“Can I cope?” – Mental health in adolescent elite athletes

iStock_000013667912Medium - KopieSport is good for you. Not only for your physical condition, but also for your mental state. This is what we have been taught by our parents, physical education teachers, coaches and popular magazines. And it is indeed well documented that recreational exercise and sport activities are associated with numerous positive psychological effects, such as a lower risk for depression, stress or anxiety.

However, when competing on the elite level, athletes have to invest a great deal of time and energy into their sport. Especially as adolescents, athletes have to integrate their sport into their academic schedule: in addition to their demanding school work, the athletes have to travel far distances for competitions, are often away from home, have to sacrifice quality time with their friends to adhere to their training schedules and need to cope with grueling talent selection procedures. One of my closest friends, who works with adolescent elite athletes on a daily basis, made me aware of another great stressor in the athletes lives: due to the (social) media, young athletes know everything about their idols’ practices, training plans and achievements. As they want to follow in their idols’ footsteps, many young athletes set themselves unrealistic goals and have unreasonably high expectations which they can hardly live up to.

Stress-related symptoms in adolescent athletes

If the aforementioned demands exceed their physical and mental resources, young athletes may experience stress and therewith associated symptoms. A German study revealed that of 341 adolescent elite athletes, every second athlete showed low values in their quality of sleep, every 6th athlete suffered from poor recreation and every 7th athlete reported not being able to cope well with stress. Sadly, many promising adolescent athletes drop out of their sport because they feel overwhelmed by the physical and mental pressure that is associated with competing at such a high level. A staggering 70% drop out during high school age, preventing promising athletes from transitioning to a professional career. Another sad consequence of not being able to cope with stress in the sport context is athletic burnout (for my previous post on burnout see here). Swedish researchers uncovered that male adolescent team athletes are – in fact – at highest risk of suffering from this disorder.

The aforementioned findings about stress-related symptoms and disorders in the sport context might seem surprising to many, as it is still a common presumption that elite athletes are mentally tough and immune to any kind of stress and psychological disorders. But just because we don’t hear a great deal about these struggles, it doesn’t mean that they don’t exist. In fact, elite athletes are at the same risk of suffering from depression as non-athletes. And when looking at eating disorders, athletes of “leanness sports”, such as running, wrestling, figure skating and dancing, are especially vulnerable. Furthermore, substance abuse is more prevalent in the athletic as in the general population; however, it is not clear if the reason for this has more to do with issues of dependence or performance enhancement.

But why don’t we hear more about the struggles that young elite athletes are dealing with? Athletes might not inform their coaches, team players or parents for several reasons: to avoid stigma, for not wanting to be pitied, for the fear of losing their playing positions or for worrying about the renewal of their contracts. Oftentimes, athletes do not come clean about their problems until they have already dropped out of their sport or have retired (as in the case of Andre Agassi).

How can we help?

First and foremost, we should not forget that for the most part, being engaged in elite sports is highly beneficial for young athletes, as it helps them develop into self-confident, mature and successful adults. Nonetheless, to ensure this positive transformation, we have to support our young athletes in coping with the stressors that are part of elite sports and we need to have an open ear for their worries and struggles. Luckily, researchers increasingly research this topic and give us important advice on how to lend our support: it has been found that young athletes desire social support and a positive coach-athlete relationship when experiencing stress. However, if a supportive social network and a good coach-athlete relationship are not enough, there are initiatives specifically addressed at elite athletes struggling with mental health issues (for example the German initiative MentalGestärkt).

The life of an adolescent elite athlete is not easy, that much is clear. But I would like to conclude this article with a quote by Roger Staubach, a former star NFL quarterback: “We all do well when things are going well. What distinguishes athletes is the ability to do well in times of great pressure.”

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