Why We Should Care About Athlete Mental Health (In A World That Doesn't)

I have a series of blog articles that I need to write on, a notepad full of themes and topics I want to cover here and on social media. I have a seemingly never-ending to-do list of things to do for work, for my athletes, programs to write, bills to pay, courses to study for, emails to send. I dedicated this whole weekend to those things. Right now, it’s 22:00 on Saturday and, somehow, I’ve gotten nothing done.

Actually, I’ve been standing here at my desk, starting at my computer and trying to write an article on Return To Play protocols for soccer players. I’ve ransacked Spotify for every genre and tempo of playlist to help me get through this, raiding my cabinets for a variety of snacks and drinks in the meantime. I just can’t shake the distraction, the anxiety.

So, I saved that article. I closed the window.

And I opened this one.

A Need For Action & Understanding.

Did you know that, in the general population,…

  • approximately 1 in 5 adults experience a mental illness?

  • about 25-30% of adults in the United States live with major depression or an anxiety disorder?

  • depression is the #1 leading cause of disability worldwide?

  • about 90% of people who die by suicide have experienced an underlying mental illness?

  • approximately 60% of people who struggle with mental health did not receive any services or treatment for it last year?

That’s tough, man. Like, really tough.

Nobody is immune to mental health challenges. Most likely, each of us will struggle with it at one point in our lives. Some people are assumed to be more susceptible to it than others, and others have battled with it for a long time (and maybe the rest of their lives). Mental illness is no walk in the park for anyone.

Now let’s talk about athletes.

Did you know that…

  • up to 45% of athletes have experienced at least one mental health concern (anxiety, depression, etc.)?

  • about 26% of athletes suffer with adverse food behaviours?

  • approximately 33% of soccer players struggle with sleep disturbances?

  • suicide made up for 7% of NCAA student-athlete deaths between 2003 and 2012?

Again, mental health and distress is tough, and nobody should deal with it alone.

Although the overall population’s mental illness statistics are alarming and make clear the need for quality, readily available, affordable care for anyone who needs it, psychological services are still stigmatised for athletes.

Thanks to incredibly courageous stories from athletes like Ian Thorpe, Per Mertesacker, Kevin Love, Briana Scurry, and many more, some players are walking the walk and sharing their stories of struggling with mental health, whether following injury, during a period of time, or before every single game of their professional career.

Unfortunately, mental illness does not discriminate between athletes and non-athletes; it comes as it wills and sometimes overstays its welcome.

Athletes deserve better than the shame we put on them around mental health struggles. They deserve the same care and acceptance we do.

I truly believe sports can heal the world, but we have to make sure our athletes are healthy before it can really altruistically change us.

Let me tell you why I think this is important.

(Here comes the vulnerability hangover.)

A Background Story.

I can’t emphasize enough or exaggerate too far how sports saved my life.

Thanks to one specific coach, who taught me new definitions of “performance” and “health”, and with the help of a few friends, I got out of the physical and mental space I was in during my childhood.

But, first, the high performance world destroyed me.

Ca. 1996, casually performing a number off the Beauty & The Beast soundtrack for my parents from the comfort of my baby potty. Crushed it! (Also, that couch was ugly. Hey, the 90s were tough.)

Ca. 1996, casually performing a number off the Beauty & The Beast soundtrack for my parents from the comfort of my baby potty. Crushed it! (Also, that couch was ugly. Hey, the 90s were tough.)

I am pretty sure that my parents put me in music and sports before I could speak. Piano, voice, choir, guitar, swimming, soccer, and gymnastics, with once ambitious and obviously unsuccessful dance lesson or two thrown into the mix.

As the American school system does, I was quickly labeled “gifted and talented”, enrolled in honours classes and named the “teacher’s pet”. I’m still not sure why; I was a trivia kid and a sponge for knowledge, if you will, since I can remember. It seemed ridiculous that this meant I was somehow special had supernatural intelligence beyond my years.

You have to understand the paradox:

I loved being active. I loved learning. I loved the playing, the singing, the moving. I was intoxicated by the achievement, the attention, the competition

What I didn’t love was the pressure that came with the achievement, attention, and competition. As a young child, I hadn’t yet put 2+2 together.

High achievements = higher pressure with the expectations of equally or higher achievement next time.

I suffered with crippling anxiety from a very young age (although no one told me the word for it until much later), so much so that I feared going into large crowds of people and was paralysed when speaking even to my mothers’ friends. My parents both had very active social lives and I was often in group environments with music and sports, so I eventually learned how to adapt and survive.

It didn’t get easier to do, but I figured out how to do it. Fake it until you make it, right?

Ca. 1999; (L-R) my sister, my pops, and I. Although my crushing anxiety kept me from talking to people, no one could rock the 90s bangs or the denim-on-denim better than I could! If only I had known…

Ca. 1999; (L-R) my sister, my pops, and I. Although my crushing anxiety kept me from talking to people, no one could rock the 90s bangs or the denim-on-denim better than I could! If only I had known…

Approaching 9-12, it became too much and I snapped. Everything in life began to feel 10x harder, as if I had to do twice the work under three times the stress to get the same results as before.

I couldn’t stand to stand up in front of crowds and sing. I couldn’t play the piano solo. I was so uncomfortable with the pressure of racing in the pool alone that it literally made me ill beforehand, upset during, and exhausted afterward.

I quit piano. I stopped singing. I rolled out on sports and other events which required me to be singled out or perform somehow. I no longer wanted to be hailed at church for my theological insights, to sing in the choir, or be called on in class to discuss my take on symbolism in The Scarlett Letter.

I needed a break, and I wanted to hide.

I told my parents I was done with everything except soccer and equestrian sports, but I had trouble explaining why; I didn’t know about anxiety or depression, and, in a house full of vivacious extroverts, they weren’t hearing it either. They grounded me from all of my electronic devices, including my beloved old-school Bose stereo system and my handheld CD player, for a month as punishment.

My teenage years were the textbook definition of a half-decade-long mental health crisis.

I had lost any and all interest in anything but soccer, but riding my gigantic horse, but being alone.

I carried the debilitating weight of panic around with me all day, feeling my heart rate spike and my chest cramp up, unable to breathe for a second and, hoping not to succumb to anxiety, instead exploding into an aggressive rage to mask the inevitable tears. I became scary when I was scared, and I didn’t know why.

Slowly but surely, I became roommates with my demon, depression.

Experts still argue about whether depression is mostly genetic, mostly just chemical, mostly event-driven, and a billion other arguments that are confusing and unhelpful. All I know is that I didn’t mean to make room for Her, but one day she showed up and just never left.

It was detached span of years, a time I spent entirely indifferent about life. Every night, I prayed that I wouldn’t wake up in the morning and cursed God when I did. When I asked myself whether I would still want to be alive if my life got better, the answer was still a hard “no”. I felt nothing.

My performance bottomed out so fast.

No matter how much I loved the bitter February air in my lungs or the crunch of frostbitten grass under my cleats during soccer practice, I knew I was falling behind.

My training performance was up to speed, and, even though I felt I was working 4x as hard as my teammates in games, I was still barely bringing equally results in competition. I would suddenly feel like I couldn’t breathe, couldn’t control the ball, couldn’t focus.

“Choking”, as we call it now. I was a textbook case, and it’s my research specialty now.

I was no longer called up to be captain. I didn’t start anymore. My coach would scream at me, tell me to pull it together or I was out, ask me if I was worth anything.

I didn’t think so.

Now I help athletes to optimise their performance physically and mentally. I still used Dustin’s words sometimes. Thanks, coach! You changed my life, my viewpoints, and my future forever.

Now I help athletes to optimise their performance physically and mentally. I still used Dustin’s words sometimes. Thanks, coach! You changed my life, my viewpoints, and my future forever.

When I got injured and was no longer able to play soccer, it was the best thing that ever happened to me and I didn’t know it.

During my rehabilitation and return to play, I came under the tutelage of a brand new coach. He changed my whole life.

For the first time ever, someone took the time to explain what was going on in my brain and body when I played under pressure and how to work to mitigate it. He helped me understand anatomy, physiology, biomechanics, movements, and the basics of training physically and mentally for athletes. He told me I was normal, and that I could still compete. He said I would be fine.

I never did get to play soccer professionally.

I tend to shy away from doing anything performance-oriented where only I am featured (hello, public speaking), but I am getting better. I coach. I serve. I teach. I tell athletes that they’re going to be okay and help them develop skills to deal with their stress and expectations. I help them come back from injuries.

A Wish.

Here’s why I think we need to care about athletes’ mental wellness:

Athletes are human beings.

They’re just like the rest of us.

And, yet, we expect them to stand in spotlights, to perform consistently, to do even better next time, to mesmerize us, to sacrifice their health for the sport, to bring home trophies and titles and records, to share their lives with the general public, to stand under scrutiny, to not be left alone, and, in many cases, to fight for their worth, their well-being, their equality, and their pay.

We are not grateful to them. We expect them to bring their game; injury or illness is irrelevant.

“Aren’t you getting paid for this? How dare you!” is the wrong answer.

It’s 2019. Mental health and wellness is still stigmatised in sports. Psychological services are still under-utilised and, often, under-available to athletes.

We expect them to do more with less.

See the outrage over concussions in the NFL. The medical community is demanding they do better to protect the health of their players.

See ACLs in soccer and shoulder injuries in baseball. The physical therapy and strength coach community is fervently calling for better training protocols and injury prevention strategies.

See early specialisation. The entire world seems to be arguing over whether kids picking only one sport too young is bad for their development as a whole.

Athletes can learn mental skills to help them improve their performance, but sometimes that’s not sufficient. It’s okay to need more help. They are human beings, just like the rest of us!

Athletes can learn mental skills to help them improve their performance, but sometimes that’s not sufficient. It’s okay to need more help. They are human beings, just like the rest of us!

And, still, we often don’t have psychologists on staff for even professional sports teams. We make mental health resources difficult to access. We stigmatize athletes being authentic and discussing their stress, their illnesses, their struggles.

We say, “suck it up, softy”.

Let me tell you something.

My whole life and experience as a child would have changed if someone had told me that my brain was just sick.

I would have been spared a lot of panic, fear, anger, and confusion if anybody had told me what “anxiety” was. Maybe my sports career’s trajectory would have been different if a coach or a psychologist would have told me earlier that, when I “choked” during performance, that my brain was sending a confused message to my body to make it feel that way, but that I was really okay, that we could changed that signal. My world would have been different if I had taken a pill every morning, just like my teammates were taking vitamins, birth control, caffeine pills, and ibuprofen for their ankle sprains.

Last semester, I had an oral exam due at university, ironically on a course about anxiety, emotions, and how to control them in sport. I hadn’t slept enough beforehand, and, due to being overseas for an unexpectedly long time, my medication had lapsed. To say I panicked in the exam is an understatement, and my professor quizzed me.

“Didn’t you learn any strategies about how to manage performance stress in this course?” he asked.

I was very literally ugly crying. “Yes,” I nodded. I’m 99% sure I was snotty, too. (Gross.) “But I have an anxiety disorder, and I need a little more help with it than that. I’m usually fine on medication, but I ran out.” Depression and anxiety are still ugly roommates some days, and I have to remind myself not to apologize for them. They’re my roommates after all.

I’m so thankful that he was gracious about it. (My grade on that exam sucked, though.)

———————

We cannot have exorbitant standards for athletes and expect them to have less care then we do. Athletes are, first and foremost, human beings. They experience thoughts and emotions just like we do. They deserve to have access to the same treatment and acceptance that we have.

Athletes always learn footwork, hand position, skills on the ball, and tactics with their teammates. They also need mental skills to keep them focused, regulate their emotions, deal with pressure, and perform.

Sometimes a little white pill takes away pain. Sometimes it substitutes for Vitamin B or Omega-3.

And, sometimes, it helps us get out of bed, train with you, play for you, hang out with you, take oral exams, laugh, coach, teach, fulfill our purpose, and be okay with being alive today.

We should care about athlete mental health and wellness because they deserve that experience too, just like us.

Please let athletes be humans.

We owe our athletes more. We need to do better.

———————

NOTE: If you or someone you know needs immediate help, please reach out to someone you trust, a medical doctor, a psychologist/psychiatrist, or one of the following suicide hotline numbers:

United Kingdom 116 123
United States 1-800-273-8255
Canada 1 800 456 4566
Ireland 116 123
Philippines 2919
Australia 131 114

It’s okay not to be okay. Ask for help if you need it.

You are worthy of being alive.

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References:

Any Mental Illness (AMI) Among Adults. (n.d.). Retrieved October 23, 2015, from http://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-adults.shtml

Major Depression Among Adults. (n.d.). Retrieved January 16, 2015, from http://www.nimh.nih.gov/health/statistics/prevalence/major-depression-among-adults.shtml

Any Anxiety Disorder Among Adults. (n.d.). Retrieved January 16, 2015, from http://www.nimh.nih.gov/health/statistics/prevalence/any-anxiety-disorder-among-adults.shtml

Gouttebarge, V., Backx, F. J., Aoki, H., & Kerkhoffs, G. M. (2015). Symptoms of Common Mental Disorders in Professional Football (Soccer) Across Five European Countries. Journal of sports science & medicine14(4), 811-8.

Rao, A. L., Asif, I. M., Drezner, J. A., Toresdahl, B. G., & Harmon, K. G. (2015). Suicide in National Collegiate Athletic Association (NCAA) Athletes: A 9-Year Analysis of the NCAA Resolutions Database. Sports health7(5), 452-7.

Keywords: mental health athletes, mental illness athletes, depression athletes, anxiety athletes, mental health stigma, athlete mentally ill