Mental Health Considerations for Athletes

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Introduction

Introduction

Athletes and mental health have been at the forefront recently, with Olympic and professional athletes publicly opening up about their struggles.

Short video to add: https://youtu.be/dakoO8WJ3mY

The mental health of athletes is as important as their physical health (Mental Health and the Correlation with Professional Athlete's Performance, a

Rapid Literature Review-Working Paper) Athletes rely on their mental health and strength to “provide a necessary basis for efficient practice and competition performance” . Mental health and correlation

The World Health Organisation defines mental health as follows: “Mental health is the foundation for the well-being and effective functioning of individuals. It is more than the absence of a mental disorder; it is the ability to think, learn, and understand one's emotions and the reactions of others. Mental health is a state of balance, both within and with the environment. Physical, psychological, social, cultural, spiritual and other interrelated factors participate in producing this balance. There are inseparable links between mental and physical health.” https://www.who.int/westernpacific/health-topics/mental-health

Our mental health influences the way we think, feel and act. It determines how we cope with stress, and how we relate to others, and it influences our decision-making processes. (WHO)

The Mental Health Continuum

Mental health is not an all-or-nothing concept and can change, thus one should consider it as being on a continuum spanning from excelling through to struggling or being in crisis. Where a person finds themselves on this continuum will influence the way a person thinks, acts and feel. A person can move between these states of well-being on the continuum. The different states are thriving, surviving, struggling and in crisis. (Keyes CL. The mental health continuum: From languishing to flourishing in life. Journal of health and social behavior. 2002 Jun 1:207-22.)

See this useful tool:

Mental Health Continuum Visual Aid  - https://aace.org.uk/wp-content/uploads/2022/05/Mental-Health-Continuum-Final-Visual_b.pdf

Prevalence of Mental Health in Elite Athletes

It remains difficult to accurately compare the prevalence of mental health symptoms in athletes to the general population. Reasons for this are: Reardon CL, Hainline B, Aron CM, Baron D, Baum AL, Bindra A, Budgett R, Campriani N, Castaldelli-Maia JM, Currie A, Derevensky JL. Mental health in elite athletes: International Olympic Committee consensus statement (2019). British journal of sports medicine. 2019 Jun 1;53(11):667-99.

Studies investigating elite athletes lack reference groups from the general population

Different instruments are utilised to assess mental health symptoms and disorders in athletes compared with the general population

Cross-cultural differences in the meaning and manifestation of mental health symptoms and disorders are not considered in some research studies

Variance in methods of reporting mental health symptoms – self-reported or physician diagnosed disorders.

Reported prevalence: Reardon CL, Hainline B, Aron CM, Baron D, Baum AL, Bindra A, Budgett R, Campriani N, Castaldelli-Maia JM, Currie A, Derevensky JL. Mental health in elite athletes: International Olympic Committee consensus statement (2019). British journal of sports medicine. 2019 Jun 1;53(11):667-99.

Male elite athletes involved in team sports such as cricket, football, handball, ice hockey and rugby) – prevalence varies from 5% for burnout and adverse alcohol used to 45% for anxiety and depression

Prospective studies with follow-up studies of up to a  12-month period indicate that mental health disorders are prevalent in 5% - 35% of elite athletes

Eating disorders are quite prevalent among female elite athletes

Collegiate athletes – 10% to 25% prevalence of mental health disorders such as depression and eating disorders

A combination of generic and sport-specific factors may increase the risk of mental health symptoms and disorders in elite athletes. Athletes may experience an increased risk when confronted with:

Severe musculoskeletal injuries

Multiple surgeries

A decline in sporting performance

A tendency for maladaptive perfectionism

On the other hand, sports participation may protect athletes against mental health symptoms and disorders seeing that exercise has antidepressant effects.

Sometimes athletes may even have mental health symptoms with no clear association between sports participation and the mental health condition

Specific Mental Health Symptoms and Disorders in Athletes (ioc consensus)

Sleep disorders

Sleep concerns

Major depressive disorder

Depression symptoms

Suicide

Anxiety and related disorders

Post-traumatic stress disorder

Trauma-related disorders

Eating disorders

Attention deficit/hyperactivity disorder

Bipolar and psychotic disorders

Sport-related concussion

Substance use and substance use disorders

Gambling disorder

Depression in Athletes

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