MedStar Health Blog

Changing the narrative starts with prioritizing wellness above winning for young athletes.

As a sports psychiatrist, I often see retired collegiate or professional athletes years after the demands and pressure of their sport has affected their psyche. While it’s never too late to seek help, there are preventative measures we can take to start showing young athletes that they are more than just winning machines.

A true change in mental health and sports requires a shift towards ensuring we meet the developmental needs of young athletes, rather than teaching them that winning is everything. By preparing kids for the challenges they’re going to face early and equipping them to prioritize self-care above reaching a podium, we can help them support their holistic personal growth through participation in sports.

1. Set achievable goals that go beyond “turning pro”.

Many athletes define success for themselves as winning a particular event or title. And for the most elite, the pinnacle of achievement is becoming a professional athlete. Yet fewer than seven percent of high school athletes play their sport in college and fewer than two percent of college athletes go on to achieve professional status, according to the National Collegiate Athletic Association (NCAA).

In that context, competitive sports have a tendency to create more losers than winners. That’s why it’s important for an individual athlete to set attainable goals and find meaning and value in the process, rather than the outcome. Setting goals that help you stay intrinsically motivated to get better or achieve mastery can ensure you feel successful, win or lose.

I’ve found this to be true for myself. As a college fencing athlete, it wasn’t until my third and final appearance at the NCAA championships that I achieved my long time goal of becoming an All-American. I’d like to think that even if I had not accomplished my goal, I’d be able to look back on my career as an unmeasured success in terms of the life skills I attained and the relationships I forged.

2. Evaluate your purpose for competing.

Sports teach us a lot about camaraderie, the human spirit, and perseverance through adversity. But, often the intrinsic value of sports is overshadowed by the pressure to perform. If you start believing that your athletic achievements are all you have to offer the world, you can lose sight of what is good about you as a person. And, if you perform solely to meet someone else’s expectations, you might choose to push through a serious injury and cause long-term damage to your body.

Some young athletes start out by having fun but continue pursuing competitive achievements. They may do this out of pressure from family members or coaches who are living vicariously through them. Kids can easily feel the weight of pressure when the focus shifts from friendly competition to a pre-professional atmosphere where they’re treated like adults before their brains are developmentally ready. If your participation in a sport is no longer fun, it’s time to reevaluate why you’re doing it in the first place.

Do you enjoy competing? Are you having fun in your sport? Losing is often painful but can be transformative. Training and competing should bring you joy and meaning. If you’re not passionate about what you’re doing, consider stopping or taking a break before it begins to take a toll on your mental health.

3. Keep the bigger picture in mind.

We incorrectly assume that achieving a performance goal, like winning a national championship or an Olympic medal will bring happiness. But in reality, it often does the opposite. Many elite “winners” acknowledge that a feeling of emptiness can come even after accomplishing a lifelong goal.

When playing a sport is all you know, it can be hard to figure out where you belong in the world after your career ends. Many elite collegiate and professional athletes struggle to adjust to “civilian” life after they’re no longer competing. I know this struggle firsthand, having transitioned abruptly from my collegiate fencing career to medical school. The world goes on as it did before, and many retired competitors will admit that something is lacking in their current life. Or, they look back on their career with regret at what they were unable to accomplish.

Even if you do reach the pinnacle of your sport, you’ll still come face-to-face with the end of your elite athletic career at some point. In case you get injured or age or your abilities decline, what do you want your life to look like? Although many of us would like to stay young forever, all of our bodies will age eventually. Staying involved as a coach or a mentor can help ease the challenges of this difficult transition.

One of the ways we can help athletes avoid struggles with mental health or burnout is to reframe the role sports should play in our lives while kids are still young. Instead of making a professional career the end-all-be-all measure of success for youth athletes, we can encourage kids to diversify their passions with non-competitive hobbies, like art or music. This helps shape well-rounded individuals who have a variety of interests that bring a sense of fulfillment in any stage of life.

Shed the stigma of seeking help.

Historically, mental health has been overlooked in athletes who are otherwise deemed to be exceptionally physically healthy. For professional athletes living in the public eye, many hesitate to seek care for mental health struggles for fear of judgment or perception of weakness.

However, it is completely normal and valid to experience bouts of depression, anxiety, or burnout when competing in sports. Whether you feel self-induced pressure to perform or you’re bearing the burden of living up to the expectations of those around you, you don’t need to feel ashamed to acknowledge when it’s too much.

Mental health challenges look different for everyone, but if you’re feeling hopeless, finding it hard to concentrate at school, or struggling with everyday activities, don’t be afraid to seek professional help from a psychologist or counselor.

Mental toughness is a necessary quality of all high-performing athletes. But having a strong mind that’s capable of overcoming struggle doesn’t mean that you have to—or should—do it alone.

Rational vs. irrational anxiety.

Rational anxiety is rooted in truth. For example, at the time of this writing, the U.S. is widely lifting domestic travel restrictions. Simultaneously, new virus variants are emerging and we’re hearing news of catastrophic viral spread in Brazil and India. It’s natural to worry whether our country is on the right track.

Other rational pandemic-related fears may include:

• Going in public after having COVID-19: If you or a loved one were affected by the virus, it’s rational that you might be more concerned about spreading the virus or catching it again.
• Traveling by mass transit: Close proximity with others in an enclosed space can be a recipe for illness—a fact-based concern, regardless of the pandemic.

Irrational anxiety is characterized by unsubstantiated worry or fear when there is clear evidence to the contrary. In daily life, this may include hesitance to enter a tall building or feeling terrified by an innocuous sight or sound.

Irrational pandemic-related anxiety may include conspiracy theories, such as:

• Obsessive worry that Americans are being microchipped through the vaccine: More than 80% of U.S. adults use smartphones, which already enable geolocation. The idea of going to such great lengths for tracking is as unreasonable as it is unlikely.
• Fear of developing COVID-19 from the vaccine: This is scientifically impossible, since there is no actual virus, alive or dead, in any of the approved vaccines.

Both rational and irrational anxiety can absorb one’s thoughts, making it tough to focus, perform daily tasks, or even leave home. However, both can be treated with a thoughtful approach to how we perceive and react to pandemic-related stressors.

Related reading: How to spot depression and anxiety in teens.

8 anxiety management strategies.

Some patients with newly diagnosed or existing-but-worsened anxiety may benefit from medication. However, symptoms often can improve significantly with supportive, guided behavioral changes to help you regain control of anxious feelings.

1. Control the controllables.

A proven technique for managing anxiety is to focus on what you can control and minimizing what you can’t. Throughout the pandemic, many patients had trouble sleeping due to racing thoughts, such as an overwhelming fear that we were all going to die. I’ll admit, this worry crossed my mind at the beginning of the pandemic.

Yes, all of us will die someday. That is not something we can control. But what we can control is how we handle the present. I typically recommend that patients work through an internal dialogue about what they can and can’t control. This can help you find positives on which to focus your thoughts.

For me, my “controllable” was getting up, getting ready for work, and presenting my best self for my patients. What might “controllables” look like in your situation?

2. Practice deep breathing.

Take deep breaths through your nose and exhale out of your mouth. Repeat this 10 times. Focusing on manual breathing subconsciously refocuses your mind away from whatever was bothering you, if even for a moment. Deep breathing is a form of mindfulness, which is key to more sophisticated awareness practices, such as meditation.

3. Set healthy boundaries.

Several friends invited me to dinner a few weeks back. We’d all been vaccinated, but I requested that we all sit outside where it’s well-ventilated. I still preferred to wear my mask, and I decided in advance that I would leave early to avoid excessive hugging, handshakes, and crowds. What I told all my friends was that I had to be home at a certain time, and no one gave me a hard time about leaving before they did.

It’s up to you what you are comfortable with. Conversely, we owe it to each other to be kind if someone isn’t as ready as you to unmask or hang out at an event or in a restaurant.

Related reading: 6 signs you should be concerned about your mental health.

4. Exercise outdoors.

Moving and getting a change of scenery can help reset the mind and body. I enjoy walking around the koi ponds and flowers at MedStar Washington Hospital Center when I have a few moments between appointments.

If you live in Southern Maryland, you may have easy access to enjoy outdoor activities such as fishing, crabbing, canoeing, and boating. In Baltimore, you might catch a baseball game. Find an activity you enjoy and take your mind off worrying for a while.

5. Give back.

It can be tough to make yourself participate when you have anxiety. However, volunteering can temporarily replace racing thoughts by helping you focus on something positive. Animal lover? Volunteer at a pet shelter. Enjoy reading? Offer to read to kids at your local library. Worried about the homeless? Help out at a food bank. There’s always work to be done, and plenty of opportunities to help in your passion area.

6. Laugh a little!

At the start of the pandemic, I began carrying a stuffed lemur in the pocket of my hospital coat. Patients and colleagues would walk by, give me an odd look, then burst out laughing. Every time, I would beam ear-to-ear behind my mask. Laughing feels good, and it feels even better to make others laugh!

7. Prepare for naysayers.

There will always be a few people who feel it is their right to ridicule others for wearing or not wearing a mask as restrictions are lifted. At work, ideally you could turn to your boss or human resources professional to proactively manage or mitigate these situations. However, that’s not always possible.

If you feel comfortable speaking your mind, remain polite but firmly state, “I respect your decision. Please respect mine.” Sometimes it helps to plan out what you will say or do in certain situations. Role playing with your therapist or a friend can help build your confidence.

8. Take your time.

Whether you are anxious about returning to work or taking your first post-pandemic vacation, incremental steps are key. In our practice, we often recommend “extinction” or “exposure therapy,” which incorporates visualization to manage stressors.

For example, if a patient is afraid of crossing bridges, they’ll start with visualizing themselves crossing the bridge. Once they’ve mastered that, we arrange for them to cross a bridge with a loved one. Over time, they can work up to crossing solo. Some patients never cross alone, and that may be sufficient for them. The point is to set realistic, personally achievable goals you can stick to and go from there.

As we all adjust to our post-pandemic society, remember: Everyone’s timeline will be a little different based on their mental health and their experiences over the past tumultuous year. If anxiety is interfering with your life, don’t hesitate to seek help. We’ve been here for you, and we will be here—no matter what curveballs the next year throws our way.

The holidays can intensify feelings of loss, especially in 2020.

Starting around Thanksgiving, many people who have lost loved ones experience sorrow as they’re reminded of memories from those who are no longer near. Holiday traditions meant to bring joy, like trimming the Christmas tree or listening to holiday music can trigger feelings of intense grief as we remember holidays past and wonder how to celebrate the festive season without the people we love.

Grief is complicated and looks different for everyone. Sometimes, it’s surprising. Whether your loss is fresh or you’ve lost someone decades ago, unexpected feelings of sadness and loss can surface that aren’t necessarily attached to a specific memory. For some, these moments of grief can appear out of nowhere. For others, grief over the holidays is expected and dreaded. This year, the public health crisis that has affected all of us in different ways may result in added grief on top of an already emotionally-loaded time of year.

There’s no right way to grieve, but there are things you can do to try to cope over the holidays while acknowledging and expressing your sadness.

How to deal with grief over the holidays.

1. Accept the emotions that you’re feeling.

The holidays can generate exaggerated feelings as the pressure to “be merry” collides with the reality of our grief. Grief can present itself in a variety of emotions, from sadness or anxiety to irritability or anger. Everyone grieves differently. But that can be difficult when you’re around family members who expect you to show sadness in the same way—or even hide it. But, you’re human and allowed to feel a wide range of emotions, including both grief and joy. Sometimes you may even feel happy and sad within a few minutes. It’s healthy to acknowledge your emotions and accept how you’re feeling rather than try to escape it.

2. Show yourself kindness.

It may sound simple, but self-care is one of the best ways to deal with grief over the holidays. Think about how you would care for others in your life experiencing loss, then apply the same measures of compassion and grace to yourself. When grief hits hard, try to find things to do that help you to feel supported and restored, whether that means getting outside for some exercise, meditating, or journaling about someone—or something—you miss.

3. Find ways to incorporate memories of your loved ones into holiday traditions.

One way to deal with grief over the holidays is to memorialize the legacy of someone you’ve lost and keep their memory alive. Whether you incorporate them into existing traditions or establish new celebrations, it can be therapeutic to remember the lives of those who’ve died. Here are a few ways you can honor the life of loved ones over the holidays:

• Set a place for them at the table
• Tell stories about them related to the holidays
• Create an altar with favorite pictures and mementos
• Write them a letter or email
• Prepare a lost loved one’s favorite holiday dish
• Light a candle in their memory

4. Talk to someone.

Experts know that grief needs to be heard and witnessed. Try to find someone who you know is a good listener and admit to them when you’re having a hard time. Healing can begin when we’re able to speak our grief into existence.

And, when you’re in the listener’s role, remember that it’s not up to you to fix it. There’s no fixing grief. Instead, listen without judgment and remember that anything they’re feeling is okay.

This is especially true for parents of kids who may also be grieving. Kids need permission to feel all kinds of emotions, even if their grief manifests differently than yours. If you can help them normalize their feelings, whether that’s joy amidst sorrow or guilt coupled with happiness, you can help them to work through the grieving process in a healthy way.

When to seek additional help for grief.

If you don’t have anyone to talk to, or you’re experiencing overwhelming grief for weeks or months, it may be helpful to seek counseling services from a therapist or psychologist. It’s healthy to ask for support, even if it’s outside of your inner circle. A professional counselor can serve as an active listener who can help you find healthy ways to cope with your grief, especially over the holidays.

Whether your grief is new this holiday season, or you struggle with sadness this time every year, know that you’re not alone. And, those feelings won’t last forever. While the holidays may never feel the same, time and support can help you to make it through to the New Year a little bit easier.