That pressure wouldn’t be unique to Meyer, whose death in early March shocked the sports world, say experts who work with student-athletes to help them overcome mental health issues.
“Collegiate athletes are just as susceptible, if not more, to most mental disorders,” Dr. Claudia Reardon, a professor of psychiatry at the University of Wisconsin, told CNN in an email. “It surprises some people who see these tough, physically flawless people and wonder how they can be depressed, anxious or suicidal.”
Student-athletes live with the same demands as regular college students, such as maintaining their grades and social life and keeping in touch with their families. But they also face the need to perform on the field or on the court, require training and training schedules, travel and – for those in high positions – scrutiny from the public and fans on social media and traditional media.
On top of that, mental health stigma persists in the sporting world — discussed, treated, and possibly exposed to what might be perceived as a weakness, experts say.
At the same time, playing sports has huge health benefits for many student-athletes, they noted, and can also help them cope with mental health problems. And university-level programs are increasingly prioritizing hiring psychologists and other people attuned to the athlete mindset to support students who have also come to college to play sports.
However, the pressure student-athletes struggle with is different from their non-athlete peers, experts told CNN, while also creating challenges for doctors and others who work with them to overcome mental hurdles.
Requirements for student-athletes pose special challenges
A 2019 NCAA survey found that about 30% of participating female student athletes felt “difficulties piled up so high” in the month prior that they “very often” or “quite often” felt they couldn’t overcome them. The survey showed that among the participating male athletes, this figure was about 25%.
Of course, athletes are people too, and just like any other segment of the population, some have mental health issues. But the mental health issues of student-athletes complicate the demands on them and their bodies, and it’s not just anxiety or depression.
On the one hand, student-athlete injuries pose a risk for post-traumatic stress, said Dr. Josh Norman, an attending psychiatrist at the Ohio State University’s Jameson Crane Sports Medicine Institute. After an injury, he says, student-athletes may show heightened vigilance, “aversion” to certain movements or situations that may remind them of the “traumatic event.”
“These things can also show up in athletics when people get very seriously injured or witness a teammate’s life-threatening (injury) or death, such as in extreme sports,” he said.
A student-athlete’s struggles with mental health can also have repercussions on their physical health, Norman said.
For example, anxiety disorders can increase student-athletes’ muscle tension or tendency to be distracted, affect their sleep and performance, and increase their risk of physical injury, Norman said. When prescribing medications, student athletes and physicians should be aware of how medications can affect athletic performance and whether they can be controlled or prohibited by the NCAA or anti-doping agencies, he said.
Student-athletes’ time demands and the expectations they face often mean they don’t have much of a chance to take a break, said Chris Bader, assistant athletic director for mental health and performance at the University of Arkansas. While college students can take a mental health day and skip classes, athletes can’t.
The attention from the media and fans may represent another mental health risk for student athletes, a view also expressed by professional athletes such as Osaka.
Last spring, during the French Open, the four-time winner announced that she would not participate in press conferences, citing her mental health. The then 23-year-old soon withdrew from the tournament entirely, saying she had suffered from “prolonged bouts of depression” since her first Grand Slam title in 2018.
Osaka added that although the journalists were kind to her, “I am not a natural speaker and experience huge waves of anxiety before speaking to the world’s media.
“I’m very nervous,” she said. on twitter”and always straining trying to engage you and give you the best answers I can.”
College athletes feel it too. Many of them are in the national arena, and Norman hears of bullying when a student-athlete loses a game or makes a mistake, he said. Being in the spotlight can also complicate student-athletes’ symptoms of depression and anxiety, as well as their ability to seek treatment privately, like most people, he says.
Last year’s NCAA rule change, which allows college athletes to make money from their name, image and likeness, dubbed the NIL, could add another layer of stress, Bader said.
“Of course, I think that many of our students do well with it. They are kind of excited about it,” he said. According to him, he knows students with 3 million followers on TikTok. “I think they accept it. But also, what impact does it ultimately have on their mental health?”
Fighting old stigma
One of the biggest hurdles for some student athletes seeking treatment is the stigma that experts say lingers in the sports world.
According to Reardon, athletes can get into trouble when they turn off their “gaming face” when they go out of bounds, and are often encouraged to push through adversity – something Bader described as “an old-school ‘rub some dirt’ mentality.” and get over it.”
However, huge strides have been made in removing stigma, thanks in part to athletes like Osaka, Biles and Phelps speaking out about their own issues, experts who spoke to CNN said. Phelps, the most decorated Olympian of all time, shared his journey with anxiety and depression in 2018, saying during an interview with the Kennedy Forum, a behavioral health advocacy group, that he had suicidal thoughts in the past. Mental illness, according to Phelps, “has a stigma, and it’s something we still deal with every day.”
In addition, today’s student-athletes often come to college having already taken part in counseling, Bader said. Some have worked with sports psychologists as young athletes and they are aware of the resources available to them and sometimes even anticipate them. Coaches and instructors also recognize the benefits of good mental health and are well aware of when a student may need support, he says.
Sports conferences and schools are also prioritizing hiring sports psychologists, psychiatrists and other professionals who understand the mindset of athletes, Bader said.
“A non-athletic doctor might say something like, ‘Well, if your sport stresses you out so much, why not just quit?'” Bader said. “It’s like asking them not to be right-handed.”
“This kind of deep understanding of athletics as a variable—almost like a demographic variable—is the first step for me in working in athletics, understanding athletics.”
But more needs to be done to combat stigma and help those in need, experts say. Less than half of participating athletes are “very happy” with the way their schools and teams take care of mental health, according to an NCAA study.
According to Reardon, the NCAA did a lot by convening a mental health task force in 2013 to develop best practices, asking agencies to implement mental health referral protocols, ensure that mental health care is accessible to qualified practitioners, and “generally create an environment that supports mental well-being and resilience.”
“But many universities and colleges,” she added, “need the resources and staff to be able to do all of these things more consistently and more meaningfully.”
And it’s worth noting that for many sports, especially team sports, the mental health benefits of student-athletes are good for the community, which serves as a built-in support system.
“Sport can be about developing confidence, competence, character, caring, connection and friendship,” Reardon said, in addition to “higher academic achievement.”
“I think that’s why you see companies looking to hire former (student) athletes,” Bader added. “It’s intangible — it’s planning, it’s motivation, it’s drive, it’s competitiveness. We want to make sure they point in the right direction when they leave our buildings.”