- Elite athletes face pressures that leave them vulnerable to mental health challenges, but often "power through" instead of seeking help.
- Recently, athletes like Simone Biles and Naomi Osaka have spoken up about their challenges, putting mental health in the spotlight.
- While progress has been made, there is still work to be done to reduce the stigma around seeking help for elite athletes.
All that glitters is not a gold medal.
By Karoline Strauss, Ph.D., Professor of Management at ESSEC Business School, and Julia Smith, Editor-in-Chief of ESSEC Knowledge
Athletes’ mental health has been in the spotlight lately. First, Naomi Osaka withdrew from the French Open after she was fined for skipping a press conference to protect her mental health. Then, highly decorated U.S. gymnast Simone Biles temporarily withdrew from the Olympics because she was struggling to cope with stress, pressure, and her mental health. As prominent athletes speak out about their mental health struggles, public awareness of the importance of mental health in professional sport is perhaps higher than ever before.
We think of athletes as exceptionally resilient and tough. We see them get up after a fall or compete while injured, and excel under pressure and scrutiny. Yet research shows that professional athletes are just as likely as non-athletes to experience mental health issues (Rice et al., 2016; Gorczynski et al., 2017).
Being a professional athlete is often seen as a dream job. After all, you are getting paid to do something you love. In addition, sport is often beneficial to mental health. Research, including my own (Kelly et al., 2020), generally shows a positive link between sport and mental health indicators. Exercise can even be effective in alleviating symptoms of anxiety and depression. But these studies were conducted with recreational rather than professional athletes, and the latter face challenging demands and difficult working conditions that are often far from a dream scenario.
A Job Like No Other?
Unsurprisingly, elite sport is extremely physically demanding. Not only that—it's also highly cognitively demanding. Athletes need to exercise concentration and precision, remember many things simultaneously, and make complex decisions (Balk et al., 2018). They also face substantive emotional demands: they need to deal with unrealistic expectations, disappointment about their performance, negative feedback, the emotions of others (coaches, teammates, spectators), and intense social media scrutiny (Balk et al., 2020). Even just witnessing other people’s unpleasant interactions can require regulating emotions and leave people feeling drained (Totterdell et al., 2012), and suppressing emotions can impair performance (Wagstaff, 2014).
Further, athletes operate within sports organizations and experience many of the workplace interpersonal difficulties we face, like team conflict or a difficult relationship with a superior. In fact, athletes often consider the organization as more stressful than training or competition (Arnold et al., 2016). Issues related to leadership, personnel, culture, team dynamics, and logistics and finances are pervasive (Arnold and Fletcher, 2012).
Money can also be a concern. While athletes with lucrative sponsorship deals and players in professional leagues may not need to worry, many athletes are facing insecure funding. Even in the U.S., the majority of athletes are not raking in money: Forbes reports that around 60 percent of U.S. Tokyo Olympians earn less than $25,000 per year.
Additionally, athletes are increasingly aware of the need to promote their personal brand. Social media is a powerful tool for athletes to develop their relationship with fans and corporate sponsors, yet it also poses a new set of challenges.
For one, being permanently connected prevents athletes from mentally disconnecting from their “job.” This can prevent them from psychologically recovering from the demands they face, making it more likely that high stress levels impact their mental health (Sonnentag and Fritz, 2015).
Social media can also expose athletes to online abuse, especially those who are women or people of colour. The racist social media abuse faced by England’s Black players following the team’s defeat at the UEFA EURO 2020 provided a recent chilling example. A BBC Sport survey found that a third of female elite British athletes face abuse on social media, including comments about their appearance. While athletes of yesteryear could retreat from the public eye with relative ease, this is more challenging for today’s athletes.
Resources Can Buffer Demands
Resources can protect athletes from the impact of the demands they face on their mental health (Balk et al., 2018). Two types of resources are particularly important.
First, a sense of autonomy and control can protect an athlete’s mental health. A sense of control of the important decisions in their life protects athletes’ mental health and can shelter them from the impact of demands.
Second, emotional support also protects athletes’ mental health. For example, a study of 130 high-level British tennis players found that having someone who will listen to them buffered the negative effect of competition pressure (Rees and Hardy, 2004).
When Demands Outweigh Resources: Athlete Burnout
When the demands one faces outweigh the resources available to cope with these demands (Smith, 1986), other mental health issues develop, potentially resulting in burnout. Little is known about how many athletes may suffer from burnout resulting from chronic high levels of stress, with some estimating that between 1 and 9 percent of athletes are experiencing some level of burnout (Gustafsson et al., 2007).
Much like burnout in other professions, athlete burnout is first and foremost about a deep sense of emotional and physical exhaustion (Gustafsson et al., 2017). When Dutch cyclist Tom Dumoulin withdrew from the Vuelta a Espana in 2020, he described feeling empty and having no energy. Beyond this feeling of exhaustion, athletes experiencing burnout also question their own abilities and achievements and develop a sense of cynicism towards their sport. While Dumoulin recovered and came away from Tokyo with a silver medal, some athletes experiencing burnout leave sports completely (Gustafsson et al., 2018), resulting in a talent loss for the sport.
Why Do Some Struggle More Than Others?
Certain factors put athletes at risk of experiencing mental health issues. First, there are periods in an athlete’s career when their mental health is particularly at risk, such as periods of injury, performance slumps, or retirement.
Some personality characteristics can also predispose athletes to mental health issues. Athletes are particularly at risk if they tend to worry about making mistakes and about being judged by others, and to feel extremely stressed, frustrated, or angry if they do not fulfill their own high expectations (Hill and Curran, 2016). Defining themselves exclusively in terms of their identity as an athlete is another risk factor: having no clear sense of who they are outside of sport puts athletes at risk of mental health issues such as burnout (Coakley, 1992).
Barriers to Seeking Help
In the light of increasing awareness of athletes’ mental health issues, governance bodies are signalling their commitment to protecting athletes’ mental health. The International Olympic Committee has released guidance to support stakeholders in the sports ecosystem in protecting the mental health of athletes, and the IOC’s Athletes’ Rights and Responsibilities declaration explicitly advocates the protection of both physical and mental health.
Yet despite these efforts, research suggests that athletes are less likely to admit to, or seek help for, mental health symptoms than members of the public (Kaier et al., 2015). Athletes are celebrated for their capacity to perform consistently well even under adversity (Gucciardi et al., 2015). Young athletes are taught to deal with pain and minor injuries by “shaking them off” and “toughing them out” (Malcom, 2006).
When competing while injured is seen as a sign of courage, athletes denying their humanity becomes something to be celebrated. When toughness is praised, seeking help may be seen as implying weakness. This celebration of toughness may inadvertently contribute to the stigma athletes experience when seeking support for mental health issues (Poucher et al., 2021). “Powering through” like this can be dangerous not only for mental health, but also physical health: Simone Biles reported experiencing “the twisties” during the Olympics, where gymnasts lose spatial awareness, which can lead to serious injuries. The stigma associated with mental health issues can prevent athletes from seeking help early when problems can be more easily remedied, and means that studies may be underestimating how many athletes are affected.
How Prominent Athletes Can Help Reduce Stigma—at a Cost
The economic costs of mental health issues exceed those of all other categories of non-communicable disease, including cardiovascular diseases and cancer (Bloom et al., 2011). The COVID-19 pandemic has only exacerbated this issue: an estimated 28 percent of the global population have experienced symptoms of depression and 26.9 percent have suffered from anxiety (Nochaiwong et al., 2021). While some research shows that the stigma of mental health issues and receiving help has decreased over the past few decades (Angermeyer et al., 2014), this varies between cultures and communities (Zhou et al., 2019). Destigmatising mental health issues are a global concern, and athletes speaking openly about their mental health can play an important role in reducing the stigma.
Popular athletes speaking out about their struggles with mental health use their platform to benefit others and to change the public perception of mental health issues. Yet being in this position also means that athletes who are already in a delicate situation now face the perhaps involuntary additional burden of being a spokesperson, leaving them vulnerable to criticism.
Over the last few years, and especially this summer, we’ve seen an increasing awareness of the mental health challenges athletes face, thanks in no small part to prominent athletes being willing to open up. Sporting bodies are starting to react by putting measures in place to protect mental health, but intense social media backlash faced by athletes who shared their challenges and the lack of widespread measures show that there is work to be done. Mental health challenges impact all of us, including athletes: moving forward, improving support for elite athletes needs to be an essential component of their working conditions.
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