MENTAL HEALTH MATTERS! PREVALENCE OF MENTAL HEALTH CONCERNS IN ATHLETES AND PERFORMERS
Anxiety can feel like fear, apprehension, powerlessness, like there is impending doom or danger, and sometimes irritability or moodiness. Anxiety often presents physically with racing heartrate, sweating, trembling, stomach or gastrointestinal problems, headaches, sore muscles or joints, or feeling tired or weak. Among college students, anxiety and depression are the most common diagnoses (American College Health Association National College Health Assessment, 2018). As for collegiate student-athletes, nearly one-third of males and about one-half of females reported being impacted by anxiety (NCAA, n.d.). Psychological intervention to teach effective coping stem from empirically validated treatments for anxiety. Licensed mental health professionals can work to adapt these treatments to the athlete's unique needs and goals. For some athletes, their anxiety disorder may be grounded in the sport experience, and it may be useful to treat it within the framework of sport performance (Goldman, 2017).
Symptoms of depression can range in severity between individuals and may include feeling sad or down, reduced motivation, increased fatigue, difficulty concentrating, disruptions in sleep and/or appetite, feelings of worthlessness, guilt, or hopelessness, and/or suicidal ideation (American Psychiatric Association, 2013). Depression can impact the innate functioning of an athlete or performer from small-scale focus, training, and motivation to larger-scale concerns with identity, purpose, and/or hope for the future. About 21% of college student-athletes report depression at baseline (NCAA, n.d.). Concerns can be monitored and improved through anything from self-help work, coaching and administrative staff improving the environment for athletes, getting athletes mental health professional support, and/or emergency procedures for significant symptoms or increased suicidality.
Substance use among athletes and performers is a significant concern for safety, performance outcomes, getting along with teammates and coaching staff, and/or legal concerns. Research has provided different rates of reported use across sports with lacrosse (69% of men, 57% of women), hockey (64% of men, 56% of women), and swimming (55% of men, 49% of women) ranking highest (NCAA, 2018). Additionally, marijuana use was reported to be one of the most commonly used substance among student athletes, with use ranging from 11-24% (NCAA, 2018). For nicotine use in the past year use varied by method between 8-17% for student-athlete use (NCAA, 2018). Prevention is key to decreasing rates of substance use with athletes, but postventions can also include linking athletes to resources, aligning with governing body rules and regulations, and/or increasing a sense of support and care within the team or athletic body.
An important factor in discussing and understanding mental health needs in athletics and performance is understanding the potential stigma, barriers, or policies in place in these settings that enforce a culture that tells athletes and performers to “push through” or “get over it.” Changing this stigma in our environments will be essential to promoting mental and emotional health in competitors and allow for those who need to seek out support, more able to do so successfully and feel supported. Every staff member and student athlete leader can address the importance of promoting mental health and well-being by partnering with mental health providers to:
- Normalize not feeling your best at all times
- Provide educational material to teams
- Share stories from other SAs and professional athletes who have chosen to speak publicly about their experiences with mental health concerns
- Model the importance of self-care
- Encourage SAs to engage in important conversations about mental health and how mental health is portrayed in sport culture and US culture. Egan, K. (2019)
Supporting mental health in competitors also requires observing, staying in touch, and gaining awareness to the signs and symptoms of these concerns so that people can get support. Potential signs of distress may include withdrawing from friends, teammates, coaches, or family, changes in mood, hygiene, and other behaviors (e.g. eating, sleeping, substance use), weight loss or weight gain, risky or violent behavior, and sharing thoughts or comments about death or dying. If you notice these signs in yourself or others that you know, show compassion, support, understanding, and a desire to help refer them to someone who can help. Reach out to your school, company, or business psychologist or counselor, call 911 if an emergency, reach out to the Suicide hotline at 1-800-784-2433 or 1-800-273-Talk, or connect with a friend to get started