Experts help athletes, including Olympians, with mental health struggles

Psychiatrist Chris Pelic, M.D., has never met Simone Biles. But the professor in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina has worked with college and professional athletes. And like most Americans, Pelic is in awe of Biles’ incredible feats as a gymnast – and her inspiring honesty about mental health. 

 

Biles, who has won seven Olympic medals, withdrew from some events at the last Olympics after suffering from the twisties. That’s a term gymnasts use for a mental block that makes them lose control of their bodies mid-air. Shortly before that, she said on Instagram, “I truly do feel like I have the weight of the world on my shoulders at times.” 

 

 

This year, she said on the Today Show, “I’m a little bit older, more mature, so just being unapologetically me.” She’s also back in the Olympic spotlight, physically and mentally primed to try to shine in Paris. 

 

But Pelic said Biles may still face challenges beyond the obvious. “Simone's going to be an interesting scenario because she wants to come back with a vengeance, and her struggles were related to the Olympics. She's going to have a lot of extra distractions with people asking questions about it while she's there,” Pelic said.

 

She may feel like she has to represent everyone who’s dealt with mental health challenges, which could put even more pressure on a hugely talented young woman in the middle of a global event, Pelic said. He hopes Biles can limit answering most questions about mental health until after her performances so she can concentrate on competing.

 

Returning to competition

 

Biles’ high-profile comeback begs the question: How do elite athletes return to competition after a difficult experience, especially one that occurred during a worldwide spectacle such as the Olympics?

 

First, Pelic said, they need the right kind of help. Like the estimated one in five American adults affected by mental illness each year, athletes face similar challenges – with the added pressure of scrutiny and competition. 

 

So it may come as no surprise that Worldmetrics.org, a data aggregator, estimates that 35% of elite athletes suffer from symptoms of anxiety and depression. And almost a quarter of pro athletes suffer from symptoms of another mental health condition: burnout.

 

Pelic said helping them recover begins with getting to the heart of the matter. “I think if they had some bona fide psychiatric conditions that needed treatment, the first thing in my mind is to address that. If there's depression, if there's anxiety, if there's substance use or eating disorder, whatever the issues are at hand, we need to effectively treat those,” he said.

 

“You will probably have conversations about sports along the way, but your priority is to get them well enough to even start thinking about that. There might be medication. It might be therapy. It might be both. And then, as they are improving or have improved fully and they start returning to whatever training they were doing, you're on guard to make sure that there's not a regression in terms of symptoms.”

 

Athletes as individuals

 

Pelic said each athlete is different. “There might have been unique circumstances that led to the symptoms; like maybe it was situational. Maybe they had an injury. Maybe it involved team dynamics. Maybe there was some scenario that they had to work through before. So you want to navigate any things that may have influenced the original symptoms in the first place and plan for that and deal with that.”

 

Unfortunately, Pelic said if a person has had depression and/or anxiety in the past, they’re at risk for having it again. “And then, when you put yourself in like a highly stressful situation, that risk goes up. So as the events start to approach, you might have more frequent appointments with a mental health professional – touch points. And having mechanisms for that athlete during their competition – that they have access to someone should things take a turn sideways.”

 

Some athletes decide to step away from competition. Others, like Biles, embrace it once they’re equipped with the help they need. 

 

Role models

 

Pelic said athletes are more comfortable getting the help they need these days – and that makes them role models beyond their athletic achievements. 

 

“Some of the changes to the mental health sports world have really been instrumental from Olympic athletes speaking out about it. Not just Simone Biles, but Michael Phelps, and there's a few others you can find, but those folks I think really have helped drive some of the change just with sports in general and the willingness people have to seek treatment, whereas before they haven't.”