By pulling out all the stops, have we inadvertently pulled the rug out from under our best young athletes?

The intense pressure experienced by athletes at the top of their sport and the apex of their abilities is nothing new. It comes with the territory and is amplified exponentially when the stakes are highest, the competition is fiercest and the whole world is watching. The best of the best separate themselves from the pack at these make-or-break moments, digging deep and finding ways to meet or exceed the fantastic expectations heaped upon them. Until, one day, they can’t. Or don’t. Or won’t.

And we are stunned.

We know that Simone Biles and Naomi Osaka are made of flesh and blood and sinew—they may be marvels of sport, but they are not part of the Marvel Universe. Yet we don’t really understand what nudges them off the rails, do we? Biles opted out of the Olympic all-around gymnastics competition when her internal wiring betrayed her. Osaka took a mental-health vacation from tennis at the height of the spring/summer season. More surprising than their decisions—and more alarming than some of the public criticism they shouldered—is the eye-opening realization that they are not the exception in sports. They are actually the rule.

An Unexpected Twist

On July 27, 2021, inside the physically crowd-less Ariake Gymnastics Centre, Simone Biles (right), leading her team into the Tokyo Olympics finals against the Russian contender

Fernando Frazão/Agência Brasil Fotografias

s, elevated off the mat with her usual power and grace…and failed to perform the 2 ½ rotation vault she had nailed countless times. She scored only 13.766 points, putting Team USA behind in the competition for the first time in almost a decade. Her failure on her sport’s biggest stage left television commentators stunned and her teammates speechless. What Biles did next shocked the world of competitive sports: She publicly withdrew from the Olympic finals, citing non-injury related mental health issues.

Peter Menzel

“I just felt like it would be a little bit better to take a back seat, work on my mindfulness,” Biles told reporters. “I just need to let the girls do it and focus on myself.”
Sian L. Beilock, the president of Barnard College and a cognitive scientist told The New York Times, “I applaud the fact [Simone Biles] was able to ascertain that she wasn’t in the right state of mind and step back. What a hard thing to do. There was so much pressure to continue. And she was able to find the strength to say, ‘No, this is not right.’”

Biles later credited Naomi Osaka (left)—who withdrew from the 2021 French Opens to focus on her own mental health and depression—as providing the motivation and courage she needed to put her own mental health first. Osaka had disclosed her decision to withdraw during the French Open on Twitter; she had been unable to manage her mental health, depression and press conference anxiety ever since her controversial 2018 US Open finals victory over Serena Williams, during which she endured the jeers and boos of a crowd that favored Williams.

Both Biles and Osaka had their critics, of course, some quite harsh. However, they received an outpouring of support from fellow elite-level athletes, who understood the immense, round-the-clock pressure to which they are subjected. Knowledgeable fans by and large echoed this support, as did most in the media. The two young champions compete in sports that favor youth physically, but demand a level of mental maturity that appeared to be beyond their grasp. And it just got to be too much.

An Epidemic

The thing is, Simone Biles and Naomi Osaka are not one-offs. Indeed, every year, countless young elite-level athletes on the fast track to stardom—many still young teens or pre-teens—are overwhelmed by pressure and expectations placed upon them by parents, coaches, fans and friends, and begin to hate the thing they loved the most. Unless you know them, or they are your kids, their stories go untold. Most youth sports programs, in fact, are set up to cull out the physically fragile or easily upended and push the rest ever forward. Although the survivors may gain confidence in their growing skills, the pressure cooker only grows more intense as they near the top of their sport.

Past a certain level, athletes will acknowledge that this unrelenting pressure—as Billie Jean King once said—is a “privilege.” But how do you explain the meltdown of a superstar? And, more importantly, what does that tell us about how young athletes are being raised today?

Studies done on the mental health issues of elite athletes give us the same picture over and over, and it’s kind of stunning. A study on NCAA Division I athletes found that 23.6% of the individuals included in the study met the clinically relevant level of depressive symptoms, with female athletes being nearly twice as likely as male athletes to experience depression. The prevalence rate for American college students, if you’re wondering, is between 7% and 9% depending on the study.

A UK study found the prevalence of mental health issues among elite athletes to be 47.8% for depression and anxiety and 26.8% for signs of distress. A similar study in Australia found the prevalence rate for mental health disorders overall to be 46.4%. A study in Sweden revealed that lifetime prevalence of mental health problems in elite athletes was 51.7% (females 58.2%, males 42.3%).

“The professional consensus is that the incidence of anxiety and depression among scholastic athletes has increased over the past 10 to 15 years,” says Marshall Mintz, a New Jersey-based sports psychologist who has worked with teenagers for three decades.

Isabella and Vinny

Swimming World Magazine

The story of Isabella [last name withheld], a prodigal lacrosse player who started to play when she was in first grade, is not unusual. Excelling at the game from the start, she gave up on other sports she enjoyed, including basketball and soccer, to optimize her shot at a college scholarship. Sure enough, Isabella earned a full ride from an elite college during her sophomore year in high school. What she loved most about lacrosse was the attention it garnered in her hometown. Everyone was rooting for her, and that made her play and practice the sport even harder. That summer, Isabella tore her ACL and was unable to play for eight months.

“It was my worst year ever,” she recalls. “I’d grown up playing lacrosse, and I had no other hobbies. So when you don’t have it, you’re like, What am I going to do?”

Like so many other young athletes, she had been pushed and pressured by her peers, her parents and coaches to focus solely on the sport she was good at—naturally, with love and caring and unqualified support. She practiced day in and day out, cultivated an athletic identity and, in the end, all this over-practice made her more vulnerable to her knee injury. With nothing else to occupy her mind, and the sight of her peers moving ahead with their lacrosse tournaments while she had to take up painful physical therapy, Isabella soon developed an eating disorder. In the end, she chose to give up on the sport to which she had devoted a decade of her young life, deciding instead to pursue a university degree and a career outside lacrosse.

Isabella’s story is hardly unique. Thanks to the changing nature of youth sports, there is an Isabella in almost every town in the country. In 2018, the American Academy of Orthopaedic Surgeons (AAOS) cited two independent studies that strongly suggested that an intense, year-round focus on one sport leads to a much higher risk of burnout and injury in young athletes, as they routinely spend excessive hours per week training. “Youth sports has experienced a paradigm shift over the past 15 to 20 years,” the AAOS noted. “Gone are the days filled with pick-up basketball games and free play. Kids are increasingly specializing in sports.”

Vinny Marciano, a swimming prodigy from New Jersey, was considered by Swimming World and other authorities in the sport to be one of America’s best young swimmers in the run-up to the 2016 Olympic Games. He was the New Jersey 100-yard freestyle champion, and the 2015-16 All Daily Swimmer of the Year, propelling Randolph High School to win the team title despite suffering tendinitis earlier that same year. He missed making the 2016 Olympic by just 0.27 seconds in the 100-meter backstroke. A year later, Marciano all but disappeared from the world of competitive swimming.

In a sport where obscurity and glory are often separated by mere fractions of a second, Marciano knew what he had to do. After failing in the Olympic trials, he joined an even more intense swimming club 90 minutes from home, where he had to put in three-hour practice sessions straight after school, stay overnight with a teammate, get up early and get through two more hours of practice before arriving late to school the next day. For six miserable months, these were his Mondays, Wednesdays and Fridays, with additional solo sets by a coach at a local YMCA. His grades tanked and, finally, he told his parents he did not want to keep going like this.

According to Jay Coakley, a leading sports sociologist and author of Sports in Society: Issues and Controversies, parental pressure doesn’t need to be explicit and heavy-handed in order to push a young athlete past his or her comfort level. Instead, just the child’s awareness of the time and money sacrificed by their parents is enough pressure to make the child keep playing long past enjoyment.

In the end, Marciano completely gave up on competitive swimming to get away from the misery of always trying to climb up a never-ending ladder. He found challenge and enjoyment in a much more leisurely sport: rock climbing. Had it not been for the intense training pressure felt by Marciano—a swimming prodigy by most accounts—after coming up short in Olympic qualifying, the swimming world might have witnessed another Michael Phelps.

Is This PTSD?

The Oxford English Dictionary defines post-traumatic stress syndrome (PTSD) as a condition of persistent mental and emotional stress occurring as a result of injury or severe psychological shock. While the PTSD symptoms in athletes with traumatic injuries, such as a concussion or a torn ACL, are well-studied, that is not the case for a very large number of elite athletes who are subject to emotional and psychological trauma in the form of bullying, humiliation, body shaming, being belittled in front of teammates by coaches or any other similar traumatizing emotional experience.
Former Olympic martial artist and (now) sports psychologist Caroline Anderson brings some personal insight into her new profession. “In my private practice,

I see a lot of athletes—many of them quite young—who have been traumatized in some way as a result of being an athlete and their involvement in sport,” she says, adding that, in addition to serious injury, trauma ranges from conflict with coaches, teammates and sporting bodies to bullying, politics, unfair selection processes and the embarrassment and shame that accompanies less-than-expected performance.

In some cases, the source of PTSD symptoms can be something entirely separate from the performance pressure of an athlete’s chosen sport. Simone Biles was among the scores of U.S. gymnasts sexually abused by team doctor Larry Nasser. During testimony before a Senate Judiciary Committee, Biles was reduced to tears when discussing her experience and its long-term aftermath.
“I can assure you,“ she told the committee, “that the impacts of this man’s abuse are never over or forgotten.”

PTSD symptoms affect a significant percentage of young athletes in some way or form, and for those without proper support, they linger long past the trauma. What matters most is having good support and people who actually understand their struggles. Perhaps that explains why the prevalence of PTSD appears to be much lower among traditional team sports athletes.
Basketball Hall of Famer Magic Johnson, who decades ago said, “Ask not what your teammates can do for you…ask what you can do for your teammates,” may have been on to something. Team sports inherently provide a much bigger support net for the mental health of young athletes who devote themselves to a single sport. Often, they sacrifice their social lives in their quest for excellence. In lieu of close friendships, however, they have teammates that rely upon one another for mental support.

Though not a perfect answer, it’s an improvement over the situation individual-sport athletes like Vinny Marciano live with, as they get stuck in a Sisyphean cycle of chasing perfection and dealing with often overwhelming pressure to always perform better. Indeed, a 2019 study found that individual-sport athletes are more likely to report anxiety and depression, and tend to play less “for fun” and more for goals than team-based sports athletes.

The culture of elite-level athletics, from teen sports to the pros, places a high value on mental resilience. Ironically, that culture has also been largely apathetic to the mental health needs of athletes until relatively recently. USC Sports Psychologist Robin Scholefield may have put it best when she observed that the whole healthy person is the most consistent peak performer. “If you’re not right with yourself,” she insists, “you’re not going to be okay as an athlete.”

Michael Phelps is one of the few elite-level male athletes to step forward and talk about his mental health issues, including a struggle with depression that only worsened during the pandemic. He encourages others to speak out, as he did prior to the 2016 Olympics. “It wasn’t easy to admit I wasn’t perfect,” he says. “But opening up took a huge weight off my back.”

Agência Brasil Fotografias

In 2021, three major college sports conferences—the Atlantic Coast Conference, Big Ten and Pac-12—launched a joint initiative called Teammates for Mental Health. So things are changing. Of course, the hard work still begins at home.

As a parent or as a coach, remember that not a single person has ever succeeded by blindly burning themselves out on a sport that makes them miserable. It is healthy for children to have sports dreams, but what is equally important is to make sure that the child learns other skills to fall back on in case their dreams are not achieved or are not all that they wanted them to be.

Multiple generations are responsible for creating the mess of mental health issues that can consume young elite-level athletes. Perhaps this generation of athletes, with their public platforms and social media followings, will follow the lead of Simone Biles, Naomi Osaka and a handful of others in making the world of sports more in tune with the mental health needs of athletes. Hopefully, their willingness to open up on the subject, to the possible detriment of their image and the value of their “brand,” triggers the kind of culture change that will swing the mental-health pendulum back in favor of the next generation of young, high-performance athletes. EDGE

Editor’s Note: Chuka Erike has been involved in the sports industry since his college days. In 2016, while working for the NBA, Chuka won the league’s Community Assist Award. During a career in sports that stretches back more than 15 years, he has devoted himself to working with young athletes who face high pressure and unrealistic expectations. He recently mentored Joey Spallina, the nation’s top-ranked lacrosse recruit, who is headed for Syracuse University in the fall.