Athletes’ mental health

The IOC experts say mental health problems are common in elite athletes, and that mind and body cannot be separated: mental health struggles can raise the risk of injury and slow recovery.

Seeing a counselor is like seeing a trainer or physical therapist. It is part of performing and living well.

Athletes often say the body gets stronger during recovery, not only during training. Minds need recovery too. The CDC notes that enough sleep helps with attention, memory, stress and mood, and lowers the risk of crashes and long-term health problems.

The CDC recommends 8 to 10 hours of sleep a night for teens (13–17) and 7 or more hours for adults. Busy, driven people often sleep far less.

Ways to rest that count

• A full day off each week
• Hobbies unrelated to sport
• Regular sleep times
• Time with people you love

From the outside, medals and highlight clips can hide a lot. Even people at the top of their sport can feel empty, anxious or alone. Struggling is not a sign that you are failing. It is a sign that you are human.

The American Academy of Pediatrics (AAP) warns that overtraining and burnout affect young athletes too, and that about 70% of kids drop out of organized sports by age 13.

College athletes juggle sport with classes, and adults who compete for fun can still tie their mood to their times. Your struggle counts, whatever level you play at.

Butterflies, a fast heartbeat and sweaty hands are signs your body is gearing up. Many athletes perform well with some nerves. Trouble starts when the fear grows so big that it takes over, or when it follows you all week.

What can help

• A simple pre-game routine you repeat every time
• Focusing on the process (effort, technique) rather than only the outcome
• Naming the feeling: “This is excitement and nerves, and that’s okay”
• Slow breathing, with a longer breath out than in
• Remembering why you started playing

Some athletes hold themselves to perfect standards. A dropped ball or a missed shot can feel like proof they are not good enough. That fear can make people tense, cautious and less free to play.

What can help

• A short “reset” cue after a mistake, like a deep breath or a tap on the chest
• Reviewing film or results with a coach, then letting it go
• Noticing what went well, not only what went wrong
• Remembering that every great athlete makes mistakes every game

Online comments can be cruel, and athletes at many levels see them. A 2021 Pew Research Center survey found that 41% of U.S. adults had personally experienced online harassment.

What can help

• Asking a friend or family member to screen messages
• Muting, blocking and reporting abusive accounts
• Taking breaks from social media around competitions
• Turning off notifications on game days

In an NCAA study of more than 23,000 student-athletes, academic worries were the biggest factor hurting mental health. Other big factors included planning for the future, money, playing time and family worries.

What can help

• Asking about academic support for athletes early, not only when grades slip
• Keeping a weekly planner with training, classes and rest
• Talking with professors before travel weeks
• Using your campus counseling center as well as team staff

The AAP notes that many young athletes now play on several teams at once and train all year. It lists too much training and overscheduling as possible risk factors for burnout.

The AAP encourages measuring success by participation and effort, and helping young athletes build skills in a variety of sports and activities.

For parents

• Ask “Did you have fun?” before “Did you win?”
• Keep the car ride home calm and kind
• Let coaches coach
• Make sure there is time for friends, rest and other interests

If your friends, schedule, self-worth and future plans all depend on sport, then one bad season, cut or injury can feel like losing everything. This is not a weakness. It is what happens when one thing fills the whole picture.

Signs to notice

• You feel lost on days off
• You introduce yourself only by your sport or position
• Your mood depends almost entirely on how you played
• You have few interests or friends outside sport

Building other parts of life gives you balance and a soft place to land. It does not make you less committed. Many athletes find it helps them relax and play more freely.

Try this

• List five things you are besides an athlete, like friend, sibling, cook, reader
• Keep one hobby that has nothing to do with sport
• Spend time with people who knew you before your sport took off
• Take one class or short course just because it interests you

Fans, classmates and even family may only talk about stats, wins and next season. Over time, athletes can start to believe that is all they are worth.

What can help

• Telling close people: “Ask me about other things too”
• Sharing other parts of your life on and off social media
• Finding spaces where nobody knows or cares about your sport

Values are the qualities you want to live by, like courage, loyalty or kindness. Sport is one place to live them, but not the only one. Knowing your values gives you direction when sport changes.

Questions to ask yourself

• What do I want teammates to say about me as a person?
• What qualities from sport do I use in the rest of my life?
• If I could not play tomorrow, what would still matter to me?

Rehab can feel slow and lonely. You may miss your team, feel left out of the group chat, or worry someone will take your spot. Feeling low after an injury is common.

What can help

• Staying connected with your team during recovery
• Setting small rehab goals and celebrating progress
• Exploring other parts of yourself: friends, school, hobbies, faith
• Talking openly with your medical team about how you feel, not just how your body feels

The CDC lists emotional signs of concussion, including anxiety or nervousness, irritability, feeling more emotional and sadness. These can show up in the days after a bump, blow or jolt to the head.

Any suspected concussion should be checked by a clinical provider before returning to play. If someone has danger signs, like a headache that gets worse, repeated vomiting, slurred speech, seizures or trouble waking up, call 911 right away.

Many athletes feel nervous when they return. They may hold back, avoid certain moves or replay the moment they got hurt. This is a normal part of coming back, and confidence often grows step by step.

What can help

• A gradual return plan agreed with your medical team
• Picturing yourself doing the move safely before you try it
• Telling your coach or trainer about the fear
• Celebrating each step back, not only full return

A 2023 review found that being forced to retire from sport because of injury is often linked with more distress, anxiety and depression. Athletes whose identity is built almost entirely around sport may be most at risk.

What can help

• Allowing yourself to grieve what you lost
• Talking with others who have been through it
• Getting support from a counselor early
• Planning small, new goals once you are ready

Burnout in sport can come from training too hard, too often, for too long, without enough rest or enjoyment. Athletes may feel exhausted, lose motivation, care less about results, and feel cut off from the joy they once felt.

Signs to notice

• Dreading practice you used to love
• Feeling tired even after rest
• Getting sick or injured more often
• Irritability and pulling away from teammates
• Performance slipping despite hard work

In the NCAA study, 44% of athletes in women’s sports and 17% in men’s sports said they felt constantly overwhelmed. 35% of athletes in women’s sports and 16% in men’s sports said they felt mentally exhausted.

If this sounds like you, you are not alone, and it is worth telling someone.

Sleep, regular meals, movement for fun, time outdoors and connection with others are the base that everything else stands on.

CDC sleep tips

• Go to bed and wake up at the same times
• Keep your bedroom quiet, dark, relaxing and cool
• Limit caffeine later in the day, and avoid alcohol and big meals near bedtime
• Put screens away at least 30 minutes before bed

The AAP encourages young athletes to build skills in a variety of sports and activities, while avoiding overtraining and overscheduling. Time away from sport can help prevent injury and burnout.

If an athlete shows signs of overtraining or burnout, the AAP advises changing what is causing it, and involving a mental health professional if needed.

A 2023 IOC consensus statement describes Relative Energy Deficiency in Sport (REDs): health and performance problems caused by a long or severe mismatch between the energy athletes eat and the energy they burn.

REDs is common in both male and female athletes in many sports. Estimates vary by sport, from 15% to 80%. Para athletes may be at even higher risk.

Possible effects

• Getting sick more often
• Hormone changes
• Low mood and less motivation
• Training that stops paying off
• Weaker bones and stress fractures

The IOC experts recommend early help and a team approach, which may include sport doctors, dietitians, psychologists and sport scientists, with coaches and family involved.

What can help

• Working with a sports dietitian, not cutting food on your own
• Telling your athletic trainer or team doctor if you often feel drained
• Getting help early if eating starts to feel out of control

Comments about weight, shape or looks can hurt, even when they are meant as advice. Athletes of any gender can be affected.

What healthy coaching looks like

• Body measurements handled privately and only when truly needed
• Coaches focusing on strength, skill and health, not weight
• No public weigh-ins or body comparisons
• Speaking up is welcome if body comments make you uncomfortable

The IOC statement notes that disordered eating, eating disorders and REDs are fairly common among some athletes, and links REDs with low mood and exercise dependence.

If you are worried about your eating, exercise or body image, talk to your clinical provider, athletic trainer or a counselor. You do not need to be “sick enough” to deserve help.

Signs of a healthy team

• Clear paths to counseling and support
• Coaches who check in on the whole person, not only the athlete
• It is okay to say “I’m not okay” without losing your spot
• No body shaming, hazing or humiliation
• Teammates looking out for each other

Bullying, hazing, humiliation, unwanted touching and sexual abuse are never normal parts of sport. If a coach, teammate or anyone in sport is abusing you, it is not your fault.

What you can do

• Tell a trusted adult, school or sport official
• Write down what happened and when, if it feels safe to do so
• If a child is being abused, report it to local authorities or police first
• If anyone is in danger right now, call 911

The U.S. Center for SafeSport takes reports of abuse and misconduct involving people in the U.S. Olympic and Paralympic Movement, including national governing bodies and their local clubs. You can report without giving your name.

How to reach them

• Phone: 833-5US-SAFE (833-587-7233), weekdays, with voicemail after hours
• Website: uscenterforsafesport.org/report-a-concern

The Center does not cover some groups, such as school, college and many pro leagues. For those, contact the organization directly or local law enforcement. If you are unsure, you can still contact the Center and they will advise you.

The NCAA has Mental Health Best Practices, updated in 2024. They cover four areas: creating healthy environments, screening for mental health concerns, clear plans for referring athletes to care, and making sure care comes from licensed providers.

Under NCAA rules, member schools in every division must provide mental health resources and education that match these best practices.

If you are a student-athlete

• Ask whether your athletic department has a sport psychologist
• Ask your athletic trainer or team doctor how to see a counselor
• Talk with your student-athlete advisory committee about mental health events
• Use your campus counseling center too

• Check in with a teammate who seems quiet or off
• Include injured teammates in plans and group chats
• Never join in on body comments or hazing
• Share how you are really doing. It gives others permission too.

Leaving sport can feel like a loss, even when you chose it. You may miss the locker room, the routine, the rush of game day and being part of something. Grief can come in waves for a long time.

Years of training build skills that matter in jobs, study and family life. Many former athletes find new goals by noticing what they are already good at.

Skills to name

• Bouncing back from setbacks
• Leadership and communication
• Showing up, even on hard days
• Taking feedback
• Working toward long-term goals

After years of hard training, some people stop moving altogether, and others keep training as if they were still competing. Finding movement you enjoy, at your own pace, can lift mood and ease the change.

Ideas

• Coaching, mentoring or volunteering
• Joining alumni or former-athlete groups
• Playing for fun in a local league
• Talking with other former athletes who have made the change

Start now

• Build interests and skills outside sport early
• Ask your school, club or players’ group about career support
• Keep in touch with friends outside your team
• Try short internships, classes or volunteering in the off-season

SAMHSA suggests talking when and where the person feels safe, speaking plainly, and watching how they react, slowing down if they seem upset.

Openers adapted from SAMHSA

• “I’ve been worried about you. Can we talk about what you’re going through?”
• “I care, and I want to listen. What do you want me to know about how you’re feeling?”
• “It seems like a hard time. How can I help you find support?”
• “Sometimes talking to someone who has been through something similar helps.”

Athlete-specific openers

• “How are you doing outside of training?”
• “How are you, not the player, you?”
• “What has rehab been like for you, honestly?”

• “Just push through it.” or “Pressure is a privilege.”
• “You’re so lucky, you’re living the dream.”
• Comments on weight, body shape or looks
• Comparing them with a more successful teammate
• Treating a loss or a cut as proof of who they are

SAMHSA encourages treating people with mental health problems with respect, compassion and empathy, and reminding them that help is available and these problems can be treated.

• Celebrate effort and character, not only wins
• Drive them to practice, rehab or an appointment
• Help them look for a counselor or sport psychologist
• Keep inviting them to plans, even if they often say no
• Protect their rest: plan low-key time together away from sport

SAMHSA suggests offering help with everyday tasks and continuing to include people in your plans without being overbearing.

The AAP says positive experiences with parents, coaches and peers, and judging success by participation and effort, can help prevent burnout in young athletes.

• Notice if your hopes for their success are adding to their pressure
• Ask what they enjoy about their sport, and listen
• Let them take breaks or try other activities without guilt
• Say “I love watching you play” instead of giving a play-by-play review

A career-ending injury, being cut or a painful loss can hit very hard. NIMH lists warning signs such as talking about wanting to die or being a burden, feeling hopeless or trapped, withdrawing, giving things away, taking dangerous risks, and drinking or using drugs more.

The 5 action steps (988 Lifeline)

1. Ask directly: “Are you thinking about suicide?” Research shows asking does not increase risk.
2. Be there, in person or by phone.
3. Help keep them safe by putting time and distance between them and dangerous items.
4. Help them connect to 988, a clinical provider or other ongoing support.
5. Follow up with a call or text in the days after.

Watching someone you love struggle under pressure is stressful. Supporters often absorb the highs and lows of every game. Keep your own life, friendships and rest going.

• Get your own counseling if you need it
• Set limits on how much of each day goes to their sport
• Talk with other parents, partners or coaches who understand

Talking therapies help people understand their thoughts and feelings and build new ways to cope. Some counselors specialize in athletes (sport psychologists).

Common approaches

• Acceptance and commitment therapy (ACT): living by your values even when feelings are hard
• Cognitive behavioral therapy (CBT): noticing and changing unhelpful thought patterns
• Mindfulness-based approaches: staying present instead of stuck in worry
• Performance psychology: focus, confidence and handling pressure

1. Talk to your clinical provider, team doctor or athletic trainer.
2. Student-athletes: ask your athletic department or campus counseling center.
3. Look for a therapist or sport psychologist who works with athletes.
4. Tell one person you trust how you are really doing.

Find A Helpline (findahelpline.com) lists free, confidential crisis helplines around the world. You can search by country and topic.

Many national sport bodies and players’ groups also offer confidential support. Ask your club, federation or union.