I once read, yet have since struggled to find (I’m actually hoping I made it up in a fugue state), an archetypal story/analogy that always makes me think about the issue of concussion and depression in boxing. It goes a little bit like this: a group of children are killing lice on a temple’s steps, when approached and asked what will happen to the rest of the lice, one of the children says: “We kill the ones we see, the ones we don’t see we take away with us”.

You can see a cut, muscle tears and broken bones can be x-rayed then the proof posted online—to be almost immediately discounted or scoffed at—and there are also lots of other physical effects of boxing that we can see with our own eyes.

Just like the lice mentioned above, though, concussion is something that fighters take away with them even in fights that they win. It is the unseen and always present risk in a sport that relies and thrives on blunt force trauma. Sometimes we bear witness to it—KOs happen and bleeding on the brain is a side effect of the nature of the sport—yet for the most part the mini-concussions and effects of blows to the head tend to remain undisclosed unless there is an in-ring accident that brings an injury to our attention.

When I was doing an article on depression in boxing a few years ago, I asked Robert Smith if the BBBoC had considered the link between concussion and depression, and how it can lead to other forms of mental illness. Smith told me that he did not think there was a link, which is only natural as explicitly acknowledging it raises the hardest type of questions, the ones that we have to direct towards ourselves.

The link between concussion and depression in athletes, both amateur and professional, has been discussed widely for well over a decade now. Indeed, Will Smith recently starred in a film—admittedly an Oscar-wanking one—about the issue, one in which his crusading doctor fights to get people to acknowledge what is basically a truism: getting concussed in any way shape or form is bad for you. So why did it take so long for it to become a real, much-discussed, issue?

Think about it, and across any sport, and the answer becomes clear: accepting the link means you also have to accept some culpability. That applies to us fans, too, as we enjoy a form of entertainment that has huge risks, long-term health implications and has been linked to mental health issues since the classic article ‘Punch Drunk’ by Dr. Harrison Stanford Martland (Martland HS (1928). “Punch Drunk”. Journal of the American Medical Association. 91 (15): 1103–1107. doi:10.1001/jama.1928.02700150029009)

Don’t worry, this is not a hand-wringing ‘Road to Damascus’ style “I’m emoting here, I’m EMOTING here” piece about how I’ve seen the light and it has spotlighted the brutality of the sport. I’m not about to wonder aloud if I should feel guilty for following it. In truth, writers only tend to do that on the night or the morning after a tragedy; days when you have to emote, and, crucially, be seen to be emoting harder than anyone else.

This approach is insulting to the boxers themselves. They have an urge or desire to fight, they do it professionally and enter into it knowing the risks better than anyone else. It isn’t fair on them to muse about walking away from boxing just because someone got hurt in a fist fight. It is time for a dose of reality: fighters get hurt all the time, even when they win, and are breaking themselves down in training week in and week out—don’t even get them started on dieting.

I don’t feel the need to feign disgust at media savvy moments, I feel it all the time, especially as I get older and see the impact boxing has had on people who I watched live throughout their careers. I feel ashamed when I look at what boxing has done to some of the fighters I’ve covered. Boxing is an unusual sport, the people involved even more so, and we find it hard to criticise certain aspects of it because so many people hate it and want to see it banned (that will never happen, more on that next week). We close ranks yet we can no longer deny what the rest of the world now knows: depression and concussion are linked.

Why am I saying this? Well, it is something that is on my mind a lot, more so this week following news that Tyson Fury is battling mental health issues and has decided not to fight Wladimir Klitschko, the second time he has had to withdraw from his maiden heavyweight world title defence. Cue support and sympathy on one side; annoyance and disapprobation on the other.

You can see the argument from both sides. For too long we have shirked the issue of mental illness and still do—because you cannot see it, it lives through its effects, and they are not always the same for everyone—so when someone, particularly a man, says they are depressed the go-to advice is ‘Be a man’ or ‘Man up’, two phrases that have probably caused too many people to suffer in silence. In fact, “Be a man” must be one of the biggest ruinations of many men, silence can be a killer when it comes to this particular illness.

The flipside of this situation is that Fury has talked about being from fighting stock and castigated David Haye when he twice withdrew from a fight. Therefore some have pointed out that he has acted hypocritically and even argued that the latest news is a ruse stemming from the controversy surrounding the UKAD’s decision to reveal the both Fury and Hughie, his cousin, had tested positive for nandrolone, with the organisation later revealing that a second test came back clean and the matter is still being looked into, clearing Fury to fight in the meantime.

The whole sound and fury of this on-off affair has left many jaded, declaring that they have no sympathy for the 28-year-old. That is fine, if you think that way it is your prerogative to do so, what I would say is that Fury does not need our sympathy, however nice it is to receive it—what he really needs is our understanding.

We have to understand that depression can cause erratic behaviour, which Fury has displayed in spades for years now, it cannot be pinpointed by an x-ray and impacts in different ways. Fury went to watch a fight at the weekend, so he can’t be depressed, right? People who are depressed don’t go to a fights, surely? Of course they do, they also work, socialise and do the things “normal” people do, in many cases year in and year out, but they do these things in almost a glib fashion. You live your life, but it is a life lived with that feeling of creeping dread or sadness deep in your gut and dark thoughts rattling around your brain: ‘Am I going to be exposed? Will this sadness ever lift? I’ve just done something good and I’m proud of what I’ve achieved, but now I have to better it and I feel so shit I can barely even move.’ And so on.

Sleep becomes your only comfort. In fact, people suffering from depression will often wake up and immediately think about going to bed later that night, the day just passes you by. They will often medicate in a bid to aid sleep—insomnia is one of the worst things about depression—so use drugs, prescription of otherwise, to obliterate themselves on a nightly basis, whatever it takes to fall into the relative happiness sleep. However, it is a false economy, as you cannot enjoy sleep, and the drugs or drink mean that you do not sleep well, you are just on pause until the next day.

Physical effects of depression include extreme lethargy, in fact there is literature out there on the difficulty of training when depressed. Ironically, light exercise can help alleviate it due to the release of endorphins; however, training for a fight or major sporting event is hardly light work, and it can be mentally and physically gruelling. No alleviation there, then. Fighting whilst locked into a depression would also be very taxing, but many have done it or, in the infamous case of Oliver McCall, tried to.

Where does that leave us when it comes to Fury? People have pointed out that he has courted controversy and claims not to care about what people think or say about him so is reaping what he has sowed. I am not sure about that. It makes me think of Sonny Liston. A bad man, one of the original bad men of boxing. Moody, surly and frightening. Sonny, though, believed that lifting the world heavyweight title would change this perception.

Think about it, we had not had as many bad men in boxing back then, so Sonny was an original. He thought that the world heavyweight Champion, ‘A Man’, the inscription on his gravestone, was universally loved, despite his past. Upon winning the belt, he jetted home and expected to see a parade. Tumbleweeds. No one showed up. Friends close to him said that something inside of him died that day, and something else hardened and grew cold. “People don’t want me,” he said. “But they’ll have to swing along with me until another fella comes along.”

It is my belief that Liston wanted to draw a line under his old life, he wanted to be a distinguished Champion, only for the public to decide otherwise. Sure, he defended the belt yet he looked a shadow of the fighter he once was.

You could blame age, no one knew how old he really was, including Liston, and the brilliance of Cassius Clay, later Muhammad Ali, but it is my theory, and just that, that Liston was crushed by the lack of recognition he received. He was open to being loved, but love did not come his way.

After his defeat, Liston trained hard for a comeback, his wife at the time said it was the fittest he had been for years, only for Ali to suffer a hernia. Fight nixed. New date added. Liston did not have the same zeal for the postponed date. What happened next went down in history, Ali clipped him and Liston went down and stayed down.

People tell me it was a fix, although that has never been conclusively proven, and other theories abound. Mine is that Liston was a man out of time, a 1950s fighter in a changing world, and the turmoil around Ali—Islam, politics, death threats and the rest—was something he could never quite get to grips with. It is my belief that he took a light shot, thought “Fuck this shit” and hit the deck to see out the count. You probably disagree, the key word is “theory”.

It was never the same again for Liston—a fascinating character who I read about as a child and still read about as a man—and we all know how it worked out for the “Champion that no one wanted”. Fury may also have expected the same love only for ill-judged pre-fight comments about homosexuality to emerge following that big win in Germany—that’s one for my column on religion and boxing—so it could be the case that the weight of public disapproval has weighed heavily on him, despite his protests, and wore him down.

Time will tell. What I will say, again, is that we are all entitled to our opinions. For the time being, though, maybe it is time to extend a little understanding to Fury and wait to see what comes next. Mental illness is the most elusive opponent any of us will ever face, if Fury is fighting that fight then he needs our understanding, which may also lead to sympathy, but that’s up to you.