IN THE BIG LEAGUES TOO!!

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Understanding anxiety issues isn't easy

Bio Ken Rosenthal has been the senior baseball writer for FOXSports.com since August 2005. He appears weekly on MLB on FOX. Follow him on Twitter.

Want to know what it’s like for a baseball player suffering from anxiety disorder?

There is no one answer, no all-encompassing connection between players who recently have dealt with the condition, players as prominent as Brewers right-hander Zack Greinke and Reds first baseman Joey. But when Dodgers trainer Stan Conte talks about the plight of left-hander Hong Chih-Kuo, who recently spent more than a month on the disabled list with anxiety disorder, the effect is nothing short of chilling.

Kuo, who turns 30 next month, is one of the game’s top left-handed relievers when healthy. But he has undergone four elbow operations and battled the “yips” — an inability to throw the ball with accuracy — in 2009. In early May, during a series in Pittsburgh, he told Conte he no longer could pitch due to his anxiety.

Conte, after receiving permission from Kuo, spoke at length about the pitcher’s condition.

“The analogy I use is if you’re scared of small places, you’re claustrophobic and you’re scared of snakes. But you’re really good at catching those snakes, and they ask you every day to walk into a small, closed window-less room to grab them,” Conte said. “They bite you. It hurts. But you’re the best in the world at doing it and they pay you a lot of money to do it. And every day it becomes worse and worse. It makes you believe you can’t do it, not for glory, not for fame, not for money.

“That’s how he was in Pittsburgh. He was like a guy in water who couldn’t float and begging to get out of the water. It was very emotional, the way he was begging us not to put him out there.”

In ’09, Kuo became unnerved by pitching in exposed bullpens in foul territory, such as the ones at Wrigley Field in Chicago and AT&T Park in San Francisco. During his rehabilitation, Conte sent him only to minor-league ballparks that had “closed” bullpens so that Kuo could warm up comfortably. Eventually, Kuo resumed pitching in open bullpens too.

Even today, mental-health conditions are difficult for many to grasp and interpreted by some as a form of weakness.

Conte, to the contrary, lauds Kuo’s mental toughness.

“He’s gone through two Tommy Johns, four elbow surgeries,” Conte said. “His elbow hurts on every pitch, has for years. Most people would have stopped. But he found ways to pitch through that pain, perform at a high level. That takes a lot of mental toughness.

“He comes in at 11 or 12 (for a 7 o’clock game). He’ll start working out, work all the way through batting practice. During games, he’s in the bullpen, throwing the ball against the wall. You’ll see him do that at Dodger Stadium. And then he’ll do a whole workout for an hour after the game.

“He’s doing everything he can possibly do every day. I know there are so many stories about guys who work hard. But this guy actually does it every day. Then to have this (anxiety) problem, fight back in 2009, have an unbelievable season in 2010 and then fall off again . . .

“What impressed me more than anything else is that he could have said my elbow hurts, I can’t pitch anymore. I asked him, ‘What do you want me to do as far as the DL? Just use the elbow?’ He said no, just tell them I have this anxiety problem. He put it out there.

“And then once again, to climb back up the mountain . . . to me, that shows how mentally tough he is. That’s the epitome of someone who loves the game and doesn’t want to quit.”

I first talked with Conte about Kuo last week at Dodger Stadium. We spoke again by phone Saturday night after Kuo granted him permission to talk on the record. Later that night, Conte sent me an email with one final thought.

“This is not something that goes away,” Conte said. “Kuo deals with this constantly, on every pitch, in the bullpen and in the games, whether he is doing well or not. It is not an injury that heals and is only a memory.

“Some days it is more tolerable than others but he has to control it and learn how to cope for the rest of his career. He knows this and at times it wears him down mentally. That is why I think he is so mentally tough.”