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Athlete Mental Health Issues on Display in Tokyo

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American gymnast Simone Biles at the Tokyo 2020 Olympics. Photo: Lindsey Wasson / Reuters

By Dr. Tomi Wahlström |

The Tokyo 2020 Olympics were unique in many ways. One of the most unique parts was how they brought new awareness about mental health issues among Olympians. We always expected that Simone Biles was going to be remembered for these games, but probably did not expect to see what ended up happening. She took a stance for her own mental health and spoke quite openly about her struggles. She was not the only athlete that mentioned mental health struggles. Naomi Osaka also spoke about how she could not handle the pressures and expectations. Mental health issues have been shared by others even before Tokyo. Michael Phelps is probably the most famous athlete spokesperson for mental health awareness.

One may ask whether there was something unique about Tokyo that caused more mental health struggles among athletes than previous Olympics. There were many factors that should be considered. The COVID-19 pandemic is the most obvious one. Also, there were some weather considerations as many events were conducted in extreme heat conditions. The fact that the games were delayed by one year was an additional factor for increased stress and pressure. Also, the time difference created a particular challenge when combined with the pandemic and the resulting restrictions.

The pandemic caused athletes to be quarantined and isolated into the Olympic village. They were not allowed to leave other than to practice sessions. In addition, they were not allowed to bring any family members with them since there were no spectators permitted at all. The resulting sense of isolation and boredom may have been very stressful for the athletes. The lack of emotional support from family members may have been a significant factor considering that some athletes are very young. They needed their families by their side. Athletes need support systems. This time, they not only did not have anyone physically present but the time difference made it hard to keep in touch with family members and other support systems digitally.

The games were played in very hot weather conditions. This is not only harmful physically but it can have a significant impact on psychological wellbeing as well. Heat can increase anxiety levels of athletes. It can impact sleep cycles and cause insomnia. Heat attacks can have severe consequences that can last up to four months. Symptoms of heat stroke can manifest with altered mental state and behavior including confusion, agitation, irritability, slurred speech, and delirium. Extreme heat can also lead to symptoms of depression and increased suicidal ideation. While Olympic athletes are fit people, they are not immune to these effects especially when they are already exposed to conditions that could lead to increased stress and anxiety.

Preparing for the Olympics is a very delicate process. It takes a lot of discipline and practice. All of the training must be timed accurately for the athlete to be in the proper state of mind and peak condition. Athletes must be in the “zone” to perform in an optimal manner. When the Olympics were postponed and athletes were forced to quarantine and not allowed to practice, the timing of the preparations was altered. Many athletes were not able to really recover from this and get back into their peak shape. This preparation is hard physically but there is also a psychological aspect to it. The Olympics are stressful and athletes are under incredible amount of pressure. They are expected to perform under any circumstances. Mental preparations take a toll and when they have to be done twice with all of the uncertainty in the air, mental illness risk increases.

Unfortunately, there is not a sufficient focus among trainers and coaches on mental health and wellbeing of Olympic athletes. The existing system focuses on performance, first and foremost, and does not support athletes with mental health issues. There needs to be better understanding of the stress and pressure that elite athletes experience. Mental health is important and mental illness is widespread. Athletes are humans like the rest of us and subject to the same pressures that we all feel. The pandemic has been hard on everyone. People have lost loved ones and been isolated from their families. Olympic athletes are also subject to the economic stressors caused by COVID-19. While not attending Olympics, they must survive. Most of them are not independently wealthy or have lucrative sponsorship deals. They struggle like the rest of us.

Tokyo Olympics were definitely something that we have never seen before. We learned a lot from them, and hopefully we have opened our eyes on the importance of mental health issues among Olympians. We will be following Simone Biles and Naomi Osaka for a while, and hoping for them to join the likes of Michael Phelps to educate us. We need to learn to start to change. They can help us if we are willing to listen. They can help themselves and other Olympians so that the games of the future would be safer for all of them.

Dr. Tomi Wahlström is the Provost at the United States Sports Academy.

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