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Mental Health
& Athletes

A Guide to Identifying Mental Health Struggles

Overview

Overview of Mental Health Challenges 

  • A mental health challenge is not a terminal illness

  • When appropriately treated, people with mental health challenges can live full, happy, healthy lives

  • Simply put, a mental health challenge is when a person experiences an emotion so often, so severely, and/or so frequently that it impairs their ability to function properly in everyday life activities, relationships, and sports.

  • Common mental health challenges in athletes:

    • General anxiety

    • Social anxiety

    • Performance anxiety

    • Depression

    • Obsessions 

    • Compulsions 

    • Feeding issues

  • Typically, signs and symptoms that show up in performance indicate a more general mental health challenge.

  • This guide is to help athletes, coaches, and parents understand and identify the warning signs of a potential mental health challenge that may benefit from mental health care.

*Note: This is not a complete list of signs and symptoms. Please consult your primary mental or medical health professional for comprehensive diagnosing and treatment, or contact Brynne Goldberg.

Warning Signs | Behavioral

  • Angry outbursts, unconsolable crying, isolating, or disengaging when performance isn’t as expected or desired

  • Avoidance of feeding (in excess of the appropriate expectations of the athlete’s sport)

  • Overeating/binging (in excess of the appropriate expectations of the athlete’s sport)

  • Exessive practicing or conditioning 

  • Exessive analysis of appearance  

  • Minimizing or avoiding conversations about experiences or feelings

  • A general closed-off-ness 

  • Lack of diversification (e.g., spending time socializing, engaging in other activities or hobbies)

  • Challenges with interpersonal relationships and connecting 

  • Nail biting, tapping, scratching 

  • Poor focus 

  • Acute difficulty in breathing (may appear similarly to an asthma attack), particularly when practicing or performing 

Warning Signs | Verbal

  • Self-deprecation, critiquing, and criticizing 

  • General poor self-esteem

  • Comparing 

  • An inability to identify, express, communicate, and discuss feelings or disappointing performances 

  • Maintaining a narrow & strict definition of success (typically solely correlated with performance and outcomes)

  • Equating success with happiness 

  • An inability to define themselves outside of being an athlete and sports

  • Feeling misunderstood

  • Being hard on themselves 

  • Feelings of guilt, shame, embarrassment

Warning Signs | Physical

  • Chronic pain or muscle tension (particularly in the neck and shoulders)

  • Frequent Headaches 

  • Frequent illness (often coinciding with an avoidance of school and/or practice)

  • Significant weight loss (in excess of the appropriate expectations of the athlete’s sport)

  • Significant weight gain (in excess of the appropriate expectations of the athlete’s sport)

  • Stress

  • Burnout

  • Fatigue 

  • Poor appetite 

Other Signs & Symptoms

  • Perfectionism 

  • Worrying (often thinking about the worst-case scenario)

  • Ruminating (overthinking past or future conversations, performances, or competitions)

  • People pleasing 

  • “As-Soon-As-Syndrome” (the belief that relief, happiness, or success relies on achieving goals, winning, or completing tasks. E.g., “once I make states, I’ll be happy and can stop stressing”)

  • ADD/ADHD-type behavior or thought patterns (*Anxiety and attention disorders can mimic/mirror one another. It’s imperative to get an accurate formal diagnosis because the treatments are very different. And, if misdiagnosed, the wrong treatment can exacerbate symptoms of anxiety.) 

Catalysts

  • Dysfunctional family & relationship dynamics 

  • Trama 

  • Injury

  • Retirement

  • Graduation

  • Transitions & changes 

  • Grave disappointments and losses  

  • Covert or overt pressure, criticism, favoritism, punishment, or authoritarianism 

Misconceptions

  • Anxiety is only when you’re afraid of things

  • Anxiety is only when you have panic attacks

  • Anxiety is only if you can’t leave the house

  • Anxiety is uncommon 

  • Anxiety is completely different from stress and burnout 

  • Anxiety is a life-altering diagnosis with no “cure”

Realities

  • Everyone experiences anxiety at some point, to some degree, almost every day

  • The most common signs and symptoms of anxiety are the ones that aren’t visible

  • People often don’t realize that the things they experience in everyday life are considered signs and symptoms of anxiety.

  • Anxiety can be considered a side effect of modern culture and society, which our brains aren’t evolved enough to cope with effectively

Communication & Support Tips

  • KIS (Keep It Simple!)

    • Instead of guessing how someone feels and guessing how you can help them, just KIS and ASK!

  • A Simple Equation to Help Guide Your Conversation

    • Validate + Reflect + Ask

      • Validate: Affirming someone’s experience, which lets them know you’re listening & understanding (e.g., “Wow, that sounds really sad/exhausting/disappointing/etc.)

      • Reflect: Demonstrate you’re listening and understanding by repeating back to someone what they’ve just told you in your own words

      • Ask
        “How do you feel about that?” 
        “How did that make you feel?”
        “What was that li
        ke for you?”
        “Can you tell me more about that?”
        “What can I do to help?”
        “What do you need?”
        “How can I support you?”

  • The 6 Main Types of Support

    • Listening: Providing a safe and comforting space for someone to vent to avoid causing the person to feel apprehensive about how you’ll react or respond.

    • Validating: Reflecting and affirming the person's feelings and experiences.

    • Advising: Offering advice based on your prior experience or what you feel is best for the person and helping the person consider alternative perspectives.

    • Fix: Helping the person figure out an answer or solution to their problem.

    • Misc.: Whatever way the person expresses would be most helpful. (e.g., going for a walk, watching a movie, processing, etc.)

  • Let Them Know You're There and Let Them Come to You

    • When people are emotional and/or dysregulated, it’s easy to become overwhelmed or overstimulated. This makes it difficult to have a rational conversation or answer questions. Therefore, it can be really helpful and important to allow the person time and space to cool down, regulate, relax, and process before trying to inquire and/or address them. *Especially after a disappointing performance*

    • Example: “I can see you’re really upset right now. That’s okay. I’ll be available if and when you need to process, vent, or get support.”

  • No One Likes to be Told How to Feel

    • Avoid telling people how they should feel

      • Examples:

        • "Get over it"​

        • "Don't be sad"

        • "Don't let them see you cry"

        • You're better than this"

        • "Don't be weak"

  • Telling people how they should feel is massively invalidating, dismissive, and diminishing of the person's experience.

  • Repeated invalidation has pervasive negative effects on a person's psyche. (Which can also negatively impact performance.)

  • Validation helps:

    • Develop a healthy acceptance of one's emotions and other's as part of the normal human experience 

    • The ability to understand one's emotions and feel sympathy/empathy for others

    • Create effective communication skills

    • Promote self-confidence, autonomy, and self-esteem

    • Maintain an open line of genuine and honest communication

    • Increase focus

    • Strengthen coping abilities

    • Improve resiliency

    • Fosters a strong rapport 

  • Specific Tips for Coaches & Parents

    • Get to know your athletes, how they typically behave and speak, how they prefer to be supported. Set aside time to have this discussion during pre-season training - before the heat and pressure of the season begins. 

    • Avoid performance analysis and negative feedback immediately after a competition - particularly if the athlete is disappointed or upset with their performance. (Aside from crucial and necessary feedback.)

    • Balance positive and negative feedback.

    • Avoid hyper-focusing on only the negative.

    • Regularly check in with athletes about their lives outside of sport.

    • Promote emotional connection and acceptance of all emotions through modeling and encouragement.

    • Acknowledge that emotions are a part of the human experience and that completely suppressing emotion is unhealthy and can subsequently have negative impacts on performance. 

    • Welcome feedback and model acceptance of it. 

    • Check your own anxiety at the door to make sure you're not projecting it onto an athlete, consequentially exacerbating their own.

Resources

Image by Jacob Rice

considerations
for athletes
in counseling

"...With athletes being channeled into specific sports at younger ages and with the associated changes in sport and life demands, mental health symptoms for athletes may begin even earlier. This is especially concerning because young athletes possess even fewer psychological coping skills...Student-athletes, in particular, have to endure the constant demands of intense practices, competition schedules, and the need to maintain or improve upon their strength and physical skills, all while maintaining passing grades to remain eligible for athletic competition. Additionally, student-athletes often have difficulty making time for leisure activities and may be less satisfied with such activities..."

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athletes are shifting
the narrative around
mental health at work