This means that, statistically, out of the 83,000 fans who attend a Borussia Dortmund home game in the Bundesliga, depression is likely to affect some 16,600 of them.
In Germany, where organized football fans and ultra groups are known for their political and social involvement, several initiatives have been launched in recent years in an attempt to raise awareness of the disease and of ways of dealing with it.
By fans, for fans
One of the first was Sankt Depri, an initiative by and for FC St. Pauli fans, meant to raise awareness of the disease among the club's supporters and aide people affected in getting help.
The initiative was founded in 2014 after Michel, a fan of the Hamburg side, lost his battle with depression and died by suicide.
Tina is a member of Sankt Depri. "At first, it was all about coping with the loss," she says. "Out of this situation, we said we have to do something about it."
As Tina herself had spoken openly about struggling with her mental health before, she joined the team, which, as of 2023, includes about 15 members.
Together, they organize an informational meeting once a month. They also offer help to supporters struggling with mental health issues through a wide range of offers: from arranging initial conversations with therapists to getting their errands done and from offering sports courses free of charge to having conversations with the family and friends of people affected.
From the beginning, Tina says, her team enjoyed the full support of the FC St. Pauli ecosystem, including fellow fans, the club's fan groups and, eventually, some of its sponsors.
She reveals, for instance, how the club allowed them to advertise their contact number inside the Millerntor Stadium's toilets, thus giving up wall space that could have been sold to a sponsor.
"The whole St. Pauli cosmos stood behind us," she says.
Karlsruhe ultras become active
Just like the members of Sankt Depri, fans of fellow second-division club Karlsruher SC were also hit by the reality of a friend losing his battle with depression six years ago. Kevin was 26 years old.
His friend Moritz is a member of KSC ultra group Armata Fidelis. He says he was particularly affected by the loss of Kevin.
"I had no personal contact with people with depression, I thought it's something you would notice," he recalls.
Maxi, another Armata Fidelis member, says the group felt that they had to become active. They started by collecting donations for a local organization that raises awareness of mental health issues and organized an evening where professionals spoke about depression and its diagnosis. The resonance caught the group by surprise.
"It was incredible to see how many people approached us and started talking to us, people who are partly affected themselves or friends of people affected," Maxi says.
Karlsruhe's ultras have since spent the past six years establishing connections with mental health groups, including the Robert Enke Stiftung, and both Moritz and Maxi agree that perceptions have changed significantly.
If someone says they have a bad day or that they need time off from football because they're unwell, they'll be understood and offered help, Maxi says. "The way we treat the topic has changed by 180 degrees."
Hope Ahead for Werder Bremen fans
Back in northern Germany, efforts to raise awareness of mental health issues in football quickly spread beyond Hamburg to neighboring Bremen, where supporters of Bundesliga side Werder Bremen have launched Hope Ahead, a project aimed at providing psychological help for fans by connecting with them various organizations and treatment options in the city.
The people behind the initiative say they are concerned about about how invisible mental health issues were in football, despite their increasing prevalence. "We wanted to change that," they say.
And their timing couldn't have been more appropriate, with Werder player Niklas Schmidt publicly announcing that he was suffering from depression in January this year.
In response, the club's ultras sent out a clear message in support of the midfielder, filling the Ostkurve terrace with banners thanking him for speaking about the topic openly during the home game against Union Berlin.
"End the taboo on mental diseases! Thank you for your openness, Niklas!" read one of the biggest banners, and the 25-year-old went over to thank them for their support at full-time.
"With such a banner at the stadium, you directly reach 42,000 people," the Hope Ahead team says, calling it "an important symbolic signal" of accepting depression and encouraging people to talk about it openly.
Football as part of the solution
Other supporters, too, have projects that involve dealing with the effects of mental health on fans.
Ultras Düsseldorf, of Fortuna Düsseldorf, have been raising donations for a mental health center in the city in the past several years while holding events where professionals talk about ways to get help; Bayern Munich's Südkurve, where the club's ultra groups are stood, developed a concept together with the local Fan Project in aid of people needing help on mental grounds during games.
Several Bundesliga clubs have similar concepts in place, including Borussia Dortmund, Schalke and Hertha Berlin.
For some fans, football can also provide a much-needed distraction, if only for a short period of time.
"The good group of people around me probably made football the area with the most normality in my life," Jon says, looking forward to his next match, albeit knowing that the excitement, the buildup, the togetherness and the emotions could be followed by more difficult days.
Just like in society at large, the conversation about mental health among football fans is starting to pick up the pace in German football. One thing is clear: The taboo needs to be broken.