripple through entire organizations. Athletes, coaches, and sport staff, including those tasked with supporting organizations through crises (e.g., sport psychologists, athletic counselors), often experience collective waves of shock, grief, and unanswered questions.

This reality was central to a recent conversation with professional soccer player for RC Strasbourg Sierra Enge and adolescent mental health and suicide expert Dr. Kimberly O’Brien. Together, Sierra and O’Brien bring both lived and professional experience to the intersection of grief, suicide prevention, and athlete mental health. Throughout our discussion, their perspectives underscored a critical truth: we still do not fully understand the weight or complexity of grief and loss within sport environments, especially when that loss is due to suicide.

Athlete Identity and the Pressure to Perform

For many athletes, sport is not just something they do. Over time, it becomes central to who they are. Sierra described growing up excelling in soccer and receiving external reinforcement that her value was directly tied to performance. Social media, increased visibility, and constant evaluation intensified this dynamic over time. She continues to navigate these same pressures as a professional athlete today.

When performance declines, injury occurs, or life circumstances disrupt sport participation, many athletes experience a significant rupture in identity. In these moments, the internal message can quickly become, “If I am not performing, I am not valuable.” This belief can fuel social and emotional challenges, including anxiety, withdrawal from sport, and social isolation.

With time, peer and professional support, and meaningful shifts in perspective, Sierra learned that she functions best when she invests in multiple parts of herself, not solely soccer. While she continues to train intensely and care deeply about her sport, the difference is that performance alone no longer determines her self-worth.

O’Brien observes this same pattern in her work with athletes across the lifespan, particularly adolescents and young adults. She emphasized that overidentification with sport can limit coping flexibility when adversity hits. To support both mental health and long-term performance, athletes need identities that extend beyond their role on the field.

Why Today’s Athletes Are Carrying More

Athletes today are navigating higher stakes and broader demands than many prior generations. Dr. O’Brien emphasized the convergence of academic and athletic pressures, while Sierra highlighted the growing expectations tied to NIL deals, public scrutiny, and constant social media comparison.

A recent systematic review examining suicide risk among college student-athletes identified several contributors, including the convergence of academic and athletic pressures, toxic or psychologically unsafe team cultures, barriers to accessing confidential mental health services, identity foreclosure tied to sport, and injury-related stressors (Anton-Lotruglio & O’Brien, 2025). These factors accumulate over time, increasing vulnerability when coping resources are already strained.

Evidence suggests that this stress exposure begins well before college. One study of high school athletes revealed that 91% reported experiencing sport-related stress, with 27% endorsing moderate to extreme levels of stress associated with athletic participation (Ward et al., 2023). This chronic stress becomes normalized long before youth athletes enter elite or collegiate sport environments.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Remembering Katie Meyer

The reality of grief in sport is best understood through the experiences of those most closely impacted. Sierra and Katie Meyer were best friends, teammates, and co-captains at Stanford University. Katie’s death by suicide in 2022 shook the college sport world and brought renewed attention to athlete mental health.

When I asked Sierra what she would say to Katie now, her message was simple and urgent: Tell someone. Make one call. Hold on a little longer. Even one trusted person can change the trajectory of a life.

At the same time, Sierra acknowledged how difficult this can be for student-athletes who are taught to be tough from a young age. “It’s not going to be an easy road,” she shared, “but if you open up to one person, maybe they can walk with you.”

Sierra speaks openly about her own mental health and her use of therapy, encouraging others to do the same. She reflected that while she had developed many independent coping skills over the years, she came to recognize how essential asking for help became as she worked through the loss of Katie.

O’Brien emphasized that suicidal crises distort perception. Emotional pain overwhelms the brain’s ability to generate alternatives. In moments of extreme distress, suicide can feel like the only option, not because others do not exist, but because the brain under intense stress cannot access them. This is why both O’Brien and Sierra emphasize the importance of social connection and accessing support before distress reaches a critical point.

Both also stress that therapy should not be a last resort for athletes. Instead, it should be treated as a protective resource. Building a relationship with a mental health professional when life feels stable creates a safety net for when it does not. “It can’t hurt,” Sierra emphasized.

Supporting Teams After Suicide

When a suicide affects a sports team, grief becomes collective, carried through the hallways, fields, and offices of athletic departments. O’Brien’s work centers on restoring psychological safety so teams and organizations can function, communicate, and ultimately heal.

This includes psychoeducation about suicide-specific grief, facilitating conversations about support needs, and helping teams navigate decisions related to memorials, daily routines, and returning to play. O’Brien emphasizes that there is no single correct response. Athletes grieve differently, and flexibility within structure is essential.

Sierra echoed this sentiment, noting that returning to structure supported her healing, while pressure to adhere to that structure when more time was needed to process caused long-term harm for one of her teammates.

Both Sierra and O’Brien emphasized that external consultants are often critical in moments of tragedy, particularly when loss involves suicide. Internal staff and coaches are grieving as well. Outside support offers containment, neutrality, and guidance at times when decision-making feels overwhelming or impossible for those closest to the loss.

Why Institutions Must Prepare in Advance

One of the clearest takeaways from my discussion with Sierra and O’Brien is that sport systems too often wait until tragedy strikes to develop a response. Suicide response protocols must exist before they are needed, especially when emotional resources are limited and decision-making capacity is compromised.

Effective institutional responses include:

- Clear suicide and crisis response protocols.
- Flexible attendance and training expectations without retaliation.
- Multiple layers of support for athletes, coaches, and staff.
- Centering survivors and respecting varied grief timelines.

Routine with flexibility allows athletes to re-engage at their own pace. “If you can come, come. If you cannot, do not,” stated Sierra.

Carrying Forward What Matters

At the end of our conversation, Sierra reflected on her friend Katie Meyer’s capacity to love deeply and consistently show up for others. Her legacy challenges sport communities to do the same. “Soccer is a sport. It’s not that serious,” Sierra shared. She expressed hope that it will not take another loss for teams to recognize this truth.

Grief and loss will continue to enter sport spaces. The critical question is whether those environments are prepared to meet it with humanity, structure, and care. Mental health support for athletes is not only a performance asset. In moments of profound loss, it is life-saving.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 dial 988 for the 988 Suicide & Crisis Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-when-grief-enters-the-locker-room/

James Donaldson on Mental Health - Kids and Multiple Medications

A checklist of things you should know about adding and mixing medications

Writer: Caroline Miller

Clinical Expert: Ron J. Steingard, MD

- What can go wrong with multiple medications?
- Things to consider if your doctor is proposing multiple medications

When children have complex psychiatric symptoms, or aren’t responding adequately to a medication they are taking, doctors often recommend adding another medication.

Taking multiple psychoactive medications is called “polypharmacy.” And studies show that the number of children taking more than one medication is soaring. Combining medications can be effective when they’re prescribed and monitored carefully by a doctor expert in using them with children. But it’s important for parents to know the risks inherent in adding medications, and how to tell if you should be concerned about what a doctor is recommending.

What can go wrong with multiple medications?

The risk in combining medications is that they can interact in ways that increase unwanted or harmful side effects. Let’s say your child is prescribed one medication that causes mild sedation, and a second does the same thing. The result can be so much sedation that the child isn’t herself and can’t stay awake, explains Dr. Ron Steingard, a child and adolescent psychiatrist at the Child Mind Institute.

Another medication interaction that can be problematic is if two medications use the same metabolic pathway—the mechanism in the body that breaks them down and delivers them to the target. In some cases these medications, taken together, can overwhelm that pathway and create a buildup of medication, Dr. Steingard says, and that can cause the kind of side effects you’d see with a much higher dose of one of the meds.

Finally, there’s a risk that a child is prescribed multiple medications when he would benefit more from other supports, including behavioral treatments that have been shown to be effective for kids with many issues, including ADHD, anxiety and depression.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Things to consider if your doctor is proposing multiple medications

- Your clinician should have specific training and substantial experience prescribing and managing these medications in children, not just adults. That’s because children, whose nervous systems are still maturing, don’t always respond to medication the same way adults do.
- Medications for your child should not be prescribed by two different doctors, unless they are coordinating their care and communicating with each other closely. If there are two prescribing doctors on your child’s treatment team, one should take the lead in your child’s care, and the other act as consultant.
- Whenever a medication is introduced, your doctor should explain clearly what symptoms it is expected to treat, and how you will evaluate whether the medication is helping your child.
- With any new medication, your doctor should explain what side effects to watch for, as well as anything in a child’s mood or behavior that might indicate that she’s having a bad reaction.

Related: Side Effects ofADHD Medication

- If one medication isn’t working, or is barely helping, it can also be a sign that the disorder has been wrongly diagnosed. It’s important that your doctor reevaluate the diagnosis, and the treatment, before adding other medications.
- Before a child begins taking a second medication, other supports should be explored that might have lower risks and more benefit. The combination of a single medication and behavioral treatment should be carefully considered before more meds are added.
- If your child is experiencing side effects from one medication, it’s advisable to explore either cutting back on the dose or switching medications before adding another med to treat side effects.
- A child should not begin taking two or more medications at the same time. Meds should be introduced one at a time, enabling you and your doctor to monitor any side effects that occur, and to measure the effects on your child’s mood and behavior.
- If your child is taking more than one medication, dosages should be changed one at a time. It’s impossible to evaluate the effect of each change if more than one is altered.
- New medications should be added and dosage changes made when your child’s life and routine are as stable as possible. You want to avoid times like the start of a new school year, vacation, a move to a new home, or a medical illness.
- When you change or add medications, it’s important to let everyone on your child’s team know—including her teachers and other caregivers—and check in to find out how she is doing.
- When you evaluate the effects of a medication, it’s important to not assume that any change, for better or worse, is a result of the medication. Pay attention to other changes in your child’s life at home and at school that might affect her emotions and behavior.
https://standingabovethecrowd.com/james-donaldson-on-mental-health-kids-and-multiple-medications/

A checklist of things you should know about adding and mixing medications

Writer: Caroline Miller

Clinical Expert: Ron J. Steingard, MD

- What can go wrong with multiple medications?

- Things to consider if your doctor is proposing multiple medications

When children have complex psychiatric symptoms, or aren’t responding adequately to a medication they are taking, doctors often recommend adding another medication.

Taking multiple psychoactive medications is called “polypharmacy.” And studies show that the number of children taking more than one medication is soaring. Combining medications can be effective when they’re prescribed and monitored carefully by a doctor expert in using them with children. But it’s important for parents to know the risks inherent in adding medications, and how to tell if you should be concerned about what a doctor is recommending.

What can go wrong with multiple medications?

The risk in combining medications is that they can interact in ways that increase unwanted or harmful side effects. Let’s say your child is prescribed one medication that causes mild sedation, and a second does the same thing. The result can be so much sedation that the child isn’t herself and can’t stay awake, explains Dr. Ron Steingard, a child and adolescent psychiatrist at the Child Mind Institute.

Another medication interaction that can be problematic is if two medications use the same metabolic pathway—the mechanism in the body that breaks them down and delivers them to the target. In some cases these medications, taken together, can overwhelm that pathway and create a buildup of medication, Dr. Steingard says, and that can cause the kind of side effects you’d see with a much higher dose of one of the meds.

Finally, there’s a risk that a child is prescribed multiple medications when he would benefit more from other supports, including behavioral treatments that have been shown to be effective for kids with many issues, including ADHD, anxiety and depression.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Things to consider if your doctor is proposing multiple medications

- Your clinician should have specific training and substantial experience prescribing and managing these medications in children, not just adults. That’s because children, whose nervous systems are still maturing, don’t always respond to medication the same way adults do.

- Medications for your child should not be prescribed by two different doctors, unless they are coordinating their care and communicating with each other closely. If there are two prescribing doctors on your child’s treatment team, one should take the lead in your child’s care, and the other act as consultant.

- Whenever a medication is introduced, your doctor should explain clearly what symptoms it is expected to treat, and how you will evaluate whether the medication is helping your child.

- With any new medication, your doctor should explain what side effects to watch for, as well as anything in a child’s mood or behavior that might indicate that she’s having a bad reaction.

Related: Side Effects ofADHD Medication

- If one medication isn’t working, or is barely helping, it can also be a sign that the disorder has been wrongly diagnosed. It’s important that your doctor reevaluate the diagnosis, and the treatment, before adding other medications.

- Before a child begins taking a second medication, other supports should be explored that might have lower risks and more benefit. The combination of a single medication and behavioral treatment should be carefully considered before more meds are added.

- If your child is experiencing side effects from one medication, it’s advisable to explore either cutting back on the dose or switching medications before adding another med to treat side effects.

- A child should not begin taking two or more medications at the same time. Meds should be introduced one at a time, enabling you and your doctor to monitor any side effects that occur, and to measure the effects on your child’s mood and behavior.

- If your child is taking more than one medication, dosages should be changed one at a time. It’s impossible to evaluate the effect of each change if more than one is altered.

- New medications should be added and dosage changes made when your child’s life and routine are as stable as possible. You want to avoid times like the start of a new school year, vacation, a move to a new home, or a medical illness.

- When you change or add medications, it’s important to let everyone on your child’s team know—including her teachers and other caregivers—and check in to find out how she is doing.

- When you evaluate the effects of a medication, it’s important to not assume that any change, for better or worse, is a result of the medication. Pay attention to other changes in your child’s life at home and at school that might affect her emotions and behavior. https://standingabovethecrowd.com/?p=16415

James Donaldson on Mental Health - Trump administration reverses itself, restores $2 billion in mental health, substance abuse grants

Officials with SAMHSA directed the Montana health department to disregard the previous notification about grants being canceled.

Less than 24 hours after terminating about $2 billion in substance abuse and mental health grants nationwide, the Trump administration reversed itself and restored the funding.  

In Montana, state public health officials and advocacy groups told Montana Free Press Wednesday that local suicide prevention, addiction recovery and other mental health programs had lost millions of dollars in federal funding overnight. Many expressed shock and confusion after receiving a letter from the U.S. Substance Abuse and Mental Health Services Administration, also known as SAMHSA, which said grant money that had already been distributed would be clawed back.

In a Thursday morning email to the Montana state health department, however, officials with SAMHSA directed the state to “disregard” the previous notification canceling the grants. The email was shared with MTFP by a state health department spokesperson.

“he termination of your federal award, previously communicated on January 13, 2026, pursuant to 2 C.F.R. § 200.340(a)(4), is hereby rescinded,” the federal notice read. “Your award will remain active under its original terms and conditions. Please disregard the prior termination notice and continue program activities as outlined in your award agreement.”

Montana public health officials and advocacy groups said that local suicide prevention, addiction recovery and other mental health programs had lost millions of dollars in federal funding, citing a letter from the Trump administration announcing that grant money that had already been distributed would be clawed back.

The email did not provide an explanation for the sudden reversal. The state spokesperson, Jon Ebelt, told MTFP that the notices referred to two grants totalling roughly $2 million annually: the Partnerships for Success grant that aims to reduce youth substance misuse, and the Strengthening Families Initiative that works to prevent substance use disorders among pregnant and postpartum women.

Sandy Whittington works at the Lewis and Clark Public Health Department on Jan. 15, 2026, in Helena. On Tuesday, the Trump administration announced cuts to grant funding from the U.S. Substance Abuse and Mental Health Services Administration, also known as SAMHSA. Later that day, the administration reversed its decision. Credit: Lauren Miller, Montana Free Press, CatchLight Local/Report for America

Lewis and Clark Public Health Officer Drenda Niemann also confirmed to MTFP that her office received notice that the termination — which would have ended a $125,000 suicide prevention grant — had been rescinded. 

“We will continue to have the grant funds for suicide prevention work through September 2026 as originally planned,” she wrote in an email Thursday. 

Missoula County received notice that funding was being restored for the Systems of Care program, which expands mental health and supportive services for youth and families, according to communications manager Allison Franz. The county, Franz said, is still waiting to hear the status of a grant supporting the Frenchtown Community Coalition.

Casey Schreiner, chief strategy officer at Alluvion Health in Great Falls, said the organization received notice Wednesday that a $545,000 grant for a program addressing substance abuse disorder among young people was cut. Organization leaders began speaking with staff members on the program about potential impacts, but by Thursday, Alluvion received notice of the reversal. 

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

The Lewis and Clark Public Health Department is pictured Jan. 15, 2026, in Helena. On Tuesday, the Trump administration announced cuts to grant funding from the U.S. Substance Abuse and Mental Health Services Administration, also known as SAMHSA. Later that day, the administration reversed its decision. Credit: Lauren Miller, Montana Free Press, CatchLight Local/Report for America

“It does not go without hiccups because you still had to have some hard conversations,” Schreiner said. 

Johns Hopkins Center for Indigenous Health, which on Wednesday announced the cuts would cancel a substance use prevention project on the Rocky Boy’s Reservation, wrote in a Thursday statement it was “tremendously relieved” to see the terminations reversed. 

“Yesterday was such a challenging one for our staff and the families we serve,” the group wrote in a public Facebook post. 

Also on Thursday morning, a spokesperson for U.S. Sen. Steve Daines emailed a MTFP reporter a link to a POLITICO article stating that the grants had been reinstated, with no other context or statements.

Daines’ office had not responded to Wednesday’s inquiries from MTFP about the cuts. A spokesperson, Gabby Wiggins, did not reply to an additional request for a statement from Daines about the reversal or a question about whether the senator had communicated with the Trump administration about the grant cuts.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-trump-administration-reverses-itself-restores-2-billion-in-mental-health-substance-abuse-grants/