The Psychological Impact of Being an Olympic Athlete

The recent Winter Olympics highlights the lifelong athletic achievements of individuals from around the globe. But it also raises awareness of the invisible battles Olympic athletes face when it comes to mental health. To learn more about the psychological struggles that come along with immense pressure, we are joined by Doctor Joseph McNamara. He is the book professor and division chief of psychology with the U.S. College of Medicine. Doctor McNamara, thank you so much for joining us today. Thank you for having me. And I'm excited to be here now at the Milan Winter games. U.S. alpine skier Mikaela Shiffrin won another gold medal. At the same time, she opened up about suffering with PTSD after a crash two years ago. Why do you think more athletes are talking about their mental health struggles in public? I think that there's been a wide societal effort to reduce the stigma that's associated with mental health concerns, and so I'm really encouraged by athletes coming forward and really setting a wonderful example, as well as people in other professions that are coming forward and talking about, the challenges that people face. Somewhere between 20 to 30% of people every year meet diagnostic criteria for, a psychiatric disorder. And it's something that is unfortunately very common that people struggle and depression and anxiety both, are certainly things that that so many people struggle with. And particularly there can be symptoms of PTSD or, social anxiety, performance anxiety. It can manifest itself in so many ways depending on what the person's experiences have been and how they've tried to address those experiences, as well as several of the athletes. They've talked about what they call invisible battles, where they hide issues behind the public persona of their sport. What can these expectations of success have on a person's psyche? So it can create an enormous pressure and so one of the things that happens, I think, is that the people put so much pressure on themselves, but also they don't want to let down their family, their friends, their fans. And so there's an incredible pressure that can be there, as well as kind of meeting their own expectations to be able to perform at the level that they've practiced their entire lives, to achieve. And so one of the things that I think is really important, it's kind of how we frame that pressure and how we, we try and use that to our advantage rather than being something that is, is crippling. And so focusing on how we can use pressure to build resilience and build strength, and how to try and work with that pressure to help us perform our best rather than being something that becomes a significant hindrance. And where we focus on the failure and the possibility of things not going well, which can really kind of snowball and then have a very significant negative impact. I know a lot of us remember when world renowned gymnast Simone Biles withdrew from multiple events at the Tokyo Games back in 2020, she suffered from the twisties. How does someone get past something as significant as this to compete and then function again? I think it really is about about resilience and getting, appropriate help. I'm always hesitant to comment on, you know, specific athletes or situation because I don't know what's going on specifically in their lives or what their struggles are. But in general, I think one of the things that's important is that focus on what can I do to be resilient, how can I handle this situation the best that I can? How can I find a way to work through it? One of my favorite questions to ask my patients is like, you know, what can I do? We specialize in something called an exposure response prevention. And the idea with that is that we will expose the patient to the fear stimuli, whatever that that might be. And then systematically work toward that. And so, for example, if somebody has a fear of snakes, we might start off with a picture of a snake, and then we might start off with a more the move to a more realistic picture of a snake, then maybe a movie of a snake, and eventually maybe go to a pet store and look at snakes and maybe even hold the snake. But systematically, we're going to work our way there. And so depending on what it is that's kind of coming up for the person that's creating the roadblocks or the challenges, really kind of asking themselves, all right, so what can I do? And how can I systematically work, toward overcoming this? And who are the different people that I can reach out to to help me in this process? Because it's a very challenging thing to try and do on your own. And we work much better, it when we have somebody to kind of help us walk through that process, we can be a very challenging process. And as we know, high profile athletes, they're not the only ones facing immense pressure to succeed that causes mental health issues. Talk about how common this is among people in all walks and stages of life, like students in a classroom? Sure. So, well, it manifests itself in so many ways. So some people are, they might be socially anxious. Some people are. Might be incredibly uncomfortable giving speech. The more people they're, the more nervous they might get. So there's so many different ways that this can manifest. So, the data is about 25% or so of of people meet criteria, for a psychiatric disorder every year. And so, you know, some people go into remission, unfortunately other people that now meet criteria. So that number kind of stays in that range. But who's come comprising that number can certainly change. And we know, for example, in childhood that if symptoms aren't addressed in childhood, they're very likely to persist into adulthood. And then further than that they're really likely to maintain. And so it's very important that we try and challenge these things as quickly as we can when they first start to come up, so that we get the help that we need and learn how to adjust and really use our resilience and develop resilience to work through these, these symptoms as they as they pop up. Again, it's a very common experience and something that a lot of people struggle with. And there are all different types of symptoms presentations. There's anxiety, certainly depression, ADHD. So there's lots of different ways that that psychiatric symptoms can come up. But what, steps would you advise for people who are undergoing these kinds of pressures to take to in order to move forward with their goals further than just give up on something? It's so important to not give up. So I think one of the important things is really focusing on those goals and its priorities, and focusing on what those values are, and then reaching out to people that can help you. There are people that certainly specialize in sports psychology. Then there are people that specialize in whether it's anxiety or depression, which are generally the areas that we see. And in my experience. And so how do we break those things down? How do we systematically work toward them and work to overcome them? And so there are visualization techniques that certainly can be used there, exposure based techniques that can be used as well as a variety of other things that, a skilled provider would be able to implement once a month. So I think it's critical to reach out for help as well, because it's something that a lot of times people like to kind of like, oh, I can do this myself. And I really respect that at the same time. The same way that anybody needs a coach, it's kind of different when the symptoms are getting significant enough that they're really interfering with your performance. It's probably time to reach out to someone, to get help, to help you be able to, display your your abilities in a way that's really, in line with how hard the athletes, or really anyone in any walk of life that's dedicated a significant amount of time to any to any skill. To be able to perform the level that really fits with what their, their abilities actually have become. Well, for the athletes, mind frame, how important would it be to set realistic goals to achieve success? I think realistic goals are incredibly important, but it's also important to aim high and so you can have realistic, goals and very practical goals at the same time. Have your aspirational goals. I, I like so many other people. When we were young, I can remember singing, playing in the backyard. And it's like, all right, Joe, it's three straight, three balls, two strikes. It's the bottom of the ninth inning in the World Series. And, you know, you throw the pitch to yourself and you hope that you hit it and you do what you can. And then like, you know, we'll see what happens. And so really, that's in many ways kind of the building blocks of starting that resilience process. Like sometimes you'll succeed, sometimes you'll fail and it's okay to fail. It's also really important to try and succeed and try and work through that and try and learn from the failures and build from the failures and grow. And so really thinking of resilience, that something of it really is striking that balance of how do I put myself in challenging enough situations that it's an iron versus iron situation so that I'm getting better, I'm getting stronger, I'm getting faster, I'm performing better, I'm doing better, and better under pressure. And as these I'm in these pressure situations, how can I get to a place where I even feel maybe potentially calm because I practice this so much and I feel so prepared, but this is what I'm ready for, and this is what I was expecting. And so this isn't significantly different. In fact, like, this is what I've been waiting for, and I'm so excited to show what I can do even in this high pressure situation. Thank you so much. This is great information. Doctor McNamara, thank you for joining us today. Absolutely. My pleasure. Thank you so much for having.