Fitness and Mental Health

Simone Biles is once again rewriting the story of what’s possible. 

As a gymnast, Biles is known as the greatest of all time (GOAT) thanks to her unmatched strength and ability. She’s no stranger to surprising people, having performed the Yurchenko double pike on the vault in competition, making her the only female gymnast to do so.

But when she pulled out of the Tokyo Olympics team final last month, citing mental health struggles, she shocked the world. 

While Biles received an outpouring of support from many, others were quick to chastise her unwillingness to perform. Through it all, Biles was steadfast.

“At the end of the day, we’re human, too, so we have to protect our mind and our body rather than just go out there and do what the world wants us to do,” she told reporters in Tokyo.

In doing so, Biles supercharged a mental health revolution among athletes — especially Black women athletes — that had already been brewing. 

Naomi Osaka stepped back from the French Open and Wimbledon earlier this year due to anxiety around the mandatory media interviews and the need to take some time for herself. Swimmer Simone Manuel opened up about her experiences with overtraining syndrome, including depression and anxiety symptoms.

Track star Sha’Carri Richardson spoke out about her grief following her mother’s death, which she said played a role in her disqualification at the Olympic Trials after a positive test for THC, the active chemical in cannabis, which is a banned substance. 

Mental health concerns are far from uncommon in elite athletes.

Some 2016 research shows that as many as 34 percent of elite athletes suffer from anxiety and depression (and as many as 19 percent may suffer from substance misuse). But never before have athletes been as open about their vulnerability.

Not only that, they’re taking a stand for what’s right for them by advocating for their needs, whether that means taking a break from competition or demanding better conditions. And many are taking notice, including Healthline’s sister brand, Psych Central, with its recent article on this topic.

When Naomi Osaka first decided to refuse media interviews earlier this year at the French Open, backlash was swift, demonstrating just how rare her stand was.

Officials threatened to suspend her and fined her $15,000. Spectators accused her of simply not wanting to do her job, and even tennis great Billie Jean King disagreed with her stepping back. 

As a culture, we’re not used to seeing athletes push back against the pressure to always be on. And we’re certainly not used to seeing Black women lead that charge. This has implications far beyond sports. 

“Culturally, it’s very important. It’s inspiring to see Black women and women of color stepping outside the cultural conditions set by white dominance and patriarchy,” said Leeja Carter, PhD. “As Black women, we’re constantly delivered messages from the media, society, our communities, that we’re only meant to use our bodies for labor. And we’re far more than that.”

Enormous pressure and growing expectations

We often think of star athletes as lucky. After all, they’re often gifted individuals who are able to use their talents to garner fame and millions.

Their job is to wow us, and when they do, we love them for it. But that can lead to a major disconnect with reality, explained Kate Miller, LMHC, who counsels college athletes at Columbia University. 

“At the end of the day, they’re human beings who happen to be exceptionally talented,” Miller said. “They’re still human beings. But that part gets lost.” 

On top of that, our expectations seem to just keep growing. The global sports industry is a $388 billion behemoth. For professional athletes, the pressure to perform — or be replaced — is enormous. 

“The dynamics have changed. We’re asking more of athletes,” said Margaret Ottley, PhD, a sport psychologist who has counseled athletes at four Olympic Games. “You win a Gold medal in a global competition one year, and now we expect you to do it again and again. We expect more goals. We expect stronger and faster.” 

This performance pressure also extends to college and high school athletes, who are often focused on getting or keeping a scholarship. For athletes of color, this pressure may be even more pronounced because of socioeconomic factors — sports may be their only ticket to an education or to support their families, Ottley added. 

“The pressure and demand for performance and excellence has magnified and really brought mental health issues to the forefront,” Ottley said. “We need to bring more visibility to that.” 

In addition to performance pressure, there’s a new level of scrutiny, thanks to a dynamic and intensifying media environment. In some ways, social media may free up an athlete to communicate directly with fans, versus sending a message mediated by reporters. 

But social media also gives fans 24/7 access to athletes, which adds complications.

“It’s not just about having an athletic image now, but also cultivating [a] personal image or an activist image,” Miller said. And when competition isn’t going so well — or an athlete pulls back from competition — it’s harder to hide from the backlash.

For Black athletes, this pushback may be even more pronounced because of stereotypes, Carter said. The strong Black woman ideal is a stereotype that puts Black women into a box of expectation that they’ll be able to endure whatever’s thrown their way and serve their team no matter what.

“That doesn’t allow Black women’s humanity to be seen,” Carter said. 

Biles, for example, overcame a tumultuous childhood to become an Olympic champion. She survived sexual assault and a toxic culture perpetuated by adults who were supposed to protect her. She has said publicly she continues to compete, in part, because she wants to hold USA Gymnastics accountable. 

Like all of us, she survived a pandemic, and like so many Black Americans, lived through a traumatic global racial reckoning over the past year. And yet, people are shocked that the pressure became too much.

“The world can’t process it because of the stereotype,” Carter said. “When you step outside of that image, it’s surprising.”

Athletes face unique mental health challenges

“I am human.”

This was the simple declaration Sha’carri Richardson shared with the world, just hours before the news broke that she had been disqualified from competing in Tokyo. It turned out she had tested positive for THC.

“I apologize,” Richardson would later tell TODAY. She explained that she knew she broke the rules. Her biological mother’s death had hit her hard.

“I apologize for the fact that I didn’t know how to control my emotions or deal with my emotions during that time,” she said.

Grief is far from an uncommon experience. And the fact that Richardson found it hard to cope is unsurprising, said Candace Stewart, strategic development officer for Hidden Opponent, a nonprofit dedicated to raising awareness of student-athlete mental health.

As a former Division 1 soccer player and member of USA Handball, Stewart has seen firsthand how mental health simply falls through the cracks.

“Coaches and athletic departments don’t give athletes the resources they need when they’re struggling — or even if you do have the resources, there’s not a lot of understanding of how to use these tools,” Stewart said. “I was introduced to meditation and visualization and how these tools can help me as an athlete. But I wasn’t introduced to how they might help me just be a better human being. There’s no roadmap for navigating that.”

Everyone has ups and downs. It’s not clear if athletes are any more likely than non-athletes to face mental health struggles. But they do face unique challenges to their mental health.

Because so much of an athlete’s life is focused on their performance, there’s little space for them to tend to the hard work of coping with their emotional lives. 

“Sport is such a well-oiled and well-tuned environment that adding anything extra is difficult,” Ottley said.

A competitive athlete, whether they’re pro or in college, spends their daily life focused on their training. It takes constant discipline: early morning practices, long days of school or other engagements like media interviews or business meetings, evening workouts, recovery, and so on.

“So, where do you fit in the mental part?” Ottley asked.

This can result in a vicious cycle, Stewart said.

“Maybe something traumatic happens in your life. Now you’re not playing well. Suddenly, not only is your personal life falling apart, you’re failing at being an athlete, which is a huge part of your identity. And you don’t know how to cope at all,” Stewart explained.

We tend to think of playing sports as good for our mental health. But Miller pointed out that it’s all too easy for the healthy aspects of athleticism to turn toxic.

Take the team environment. On the one hand, a team is a built-in support network. But if the culture of the program or team is a toxic one, that is an entirely different story.

This is especially pertinent for athletes of color, who may be navigating institutions that are white dominated, archaic, and inattentive to their specific needs. 

“It’s not surprising that you have Naomi Osaka, who is biracial and bicultural, who is experiencing anxiety talking to the media in a noninclusive workplace,” Carter said.

“What they’re experiencing is a system that is designed to never have worked for them, and [that] they have to work harder to be successful in,” Carter said. 

Finally, there’s a stigma to admitting you’re struggling.

“Athletes’ perception of self is that we are ordinary people doing extraordinary things. To say, go see a psychologist, that in itself is going to mess with our psyche,” Ottley said. “So a lot of athletes go through it alone. They don’t want the coach to think something is wrong with them.” 

Even Biles was resistant to therapy at first. She told Glamour earlier this year that she didn’t speak at all during one of the first sessions she attended.

“I just wouldn’t say anything,” she said. “I was like, ‘I’m not crazy. I don’t need to be here.’” Biles eventually looked forward to going to therapy, seeing it as a “safe space.”

Where we go from here

In the end, what’s happening with athletes right now is a reflection of what’s happening in our wider culture. Black athletes standing up for themselves offer lessons for everyone, athlete or not.

Carter said that we need to recognize that athletes are employees. Pro sports may be a “privileged profession,” as Naomi Osaka put it. But it is a profession nonetheless. Like any employee, athletes have a right to a safe environment to do their jobs in. 

“We need sport organizations to take a step back and say, what does the environment look like for these athletes? What do diverse workplaces look like? How do we create models of health that are sustainable?” Carter said. 

Mental health struggles — and the stigma surrounding them — are common and enduring. But thanks to increased awareness, a conversation has begun that will make it harder for that stigma to continue.

“Sport is a microcosm of society,” Ottley said. “Mental health issues were always there, but the difference is now we are talking about it.”

Whether the current wave of athletes speaking up is enough to change the culture of sports remains to be seen. But for individual athletes, this movement couldn’t be more profound.

“They are paving the ground,” Stewart said. “It gives people a way to introduce the conversation. It makes it safer for athletes to talk about this.”

This month, Biles returned to competition for the final event of the Olympics, taking home the bronze medal for her performance on the balance beam. She told reporters she was competing for herself and no one else, proving that great performance can’t be forced. 

If what we want from athletes is to be wowed, then perhaps we have to start understanding what it takes to get there. Sometimes, that’s a mental health break.

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