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Throughout my long career in sports medicine, I have met many sports psychologists. Some worked with national teams, some with clubs, and others individually with elite athletes. With sports psychiatrists, however, the situation was completely different. There were very few of them.

This has always been one of the paradoxes of our sport. We had orthopaedic surgeons, cardiologists, physiologists, physiotherapists, nutritionists and psychologists. We measured lactate, VO₂max, body fat percentage, strength, speed and reaction time. But when an athlete could no longer sleep, began to lose concentration, became overwhelmed by anxiety, could no longer step onto the field with the same sense of confidence, or lost interest in something that had represented their entire life, the system often did not know where to send them. Because a sports psychologist and a sports psychiatrist are not the same thing.

Sports psychology plays an enormous role in motivation, concentration, stress management, self-confidence and mental preparation. Clinical psychologists and psychotherapists also have an important role in treating mental health problems. But a psychiatrist is a physician. A psychiatrist must be able to recognise when the problem is no longer merely an issue of sporting performance or mental preparation, but a medical condition requiring clinical diagnosis and, when necessary, psychotherapy, pharmacotherapy, or a combination of different approaches.

This is precisely why sports psychiatry has gained a much clearer position within modern medicine in recent years. The first international consensus statement on sports psychiatry was published in 2024, defining it as a distinct field concerned with mental health and mental disorders in competitive and elite sport, as well as with the use of sport and physical activity in the prevention and treatment of mental disorders. [1]

In other words, it is a discipline we have been missing.

Champions Can Be Ill Too

There is still an almost romanticised image of the elite athlete.

If someone gets up at six in the morning, trains twice a day, endures pain, injuries, defeats, selection processes and years of sacrifice, and then walks out in front of tens of thousands of people to decide, within a matter of seconds, the result for which they have been preparing their whole life, then surely that person must be extraordinarily mentally strong.

And they are. But mental strength does not provide immunity against mental illness. A major systematic review conducted in the context of the International Olympic Committee showed that the prevalence of mental health symptoms and disorders among active elite athletes varies depending on the condition studied, ranging from approximately 19% to around 34% for anxiety and depression. [2]

Depressive and anxiety symptoms, sleep disorders, eating problems, alcohol and substance misuse, burnout, concentration and attention difficulties, reactions to injury, performance pressure and problems associated with retirement from sport are all seen in elite athletes. For this very reason, the IOC has developed specific tools for the early recognition of mental health problems in athletes. [3]

And there is another problem. Athletes are trained to endure. Sometimes they become so good at enduring that they continue to do so even when they should be asking for help.

Research on help-seeking among athletes shows that stigma remains one of the most important barriers. The fear of being seen as weak, unreliable or somehow unfit for elite sport may prevent them from speaking openly about what is happening to them.

I personally know athletes who take antidepressant medication while practically no one around them is aware of it. Not because they have done anything wrong. But because in sport, a broken bone is accepted as an injury, while depression is still too often regarded as weakness.

If Michael Phelps Could Speak About It, Why Shouldn’t Anyone Else?

Perhaps this is why what Michael Phelps did was so important.

The most successful Olympian in history has spoken openly about serious periods of depression, including difficulties that emerged after the Olympic Games. Instead of preserving the image of the invincible champion at all costs, he chose to talk publicly about mental health and about the need to seek help.

That did not diminish his 23 Olympic gold medals. Quite the opposite. Perhaps it was then that he demonstrated another kind of courage. Because it is much easier to show the world a medal than to tell the world that you are not well.

We Tried

For all these reasons, over the years I also tried to help create a core group of professionals who would be available to our athletes. One of the people who became most involved was Dr Đorđe Ćurčić. Unfortunately, his departure for Germany interrupted something that had only just begun to take shape. Dr Đorđe Koldžić, who now lives in the United States, also left an important mark.

Of course, modern technology has made it possible to speak with specialists on another continent. Telemedicine exists. Online psychotherapy exists. But sometimes an athlete needs to be looked directly in the eyes.

Someone needs to sit beside them when they suffer an injury only a few months before the Olympic Games. Someone needs to talk to them when they lose their place on the national team. Someone needs to observe not only the way they speak, but also the way they remain silent.

That is why having a specialist physically present remains irreplaceable.

And this is where the story of Dr Marina Lukić begins.

The Girl Who Wanted to Work in Sport

From a very young age, Marina Lukić dreamed of a career connected with sport. At one point, she even wanted to become a sports journalist.

Life had a different plan.

When she was 15 years old, on 30 May 1999, she was on the bridge in Varvarin during the NATO bombing. She was seriously injured, while her best friend, Sanja Milenković, lost her life. Marina survived.

I do not believe that events like these should be romanticised, nor should tragedy automatically be used to explain someone’s later success. Trauma does not necessarily make people stronger. It can damage them profoundly. But there is something else in Marina’s story that matters.

Despite everything, she continued her education, graduated from the Faculty of Medicine in Belgrade and began her specialist training in psychiatry and psychotherapy in Germany. She worked in several German psychiatric clinics and, after years of clinical experience, decided in 2023 to return to Belgrade.

Today she is a member of the German Society for Sports Psychiatry, DGSPP, and the International Society for Sports Psychiatry, ISSP, and she also works with athletes.

And so, many years later, her childhood wish to remain close to sport came true in a way she probably could never have imagined. She did not become a sports journalist.

She became someone who can help an athlete precisely when the public, the coach, journalists, and sometimes even the athlete’s own family fail to see that help is needed.

Then She Decided Not Just to Treat Individuals

For me, perhaps the most interesting part comes next.

Marina did not simply decide to see athletes in her consulting room.

She decided to build a system.

That is how MindUp 2026 – Mental Health in Sport: Science, Performance and Wellbeing was created. The conference will be held on 12 September at the Institute of Sport and Sports Medicine of the Republic of Serbia in Belgrade.

The organisers describe it as the first conference in Serbia with international participation devoted exclusively to mental health in sport.

More importantly, attendance is free of charge.

At a time when the conference industry has become a serious business, when participants often pay registration fees, workshop fees and even additional fees for certificates, someone has decided to organise a professional meeting and simply say:

Come and learn. You do not have to pay anything.

And the programme has not been created merely to fill a timetable.

Experts in sports psychiatry and sports psychology are coming to Belgrade, including Prof. Dr Alexander Schorb from Austria, while the programme also brings together sports psychologists, psychiatrists, coaches and elite athletes.

Among the participants, for example, is Dejan Savić, one of the most successful water polo coaches in the history of Serbian sport.

This is extremely important.

The mental health of an athlete cannot be the responsibility of the psychiatrist alone.

Nor of the psychologist alone.

Nor of the sports physician alone.

What is needed is a network.

Coming Back

In recent years, we have constantly talked about educated young people leaving Serbia. We often say that every year a population equivalent to an entire town leaves the country. That is why Marina’s decision may be just as important as the conference she is organising. Because she did the opposite.

She left, learned, acquired clinical experience in a well-organised medical system — and then came back. And she did not simply say: now I will charge well for the expertise I have acquired.

What she essentially said was: Let us build something.

And let us make it free.

For athletes, physicians, psychologists, coaches and all those who tomorrow may be able to recognise that something is wrong with an athlete before the problem becomes serious.

I do not know whether one conference can change our sport. It probably cannot. But it can create a core group of people who will start talking to one another.

It can connect the psychiatrist, the psychologist, the sports physician and the coach. It can teach a young athlete that going to a psychiatrist is not an admission of weakness. And perhaps it can teach the rest of us something even simpler.

A champion is not a machine.

An elite athlete can have a perfect heart. A fascinating VO₂max. A body without a gram of excess fat. Muscles capable of enduring things that most of us cannot even imagine. And yet that person may still not be well.

That is why, to me, MindUp is not simply another conference.

And Marina Lukić is not interesting merely because she returned from Germany, because she became a psychiatrist, or because she survived an event that changed her life. She is interesting because she decided to turn her knowledge into something that might remain after her and benefit others.

At a time when we constantly hear how many people are leaving, it is good, at least occasionally, to tell the story of someone who came back. And who is now trying to create a reason for others, perhaps one day, to come back as well.

♥

Dr Marina Lukić i zašto nam je potrebna sportska psihijatrija

Tokom dugogodišnjeg rada u sportskoj medicini upoznao sam mnogo sportskih psihologa. Neki su radili sa reprezentacijama, neki sa klubovima, neki individualno sa vrhunskim sportistima. Sa sportskim psihijatrima bilo je potpuno drugačije. Njih je bilo vrlo malo.

I to je oduvek bio jedan od paradoksa našeg sporta. Imali smo ortopede, kardiologe, fiziologe, fizioterapeute, nutricioniste i psihologe. Merili smo laktate, VO₂max, procenat masti, snagu, brzinu i vreme reakcije. A kada sportista više nije mogao da spava, kada bi počeo da gubi koncentraciju, kada bi ga preplavljivala anksioznost, kada više nije mogao da izađe na teren sa istim osećanjem sigurnosti ili kada bi izgubio interesovanje za nešto što je predstavljalo ceo njegov život – sistem često nije znao kome da ga pošalje. Jer sportski psiholog i sportski psihijatar nisu isto.

Psihologija sporta ima ogromnu ulogu u motivaciji, koncentraciji, kontroli stresa, samopouzdanju i mentalnoj pripremi. Klinički psiholozi i psihoterapeuti imaju važnu ulogu i u lečenju mentalnih problema. Ali psihijatar je lekar. On mora da prepozna kada problem više nije samo pitanje sportske forme ili mentalne pripreme, već zdravstveno stanje koje zahteva medicinsku dijagnostiku i, kada je potrebno, psihoterapiju, farmakoterapiju ili kombinaciju različitih pristupa.

Upravo je zato sportska psihijatrija poslednjih godina dobila mnogo jasnije mesto u svetskoj medicini. Prvi međunarodni konsenzus o sportskoj psihijatriji objavljen je 2024. godine i definiše je kao posebnu oblast koja obuhvata mentalno zdravlje i mentalne poremećaje u takmičarskom i vrhunskom sportu, ali i primenu sporta i fizičke aktivnosti u prevenciji i lečenju mentalnih poremećaja. [1]

Drugim rečima – radi se o disciplini koja nam je nedostajala.

Šampioni takođe mogu da budu bolesni

Još uvek postoji gotovo romantična predstava o vrhunskom sportisti. Ako neko ustaje u šest ujutru, trenira dva puta dnevno, izdrži bol, povrede, poraze, selekcije i godine odricanja i na kraju izađe pred desetine hiljada ljudi da bi u nekoliko sekundi odlučio rezultat za koji se pripremao ceo život – onda mora da bude psihički neverovatno jak. Jeste. Ali psihička snaga nije imunitet na psihičku bolest.

Veliki sistematski pregled urađen za Međunarodni olimpijski komitet pokazao je da učestalost simptoma i poremećaja mentalnog zdravlja kod aktivnih elitnih sportista, zavisno od problema koji se ispituje, ide od oko 19%, pa do približno 34% za anksioznost i depresiju. [2]

Javljaju se depresivni i anksiozni simptomi, poremećaji spavanja, problemi sa ishranom, zloupotreba alkohola i drugih supstanci, burnout, problemi koncentracije i pažnje, reakcije na povrede, pritisak rezultata i problemi koji nastaju kada se karijera završi. IOC je upravo zbog toga razvio posebne alate za rano prepoznavanje mentalnih problema kod sportista. [3]

A postoji još jedan problem. Sportista je naučen da izdrži. Ponekad toliko dobro da izdrži i onda kada bi trebalo da zatraži pomoć. Istraživanja o traženju stručne pomoći među sportistima pokazuju da je stigma jedna od najvažnijih prepreka. Strah da će biti doživljeni kao slabi, nepouzdani ili nedovoljno sposobni za vrhunski sport može da ih spreči da kažu šta im se događa.

Znam i sam sportiste koji koriste antidepresivnu terapiju, a da o tome praktično niko oko njih ne zna. Ne zato što su uradili nešto pogrešno. Nego zato što se slomljena kost u sportu prihvata kao povreda, dok se depresija još uvek neretko doživljava kao slabost.

Ako je mogao Felps, zašto ne bi mogao bilo ko?

Možda je zato toliko važno ono što je uradio Majkl Felps. Najuspešniji olimpijac u istoriji otvoreno je govorio o ozbiljnim periodima depresije, uključujući probleme koji su se pojavljivali posle Olimpijskih igara. Umesto da sliku nepobedivog šampiona čuva po svaku cenu, odlučio je da govori o mentalnom zdravlju i potrebi da čovek zatraži pomoć.

To nije umanjilo njegove 23 olimpijske zlatne medalje. Naprotiv. Možda je upravo tada pokazao jednu drugu vrstu hrabrosti. Jer mnogo je jednostavnije pokazati svetu medalju nego reći da vam nije dobro.

Mi smo pokušavali

Zbog svega toga sam i sam tokom godina pokušavao da pomognem da se napravi jezgro stručnjaka koji bi bili dostupni našim sportistima. Jedan od ljudi koji se najviše uključio bio je dr Đorđe Ćurčić. Nažalost, njegov odlazak u Nemačku prekinuo je nešto što je tek počinjalo da dobija smisao. Važan trag ostavio je i dr Đorđe Koldžić, koji danas živi u Sjedinjenim Američkim Državama.

Naravno, savremena tehnologija je omogućila da razgovaramo sa stručnjacima sa drugog kontinenta. Postoji telemedicina. Postoji onlajn psihoterapija. Ali sportistu ponekad treba pogledati u oči. Treba sedeti pored njega kada se povredio nekoliko meseci pre Olimpijskih igara. Razgovarati kada je izgubio mesto u reprezentaciji. Videti način na koji govori, ali i način na koji ćuti. Zbog toga je prisustvo stručnjaka ovde nezamenljivo.

I tu počinje priča o dr Marini Lukić.

Devojčica koja je želela sport

Marina Lukić je kao veoma mlada maštala o poslu povezanom sa sportom – čak o tome da postane sportski novinar.

Život je imao drugačiji plan. Kada je imala 15 godina, 30. maja 1999. godine, nalazila se na Varvarinskom mostu tokom bombardovanja. Bila je teško povređena, a njena najbolja drugarica Sanja Milenković izgubila je život. Marina je preživela.

Ne mislim da takve događaje treba romantizovati niti od tragedije praviti obavezno objašnjenje nečijeg kasnijeg uspeha. Trauma ne mora čoveka da učini jačim. Nekoga može ozbiljno da ošteti. Ali u Marininoj priči važno je nešto drugo.

Posle svega nastavila je školovanje, završila Medicinski fakultet u Beogradu, a specijalizaciju iz psihijatrije i psihoterapije započela je u Nemačkoj. Radila je u više nemačkih psihijatrijskih klinika, a posle višegodišnjeg kliničkog iskustva 2023. godine odlučila je da se vrati u Beograd. Danas je član nemačkog društva za sportsku psihijatriju DGSPP i International Society for Sports Psychiatry – ISSP, a radi i sa sportistima.

I tako se, posle mnogo godina, njena dečja želja da bude blizu sporta ostvarila na način koji verovatno nije mogla da zamisli. Nije postala sportski novinar. Postala je neko ko sportisti može da pomogne onda kada publika, trener, novinari, pa ponekad ni njegova porodica ne vide da mu je pomoć potrebna.

A onda je odlučila da ne leči samo pojedince Meni je možda najzanimljiviji sledeći korak. Marina nije odlučila samo da prima sportiste u ordinaciji. Odlučila je da napravi sistem.

Tako je nastao MindUp 2026 – Mentalno zdravlje u sportu: nauka, performans i wellbeing, koji će 12. septembra biti održan u Zavodu za sport i medicinu sporta Republike Srbije u Beogradu. Organizatori ga predstavljaju kao prvu konferenciju sa međunarodnim učešćem u Srbiji posvećenu isključivo mentalnom zdravlju u sportu.

Još važnije – učešće je besplatno. U vremenu u kome je kongresna industrija postala ozbiljan biznis, gde se neretko plaćaju i kotizacija i radionice i sertifikati, neko je odlučio da napravi stručni skup i kaže: dođite da učimo, ne morate ništa da platite.

A program nije napravljen samo da bi se ispunila satnica. U Beograd dolaze stručnjaci iz oblasti sportske psihijatrije i psihologije, među njima i prof. dr Alexander Schorb iz Austrije, dok program uključuje sportske psihologe, psihijatre, trenere i vrhunske sportiste. Među učesnicima je, na primer, i jedan od najuspešnijih vaterpolo trenera našeg sporta Dejan Savić.

To je veoma važno. Mentalno zdravlje sportiste ne može da bude posao samo psihijatra. Niti samo psihologa. Niti samo sportskog lekara. Potrebna je mreža.

Povratak

Poslednjih godina neprestano govorimo o odlasku obrazovanih mladih ljudi iz Srbije. Često kažemo da iz zemlje odlaze čitavi gradovi. Zbog toga mi se Marinina odluka čini možda jednako važnom kao i konferencija koju organizuje. Jer ona je uradila suprotno.

Otišla je, naučila, stekla kliničko iskustvo u uređenom medicinskom sistemu – i vratila se. A onda nije rekla samo: sada ću svoje znanje dobro naplatiti. Rekla je, u suštini: hajde da nešto napravimo. Besplatno.

Za sportiste, lekare, psihologe, trenere i ljude koji će sutra možda prepoznati problem kod nekoga pre nego što postane ozbiljan. Ne znam da li jedna konferencija može da promeni naš sport. Verovatno ne može.

Ali može da napravi jezgro ljudi koji će početi međusobno da razgovaraju. Može da poveže psihijatra, psihologa, sportskog lekara i trenera. Može da nauči mladog sportistu da odlazak psihijatru nije priznanje slabosti.

A možda može da nauči i nas ostale nešto još jednostavnije. Šampion nije robot. Srce vrhunskog sportiste može biti savršeno. VO₂max fascinantan. Telo bez grama viška masti. Mišići sposobni da izdrže ono što većina nas ne može ni da zamisli. A da čoveku ipak nije dobro.

Zbog toga mi se čini da MindUp nije samo još jedna konferencija. A Marina Lukić nije zanimljiva samo zato što se vratila iz Nemačke, što je postala psihijatar ili zato što je preživela događaj koji joj je promenio život. Zanimljiva je zato što je odlučila da od svog znanja napravi nešto što će ostati i drugima.

U vremenu u kome često slušamo koliko ljudi odlazi, lepo je makar ponekad napisati priču o nekome ko se vratio. I ko pokušava da napravi razlog da možda jednoga dana i drugi urade isto.

References

1. Claussen MC, Currie A, Koh Boon Yau E, Nishida M, Martínez V, Burger J, Creado S, Schorb A, Nicola RF, Pattojoshi A, Menon R, Glick I, Whitehead J, Edwards C, Baron D. First international consensus statement on sports psychiatry. Scand J Med Sci Sports. 2024 Apr;34(4):e14627. doi: 10.1111/sms.14627. PMID: 38610076; PMCID: PMC12810445.
2. Gouttebarge V, Castaldelli-Maia JM, Gorczynski P, Hainline B, Hitchcock ME, Kerkhoffs GM, Rice SM, Reardon CL. Occurrence of mental health symptoms and disorders in current and former elite athletes: a systematic review and meta-analysis. Br J Sports Med. 2019 Jun;53(11):700–706. doi: 10.1136/bjsports-2019-100671. PMID: 31097451; PMCID: PMC6579497.
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4. Gouttebarge V, Bindra A, Blauwet C, Campriani N, Currie A, Engebretsen L, Hainline B, Kroshus E, McDuff D, Mountjoy M, Purcell R, Putukian M, Reardon CL, Rice SM, Budgett R. International Olympic Committee (IOC) Sport Mental Health Assessment Tool 1 (SMHAT-1) and Sport Mental Health Recognition Tool 1 (SMHRT-1): towards better support of athletes’ mental health. Br J Sports Med. 2021 Jan;55(1):30–37. doi: 10.1136/bjsports-2020-102411. Epub 2020 Sep 18. PMID: 32948518; PMCID: PMC7788187.
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