Beyond the medals: Supporting athletes’ mental health

Elite athletes spend years training for one defining physical performance. But long-term success depends equally on mental resilience. Public scrutiny, the stigma of appearing vulnerable, and the post-competition crash can make that as challenging as the sport itself.

“For professional athletes, it’s about numbers and one or two performances and less about having fun, like it was when they were kids,” said Arlington, MA-based psychologist Jeffrey Brown, and author of the book, “The Winner’s Brain” and a senior lecturer at Harvard Medical School. “They may have done a routine thousands of times, but they only get one chance to perform it for a gold medal.”

Athletes are tough and have a mindset that they need to power through, said Dedham, MA-based psychologist Elizabeth Ward, who supports elite athletes in her private practice and as a mental performance and mental health provider through the U.S. Olympic & Paralympic Committee’s Sports Registry. “But it can get to a certain point where it takes a toll, and they need to look after themselves.”

In addition to stresses about performance, today’s elite athletes face additional pressure from the increased attention of social media. “Everybody has their phone out, and everybody thinks they’re a reporter,” said Brown. “Athletes have to have a thick skin.”

“There’s so much more pressure on Olympic competitors, everything is more publicized,” agreed Ward, who is a former Harvard University ice hockey player and international competitor. “For example, when Lindsay Vonn hit that gate, it went viral in seconds. Twenty years ago, some people would have watched it live on TV, but then it took another day to get into the newspapers.”

And, it isn’t just what people say about them, but how athletes comment and present themselves on social media that can create stress, added Brown. “Anyone in the limelight could benefit from media training. Athletes train physically, but I think media training is good for just about anybody in our world today.”

Brown and Ward noted that there are several signs that mental health professionals as well as parents, coaches, friends, and family members can look out for to determine whether athletes are struggling, including:

• Changes in behavior, such as withdrawing from activities they previously enjoyed.
• An increase in speaking negatively about the future.
• Trouble sleeping or eating.

Family history should also be considered, said Brown. “Your genetics can be a real boost for your athletic performance, but they can also [impact] mental health.”

Prominent athletes such as Michael Phelps and Simone Biles talking openly about their personal mental health struggles have gone a long way in decreasing the stigma around asking for help, said Ward.

“We still have a long way to go, but it has made a huge difference. Each Olympic cycle, more and more people talk about their experiences, which is so valuable,” she said.

A major mental health support for athletes can be coping strategies, both for their day-to-day lives to avoid burnout and before big competitions or performances.

For example, weather can be a major stressor, said Brown, who has served as the lead psychologist for the Boston Marathon medical team. “They worry about [conditions] like rain or snow, so maybe they need to be thinking about practicing in different environments, so they feel prepared. It’s part of building resilience. Practicing and being able to bounce back from a failure, an error, a glitch or a hiccup and coming back is part of being a real pro.”

A key piece of working with athletes as a psychologist is developing an alliance with that athlete, said Brown. “They like to excel. You need to be able to help them understand that what they perceive as a weakness may just be something they need to talk through. They need perspective that allows them to continue to strengthen and be a top performer, whether it’s physically, mentally, spiritually, vocationally, whatever they want to do.”

Coping skills are vital, said Ward. “Create strategies to help the athlete feel confident when they are the top of the mountain by themselves, or at the side of the rink before they hit the ice, or whatever. Have conversations that give them the resources they need ahead of the high stakes situations.”

Many elite athletes can also use support after the game is over.

Post-competition can be a big letdown, said Ward. “There’s a lot of adrenaline and so many incredible experiences taking place, like selfies with Snoop Dogg or whatever. And then suddenly, the media is gone. The excitement is gone, and they’re no longer striving for their goal. There’s no grieving period that takes place after a big event.”

For some, professional careers don’t last as long as they might have expected. That can create a sense of loss. An athlete might be far younger than what would be considered a traditional retirement age, and now they must transition to something different. “They need to redefine what they are going to do,” said Brown. “They might stay connected to the sport, or repurpose their skills, abilities, and education.”