Stress at the heart of ailments

Fame comes at price with players going on the disabled list with anxiety problems. Is the pressure and stress of baseball causing them to succumb?

The Kansas City Royals starting pitcher Zack Greinke almost left the game for good three years ago while suffering from depression and social anxiety disorder.

Social anxiety disorder is the term the St Louis Cardinals used when they put shortstop Khalil Greene on the disabled list or DL. Joey Votto, the Cincinnati Reds slugger, is out because of stress-related issues linked to an inner ear infection that caused dizzy spells. These are not typical baseball ailments. But Greene and Votto are not the only players trying to overcome mental obstacles this season more so than pulled hamstrings, sprained ankles or sore arms.

The Detroit Tigers pitcher Dontrelle Willis missed the first six weeks with an anxiety disorder, similar to the problem that prompted the Kansas City Royals ace Zack Greinke to almost give up the game three years ago. Is the pressure and stress of baseball causing players to succumb? "The game can become all- encompassing," the Reds manager Dusty Baker said. "Day and night." Cardinals' general manager John Mozeliak said Greene was being treated for symptoms of anxiety but would not specify the type of treatment, citing privacy. Since going on the DL, Greene has been on the field for work-outs every day.

Votto, however, was not with the Reds this week. The first baseman, runner-up for National League rookie of the year last season, is getting time away from the game to sort out his troubles - despite a .357 batting average. A Reds' spokesman said the team were not releasing any information beyond the fact he was on the DL for stress-related issues - at Votto's request. Baker thinks serious stress is the price some must pay for reaching an elevated stage so quickly, set for life in their 20s while their less athletic peers climb the career ladder. "I've always said sports is one of the few professions where you reach your goal at a very young age," said Baker. "And then what?"

Then what? Success or failure on a daily basis with thousands cheering or jeering in the stands and untold masses watching from home. Seeing the reruns a dozen times, wincing as the slip-ups seem to get even more attention. Baker said baseball thoughts have a way of interrupting a sound sleep for managers and players. The result can be a loss of balance in life. Salaries have long been a sore spot for some, and as the numbers go up so do the complaints. "People push money in your face all the time, especially when you're losing," Baker said. "There's a lot more pressure, a lot more coverage, a lot more everything."

But Cardinals' manager Tony La Russa is not sure it is the entire answer, pointing out anxiety issues have been part of the game at least since he was hired as manager of the Chicago White Sox in 1979. Yes, there are more media outlets, more opinions, more tele-casts, ever-incessant highlights, but he said pressure has always been there. "As long as I've been around, the level of distractions have been significant," La Russa said. "Even when it's there a little, it's still a lot."

La Russa does his best to ignore the chatter, and urges his players to do the same, telling them the game is difficult enough without letting the criticism - or the praise - get into their heads. "I don't know who's paying attention to bloggers, I really don't," he said. "That's just part of the cost of doing business. "The point is, you take compliments the way you do criticism. You ignore them. You can't live with either one."

Votto went on the DL in late May while leading the National League with a .464 on-base percentage and ranking among the league leaders in several other categories. General manager Walt Jocketty said a schedule for Votto's return was unclear, and Baker was waiting for Votto to telephone. "He'll call," the manager said. "He's probably one of the most respectful players I've had - on and off the field. He's a great example."

Greene's poor 2008 season with San Diego ended prematurely when he punched a dugout wall and broke his left hand in July. The Cardinals acquired him counting on a rebound season more like 2007, when he had 27 homers and 97 RBIs, than '08, when he slumped to a .213 average with only 10 homers and 35 RBIs. Thus far, despite optimism off a productive spring, this season has been much like the last. The Cardinals were unaware of Greene's past anxiety issues when they made the deal, but Mozeliak hesitates to criticise San Diego for off-loading their problems. St Louis hope Greene can resume his career in mid-June.

* AP