Taking a Look at Child Athlete Mental Health

matimix/AdobeStock

Q&A

With the eye-opening conversation taking place around young athletes and suicide,^1,2 Psychiatric Times^TM is interested in taking a closer look at athlete mental health, specifically for children and adolescents. As part of our investigation, we sat down with Rashmi Parmar, MD, a psychiatrist with Mindpath Health, to talk all about young athletes’ mental health.

Psychiatric Times (PT): Olympic athletes like Simone Biles are under a lot of pressure.³ How can we preserve the mental health of young athletes?

Parmar: We are well aware of the benefits of physical activity and exercise that goes hand in hand with sports. People who participate in sports at a young age benefit in numerous ways throughout their lifespan. It impacts a person’s physical as well emotional wellbeing in a positive way—not to mention the added benefit of overall personality development, along with the capacity to develop better communication skills, networking abilities, and resilience towards accepting loss/failure.

However, excessive involvement in sports also has its downside. Some competitive sports may involve a busy schedule of practice and exercise, which does not leave enough time for other activities in an athlete’s day-to-day routine. You must also learn to deal with the competitive attitude of sports, and thereby cope with winning or losing in a graceful manner.

Here are some ways to preserve the mental health of young athletes.

-As a parent or a coach for a young athlete, start with modeling positive behaviors yourself first. Take difficult moments in a game as a teaching opportunity rather than directly yelling or screaming at the child out of frustration. Avoid intimidation efforts. Children observe adults closely in their reaction to stress and will imitate them when dealing with a stressful situation.

-Create a nurturing environment around the child while playing sports with a lot of emphasis on positive values like fair play, sportsmanship, respect, etc. Comment directly on their positive attributes and overall efforts towards the game rather than their actual performance. Incorporate some fun and lighter moments during practice whenever possible to create a balance.

-Emphasize more on learning and improving at a sport rather than placing importance solely on winning or losing a game.

-Encourage a child to try their hands at multiple sports from an early age rather than specializing in one. Research shows it is linked with better overall success and fewer sports related injuries over time.

-Teach them to be aware of their feelings, and encourage conversation about mental health and stress management. Introduce them to creative stress management skills like participation in other activities/hobbies outside of sports, maintaining a healthy and well-balanced lifestyle with adequate relaxation time.

PT: How much pressure is too much?

Parmar: This is a very subjective question that is quite difficult to answer. Generally, I educate my child and adolescent patients that a healthy amount of pressure is essential for improving performance and boosting self-confidence. This rule generally applies to most aspects of life, whether it is academics or sports. However, if the pressure exceeds to inappropriate levels, you will start noticing problems not just with the child’s performance in the particular activity, but also in their overall physical and emotional well-being.

Kids and young adults often need pushing and encouragement to keep working on their goals, especially when we consider competitive sports. It is essential to prepare them in advance for the tough environment and pressure they will be facing. It is also important to keep in mind that the expectations placed on the child or young athlete should be based in reality, and in sync with their overall abilities. Pushing them too far when they clearly lack the required skills or capabilities to succeed at that level can prove very problematic. You do not want to create false hope only to disappoint them at a later stage when they realize their shortcomings.

Some of the early signs that a child is under excessive pressure are:

-Visible signs of emotional stress like withdrawn behavior, tearfulness, sad mood, and anxiety symptoms

-Excessive fatigue, low motivation to do things

-Waning level of interest in sports and/or other activities

-Changes in sleep and appetite

-Decline in overall performance at school and/or sports

PT: Is it better to specialize in one sport or try several? Is early specialization in one sport dangerous to a child’s mental health?

Parmar: Prior research has made it clear that specializing in a single sport especially before puberty is linked with more injuries, overall stress, and burnout in athletes. This is why the American Academy of Pediatrics recommends trying out different sports at an early age to reduce the risk of longer term adverse outcomes. The rationale of specializing early in a particular game to get an edge over others has not proven to be of any particular benefit in the long run. In fact, a lot of renowned athletes start competing in their preferred sport at an older age after having sampled multiple sports when younger.

Participating in different sports is beneficial for overall personality development, leadership and team building skills, development of a broader spectrum of skills, and better health in general. When you specialize in a single sport, you are at higher risk of overusing the same group of muscles which are bound to get worn out or injured over time.

PT: How does injury impact a child athlete’s mental health?

Parmar: A significant sports injury does not only hurt the child physically, but also has lasting emotional effects. Young athletes often take it hard when they have to take a break from their sport to heal injuries sustained while playing. Many feel devastated and lost without the sport, especially if they have devoted a significant part of their life to it. Many feel pressured to hide their true emotions and act tough in face of difficult situations during play. It is important to let athletes know that difficult emotions are a normal part of play just like physical injuries are meant to be. It is ok to take time to process them and ask for help when needed.

When left untreated or ignored, many can develop serious conditions like depression, anxiety disorder, or may abuse alcohol or illicit substances to cope with their feelings.

It is important to realize that one must be physically as well as mentally fit to be able to excel at a sport. Star athletes like Simone Biles face tremendous amounts of pressure when they represent their countries on a global stage. One can only imagine their true internal feelings before facing every game, weighed down by the pressure of an expected flawless performance. The world can forget that even star athletes are humans and are vulnerable to weaknesses and can make mistakes. This kind of relentless pressure can lead to burnout and eventual decline in performance if not managed well.

What Simone Biles did during the Tokyo Olympics was exemplary and raised awareness of mental health in the world of global sports. It must have taken a lot of courage and determination on her part to withdraw from the Olympics. She definitely paved the way for future aspiring young athletes to advocate for their emotional wellbeing in face of stressful situations. In general, there is a huge taboo amongst younger athletes in seeking help for their mental health, followed by low awareness and denial of the need to seek help.’ Many embrace the ‘perfect or superhuman’ identity as a normal part of their lives. External pressure from coaches and parents makes the situation worse.

PT: Thank you!

References

1. Harry Miller: Ohio State offensive lineman says he is medically retiring from football, citing mental health struggles. CNN. March 11, 2022. Accessed March 14, 2022. https://www.cnn.com/2022/03/11/sport/ohio-state-harry-miller-medically-retiring-spt-intl/index.html

2. Fieldstadt E. Parents of Stanford soccer captain found dead in dorm say they ‘had no red flags.’ NBC News. March 4, 2022. Accessed March 14, 2022. https://www.nbcnews.com/news/us-news/parents-stanford-soccer-captain-found-dead-dorm-say-no-red-flags-rcna18700

3. Silva D. ‘We're human, too’: Simone Biles highlights importance of mental health in Olympics withdrawal. NBC News. July 27, 2021. Accessed March 3, 2022. https://www.nbcnews.com/news/olympics/we-re-human-too-simone-biles-highlights-importance-mental-health-n1275224