In most cases, athletes with mild, or short-lived, symptoms do not require any specific investigation. Those who have more significant or refractory symptoms, however, may require some form of laboratory or radiological investigation. It is important to remember that other conditions can present with symptoms of depression. Depression is a relatively common complication of a number of different medical disorders. These include Cushing’s syndrome, hypothyroidism, hyperparathyroidism, pancreatic and lung cancer, myocardial infarction, Wilson’s disease and AIDS.

An association between depression and decreased ferritin levels before the occurrence of anaemia has also been reported. 4 Athletes with suspected depression should be tested for iron deficiency (ferritin), subclinical thyroid (thyroid-stimulating hormone, free T4) and vitamin D deficiency (vitamin D 25-OH).

Imaging studies

Imaging studies, like CT or MRI scans, are rarely useful.

Imaging is rarely needed. In general terms, scans alone cannot be used to diagnose a mental disorder. Cross-sectional imaging, like CT and MRI scans, may be useful when there is suspicion of an intracranial cause. Tumours and other space-occupying lesions can generally be readily seen on this type of imaging.