13 Anxiety Among Male Athletes

Recently, an increased number of athletes have been speaking out about their mental health struggles. Simone Biles is a gymnast and a world-renowned athlete that has spoken out about her mental health issues. She has won 4 gold medals in the Olympics and is the face of the sport. Shortly after backing out of the 2020 Olympic games in Tokyo, she said, “I was feeling very overwhelmed because there was a lot and I think there was a lot of pressure outside the sport that was placed on me to compete at that Olympics” (Weg, 2021). Professional basketball player Kevin Love won a championship with the Cleveland Cavaliers in 2016 and has also shared his struggles with anxiety. In his tribune he discusses growing up with the mentality of toughness and never asking anyone for help. On November 5th, 2018, he ran into the locker room during a timeout and never reentered the game. He suffered an anxiety attack during the first half of a basketball game against the Atlanta Hawks. He then sought the help he needed and continued his successful career. After the incident, he released a statement stating, “For 29 years, I thought about mental health as someone else’s problem” (Love, 2022). These are just two examples of athletes that struggle with some form of anxiety. There are many more athletes across the world that have spoken out about their struggles with mental health.

Anxiety can be defined as feelings of nervousness and apprehensiveness (Anxiety, 2022). For male athletes, there is no uniform treatment or diagnosis for anxiety. To be clear, the anxiety that male athletes face is not solely sport related. Some other factors that can lead to anxiety in athletes are pressures from academic courses, family, coaches, and how they are treated by their peers (Baker et al, 2006).

  The Effects of Different Types of Anxiety

The perception of anxiety is different to every individual, and because of this, there is no uniform way to treat the illness. For instance, while therapy may work for some, it will not work for others, and while medication can help some individuals, it will not help others. This needs to be considered based on the identities of the athlete, and what treatment options they feel are best for their personal lifestyles. Social support is a key factor in getting athletes back into play.

Pre-competition anxiety is a disorder felt by some athletes that participate in any form of competition. The symptoms progressively worsen as the time of the competition gets closer. Nervousness is normal, but consistent pre-competition anxiety can prevent the athlete from competing at their highest level. Some symptoms of pre-competition anxiety are poor concentration, trouble sleeping, clenched jaws, sweaty palms, and increased breathing rates (Abazar, 2014). According to Anagnostopoulos, African American male athletes experienced lower levels of pre-competition anxiety compared to Caucasian, Asian, and Hawaiian athletes.

One of the most common types of anxiety in male athletes is competition anxiety. Competition anxiety is when an athlete experiences anxiety symptoms when faced with what they consider high stakes competition. Some physical symptoms of competition anxiety are sweaty palms, shallow breathing, and a racing heartbeat (Greene & Cohn, 2020). In Covassin’s article (2014), there was a study that showed how concussed athletes experienced the highest levels of state anxiety when they did not receive proper social support throughout their recovery. The study also discussed how 89% of the time injured athletes rely on family support compared to the 11% of time where they rely on some other form of support (Covassin et al., 2014). Male athletes do not have proper resources to diagnose and treat anxiety and other mental health problems. This can lead to more frequent and severe cases of anxiety.

“muscle, shoulder, strength, fitness, gym, athlete, equipment, competition” is in the Public Domain, CC0

Post competition anxiety can set  in after the completion of a sporting event, season, or career. The symptoms of post competition anxiety are fatigue, mood swings, insomnia, and restlessness. Covassin also discusses that one of the root causes for post injury anxiety is that athletes are anxious about what their lives will be like without their sport. When an athlete gets injured, they can feel the post injury anxiety and wonder about when they will be able to play their sport again. Making the decision to play sports puts you at an increased risk for injury. For many athletes playing sports was the only way they were able to get a college education.

The effects of anxiety can have on and off the field effects. Anxiety can affect an athlete’s performance if not handled properly. In Palazzolo’s article, he discusses how competition anxiety is  the most important predictor of an athlete’s performance. Some of the off-field effects of anxiety are rapid changes of emotions, headaches, and having a tough time focusing (Palazollo, 2019).

 Implementation of Mental Health Services

Some athletes feel pre-competition anxiety while others could be feeling post-injury anxiety. There is a lot of research on ways to implement mental health services for athletes, such as visiting healthcare facilities. This provides a way for athletes to receive the help they need and will be a great resource for men to help combat the stigma around mental health issues. By going to health facilities within their own athletic facilities, they will receive the resources they need from within their own athletic department. One of the biggest drivers that cause male athletes to experience higher levels of stress and anxiety is the overwhelming feeling of too much pressure. This pressure can come from social factors, such as family and friends, their classmates, or even within their athletic relationships, such as from teammates, coaches, and athletic directors. Men can be too stubborn or ashamed to ask for help. Due to the stigma around mental health, and the idea of “toxic masculinity,” men often feel as if they do not need help, or that anxiety is not a mental illness (Baker et al, 2006). The locker room is another setting where hegemonic masculinity is popular. Kevin Love grew up in the locker room setting and linking mental toughness to performance on the court. He now uses his platform to promote athletes seeking help for their mental health struggles. Something that healthcare professionals may not know much about is when an athlete is feeling pre-competition anxiety or an adrenaline rush. Adrenaline is a part of the body’s fight or flight mechanism. It triggers in response to stress, danger, fright, or highly competitive situations (Merriam-Webster, 2022). Adrenaline occurs during the same time as pre-competition anxiety, which is right before high stakes competition. The right amount of adrenaline can be a good thing for the athlete. Adrenaline increases the individual’s heart rate, and which causes more oxygen to get into the muscles (Krahenbuhl, 1975).

“Practitioner Tips For Preventing Injury” is licensed under CC BY-ND 2.0

 The Weight of BMI on Athletes Mental Health

Some sports require different body types to be successful, which can also lead to anxiety. Tran’s article (2021) discusses how Asian-identified student athletes had a strong correlation between anxiety and their Body Mass Index (BMI) score. BMI is a measure of body fat based on height and weight (Adab et al., 2018). While athletes are physically active, their sport may require them to have more body weight than normal. Thus, BMI scores may not actually reflect an athlete’s health. For example, offensive lineman in football or disk/shot-put throwers in track and field may be predisposed to feel certain types of anxiety because of their BMI scores. However, their BMI does not indicate they are unhealthy. Both of those disciplines require larger stature and muscle. The disparities that male athletes face regarding lack of support are limited resources for help, fear of appearing “non-masculine,” and coaches and teammates not understanding how anxiety affects different people. From the society’s point of view, an athlete may appear to be overweight, but they could be very healthy due to their fitness regimen. If the athlete was a football player for example, they would be practicing and working out year-round, so their cardiovascular fitness levels are very high. If people in society make fun or make comments about their weight this could lead to mental health issues such as anxiety.

References

Abazar. (n.d.). Pre – competition anxiety (PCA). CAASN. Retrieved October 29, 2022, from https://caasn.com/pre-competition-anxiety.html

Adab, P., Pallan, M., & Whincup, P. H. (2018, March 29). Is BMI the best measure of obesity? The BMJ. Retrieved October 6, 2022, from https://www.bmj.com/content/360/bmj.k1274.short

American Psychological Association. (n.d.). Anxiety. American Psychological Association. Retrieved November 3, 2022, from https://www.apa.org/topics/anxiety

Baker, J., Côté, J., & Hawes, R. (2006, June 17). The relationship between coaching behaviours and sport anxiety in athletes. Journal of Science and Medicine in Sport. Retrieved November 3, 2022, from https://www.sciencedirect.com/science/article/abs/pii/S1440244000800730

Covassin, T., Crutcher, B., Bleecker, A., Heiden, E. O., Dailey, A., & Yang, J. (2014, August 1). Postinjury anxiety and social support among collegiate athletes: A comparison between orthopaedic injuries and concussions. Allen Press. Retrieved September 20, 2022, from https://meridian.Allenpress.com/jat/article/49/4/462/191292/ Postinjury-Anxiety-and-Social-Support-Among

Donohue B;Phrathep D;Stucki KB;Kowal I;Breslin G;Cohen M;White S;Jefferson L;White T;Irvin J;Reese G;Kessler FHP;Kieslich da Silva A;Gabriel Santos da Silva F;Fothergill M;Robinson G;Allen H;Light A;Allen DN; (n.d.). Adapting an evidence-supported optimization program for Mental Health and Sport Performance in collegiate athletes to fit youth from ethnic/racial minority and low-income neighborhoods: A National Institutes of Health Stage Model Feasibility Study. International journal of psychiatry in medicine. Retrieved September 19, 2022, from https://pubmed.ncbi.nlm.nih.gov/33910408/

Greene, M., & Cohn, D. (2020, May 5). Managing competition anxiety while staying-at-home. Anxiety and Depression Association of America, ADAA. Retrieved October 29, 2022, from https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/managing-competition-anxiety-while-staying-home#:~:text=Competition%20anxiety%20is%20the%20term,heart%2C%20and%20negative%20mind%20chatter.

J;, P. (n.d.). Anxiety and performance. L’Encephale. Retrieved October 29, 2022, from https://pubmed.ncbi.nlm.nih.gov/31542211/

Krahenbuhl GS. Adrenaline, arousal and sport. The Journal of Sports Medicine. 1975;3(3):117-121. doi:10.1177/036354657500300304

Love, K. (2022, February 28). Everyone is going through something: By Kevin Love. The Players’ Tribune. Retrieved October 29, 2022, from https://www.theplayerstribune.com/articles/kevin-love-everyone-is-going-through-something

Merriam-Webster. (n.d.). Adrenaline. In Merriam-Webster.com dictionary. Retrieved November 2, 2022, from https://www.merriam-webster.com/dictionary/adrenaline

panelJ.PalazzoloMD, A. links open overlay, J.PalazzoloMD, a, b, sport, A. I. the world of, sport, R. D. le monde du, Filaire, E., Burton, D., Terry, P. C., Halvari, H., & Boardley, I. D. (2019, September 18). Anxiety and performance. L’Encéphale. Retrieved December 12, 2022, from https://www.sciencedirect.com/science/article/abs/pii/S0013700619302428

Tran, A. (n.d.). In or out of the game? Counter-stereotype paradoxes and Asian-identified student-athlete mental health. Retrieved October 7, 2022, from https://psycnet.apa.org/record/2021-64109-001

Weg, A. (2021, November 18). Simone Biles reveals the tool she uses to manage her anxiety. Prevention. Retrieved November 3, 2022, from https://www.prevention.com/health/mental-health/a38291758/simone-biles-shares-tool-to-manage-anxiety/