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How Therapy Can Help Athletes

By Talkspace | May 14, 2020, 10:30 a.m. (ET)

Sponsored Content by Talkspace


While athletes face some pressures similar to those of non-athletes, the additional responsibilities and pressures they endure can exacerbate some common stressors. The pressure to perform at a high level without showing weakness or letting emotions get the best of athletes, all while dealing with the occasional loss or poor showing, can lead to, or worsen, a pre-existing mental health condition.

Talkspace therapist Christine Tolman, LCPC, explains that athletes are “expected to represent the ‘best of the best’ in their field or at the school, and throughout all of this, they still have the basic need for socialization. This high pressure and lack of appropriate outlets can lead to mental health concerns in some cases, with little time for treatment.”

Stressors Faced by Athletes 

Athletes experience numerous and varied types of challenges during the course of their career. First, it is common for elite athletes to have an intense inner drive and a sense of competitiveness, often far greater than that of their peers. For some, this may manifest as a sense of self-competitiveness where the individual places a significant amount of pressure on themselves to achieve certain milestones. Of course, in addition to this self-imposed stress, athletes also experience pressure from coaches, fans, the media, and even their parents, all of whom have a vested interest in their performance.

Impact of Neglecting Mental Health on Athletes

Athletes become accustomed to working under stressful extremes. Whether it’s pushing through fatigue to finish one more drill on the court, or finding a last reserve of strength to push past a competitor in a dead heat on the track, athletes are used to pushing their bodies to their limits. However, athletes are also schooled in practices to help the body recover, whether with a healthy diet or proper stretching, and should the body be pushed beyond its limits, coaches and athletic departments have proper channels for physical rehabilitation.

What receives less attention, however, is the mental health of athletes. In an excerpt from the Sport Science Institute’s guide to understanding and supporting student-athlete mental wellness published by the NCAA, Chris Carr and Jamie Davidson make the point that “Student-athletes, coaches and staff tend to minimize mental disorders or psychological distress because of the expectations of strength, stability and "mental toughness" inherent in the sports culture.” The authors continue, saying that, “As a result, student-athletes often avoid disclosing a mental health concern, especially if the perceived negative consequence includes being rejected by teammates or coaches due to the disclosure.” This idea extends beyond just college athletes, but to all those who experience athletic environments that emphasize “mental toughness.”

There are four areas of particular concern for the mental health of athletes: depression, anxiety, body image, and peak performance.


Athletes must balance the expectations of high performance on the field, court, track, or pool as well as commitments either in the classroom, in the workplace, or at home. It’s rare — and nearly unheard of — for external stressors not to inhibit the training of athletes.

And yet, there remains significant stigma around asking for help among athletes, which can be seen wrongly as a sign of weakness or vulnerability. For athletes, so much of their personal worth is often placed on performance, if that performance doesn’t measure up self-esteem issues can lead inevitably to depression.

There are as many causes of depression in athletes as in non-athletes — whether it be burnout, the performance pressures, perceptions of failure, injury, identity issues, or relationship problems — but athlete’s often mask these signs as they attempt to continue training for competition.

Signs of depression in athletes may include:

  • Difficulty concentrating or a lack of confidence or motivation
  • Decreases in energy or feelings of chronic fatigue
  • Changes in sleep, eating patterns, or appetite
  • A short temper or excessive irritability
  • Increases in drug or alcohol abuse
  • Loss of interest in activities that once provided pleasure
  • Difficulties with motor skills

If these symptoms present and interfere with daily functioning more often than not for a period lasting two weeks or longer, it is important to seek out care from a licensed mental health provider for a proper diagnosis and effective treatment.


Whether it be nerves before a presentation at work, butterflies about a new relationship, or the anxiety of tight deadlines, all of us experience some form of anxiety. But for athletes there can be extreme stress in the form of letting fans down, disappointing coaches and family, and financial pressures (for athletes with scholarships, sponsorship, or endorsements). Additionally, stress on athletes is compounded as the pressures to perform during the typical season increase.

While anxiety around competition is normal, when anxiety doesn’t pass after a game or match, but instead lingers and increases, these feelings can interrupt and interfere with daily activities like work, practices, relationships, and academics.

Signs of anxiety disorders in athletes may include:

  • Apprehensiveness
  • Feelings of powerlessness
  • A sense of doom, panic, or impending danger
  • Tiredness or weakness
  • Rapid breathing
  • Sweating
  • Trembling

For athletes, these symptoms may indicate an anxiety disorder if they appear frequently and severely enough to impact their ability to achieve their athletic potential or have a negative impact on functioning in daily life.

Body image

Because athlete’s bodies are highly tuned and weight can have a significant impact on performance, coaches often feel justified indicating that a team member should add muscle or lose weight. These instructions, however, can also create an unrealistic view of how a body should look, which can in turn distort an athlete’s view of their own anatomy.

Issues with negative body image and eating disorders are common amongst athletes of all genders and should be addressed by a licensed mental health professional.

Signs of disordered eating in athletes may include:

  • Significant, severe, or continual weight fluctuations
  • Alternating between periods of overeating and fasting
  • Persistent dieting despite being underweight
  • Obsessing over caloric content of food
  • Fixation on food without eating
  • Ritualistic eating patterns — portion sizing, avoidance of eating with others, hiding food
  • Depression or lethargy

While it may be difficult to separate thoughts of food and eating from athletic performance, the cultivation of healthy relationships with food starts early and must continually be set and modeled by coaches and administrators.

Peak performance

While the goal of all athletes is to perform at the highest level, occasionally, following the guidance of coaches — fueling the body with enough sleep and a healthy diet — still leaves athletes short of their goals. While athletes must manage the stress and anxieties about their own performance in order to take the field, a healthy relationship with competition, and managing expectations is as important as being mentally tough. It’s important to remember that teamwork and on-field conduct are as important to competition as sealing a victory.

Gender and Mental Health Issues for Athletes

Toxic masculinity can play a role in male athletes not seeking treatment for mental health conditions. Reinforcing notions like “real men don’t need to talk about their feelings” or “having mental health issues means you’re weak,” can negatively impact an individual’s well-being, as well as their motivation to seek treatment. However, the tide is turning and several notable male professional athletes have spoken about their own mental health and how they’ve incorporated mental health treatment into their life.

Female athletes also have a number of unique challenges to cope with — including issues related to eating disorders, body image, perfectionism, and self-esteem issues. One of the most tragic examples of this is Madison Holleran, a former division I athlete who died by suicide after reportedly struggling to balance academics and sports-related stressors. Recently, gymnast Simone Biles opened up about her experiences with the unrealistic body expectations in the sport of gymnastics. While these challenges aren’t limited to just one gender, they may be seen at a higher rate. Mental illness and struggle don’t discriminate — no gender, race, religion, or orientation is immune.

Mental Health in Athletics Moving Forward

As a starting point, placing more emphasis on mental health risk factors and treatment — starting as early as youth sports — will be impactful. Better identification from coaches and more understanding of the consequences of competition and stress will also improve mental health outcomes for athletes. In some cases, unfortunately, coaches may be limited in their knowledge of how to help athletes deal with mental health symptoms.

Thus, coaches and staff should receive training on identification of common signs and symptoms for mental health challenges. Most important is to normalize conversations around mental health and mental health treatment.

Athletes are, more than ever before, speaking out about their mental health issues and how treatment has changed their life. Michael Phelps, Kevin Love, Demar DeRozan, and Brandon Marshall are all famous athletes who have publicly shared their experiences with mental health concerns.

Where to Seek Effective Mental Health Care

For athletes, it’s important to know the different kinds of care available. A “sports psychologist” may be someone who can help improve performance, but may not be as well versed in treating severe depression. According to Director of Clinical Content, and therapist at Talkspace, Dr. Amy Cirbus, LMHC, LPC, “A sports psychologist helps manage an athlete’s mental health so that they can reach their athletic potential. A licensed therapist considers the mental health of the athlete in order to enhance their overall health and well-being, ensuring their quality of life as a human being.”

Knowing the distinction between a licensed mental health provider and a certified sports performance consultant is crucial for getting necessary care. While both may identify or use the title “sports psychologist,” their training, expertise, and focus will be different.

Seeking help from a mental health provider can help athletes on and off the field. Seeking help for mental health issues “may help athletes to process their experiences and find healthy coping skills to manage the stress and pressure that comes with their position. This can allow the athlete to focus on their sport in a healthy manner which could increase performance overall,” says Tolman. “It can also allow them to have a more balanced life outside of their athletic identity.”

Talkspace Online Therapy for Athletes

Talkspace offers you access to licensed therapists across the country. From an Apple or Android device, or a desktop, you can message your therapist using text, voice, video, or live video calls.

It can be difficult to wait days or weeks until your next appointment, but with Talkspace, you can message your therapist whenever you’re at a laptop, or on your tablet or smartphone. Your conversation carries over seamlessly across devices and uses banking-grade encryption to keep it safe and confidential.

What is online therapy?

At its core, online therapy is the same as traditional therapy. Online therapy differs, however, in that it puts therapy in the palm of your hand and enables you to share your thoughts with a professional anytime you wish. This makes therapy even more convenient for those new to the practice. Your licensed therapist will provide tools, an experienced perspective, and ways to reframe your current challenges — ultimately improving your performance on the field and your well-being off of it.