The Importance of Mental Health in Athletes

Athletic success requires physical training and knowledge of your sport. But, to perform at your best, you also must nurture your mental health.

“Just as there is the physical side, there’s also a mental side to every sport and every game,” says Rachel Vanderkruik, PhD, a psychologist with Mass General Brigham Women's Sports Medicine focused on sport psychology for female athletes. “This involves how athletes mentally prepare, stay focused and motivated, and manage difficult emotions in the context of training or competition. It can also sometimes include the need to address mental health issues, such as anxiety or disordered eating behaviors.”

Vanderkruik encourages athletes to focus on their mental health and speak up when they need help. There are skills that help you cope—and make you a stronger, more resilient athlete.

How sports affect athletes’ mental health

Research shows that sports can have protective effects against mental illness. Being part of a team and engaging in regular physical activity are good for your mental well-being. But some aspects of sports may make it more difficult to maintain mental health.

“There are many aspects of sport that can benefit mental health, including physical activity and social connections to teammates and a sport community,” Dr. Vanderkruik says. “However, the same risk factors that exist for any kind of mental illness certainly apply for athletes. For example, you may be more at risk if you have a personal or family history of mental illness, social isolation, or significant life stressors.”

Certain sport-related factors can contribute to mental health concerns for athletes, including:

• Time and physical demands of competition and travel
• High competition levels, which can contribute to fear of failure, pressure to meet expectations, or worries about letting down other people in practices or games
• Multiple responsibilities (for example, managing sports and school for student-athletes)
• Intense performance-related pressure from yourself or others

Additionally, athletes who experience an injury or are retiring from their athletic careers can often experience depressive symptoms or anxiety related to fear of reinjury, loss of identity, or a sense of isolation, Dr. Vanderkruik says.

Sports that are individual rather than team-based, as well as those that focus on body aesthetics, also may present mental health challenges for athletes. Examples include gymnastics and wrestling, which may put athletes at risk for body dysmorphia (the constant worry over a perceived defect in appearance) or disordered eating behaviors.

Signs of sports mental health issues

It can be difficult to notice signs of an athlete struggling with mental health, Dr. Vanderkruik says. Mental health issues can affect people differently and athletes may be good at hiding signs of emotional challenges.

“Athletes might be very good at masking behavior. They learn to tolerate a lot of discomfort, putting their bodies through so much, and working so hard—often through pain. Sometimes they can be good at masking or covering up symptoms,” she says.

It’s important to pay attention to any changes in behaviors that may differ from that particular athlete’s “normal.” For example, they may start to eat more or eat less or have changes in sleep patterns. They may start to withdraw or have other changes in social behavior.

Support athletes’ mental health by building a supportive team culture

“There still may be some stigma or barriers to athletes talking about mental health because of inaccurate perceptions. Some people may worry that admitting that you have anxiety or another issue is a sign of weakness, whereas it’s actually quite the opposite—acknowledging such concerns and seeking help are signs of strength,” Dr. Vanderkruik says.

Players, parents, coaches, and support staff can help create a culture where it’s normal and encouraged to talk about mental well-being. Dr. Vanderkruik offered several suggestions:

• Avoid setting unrealistic expectations or adding unnecessary pressure, especially among young athletes.
• Check in with athletes regularly to give them opportunities to talk. Set an open-door policy or office hours when athletes can come talk to you about anything going on in their lives.
• Emphasize that mental health is important to performance and that attending to your mental health is a sign of strength, not weakness.
• Have a working relationship with a sports psychologist for athletes to see and consult with when needed. If that’s not in the budget, identify online resources.
• Nurture team camaraderie and cohesion by having events where teammates can connect and develop trusting relationships.
• Offer education, such as hosting workshops or sending videos on stress management or sports nutrition.
• Talk openly and regularly about difficult emotions in the context of sport to normalize discussions about mental health.

Mental skills for athletes

Dr. Vanderkruik notes that athletes can practice mental skills to help manage or cope with difficult emotions. These tools can help boost confidence, build resilience, and manage anxiety. They can also help athletes learn how to manage disappointments, failures, and setbacks, and seek opportunities for improvement and growth.

Some examples of these mental skills include:

1. Mindfulness: Mindfulness is a type of meditation that involves focusing on the present moment without judgment. Mindfulness techniques include mindful breathing, body scanning, or simply paying more attention to your senses. When you practice mindfulness in daily life, it can help you remain focused and calm during challenging situations.
2. Visualization: Visualization involves picturing yourself achieving your performance goals and competing successfully. An athlete can think in vivid detail about how an event or game will unfold, sensations they may experience, how they’d like to perform, and how they’d recover from challenges or setbacks. The more you mentally rehearse a successful performance, the more conditioned you are to have successful outcomes.
3. Self-talk: When you’re practicing, performing, and competing, your brain is constantly creating a steady stream of thoughts and narratives. Some thoughts may be negative and detrimental to your performance. Examples include, “I’m such an idiot. Why did I do that? Everyone's going to make fun of me. My coach is going to be upset with me.” If you work on developing more helpful or positive self-talk, you can encourage and motivate yourself to try again and get back on your feet. Think, “It’s okay. I’m going to learn from that and do better at my next opportunity. I am strong and resilient.”

“Mental health is like a muscle. Just like we physically train and condition our muscles, it’s also important to practice and develop these mental skills. The more you practice them, the stronger and more effective they become,” Dr. Vanderkruik says. “The more you can practice how to respond to difficult emotions and unhelpful thoughts, and what to do with symptoms of anxiety or depression, the better you can cope and perform. The mental side of sport is just as important as the physical side of competing and performance.”