In the intense world of competitive sports, athletes often receive notoriety for their strength, physical fitness, and discipline. However, beneath that facade of strength, many struggle with significant mental health issues. Studies indicate that athletes are just as susceptible to mental health conditions such as anxiety, depression, and eating disorders, as anyone else. This blog delves into the specific pressures that athletes encounter and presents research-backed strategies for mental health professionals seeking to provide effective support.
Understanding the Scope of Mental Health Issues in Athletes
While athletes may seem immune to mental health struggles due to their relatively high levels of physical health, reality tells a different story. For instance, Kerr, et. al (2014) found that 23% of elite athletes experienced anxiety while 19% reported symptoms of depression [1]. Similarly, Kerr, et.al, (2014) also found that former collegiate athletes often struggle with depression and anxiety long after they leave school [1]. These rates are comparable to or even exceed the rates experienced in the general population.
Athletes are faced with an incredible amount of stress within their sport and the political environment around their sport. For example, an injury can lead to absence from the sport, disqualification, disappointment, and potential long-term psychological impact. On top of that, it can be extremely difficult to properly recover from these injuries due to the pressure of needing to urgently return to the sport; this may in fact lead to reinjury. Studies show that athletes who experience severe or recurring injuries are at higher risk for depression and anxiety [2].
Take the case of Michael Phelps, the most decorated Olympian in history. Despite his success, Phelps has openly discussed his struggles with depression and suicidal thoughts, highlighting how even the most successful athletes are not immune to mental health challenges [3]. His openness has been instrumental in reducing stigma, but the story underscores a crucial point: athletes need better mental health support systems tailored to their unique experiences.
Simone Biles is also a decorated Olympic gymnast who withdrew from the 2020 Tokyo Olympics because of the “twistees.” The “twistees” refers to a mental block when a gymnast loses control of their body in the air and is no longer able to complete a twisting skill they have performed many times before. In an interview with the New York Post , Biles said, “We have to protect our body and our mind … It just sucks when you’re fighting with your own head. Whenever you get in a high-stress situation, you kind of freak out.” [4].
Michael Phelps and Simone Biles are famous examples but many athletes who do not have their level of fame also experience similar challenges. I am an Olympic fencer who has competed in four Olympic Games earning a Bronze medal for 25+ years of commitment to the sport. Although my competitive success suggests that I am arguably one of the best women’s epee fencers in U.S. history, my road to earning this level of achievement was littered with personal doubt, fear of failure, and feelings of unworthiness and inadequacy. Looking back at my athletic career, I know that if I had been aware that I could have sought help for my destructive feelings, access to mental health coaching could have made a big difference in my happiness level, and even my success.
Barriers to Seeking Help
Despite the prevalence of mental health issues among athletes, many are reluctant to seek help. The reasons are complex, ranging from stigma to practical barriers. In a culture that often equates strength with stoicism, athletes may fear that reaching out for support will be perceived as a sign of weakness. This stigma is particularly pronounced in male athletes, who may feel an added societal pressure to maintain a “tough” image [2].
Facilitators and Support Systems
Fortunately, there are ways to mitigate these barriers and create a more supportive environment for athletes. Research shows that mental health literacy programs specifically designed for athletes can significantly improve help-seeking behaviors and reduce stigma [5]. Organizations like the National Collegiate Athletic Association (NCAA) and the International Olympic Committee (IOC) have begun implementing such programs, focusing on educating athletes, coaches, and support staff about recognizing and addressing mental health issues early.
A comprehensive mental health framework is essential for the athletic context. For example, the IOC’s recent consensus statement emphasizes the need for multidisciplinary support teams, including sports psychologists, physicians, and counselors, to create a robust support system for athletes [6]. By integrating mental health services directly into athletes’ routines, these frameworks can help normalize seeking help and make it more accessible.
The Path Forward: Creating a Culture of Support
To foster a healthier environment for athletes, sports organizations and mental health professionals must work together to develop and implement proactive strategies. Incorporating these strategies into school and elite athletic programs is critical to ensuring ongoing positive mental health:
- Integrate Regular Mental Health Screenings: Organizations should incorporate mental health check-ups as part of routine health evaluations for athletes. The IOC recommends screening athletes during critical times such as post-injury, post-competition, and during major life transitions, like retirement, to catch potential issues early [6].
- Increase Accessibility of Mental Health Resources: Sports organizations must provide resources that are easily accessible and confidential. Many athletes hesitate to seek help due to fears of being judged or losing their position on the team. Confidential online resources and helplines can offer support without risking these consequences.
- Train Coaches and Support Staff: Coaches and team staff play a pivotal role in an athlete’s life and can be instrumental in supporting their mental health. Mental health training programs can help coaches recognize signs of distress and provide initial support or refer athletes to the appropriate professionals [5].
- Promote Open Conversations About Mental Health: Athletes like Michael Phelps have paved the way for more open discussions about mental health in sports. These conversations are crucial in breaking down stigma and encouraging other athletes to seek help without fear of judgment.
Call to Action: Resources for Athletes and Professionals
To support athletes effectively, medical and mental health professionals need access to the right resources:
The NCAA Mental Health Best Practices Guide: This comprehensive guide provides actionable steps for integrating mental health services into collegiate sports programs and is available for free online.
International Olympic Committee (IOC) Mental Health Toolkit: A resource aimed at sports professionals, offering tools for recognizing and addressing mental health issues in athletes.
The National Institute of Mental Health (NIMH): Offers research-based resources on athlete-specific mental health issues, including concussion-related depression and anxiety.
By utilizing these resources and embracing a proactive, collaborative approach, mental health professionals can better support athletes and help them thrive both on and off the field.
Conclusion
Athletes may be physically strong, but they are not immune to struggles of mental health challenges. By understanding the unique pressures they face and implementing evidence-based strategies, we can create a culture where athletes feel supported and encouraged to seek the help they need.
References:
[1] Kerr ZY, DeFreese JD, Marshall SW. Current Physical and Mental Health of Former Collegiate Athletes. Orthopaedic Journal of Sports Medicine. 2014;2(8). doi:10.1177/2325967114544107
[2] Devi, Gomati. “Sports Performance and mental health of Athletes.” Sports Science & Health Advances 1.01 (2023): 46-49.
[3] Rice, S.M., Purcell, R., De Silva, S. et al. The Mental Health of Elite Athletes: A Narrative Systematic Review. Sports Med 46, 1333–1353 (2016). https://doi.org/10.1007/s40279-016-0492-2
[4] Ridley, Jane. “Inside Simone Biles’ shocking exit: Anatomy of an Olympics breakdown.” New York Post, 28 July 2021, nypost.com/article/history-of-simone-biles-mental-health-issues/. Accessed 31 Oct. 2024.
[5] Purcell, R., Gwyther, K. & Rice, S. M. Mental Health in Elite Athletes: Increased Awareness Requires an Early Intervention Framework to Respond to Athlete Needs. SportsMed – Open5, 46 (2019). https://doi.org/10.1186/s40798-019-0220-1
[6] Reardon, Claudia L. MD. The Mental Health of Athletes: Recreational to Elite. Current Sports Medicine Reports 20(12):p 631-637, December 2021. | DOI: 10.1249/JSR.0000000000000916
Kelley Hurley
As a four-time Olympian, Olympic bronze medalist, NCAA Champion, and five-time USA National Champion, Kelley brings an insider’s perspective to the mental health challenges athletes face. Her nearly two-decade career at the highest levels of international fencing demanded intense focus, emotional resilience, and constant adaptation—all under public scrutiny and high expectations. Having personally experienced both the triumphs and psychological pressures of elite competition, she is uniquely positioned to speak to the hidden mental toll that athletes endure. Kelley’s voice bridges the gap between athlete and clinician, offering a rare and authentic lens through which to explore how mental health professionals can better support this often-overlooked population.