How to Support Mental Health Wellness for Student-Athletes

Student-athletes are at higher risk for mental illness due to several factors. The intense pressure to perform both academically and athletically can lead to significant stress and anxiety. Balancing rigorous training schedules with academic responsibilities often results in physical exhaustion and lack of sleep, which can negatively impact mental health. The high expectations from coaches, teammates, and themselves can contribute to feelings of inadequacy and low self-esteem.

Additionally, the culture of toughness in sports can discourage athletes from seeking help for mental health issues, exacerbating the problem. Injuries and the fear of losing their athletic identity further contribute to mental health struggles.

A 2023 NCAA Student-Athlete Health and Wellness Study survey of student-athletes suggests they are experiencing fewer mental health concerns than they did at the height of the COVID-19 pandemic, but some demographics have shown more improvement than others. The survey asked questions about feeling mentally exhausted, overwhelmed, and whether the student athletes experienced sleep difficulties.

When asked what is driving their negative mental health, most of the answers were not athletics related. The biggest cause of anxiety was academic worries followed by financial worries and the future.

College is a transitional time of navigating new friendships and developing a sense of belonging. These additional stressors can acerbate psychological vulnerabilities.

A majority of student-athletes said they feel their coaches care about their mental health, but only 54% of men and 33% of women feel comfortable talking to their coaches about mental health. “This could be due to stigma, but it could also be that there are more resources on campus so students may not want to talk to coaches about mental health,” said Lydia Bell, Director of Research and Policy at the National Collegiate Athletics Association (NCAA).

The survey also addressed whether the student-athletes felt adequately rested. Sleep is something that a lot of college students struggle with, not just athletes. The NCAA survey found that about 50% of athletes say that they wake up well rested less than three days a week. Only 14% of women felt well rested most days of the week.

Collegiate athletes are just as susceptible, if not more so, to most mental health disorders. With demands for their time in academics, athletics, and social life at college, it can be a lot to juggle in their first time living away from home and family. College is a transitional time of navigating new friendships and developing a sense of belonging. These additional stressors can acerbate psychological vulnerabilities. Emergence of some mental illnesses coincide with the college years like bipolar disorder, major depression, and schizophrenia. Some mental illnesses, like bulimia, are more likely to develop in high achievers and those that strive for perfectionism.

Performance anxiety is more common among female student-athletes. The 2019 NCAA study found that nearly 50% of first year female student-athletes were “frequently overwhelmed” by all they had to do in the past year, compared to 24% of male student-athletes.

Social media presents unique challenges for student-athletes, some of whom arrive at college with a large social media following. The scrutiny of social media commentators can exacerbate performance anxiety, as well as provide an avenue for online bullying.

Mental health can also impact a student-athlete’s physical health through lack of focus, muscle tension, or underperformance.

Some outwards signs of mental distress can include:

• Changes in Mood: Increased irritability, sadness, or mood swings.
• Withdrawal: Avoiding social interactions or isolating from teammates and friends.
• Changes in Sleep Patterns: Insomnia, excessive sleeping, or disrupted sleep.
• Appetite Changes: Noticeable increase or decrease in appetite, leading to weight changes.
• Decreased Performance: Sudden drop in athletic or academic performance.
• Fatigue: Persistent tiredness or lack of energy.
• Concentration Issues: Difficulty focusing, making decisions, or remembering things.
• Physical Symptoms: Unexplained aches, pains, or digestive issues.
• Anxiety and Worry: Excessive worrying or feelings of anxiety, panic attacks.
• Depression: Feelings of hopelessness, worthlessness, or thoughts of self-harm or suicide.
• Substance Use: Increased use of alcohol, drugs, or other substances.
• Loss of Interest: Lack of interest in activities once enjoyed, including sports.
• Behavioral Changes: Noticeable changes in behavior, such as aggression or risk-taking.

It is important to remove the stigma that comes from discussing mental health issues in sports. Motivational expressions in sports, such as “putting on your game face” or “no pain, no gain,” often push student-athletes to sacrifice or ignore their mental well-being in the pursuit of victory.

The good news is that awareness about the importance of mental wellness for athletes at all levels has increased. In early 2024, the NCAA released an updated Mental Health Best Practices document, developed by the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports and the Mental Health Advisory Group. This document requires all member schools to create environments that support physical and mental health by ensuring access to appropriate resources and promoting open discussions about health.

…If you can look back and remember all of the positives that you have gotten from athletics, you are a “winner”.

-Kenneth Glinstein, PhD

Schools in all divisions must provide mental health resources and education aligned with these best practices. Starting August 1, 2024, Division I schools must attest to providing such services, with the first attestation deadline set for November 2025.

Dr. Peter Panagakis, PsyD recommends the following tips for authority figures (coaches, parents, athletic directors, teachers, etc)  to best support athletes:

1. Avoid creating forced expectations to play one specific sport and to perform at a desired level, while encouraging kids/athletes to play a variety of sports and to try their best.
2. Monitor for burnout cues (i.e., physical exhaustion; nagging injuries; frustration/anger; refusal to practice or play) and make time for recovery days.
3. Ensure proper rest/sleep, hydration, and nutrition is maintained.
4. Create an environment where kids and athletes feel comfortable to voice their needs and limits.
5. Encourage collaboration where objectives, short-term goals, and long-term goals are created between athletes and authority figures.
6. Identify how losses and failures are learning and growth opportunities.
7. Remember that sports can be competitive and fun at the same time.

Here are some tips from Dr. Panagakis’ for student-athletes:

1. Know the warning signs for burnout (i.e. performance anxiety; sleep disturbance; injuries; lack of motivation; fatigue; poor nutrition) and identify self-care measures (i.e. limiting length and intensity of workouts based on level of achievement and ability; consulting with trainers and support system members; incorporate recovery days away from physical training).
2. Engage in activity scheduling to ensure enough time is devoted to academic studies and social engagement. There are several online resources available to assist in utilizing activity scheduling.
3. Use SMART goals to enhance ability and performance, while maintaining awareness of the importance of setting realistic goals and adjusting goals that are either too easy or too hard to achieve.
4. Use visualization prior to competitive athletic performance as a way of enhancing confidence and mental preparedness, while also reducing anxiety.
5. Remember that athletics do not singularly define who you are. How you perform in sports does matter, but those performances are moments in time. Other moments, such as being a good friend, child, partner, student, employee, and person really define you for the long-haul.

According to Kenneth Glinstein, PhD a licensed psychologist and former student-athlete, “There needs to be a balance between athletics, school work, and socialization. Very few athletes are going to become professional athletes. But if you can look back and remember all of the positives that you have gotten from athletics, you are a “winner.”

LifeStance Health offers treatment options for student-athletes who may be dealing with mental health issues related to stress and anxiety due to athletic performance pressure. Find your nearest LifeStance provider to learn more.

It is important to remove the stigma that comes from discussing mental health issues in sports. It doesn’t help those motivational expressions in sports, including “putting on your game face” or “no pain, no gain” encourage student-athletes to sacrifice or ignore their mental well-being in order to win.

The good news is that awareness about the importance of mental wellness for athletes at all levels has increased. More kids entering college are likely to have worked with a sports psychologist at the high school level. Governing associations like the NCAA have provided mental health resources to student-athletes and their parents.

Parents and other adults working with student-athletes should check in with them at regular intervals about their mental well-being, separate from any conversation on academic or athletic performance. This provides a safe space for college athletes to express their feelings. Parents and sports team staff can also suggest that student-athletes take mental health breaks or incorporate meditation or affirmations into their daily routine to promote balance. More serious mental health concerns should be addressed by a sports psychologist who understands the mindset of an athlete and can help them achieve success in their sport without sacrificing their mental health.