Addressing Mental Wellness in Female Athletes

Today I was working with a massage client and we got to talking about babies, moms, and teens. She asked a question that triggered a pain point for me.

"I often wonder why the US has such a rise in teen suicide."

And I couldn't agree more.

I have some thoughts on this, but first, let me give you some background on that. For eight years I taught at a high school. It was a school in an upper-middle-class suburb of Denver. The students there, for all appearances, had good lives. Most had been involved in extracurricular sports from a young age. You saw the packs of moms who had grown closer as their kids had grown up together. It was a Shiny Happy People school from the outside, but my position as a teacher and athletic trainer gave me another view too.

I saw students enter the school with big plans for success in sports, or band, or theater, only to find out that they weren't as good as they thought. Their positions with their teams were cut (or they quit because of spending most of their time on the sidelines). When they left their team, they also often left their social groups - the kids they had been with since elementary school. There was no place to go because every other option was full of kids who had been groomed for it since preschool. 

They often found themselves alone in unfamiliar territory, without a peer group, and without a trusted adult mentor.

Some of these kids carried on, but many slow moved into the background. I would see them in passing between classes, but the joy was fading. I would try to invite them to be a part of the athletic training staff to keep their foot in with their group, but not many took me up on that offer. Often they would come and sit with me in the training room just to talk, and that was OK with me. I was fine being the adult to talk with when there was no one else. I'm not sure what happened in these kids' home life, but it was clear that they were just trying to find their place in the world again - that identity we all seek and crave to be settled.

I left that position about nine years ago.

One of the saddest parts of my leaving that school is that it now has one of the highest suicide rates. It's not like I think that my being there could have prevented those, but just what if? What if I could have intervened to give a kid a place and sense of purpose, at least during the transition? 

We have so many support measures in place for kids with special needs or low economic "at-risk" youth, and I don't think we give enough attention to the kids who are seemingly OK.

These include our athletes, our high academic achievers, our artistic souls, and so many more.

I think they hide many red flags because of how they are supposed to present themselves to the world. 

I know as I teen my parents expected me to act in a particular way. Acting out, failing, etc. were not acceptable behaviors, and since I was a "good kid" I obliged even if it meant covering up the frustrations that I was feeling. I often felt like I was given a load to sort out by myself, despite my parents being very supportive and available. 

Sometimes we're too close to our kids to see what's going on under the surface.

One thing that is encouraging for at-risk teens (and helpful to them) is having a non-parent adult mentor available. Often this role is assumed by a coach, teacher, or club sponsor. However, when the student loses the connection to their social group, they also lose the connection to the mentor and there is no other place to go. While the research tends to be on that "at-risk" demographic, I don't believe there is much difference anymore in all the socio-economic statuses.

In fact, teens who fall into higher socio-economic categories are more likely to present with the self-destructive behaviors that anxiety, depression, and feeling disconnected invoke:  

Disordered Eating/Eating Disorders 


Alcohol and Drug Abuse 

Emotional Outburst/Dysregulation 

Changes in Academic & Athletic Performance 

Social Isolation

I know that the school where I taught was not alone in seeing these changes. We're seeing it even in the online setting where I teach now. Consistent across the board is that we need more resources to help our kids connect, have a safe space to share feelings, and continue to develop our teens' social-emotional intelligence and better understand how to help each other when needed.

It's not just the teens

The past few days have been a whirlwind of discussion around athlete mental health after Simone Biles withdrew from the US Women's Gymnastics Team Competition at the 2020 Tokyo Olympics. I, for one, was so proud of her for taking care of herself and recognizing the need to support her mental health.

This is something that athletes are not encouraged to do.

Athlete mental health has been a topic dear to me for years.

Back in 2002 I was geared up to begin a Masters in Sports Psychology, a natural fit with my degrees in Communication Theory and Athletic Training, but decided to switch gears and study Education so I could teach in high schools. Over the past two years, I've almost pulled the trigger on the Masters (or maybe Doctorate) in Sports Psych again because I keep seeing our athletes struggling and not getting the support that is needed.

Even though I chose to work at a high school, the support that I gave athletes in their mental recovery and health was equivalent to the modalities and services I provided to treat physical pain, injuries, and support performance.

Over the past 20 years, I've held space for athletes in my training room, on the sidelines, in my classroom, and via text. I've done this to help them work through the mental pressure and the fear that something bad is going to happen. This holistic approach isn't often seen coming from an athletic trainer, but honestly, we're trained with that mindset I just happened to be the one to connect those dots and use it to benefit my athletes' recovery and performance.

I had the privilege of being able to collaborate with a Psychologist where we could combine our training to best benefit the athlete, or refer her for more specific clinical help. What's happening at all levels of athletic competition, from our youth through our elite athletes, is so hard for me to see knowing how much sports psychology and athlete mental health has been dismissed in our society. That "go big or go home" mentality.

Parents and coaches, especially at the lower levels, don't understand that we often need to address the whole athlete and nourish the physical and mental pieces that affect performance.

Athletes are very good at putting on a game face.

We've learned not to disappoint and to rise and meet what is expected of us. We silence the pain, the emotions, and the urges to harm ourselves to get out and perform. And we're rewarded for it.

When we ask for a break, we're punished.

I've had athletes threatened with continued lack of playtime, losing their potion on the team, and being outwardly dismissed and ignored in from of teammates simply because they were physically injured and needed to heal.

This is the message we're giving our athletes: 

You are not allowed to take a break to care for yourself. It is not about you it's about everyone else.

We need to change this approach and this mindset. I've seen athletes drop their sport because the mental stress was overwhelming. It killed the joy and play that once drew them in. I've linked physical pain, injury, and chronic conditions back to this mental stress and pressure of being perfect come through my doors.

I'm grateful for the athletes, like Simone Biles and Naomi Osaka, who are coming forward to normalize mental health as a key piece of sports performance training and recovery.

In fact, they are asked to play through pain. Think of the bigger picture. "Pain is weakness leaving the body." "Go big or go home." And all of that nonsense. Our teen athletes are not alone in these situations.

I think one of the reasons parents, especially moms, miss the crisis that their teens are in is because we're not supported in our own mental wellness needs. I believe that the loneliness that our teens feel is also felt by many moms. Many of us left our old social groups and athletic lives to start our families, and are struggling with who we are now. We don't fit the old mold anymore, and yet don't have anyone to talk to about how hard that transition is.

We are also asked to put aside our physical and mental wellness in order to be there for others. Our partners. Our kids. Our work. Our friends. Our families.

Just like for our teens, social media is inundating us with images and messages of who we are supposed to be. The athlete in me was crushed when I wasn't back to my pre-pregnancy weight six weeks after giving birth to my son, and out training for a half-marathon with my kids in a jogging stroller. I wasn't even a runner! But in my mind, I had already failed everyone around me - the expectations - and therefore myself. Those around me didn't see and hear my cries for help as I sank into depression, and yet for years, I set my wellness aside to continue to be present and step into the role I was supposed to assume.

If we are not able to advocate for our own mental wellness, how can we expect our teens to do it for themselves? And if we're not mentally and physically well, how can we support our teens when they need us most?

Sometimes we need to help them to find their voice, but it's no good if we don't have full use of our own?

We have a long road ahead of us. The positive in all of this is that mental wellness is finally getting the attention it deserves. Its place in performance, whether it's on the field, in the classroom, or in life, is becoming more clear and I hope the hype continues.

My hope is for parents to start seeking out mental health professionals, sports psychologists, and other trained professionals to support their teen's mental skills training as much as they invest in developing their physical performance. I hope that injury prevention starts moving beyond the corrective exercises and cross-training and starts looking at the mental and nutritional factors that are also factors in athletic wellness.

Of course, I'll be here for it. I'll be here to support the athlete in nourishing their whole selves for elite performance and continue to refer and collaborate with others to serve their needs the best. It's just what I do.

Categories: mental wellness, mindet, performance

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