Will Heininger was a 295-pound defensive tackle for the University of Michigan by the end of his freshman year when he understood he had a large trouble: He was seriously depressed.

Surrounded by a collegiate culture of superathletes in a sport known for its toughness, Heininger was afraid to let anyone know how desperate he was.

“I had consuming thoughts from the time I woke up to the time I went to bed,” he said. “My parents had gotten divorced the year before, we were in a new house and nothing looked joyful. Nothing looked rewarding.”

For a long time, Heininger was not unable to hide his depression. “I was functioning at this type of high amount, going to football workouts, going to work and going to class — keeping it all in,” he said. “Then I broke down.”

First, Heininger opened up to his mom and she helped him locate a therapist. However, the relationship was not a good healthy, he said. The therapist recommended that Heininger stop football, the only thing he really cared about at the time. So Heininger decided to try to survive on his own.

Not long at soccer practice, he abruptly became totally overwhelmed. His athletic trainer detected something was wrong, Heininger recalled.

He was brought by the athletic trainer to a therapist who was part of the university’s fit program.

“I hadn’t even known she was there,” Heininger said.

He sat down with her and began to cry. “That was a big turning point for me. It began the healing process, one of the hardest things I Have ever needed to go through,” he said.

Daily treatment was started by Heininger and was given drugs to help treat the depression. He slowly started to open around his fellow athletes and friends. Now, five years afterwards, he has overcome his depression, and works in the financial services business in Chicago.

Heininger is not alone. The National Athletic Trainers’ Association (NATA) estimates that about one in four U.S. youths fulfills the standards for having a mental-health disorder.

To help professionals working with school athletes recognize and refer students with psychological issues, the NATA lately published guidelines in the Journal of Athletic Training.

The guidelines emphasize the need to take away the stigma of mental health issues and educate folks working with student-athletes how to see emotional anxieties early and get the help that is necessary.

“We are addressing a public health issue, and when we can shed more light on what athletes go through we can help educate the public,” said Timothy Neal, the composer of the guidelines and the assistant director for sports medicine at Syracuse University.

Neal said the vast majority of schools need to develop plans for coping with mental health problems among student-athletes.

“There are unique stressors for student-athletes,” Neal said. “They’re compelled to exercise, miss holidays, miss summer vacations, as well as their failures and successes — in athletics and in school — stand out.” Additionally they spend long hours together with the exact same group of teammates, he added.

The culture of sports also demands rigor and a certain toughness which makes it hard for students to feel comfortable acknowledging they’ve issues or weaknesses.

“We have to de-stigmatize mental health issues,” Neal said. “I tell sportsmen it’s normal to have these sorts of scenarios; in the event that you injure your knee you’re going to attend a specialist. In the exact same way, an athletic trainer can refer you to a mental health professional to find out if you will need assistance.”

That “culture of resistance” was noted in a report released last month from the U.S. Institute of Medicine. Despite signs that concussions cause some degree of brain injury, many sportsmen don’t report their head injuries.

Although football-related concussions have really been in the news recently, mental health issues among student-athletes aren’t as well understood, Neal said. The threat of mental health issues is higher among sportsmen than is the possibility of having a concussion, he explained.

“Most universities have four to five times more students receiving attention for mental issues than those receiving attention for concussions,” he said.

In treating student athletes for mental health issues, Neal said athletic trainers and counselors should comprehend that athletes are naturally target-oriented.

“Tell them they’ll possess a more purposeful life if they get help,” he said.