What about the 10k runner that wants a TUE for periodic EPO use?
This runner depends upon good racing results for basic emotional, mental, physical, psychological, financial health and ell being.
They led an abnormal childhood as their parents were runners who lived a secluded life training in remote locations at high altitudes. The parents neglected this runner as they were focused on running not childrearing. Ths runner was poorly homeschooled and has developed few other marketable skills
This runner was lucky enough to get a pro shoe contract when they were 15. They depend upon income from that contract to support their spouse and child.
This runner has found that periodic doses of EPO help this runner function more normally. Without the EPO, the runner cannot run high mileage, hit target times in training, keep up with teammates and achieve racing success (times and finish places) needed to meet contract incentives and get paid.
Without the EPO, this runner experiences severe anxiety, depression and has been suicidal. The runner has a very hard time focusing in training if they are not hitting target mileages and times. Without EPO, the runner has abused their wife and child.
This runner needs EPO to function normally as an elite distance runner. The runner may be at a genetic disadvantage as their hematocrit does not seem to respond as well to altitude and other hard training like their teammates.
All of this runner's grandparents were obese, and this runner seems genetically predisposed to easily gain weight if they can not train intensely and at high mileages that the EPO helps them do. Without EPO, this runner has resorted to disordered eating behavior (starvation and bulimia) to maintain weight.
This runner fears not being able to perform well enough to represent their country in international cometitions. Failing to do that would require this runner to go on public assistance to survive, which would lead to additional depression, anxiety, abuse, disordered eating and suicidal tendencies.