Ask the Doc: Dr. Benjamin on MMA, concussions and mental illness

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Laying down the beats

Rush Avatar


Joined:Jan 2007

In the wake up the recent deaths of MMA fighters Evan Tanner, Justin Levens and Justin Eilers, many fans are struggling to find a correlation.

While there may be none, some people, including researcher Chris Nowinski, see combat sports (and concussions) going hand-in-hand with depression and mental illness in later life.

In his latest “Ask the Doc” column, combat-sports specialist Dr. Johnny Benjamin discusses the topic, specifically as it relates to MMA, and why there’s so little relevant information available on it. He also gives two reasons why there’s so much controversy about trying to connect the two.

Q. Dave Meltzer recently wrote an article discussing three unrelated deaths of former UFC fighters; two of the fallen fighters were known to suffer from depression. Metzler notes Chris Nowinski’s studies correlating boxing to mental illness later in life. Many fans and fighters feel MMA is safer than boxing. MMA fighters are more likely to suffer a few concussive blows (i.e. knockouts) as opposed to a myriad of “padded” shots as in boxing. Many fights end without any substantial head shots. Is it fair to assume the same long-term consequences in MMA? Steve in Los Angeles

A. Steve, you are asking the million-dollar question.

Also, my hat is off to Dave Meltzer for even attempting to intelligently discuss this difficult subject. This and apparently many other topics are difficult for the MMA faithful to discuss reasonably without deteriorating into emotional outbursts, personal attacks and worse. Good articles are written to make intelligent readers think not to defame anyone or anything.

Do repeated blows to the head make MMA participants more likely to suffer with depression or other forms of mental illness later in life? It’s a great question and one that needs to be investigated and researched now rather than adopting a wait-and-see approach.

The current form of MMA is relatively early in its life cycle. We are talking less than 20 years. As major sports go, MMA is still in its infancy. Therefore, I would assume nothing with respect to the potential long-term health consequences. But as you’ve implied, I would learn a few things from the collective experience of other, more mature (older) contact and combat sports. It is also prudent to be proactive when it comes to fighter safety, since it is very difficult, if not impossible, to fully restore competitors’ mental health once it has traumatically been taken from them.

Retrospective (looking back after the deed is done) studies of professional athletes involved in boxing, football, soccer, hockey and rugby seem to suggest a link between repetitive blows to the head, concussions (MTBI, which is minor traumatic brain injury) and depression or dementia. This is a very controversial statement for at least two major reasons.

First, it is very difficult to prove a direct causal relationship. Did the accumulation of blows to the head directly cause permanent brain injury that led to depression or dementia? Or are the athletes that participate in these sports on the professional level more prone to depression to begin with? Do their inherent, aggressive, possibly somewhat antisocial personality traits allow them to achieve in these sports at a high level? Simply put, they may be a little crazy or unstable to begin with. That’s why they do so well in these contact and combat sports. (Absolutely no disrespect is intended to those that suffer with mental illness.)

Second, the powers that govern these major sports fear the cost associated with acknowledging a relationship between participation in these sports and subsequent dementia and/or depression. Simply put, if the sport caused it, somebody is going to have to pay for it. Forget lawsuits and punitive damages (which will most certainly come); just the cost of long-term care would be staggering. No one is prepared to pay that without a serious fight.

Professional MMA fighters should assume nothing and be prepared for everything. When your favorite fighters’ careers are over and no one is any longer screaming their names, paying them sponsorship fees and buying their pay-per-view appearances, who is going to pay their medical expenses and provide assistance to their often forgotten caregivers? Your heroes have families too.

Again, Steve, it’s a great question but not one anyone can answer definitively at this time.

Dr. Johnny Benjamin is MMAjunkie.com’s medical columnist and consultant and a noted combat-sports specialist. He was also recently appointed to the ABC’s medical advisory team and will help review and refine the unified rules of MMA. Dr. Benjamin writes an “Ask the Doc” column every two weeks for MMAjunkie.com. To submit a question for a future column, email him at askthedoc [AT] mmajunkie.com, or share your questions and thoughts in the comments section below. You can find Dr. Benjamin online at www.drjohnnybenjamin.com, and you can read his other sports-related articles at blog.drjohnnybenjamin.com.

Check out more UFC News at MMAjunkie.com. This story originally appeared on MMAjunkie.com and is syndicated on Yahoo! Sports as part of a content-partnership deal between the two sites.

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Last edited 1/11/09 6:34AM server time by Rush
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Post #1   1/11/09 6:33:47AM   


Heavyweight Champ

Aether Avatar


Joined:Apr 2007
I re-read it after I posted and he basically said what I said towards the end.

I think that in all 3 of these cases it's just a result of people with pre-existing emotional problems, although of course brain damage has to be a concern for any athlete in combat sports. I have to agree that a sport centered around giving and receiving physical damage to an opponent has to attract more competitors with emotional problems than more team and objective oriented sports.

Of course it's not like all fighters are ****** up or that the ones who are simply like to hurt people, but it's sort of undeniable that any combat sport is inherently violent, and people with emotional issues are far more likely to engage in and enjoy violent activity.

Last edited 1/11/09 7:50AM server time by aether
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Post #2   1/11/09 7:41:57AM   


Go ahead, MOD my day

Jackelope Avatar


Joined:Jan 2007
I love how the writer feels like he has to explain what "retrospective" means. Why not just word it differently if you're going to go through the trouble of typing out an explanation?

Anyway, I do agree that people with certain issues will be drawn to competing in this sport. At the same time, I feel that there are plenty of competitors who do not have those issues. Does this guy really think Lyoto Machida has personal problems like anger or depression? Or Fedor? Or Couture? Pick any number of top level MMA participants who are humble, respectful, and intelligent people. (You know, intelligence- people who know what "retrospective" means without having to have it explained to them )

Anyway, I didn't really like the article. But who the hell am I? LOL

Post #3   1/11/09 12:07:29PM   


MMA Regular

HumanTarget Avatar

Joined:Apr 2008
Im not a doctor but I can break it down on what needs to be said in fewer words. Listen, if you are in any contact sport that can get pretty rough there is a chance for all kinds of head injuries and mental illnesses. Some are safer than others but MMA is still dangerous and people know what they are getting into when they are stepping in that cage. Its their own choice so who gives a shit...

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Post #4   1/11/09 1:41:07PM   


Standup Guy

motorboatensob Avatar

Joined:Jan 2007
If that was the case then all boxers would be down and out and killing themselves and going crazy. I don't buy it sounds like someone else just trying to give MMA a bad name. I have said it before I would rather get hit one good time and go out then 250 shots at half as hard then get 10 sec to recover and get hit some more.

Post #5   1/11/09 3:37:33PM