The past two weeks of the Olympics have been a thrill for those of us who love watching our fellow humans accomplish seemingly unfathomable feats. But aside from their unique skills, many of the medallists have a lot to say about their mental health.
First, there's the GOAT, Simone Biles. Her gymnastics skills are superhuman. After withdrawing from the Tokyo Olympics because of “Twisties,” she said she was shaking before the Olympic team gymnastics final and withdrew after realizing she was “not in a great mental state.” It was a courageous and difficult decision for someone who was always going to be a gold medal contender. “I had to deal with some issues,” she told reporters. One of the things she had to deal with was being a victim of U.S. Olympic gymnastics team doctor Larry Nasser. Nasser was later accused and convicted of child pornography and child sexual abuse. In a sport where perfection is expected and eating disorders are prominent, Biles' teammate Suni Lee said, “Because it's a sport, we're really focused on our mental state right now.” And Michael Phelps, the most decorated athlete in Olympic history, has openly spoken out about his struggles with anxiety, depression, ADHD and suicidal thoughts. Phelps said he previously viewed vulnerability as a weakness, but has since learned that vulnerability can lead to change.
In October 2023, to mark World Mental Health Day, several Olympians were interviewed about their experiences with mental health struggles. Noah Lyles, who won gold in the 100 meters and is currently hailed as the fastest man in the world, told reporters, “I've been in therapy since I was nine years old, so this is not foreign to me. It's normal, it's natural. Mental health is not a thing, it's part of everyday life. We're just talking about everyday things, and it just happens that we feel vulnerable and uncomfortable. When we feel vulnerable, we don't want to talk about it. But it's the same everyday thing that we go through all the time, so it's like, let's start with the easy stuff.”
Top athletes speaking openly about their mental health issues serve as a positive example to those who feel there is still a stigma attached to mental health: hearing that Olympic heroes share the same struggles as the rest of us helps normalize the fact that we are all human, and vulnerable.
In 2018, the International Olympic Committee convened an expert meeting to review the scientific literature on mental health symptoms in elite athletes. The aim was to identify best practices for interventions to improve their mental health. They concluded that management of mental health symptoms in elite athletes should be comprehensive and integrated. They included a unique self-report screening tool called the Baron Depression Screener for Athletes. It consists of 10 items, with respondents scoring each item from 0 (not at all) to 2 (most of the time over a two-week period). If an athlete scores more than 5, they should be evaluated by a mental health professional.
After realising the scale of the problem, the IOC set out to expand its mental health services. They developed Athlete365, a platform to support athletes on and off the field, providing advice and strategies, with a primary focus on wellbeing. One of the services offered is an online course called “Sleep to Compete”, which highlights the importance of good quality sleep for peak athletic performance and gives participants techniques to improve their sleep habits. Athletes taking part in the Tokyo and Beijing Olympics had access to the Mentally Fit helpline, developed to provide confidential, specialised mental health support services before, during and after the Olympics.
For 2023, the IOC has developed a new Mental Health Action Plan designed to take a broader approach to supporting and protecting athletes' mental health. The plan emphasizes the importance of mental health, not just physical health. Researchers who helped develop the plan cited a 2019 study that found 34% of elite athletes and 26% of former athletes reported symptoms of anxiety or depression. Some athletes have their own therapists to help with mental health issues. But during the Paris games, former NBA chief psychologist Kevin Smith and his team were available 24/7 to assess athletes' mental health. Athletes could schedule appointments with psychologists or call on one in the Olympic Village or arena during competition. The psychological support staff responded to Team USA without prejudice, with the goal of reducing stigma. Smith told reporters: “In the Olympic environment, where there's tension, anxiety, regret and imposter syndrome, it's good to have someone to reinforce the confidence that athletes once had but may have disappeared in an instant. They just need to be reminded, they need to hear those special words at the right time to reinvigorate all of their hard work and achievements.”
Thank you Olympic athletes. Many of you began training almost as soon as you could walk. You have sacrificed not only your time and energy, but for some of you, your mental health. I hope that by speaking out about how the pressures and expectations of sports training have led to psychological symptoms, we “ordinary people” can also remove the stigma from seeking help. Instead of being negatively impacted by the need to be perfect, you have promoted your mental health in the same way you promoted healthy eating, staying hydrated, and getting enough sleep.
Congratulations to all the medallists and to everyone who worked so hard to qualify – you are all heroes.
