Sports and athleticism hold a unique space in our society. Whether professional, amateur, or recreational, those who dedicate themselves to a sport or active lifestyle are often perceived to be "stronger" and "tougher" than others. Devotion to a sport conveys a certain resilience and ability to persevere through adversity. This may be true when things are going as planned, but when athletes face injury, performance setbacks, or end of career transitions, the proverbial rug is swiftly pulled and athletes may find themselves with feelings of sadness, shame, anxiety, and fear. Because of the unique relationship many have with their pursuit of sport and fitness, it is important to consider specific factors which may add insight into these mental challenges.

Self-Worth and Performance: Another Relationship to Consider

I view the relationship an individual has with their sport or activity, whether it be professional football or amateur bike racing, to be no different than relationships with other people. The pursuit of this "relationship" through continued goal setting, improvement, and reward through achievement sets athletes up for possible dependence on sport for ultimate internal validation and identity. Ideally, there is complete differentiation between an individual and their sport just as in our relationships it is ideal if we are not co-dependent on others for emotional validation. Of course, this differentiation is always difficult, but because of the emotional investment and inherent behavioral rewards in sports and athleticism (confounded by superficial societal value on sports and the athletic physique), relationships individuals have with their activity quickly becomes a snare of sometimes debilitating proportions.

In order to address this, I believe it is important to employ an approach which takes into account the need for establishment of core identity outside the athletic pursuit. This may mean working with individuals to challenge core negative self-beliefs and issues of inherent self-worth. Individuals must believe they are worthy intrinsically, in order to begin establishing a healthy approach to recovery and re-engagement with their athletic activity.

Focusing On Mental Health = Weakness

Athleticism on any level is founded on the idea that one must "persevere" through pain and discomfort and mental health "issues" carry a debilitating stigma. While this may be true in the purely physical context, mental health concerns are not so easily addressed with brute force. By nature, addressing mental health concerns involves a level of disclosure and immediacy with another person which in itself is intimidating, and in near complete opposition to the aggressive attitude necessary for individuals to succeed in competition. To combat this, it is important that friends, loved ones, and counselors understand the pressure and necessary coping mechanisms when talking with someone who has invested themselves in athletics. When athletes learn to balance these two mindsets, there can be a return of confidence and focus in competition along with a core acceptance of self and relief from depressive and anxious thoughts.

Traumatic Brain Injury and the Need for Medical Assessment

While the connection between brain injury and mental and emotional disorders is not new, it is now at the forefront of the discussion in the United States when considering these difficulties in athletes. Struggles with mental health are prevalent among professional and amateur athletes, particularly among boxers, football, and hockey players who suffer from CTE (chronic traumatic encephalopathy). This connection is well documented and represents the need for attention from doctors, psychiatrists, and mental health providers to team up in identifying early signs of distress and engage in a robust plan for treatment.

What It All Means

It is important for athletes and their coaches, family, and friends to develop an awareness of the signs and symptoms of mental health issues. Further, it is important for all individuals involved in the treatment of athletes, amateurs, and recreational enthusiasts to recognize the unique implications and presentation of mental health concerns in these individuals. Removing the stigma is only the first step towards a comprehensive approach to wellness.