Playing in the Premier League seems like a dream job. What can be so difficult, some fans say, about kicking a ball around, being paid huge amounts of money and accepting the adulation of thousands of people? The revelation of Aaron Lennon's mental health problems have shown that it is not so easy.
The 30-year-old Everton forward was hospitalised on May 2 under the Mental Health Act. It came as a shock to the football community. Unfortunately, under the surface, many players are struggling to deal with the pressures of performing at the highest level.
Figures released by the Professional Footballers' Association, the players' union, show the extent of the problem.
The PFA, which has provided a dedicated service to help with its members' well-being since 2012, has received more requests for help since Lennon's problems emerged. In the first five months of this year, 178 present and former players have sought counselling, more than in the whole of 2016. Last year, the figure was 160, 62 of whom were active players.
The culture of football makes it hard for players to admit their problems. It is nothing new, either. The pressure is intense. Jamie Carragher has spoken at length about how his primary emotion after winning matches was not elation, but short-lived relief. Footballers do not come much "tougher" than the former Liverpool defender, but even Carragher needed to talk to a sports psychologist in an attempt to ease his concerns.
Not everyone is so open. One Premier League player was at the height of his career and on a tour of the Far East. His depression was so extreme that he considered jumping from the window of his hotel; he had to be talked out of a suicide attempt. In an attempt to bring attention to the problem of depression, the player involved later decided to go public and tell his story to the newspaper where I was football editor. At the last moment, however, he had second thoughts and could not go through with it.
Other former players have been more forthcoming. Paul Tisdale, manager of Exeter City, spent much of his career dreading going to work. The 44-year-old played for Southampton for six years in the 1990s but made only 16 first-team appearances. As a fringe player, he was almost completely ignored by the management staff, particularly under Graeme Souness.
"I hated going to training," said Tisdale. "Every day was agony. It wears you down. It's worse when you're injured. You're made to feel worthless, like it's your fault." It was less man-management than psychological warfare and an approach that is not unusual in the game.
When Tisdale moved into management, he vowed that he would never act that way towards his players. "I try to include them, explain why they are not in the team and tell them what they need to do to achieve their ambitions." It's an approach that is working for him as Exeter have punched above their weight during the manager's 11 years at the club. This season they have reached the League Two playoffs, where they will face Carlisle United.
Tisdale is more enlightened than most. Managers are fixated on getting results. Most are unlikely to have even considered the effect of their methods on the mental health of the men in their charge.
Craig Johnston, who played for Liverpool in the 1980s, is one of the few former professionals who speaks articulately about the stresses of the game. The Australian, who struggled with self-esteem in a football environment, recalls that being shunted in and out of the team caused him to have a full-on breakdown. He had spent a game as an unused substitute, which meant he was required at training the next morning. Those who had participated in the match were allowed the next day off and were going out for the night as a team.
The entire system at Anfield was built to make those who did not play feel like outsiders. It reached the point where the midfielder could not take any more.
"I got home and my wife asked me how I was," he said. "I flipped. I started ripping my suit off, screaming and shouting 'I'm good enough for this team!' The suit was all ripped, my fingernails were bloody and I was standing there screaming."
Across Europe, Johnston was feted as part of the continent's best squad to the point where few people would have had much sympathy with his breakdown. If he had mentioned it at the club, it would have been seen as a sign of weakness or a butt for jokes.
The game is less Darwinian now, but football clubs are not easy workplaces. They are largely all-male environments where the lines between "leadership" and bullying are blurred. The same is true of the boundaries between "banter" and cruelty. The increasing use of psychologists by teams and PFA intervention is a welcome development.
Wealth, fame and adulation are no safeguard against depression, and football players are as prone to mental health concerns as any other section of society. Lennon's case is extreme and sad, but the saddest part might be that he is far from unusual.