“Telling an athlete to go outside and exercise [in order to feel better during COVID-19 isolation] isn’t really helpful for those struggling with mental illness.”
Those are the words of a prospective Olympian who has struggled with depression, post-traumatic stress disorder and anxiety. They highlight one of the challenges faced by athletes during this time of extreme, far-reaching disruption in training and daily routines.
The recommendation of daily outdoor physical activity included on most governments’ lists of essential reasons to leave home is a welcome one, given its proven benefits to promote good mental health. However, elite athletes — the ones you might assume would thrive most in a world (finally) valuing daily exercise as essential — may be suffering more than most.
For Olympians, Paralympians and hopefuls, familiar routines have evaporated and hoped-for opportunities have given way to uncertainty during the COVID-19 pandemic. The usual sources of stress or of support — families, friends, school, housing, relationships, jobs to name a few — take on new significance, positive or negative. Pre-existing mental illness may be worsened as the situation remains in flux.
As some waves of uncertainty abate (there will be an Olympic Games, just not in 2020), others emerge: what happens with funding? Will the athletes who planned to retire after the Games in August keep training until 2021? (Some will not.) When can full-time training start again?
The toll on athletes
As an Olympic rower turned sports medicine physician, and an elite volleyball player turned sports psychiatrist, we get it. We have seen an uptick in the number of athletes coming to see us to help them navigate the distress and uncertainty that this is causing.
While some challenges can be anticipated — disappointment at the postponement of the Tokyo 2020 Olympic and Paralympic Games, anxiety about not being able to train, insomnia with the change in routine — others may come as a surprise.
Elite athletes suffer from depression at a rate similar to the general population (rates range from four per cent to 68 per cent), but the culture of sport can make recognizing the signs and symptoms in oneself difficult, let alone reaching out for help. A recent study revealed about one out of six international track and field athletes reported having experienced suicidal ideation.
For many athletes, the team environment is critical. Research shows that team training not only boosts performance, but lessens the pain athletes feel. A sudden shift to solo exercise can be frustrating, painful and lonely, placing significant mental strain on even the most resilient athletes.
Athletes become creatures of habit, of predictable routines. And COVID-19 has been anything but predictable.
Ways to overcome
There’s hope. Athletes are no strangers to adversity. Getting through it is often about reminding them of the various ways they have handled and overcome challenges in the past. This pandemic has evened the playing field somewhat as athletes around the world find themselves on the same team in a contest far bigger than sport.
Here’s our top advice:
Be aware of your health and your needs.
· Control what you can control in your life: eating, sleeping, self-care, staying connected, having a purpose, forward thinking — these basics will get you through.
· Take charge of your training: work with your sporting organization to develop appropriate training regimens.
· Remember that you are not alone. You may not want to burden your teammates if you are concerned they are struggling too, but reaching out can be a big help to you and to the other person.
Sport prepares us for adversity.
· Mental toughness, resilience, adversity tolerance — the qualities that make elite athletes tenacious competitors also make them leaders in life. The strength and leadership of athletes, coaches and the athlete’s entourage are accessible online, with positive messages of support and solidarity weaving together a global network of shared ideas and experiences. Isolation doesn’t have to mean “alone.”
· For all of our toughness, athletes also feel for our friends whose businesses are shuttered and finances are in peril. In these times we will experience a myriad of emotions ranging from guilt (for even thinking about sport), to sadness, fear or comfort. Friends may try to find ways to bring laughter as an oasis in this storm. Allow it.
We can’t always overcome mental ill health on our own. We can take one step to reach out for support. Sport teaches us to choose our path, the healthy path follows forward thinking: continuing to train and maintain goals, while making use of available support and trusting that opportunity will still come.
The most important thing we can do right now is whatever it takes to keep moving forward so that when the lockdowns are lifted, the arenas and playing fields reopen and the fans in the stands trickle back in, we will be ready.
Carla Edwards, Sports Psychiatrist, Assistant Clinical Professor in Psychiatry and Behavioural Neurosciences, McMaster University and Jane Thornton, Clinician Scientist, Sport Medicine Physician, Western University