Olympians Are Experiencing A Mental Health Crisis. Does Anyone Care?

On Tuesday, decorated gymnast Simone Biles announced that she wouldn't be competing in the individual all-around competition at the 2020 Tokyo Olympics, after withdrawing from the team finals. At first, spectators only knew the decision to step back from the competition — which she hasn't lost since 2013 — was caused by a medical issue. But soon after, Biles clarified that her decision was based on mental health concerns. “We have to protect our body and our mind," Biles said in a press conference later that day. “It just sucks when you’re fighting with your own head." She added a gentle reminder that she, her teammates, and all those competing are ​​"not just athletes, we’re people at the end of the day."

But Simone Biles is just the most recent in a string of high-profile athletes to have spoken out about mental health and the toll that professional sports can take on their wellbeing. Tennis pro Naomi Osaka has also come forward about the detrimental impact doing press during tournaments has had on her mental health, and decorated swimmer Michael Phelps executive-produced (and candidly spoke in) a documentary exploring the mental health challenges Olympians deal with, called The Weight of Gold.

It’s no coincidence that the issue is in the spotlight this year. Considering the extended lead-up to the 2020 Tokyo Games, the still-present threat of COVID-19, and the controversy that has surrounded this year's event, it's been especially stressful for athletes, exacerbating problems that have existed in professional sports for years.

Dalilah Muhammad found out the 2020 Tokyo Olympics would be postponed via Instagram. The two-time Olympic hurdler was actually taking a quick break from training on the track when she saw the news, she tells Refinery29. She looked at the athletes she was working out with and asked, “Is this true?” she remembers. “We were like, ‘Do we keep training or go home?’ There were so many emotions, it was overwhelming.” 

The spring of 2020 was brutal for most people, and athletes were no exception. Even before the 2020 Games were officially postponed at the end of March, athletes such as Muhammad had been in limbo, unsure if or when the sporting event would happen. For Olympic and Paralympic hopefuls, that kind of uncertainty can take a huge toll: Their training plans are meticulously designed to get them into peak mental and physical shape during the Olympics. If their events were being postponed, that could mean losing weeks of hard work and having to pivot to a new, longer training schedule. For some, COVID-19 restrictions had already thrown off their training, and not knowing if they would need to find a way to regain their fitness before the Summer Games was another stressor, on top of the already fraught early weeks of the pandemic.

“The most stressful time was when we didn’t know what would happen,” says Olympic swimmer Haley Anderson. “I was home alone in quarantine in my L.A. apartment and going through that... [For me, spending] even one day out of the water is really difficult. And then it was two days, and three days. It was the unknown of: If they don’t postpone, how can we get in shape in time to compete?”

Once word came that the Tokyo Games would be moved to summer 2021, many athletes had to ask themselves if it was sustainable for them to keep up with their intense training now that their events were more than a year away, says Jessica Bartley, PsyD, LCSW, who was hired as the U.S. Olympic and Paralympic Committee’s first director of mental health services in September. In the spring of 2020, Dr. Bartley hadn’t joined the USOPC yet, but had done contract work as a clinical sport psychologist with USA Karate and worked with USA Track & Field athletes. At the time, she had discussions with a number of athletes about whether they were willing to train for yet another year. “There were athletes who put off school or starting a family, so [we had to have] very candid conversations and ask, ‘What do these athletic goals mean for you and what do they mean for you in the grand scheme of life?’” Dr. Bartley says.

Would-be Olympians were also facing the same issues the rest of us were in early 2020: They were afraid for their health and their families' wellbeing; they were isolated from their social support systems. Some — including Muhammad this past January — were diagnosed with COVID-19. In May of 2020, the murder of George Floyd by Minneapolis Police changed everything once again: as a public outcry for justice overwhelmed the nation, it also weighed heavily on Black athletes, many of whom already carried the burden of achieving success in a racially discriminatory system. “You’re motivated to still go for it because it’s your dream, but you’re trudging along at times,” swimmer Simone Manuel said this June after revealing she’d been diagnosed with overtraining syndrome. “Being a Black person in America played a part in it.” 

For the athletes who made it to the 2020 Games, the stressors only continued to add up. During every Olympics and Paralympics, participating athletes are left to grapple with a relentless barrage of media attention, and the pressures inherent to competing on a world stage. “It’s also lonely and you spend so much time traveling with your team, you might be in a hotel room by yourself,” 17-time Paralympic medalist and track and field star Tatyana McFadden tells Refinery29. Additionally, many athletes are under tremendous financial pressure. While big-name athletes might have sponsorships that pay the bills, most of those who compete have to find other ways to make ends meet while also training. This year, the event’s institutional racism and sexism have been in the spotlight as well, with people questioning, as the nonprofit Color of Change tweeted, the Olympics’ “pattern of selectively & cruelly punishing Black women.” 

Despite all that athletes face, however, their mental health needs can go unaddressed.

That’s partially because some athletes feel uncomfortable asking for help, according to Trent Petrie, PhD, a professor and director for the University of Northern Texas Center for Sports Psychology. In a June 2020 survey, he asked college athletes about their use of mental health services before and about six weeks following the cancellation of the college sports seasons, which occurred in mid-March 2020. “The unfortunate reality is that in our sample, upwards of 70% never were using any of the mental health resources that were available to them,” he says. As a society, people have a hard time asking for help with mental health in general, says Dr. Petrie. But athletes have additional pressures that can make it even more challenging. “Some see it as signifying weakness or vulnerability,” he says. “There’s a ‘push-through’ mentality that athletes have,” Muhammad agrees.” It’s good in sport but it’s not always good in real life.” 

But others say that athletes not speaking up is a symptom of systemic issues in sports that penalize athletes who do prioritize their mental health. “I think it has to start with organizations and governing bodies prioritizing the mental health of athletes, which is not something I often see,” Aly Raisman, a gymnast and three-time Olympic gold medalist, tells Refinery29. “For a long time, it’s been the medals and money and reputation of organizations over athletes' mental health and wellbeing. It’ll be hard for athletes to feel like they’re being taken care of or treated the way they should be.” 

Both Raisman and Dr. Petrie say they’ve felt heartened by big names such as Simone Biles and tennis pro Naomi Osaka coming forward about their mental health, saying that these kinds of statements can normalize seeking care for all athletes. But, Raisman adds, she’d like to see governing bodies, such as USA Gymnastics, make looking after the mental health of athletes a top priority. Doing so might give more folks the courage to ask for support, she says.

And in that area, Raisman says she doesn’t believe things have gotten better. “I can’t speak for the other governing bodies or other athletes, but from my perspective, personally, in my every day I don’t see a difference in the way that I’m treated by USA Gymnastics,” she told Refinery29 in an interview the week before the Olympics. “Myself and other survivors who have spoken out are treated like garbage on the side of the street. They don’t care about how we feel. But, you know, I hope that the Olympic athletes who are competing now are treated better. But from what I'm seeing online from certain athletes speaking out…”

Here, Raisman trails off. But her point is clear: After Osaka announced she wouldn’t be appearing at press conferences at the French Open, in part to protect her mental health, she was threatened with suspension and fined $15,000. She ultimately withdrew from the Open entirely and has since been vehemently criticized — though others, including tennis stars such as Billie Jean King, Serena Williams and, Venus Williams, have spoken up in support of the athlete.

Biles, meanwhile, has received both praise and negative attention online for her withdrawal. Controversial media talking head Piers Morgan tweeted of Biles: "Are ‘mental health issues’ now the go-to excuse for any poor performance in elite sport?... Just admit you did badly, made mistakes, and will strive to do better next time. Kids need strong role models not this nonsense." But many others also made their voices heard in support of Biles. Raisman said she was “proud” of Biles. USA Gymnastics tweeted: “We wholeheartedly support Simone’s decision and applaud her bravery in prioritizing her well-being. Her courage shows, yet again, why she is a role model for so many.” 

Still, given the backlash athletes who speak up about mental health are currently facing and have experienced in the past, Raisman says: “[Governing bodies just trying to do ] ‘better’ is not acceptable. When someone says it’s ‘better,’ it’s just starting from such a low bar that it’s still not acceptable, even if someone says it’s a little bit better.”

Refinery29 asked USA Gymnastics if they'd like to comment on this sentiment, but has not yet received a response. When Refinery29 told Dr. Bartley we'd heard from someone who said that the governing bodies and USOPC haven't done enough to prioritize athlete mental health, she said: "We are rapidly growing the mental health support available to Team USA athletes and look forward to how we can continue to improve what we are offering to meet their mental health needs."

The issue here is an urgent one, since getting the appropriate help can be life-changing. In 2019, for instance, Olympic weightlifter Kate Nye revealed she’d been diagnosed with bipolar II disorder and mild ADHD. She sought help from a psychologist at the urging of her husband, in the midst of Olympic qualifications when she was finding it hard to get out of bed. She thought she had depression, but “having that diagnosis helped me make sense of my symptoms and be able to deal with them in more healthy ways,” she tells Refinery29. “That diagnosis helped me get to the point where I feel I have my mental health in check most of the time. It was really hard at the time accepting that I have bipolar disorder, but it ultimately helped me get to where I am — and I’ve never felt better.” 

Although there’s much more work to be done, with Osaka, Biles, Phelps, and others putting mental health in the spotlight, the Olympics and Paralympics have had no choice but to listen. Due to the extra stressors the Tokyo Games have presented, Dr. Bartley says that the team tried to add extra mental health safety nets for athletes this year. She says that Team USA has a mental health support line, with a contracted troupe of licensed mental health professionals who can pick up the phone 24 hours a day. They also have built up what Dr. Bartley says is a diverse network of professionals available for virtual and in-person counselling to all the Olympic and Paralympic hopefuls, which launched this spring.

“We’ve been trying to come to the athletes so they don’t have to come to us,” Dr. Bartley adds. “A coach, for example, might tell us that so-and-so just tore their ACL and will ask, ‘Will you reach out to them?’ With an injury like that, you won’t just need physical treatment, but mentally, they may need us.” She also says she'd welcome any Team USA athlete, past or present, to contact her and weigh in on what their mental health support needs are. 

Dr. Bartley notes that aftercare, too, will be a top priority, since the post-games period can be difficult for many athletes. “You’re doing so much training, and then races are over in seconds,” McFadden says. Olympic runner Alexi Pappas echoed this sentiment in her memoir. “It’s not uncommon for Olympians to feel a sort of post-Olympic depression, however mild or severe,” she wrote. "It makes sense: You’ve worked your whole life toward this exceptionally challenging and singular goal, and then it happens, and suddenly it’s over."

A team of sport psychologists has traveled with Team USA to the Games as well, adds Sean McCann, PhD, a senior sport psychologist at the USOPC in an email. “Not having family, friends, or fans on the ground during the Games this year will bring in a new set of challenges, but we will be with them every step of the way,” he says. “In Tokyo, it will be so important for athletes to stay virtually connected with their family and friends and tap into their support systems however they can. On the ground, athletes should plan to find a mentor, coach, or another athlete to use as a sounding board so they don’t ever feel like they’re ever going at it alone. We’re a community and a Team USA family, and we need to take care of one another.” 

Yes, there's value in non-professional support, too. “In my opinion, some of the best resources in the sport are your peers,” Muhammad says. “They’re going through the same things you’re dealing with. When you’re having open, candid conversations, you start realizing you’re not alone.” She says she’s never used a sports psychologist on her team. “It’s kind of hard to use initially," Muhammad notes. "When you’re feeling a certain way, I think a lot of times you’re putting it off thinking: It’s not that bad. And reassuring yourself there’s nothing wrong until you absolutely need the help."

Ultimately, there’s no one cure-all to the Olympics’ mental health problem. “One of the most important things, in my opinion, is acknowledging that mental health doesn’t mean the same thing for every person or every athlete,” Raisman says. “It can’t be a one-size-fits-all approach.” 

Hopefully, more athletes who need to will follow Biles’ and Osaka’s examples and begin prioritizing their own mental health. Muhammad says in the past few years she’s taken additional steps to look after her own mental wellbeing in her own way. “I do think athletes struggle a lot more than we let on, especially when you’re at the top of your game and sport,” she says. “You’re fighting this battle of being someone’s hero and strong figure, while also dealing with your own human feelings. You’re battling. Putting on a show. When do you do it for the greater good, and when do you just break down and say enough is enough?" she asks. "I’ve had those moments, especially after my 2019 season… when I was putting a lot of pressure on myself to win. I was fortunate to achieve the goal I set out to, but it didn’t change the feeling I was feeling, that it almost wasn’t enough.” 

The one thing she knows is that silence isn't the answer. “Letting people know where your head is at can really change the end game,” Muhammad says. “For me, just realizing that you're human and that you can let yourself feel the way you’re feeling. And you can let it be known so you can, in return, protect your mental health... That's big.”