Mental Health: Impact on Performance
Overview | Stress | Anxiety | Depression | Eating Disorders | Trauma | Substance Use | Loss of Relationship
A large-scale study found that stress was in the top three mental health concerns identified by student-athletes, along with anxiety and depression.3 Researchers have found that extremes of exercise are associated with increased stress and burnout, and potential adverse effects, despite the many health benefits of exercise.4 It certainly does not help that athletes often neglect stress management and self-care strategies to prioritize athletic and academic obligations.1 Stress can interfere with performance in academics and athletics, reduce overall wellness, and predispose athletes to athletic injury.4 This increased risk of injury is due to stress-induced attentional changes, distraction, and increased self-consciousness that can interfere with performance. Stress also increases muscle tension and induced coordination changes that can affect athletic performance and increase the risk of injury. In fact, researchers have found that reducing stress can significantly decrease illness and injury rates among athletes.4 What is more, if an athletic injury occurs, it is important to recognize that athletic injury is a major stressor in itself. Athletes may experience isolation from teammates, sadness and/or depressive symptoms, and worry about returning to the pre-injury level of competition.1 In short, athletic injury can be a feedback system, where stress contributes to producing athletic injuries, and then athletic injury can trigger psychological distress. For these reasons, stress is a key mental health
In a 2019 study, researchers found that about 1/3 of male student-athletes and 1/2 of female student-athletes reported being impacted by anxiety in the last 12 months.1 Anxiety was also listed by student-athletes as one of their top three mental health concerns, along with stress and depression.3 Researchers found in a meta-analysis (combined results of multiple scientific studies) that trait anxiety was negatively associated with athletic performance, with one study analyzing race times in distance-runners, and one examining performance errors following a competitive motor task. This indicates that anxiety may impact performance regardless of the type of athletic exertion, or a specific sport. What is more, anxiety changes attentional systems, which in turn compromises executive function (higher-level cognitive systems, such as working memory, cognitive flexibility, organization, planning, and impulse control), stimulus processing (making sense of the world around oneself - touch, vision, sound, smells, etc.), and information selection (blocking out meaningless information) abilities. These capacities are necessary for elite sports performance and academics.5 Untreated anxiety can therefore significantly impact athletic performance.
In a 2019 study, about 21% of male student-athletes and 28% of female student-athletes reported that they "felt depressed" in the last 12 months.1 Depression was also listed by student-athletes as one of their top three mental health concerns, along with stress and anxiety.3 Interestingly, researchers have stated that elite athletes tend to be at a greater risk for depression than less elite athletes.4 Depressive symptoms impact function in a number of ways. For one thing, depression can make it feel nearly impossible to get out of bed and complete daily tasks. This is extremely challenging for student-athletes, who have large time commitments, often with required tasks every day.1 Symptoms of depression can include changes in appetite and weight changes.6 Weight and nutrition are important parts of athletic performance, and improper fueling secondary to depression can take a significant toll on performance. Loss of interest in activities is another symptom of depression. Athletes who are not interested in their sport do not perform well, because they are not fully engaged in practices, health behaviors, or competition. People with depression can also experience fatigue, loss of energy, changes in sleep patterns, and moving/talking slowly. Athletes need to be well-rested through sufficient sleep in order to recover from practice and learn new motor patterns. They also must have the energy and speed necessary to perform. Finally, people with depression can experience physical aches, pains, and cramps that make training and competing difficult. Depression is also a particularly dangerous mental illness because suicidal ideation can happen with depressive symptoms. In fact, in a 2019 study, 12% of college student survey respondents endorsed that they have "seriously considered suicide" at any time in the past 12 months.1 That's more than 1 in 10! Depression negatively impacts wellness and performance in a significant manner, is a safety concern, and is worthy of a referral to counseling & psychological services.
Eating disorders are serious mental illnesses that can lead to other physical and mental illnesses.7 Eating disorder prevention is an ongoing concern for athletic trainers, coaches, and other individuals involved in athletic care. Finding an exact number of athletes experiencing eating disorders is extremely challenging, and the numbers may be unreliable.1,7 There are a couple of possible reasons for this phenomenon. In the athletic setting, it is typically celebrated as good work ethic and making athletic progress when athletes focus on healthy eating and exercising above and beyond regular training. This renders identification of disordered eating behavior and eating disorders challenging for researchers and people involved in athlete care.1 Additionally, people affected by disordered eating often do not seek treatment or even report disordered eating behavior.7 However, researchers have stated that college-age people and athletes are at increased risk for eating disorders.2 Effects of eating disorders on performance are extensive. Malnutrition is an obvious effect, where athletes who are not fueled properly have difficulty performing. They may experience fatigue, difficulty concentrating, and cardiac abnormalities. Another implication is an increased risk of athletic injury and stress fractures due to decreased bone mineral density and malnutrition. Death is another risk eating disorders pose for athletes. In fact, anorexia nervosa has the highest mortality rate of any mental health disorder. Although many people with this disorder die due to complications associated with starvation, others die of suicide.8 Eating disorders reduce overall psychological well-being and have significant physical health effects that damage the athlete's ability to perform in their sport.
Post-Traumatic Stress Disorder (PTSD) can occur among individuals who have experienced a dangerous, scary, or alarming event. Athletes are not immune to mental health challenges related to traumatic experiences.10 Traumatic experiences may have happened during childhood, during college but outside of athletics, or during the athletic experience. Childhood experiences may include exposure to domestic violence, parental substance abuse or incarceration, and a history of child abuse and neglect. Such exposures may trigger PTSD and continue to adversely impact athlete mental health during college.9 It is also important to note that athletes have a life outside of athletics. They are not immune to traumatic events occurring during the athletic experience but outside of sport participation. Domestic/dating violence, witnessing adverse events, sexual assault, and other traumatic experiences can trigger PTSD and, without treatment, negatively influence athlete wellness and performance. Further, athletic injuries during participation in sports are common and can qualify as a traumatic event that provokes PTSD symptoms.11 Among athletes, symptoms of Acute Stress Disorder have been reported as soon as the second day after a traumatic physical injury and occur in 23%–45% of patients following injury. Of these athletes, up to 50% later met the criteria for PTSD. Early detection and treatment of trauma-related disorders among athletes is essential and can reduce the risk of progression to chronic conditions.9 Trauma influences performance in a number of ways. Athletes may experience flashbacks, bad dreams, or frightening thoughts, which can be accompanied by sweating and a racing heart. This is essentially re-living the trauma and can affect their ability to focus on their sport or to get the rest and recovery they need. Athletes also may experience avoidance symptoms, where they stay away from objects, places, and events that remind them of the traumatic experience. This limits what activities they are willing to participate in, and impacts their ability to participate in sports practice and competition, as well as leisure activities. Finally, they may exhibit mood symptoms, where they lose interest in the activities they used to enjoy, feel guilt or blame, or have negative thoughts about themselves and/or the world around them.10 Being engaged and interest in the sport and having a positive view of oneself and the world around oneself are essential for athletic performance. In these ways, post-traumatic stress disorders can have a severe impact on athletic performance, and require appropriate treatment.
Student-athletes may be at a greater risk for abusing alcohol than their non-athlete peers.15 A recent systematic review also suggested alcohol abuse and related violence rates may be higher among athletic populations compared to non-athletes. Researchers noted that masculinity, violent social identity, and antisocial norms connected to specific sports could be potential factors that may impact this connection between sport and violence among athlete populations.16 Athletes also may experience more frequent negative consequences of substance abuse. For example, the "hangover effect" after a night of heavy drinking can reduce athletic performance by 11.4%. This decrease in performance can be extremely distressing for athletes. Student-athletes with the heaviest drinking patterns are also 6.15 times more likely to experience unintentional alcohol-related injuries compared to other athletes, including injuries that may be season- or career-ending.15 On the topic of injuries, substance use is a common problematic response to athletic injury. Often, substances (alcohol or other) are used to self-medicate in an attempt to improve the mood disturbances or depression often associated with the psychological effects of an injury.4 This can create a feedback loop, where athletes have an alcohol-related injury, then self-medicate injury-related mood disturbances with alcohol, get injured again, and so on. Additionally, alcohol is high in calories and low in nutrients. Drinking too much can lead to malnutrition and weight gain, further impacting athletic performance. In essence, athletes need to take extra caution regarding alcohol use and abuse, because the physical and psychological consequences can be quite severe. Developing awareness about moderating alcohol use is important for individuals involved in athlete care.
References
1. Egan, K. (2019). Supporting mental health and well-being among student-athletes. Clinical Sports Medicine, 38, 537-544. doi: 10.1016/j.csm.2019.05.003
2. Ryan, H., Gayles, J. G., & Bell, L. (2018). Student‐Athletes and Mental Health Experiences. New Directions for Student Services, 2018(163), 67–79. doi: 10.1002/ss.20271
3. Hilliard, R. C., Watson, J. C., 2nd, & Zizzi, S. J. (2020). Stigma, attitudes, and intentions to seek mental health services in college student-athletes. Journal of American College Health, 1–10. doi: 10.1080/07448481.2020.1806851
4. Putukian, M. (2016). The psychological response to injury in student athletes: a narrative review with a focus on mental health. British Journal of Sports Medicine, 50(3), 145–148. doi: 10.1136/bjsports-2015-095586
5. Rice, S. M., Gwyther, K., Santesteban-Echarri, O., Baron, D., Gorczynski, P., Gouttebarge, V., Reardon, C., Hitchcock, M., Brian Hainline, & Purcell, R. (2019). Determinants of anxiety in elite athletes: A systematic review and meta-analysis. British Journal of Sports Medicine, 53(11), 722. doi: 10.1136/bjsports-2019-100620
6. National Institute of Mental Health (2018). Depression. Retrieved from: https://www.nimh.nih.gov/health/topics/depression/index.shtml#part_145397
7. McLester, C. N., Hardin, R., & Hoppe, S. (2014). Susceptibility to eating disorders among collegiate female student-athletes. Journal of athletic training, 49(3), 406–410. doi: 10.4085/1062-6050-49.2.16
8. U.S. Department of Health and Human Services, National Institute of Mental Health. (2016). Eating Disorders. Retrieved from: https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml#part_145414
9. Aron, C. M., Harvey, S., Hainline, B., Hitchcock, M. E., & Reardon, C. L. (2019). Post-traumatic stress disorder (PTSD) and other trauma-related mental disorders in elite athletes: A narrative review. British Journal of Sports Medicine, 53(12), 779-784. doi:10.1136/bjsports-2019-100695
10. National Institute of Mental Health. (2019). Post-traumatic stress disorder. Retrieved from: https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
11. Brassil, H. E., & Salvatore, A. P. (2018). The frequency of post-traumatic stress disorder symptoms in athletes with and without sports related concussion. Clinical and Translational Medicine, 7(1), 1-9. doi:10.1186/s40169-018-0200-y
12. Orenstein, G.A., & Lewis L. (November 22, 2020). Erikson's stages of psychosocial development. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK556096/
13. Reimer, J.E. & Estrada, A.R. (2020) College Students' Grief Over a Breakup, Journal of Loss and Trauma. doi: 10.1080/15325024.2020.1757992
14. National Cancer Institute. (2013). Grief, bereavement, and coping with loss (PDQ®): Patient version. Retrieved from: https://www.cancer.gov/about-cancer/advanced-cancer/caregivers/planning/bereavement-pdq#section/all
15. National Collegiate Athletic Association. (n.d.). Substance Use. Retrieved from: https://www.ncaa.org/themes-topics/substance-use#:~:text=Those%20student%2Dathletes%20with%20the,season%2D%20or%20career%2Dending.&text=Heavy%20drinking%20can%20result%20in,performance%20by%2011.4%20percent4.
16. Sønderlund, A.L., O'Brien K., Kermer, P., Rowland, B., De Groot, F., Staiger, P., Zinkiewicz, L., .Millera, P. (2013). The association between sports participation, alcohol use and aggression and violence: A systematic review. Journal of Science and Medicine in Sport, 17(1), 2–7. doi: 10.1016/j.jsams.2013.03.011
Developed 2021 by Quinn DeStefano, OTD Student
Reviewed 2021 by Aaron Grusonik, MA, Psy.D
Overview
Researchers agree that mental health and well-being are essential for optimal performance within all areas of life, including sports, academics, and relationships.1 The NCAA encourages positive mental health and considers mental health to be an increasing area of concern for college athletes.2 This means promoting wellness and preventing mental illness, not only responding to mental illness after it happens. However, it is important to develop an understanding of the implications of mental illnesses on athletic performance in order to begin prioritizing wellness promotion to avoid these effects. Among individuals between 18-24 years old, 19.4% experience a mental health disorder of some kind.2 College athletes fall into this age range and were included in the sample. These mental illnesses are described as any changes in actions, thoughts, or emotions that negatively impact how a person thinks, feels, and acts. Although exercise and athletics provide multiple benefits to mental health, such as self-confidence, connectedness, social support, and positive self-esteem, student-athletes also experience a unique set of stressors that are linked with mental illness. Increased academic pressures, longer playing seasons, pressure from coaches to win, the commercialization of college athletics, injuries, identity defined by performance in sport, and bodyweight expectations are several examples. Additionally, researchers have found that student-athletes greatly under-utilize mental health services, for a number of reasons including persistent negative stigmas around mental illness.2 Mental health concerns impact athlete performance in different ways depending on the person and the specific mental health challenge. However, it is well-documented that mental health challenges greatly impact athletic performance. Stress, anxiety, depression, eating disorders, trauma, substance use, and loss of relationships impact athletic performance.
Stress
A large-scale study found that stress was in the top three mental health concerns identified by student-athletes, along with anxiety and depression.3 Researchers have found that extremes of exercise are associated with increased stress and burnout, and potential adverse effects, despite the many health benefits of exercise.4 It certainly does not help that athletes often neglect stress management and self-care strategies to prioritize athletic and academic obligations.1 Stress can interfere with performance in academics and athletics, reduce overall wellness, and predispose athletes to athletic injury.4 This increased risk of injury is due to stress-induced attentional changes, distraction, and increased self-consciousness that can interfere with performance. Stress also increases muscle tension and induced coordination changes that can affect athletic performance and increase the risk of injury. In fact, researchers have found that reducing stress can significantly decrease illness and injury rates among athletes.4 What is more, if an athletic injury occurs, it is important to recognize that athletic injury is a major stressor in itself. Athletes may experience isolation from teammates, sadness and/or depressive symptoms, and worry about returning to the pre-injury level of competition.1 In short, athletic injury can be a feedback system, where stress contributes to producing athletic injuries, and then athletic injury can trigger psychological distress. For these reasons, stress is a key mental health
- MSU Bobcats: Stress & Stress Management
- MSU Counseling & Psychological Services: Stress Management Self-Help
- University of Michigan Medicine Stress Management
- The American Institute of Stress: How Proper Breathing Can Reduce Stress
- Oregon State University: Stress Management Strategies (PDF)
- Oregon State University: 50 Ways to Take a Break (PDF)
- National Institute of Mental Health Handout: I'm So Stressed Out! (PDF)
Anxiety
In a 2019 study, researchers found that about 1/3 of male student-athletes and 1/2 of female student-athletes reported being impacted by anxiety in the last 12 months.1 Anxiety was also listed by student-athletes as one of their top three mental health concerns, along with stress and depression.3 Researchers found in a meta-analysis (combined results of multiple scientific studies) that trait anxiety was negatively associated with athletic performance, with one study analyzing race times in distance-runners, and one examining performance errors following a competitive motor task. This indicates that anxiety may impact performance regardless of the type of athletic exertion, or a specific sport. What is more, anxiety changes attentional systems, which in turn compromises executive function (higher-level cognitive systems, such as working memory, cognitive flexibility, organization, planning, and impulse control), stimulus processing (making sense of the world around oneself - touch, vision, sound, smells, etc.), and information selection (blocking out meaningless information) abilities. These capacities are necessary for elite sports performance and academics.5 Untreated anxiety can therefore significantly impact athletic performance.
- MSU Bobcats Signs & Symptoms: Anxiety
- MSU Counseling & Psychological Services: Anxiety Self-Help
- National Institute of Mental Health: Anxiety Disorders
- North Central College: How to Reduce Anxiety in College Students
- NCAA Mind, Body, and Sport: Anxiety Disorders in Athletes
Depression
In a 2019 study, about 21% of male student-athletes and 28% of female student-athletes reported that they "felt depressed" in the last 12 months.1 Depression was also listed by student-athletes as one of their top three mental health concerns, along with stress and anxiety.3 Interestingly, researchers have stated that elite athletes tend to be at a greater risk for depression than less elite athletes.4 Depressive symptoms impact function in a number of ways. For one thing, depression can make it feel nearly impossible to get out of bed and complete daily tasks. This is extremely challenging for student-athletes, who have large time commitments, often with required tasks every day.1 Symptoms of depression can include changes in appetite and weight changes.6 Weight and nutrition are important parts of athletic performance, and improper fueling secondary to depression can take a significant toll on performance. Loss of interest in activities is another symptom of depression. Athletes who are not interested in their sport do not perform well, because they are not fully engaged in practices, health behaviors, or competition. People with depression can also experience fatigue, loss of energy, changes in sleep patterns, and moving/talking slowly. Athletes need to be well-rested through sufficient sleep in order to recover from practice and learn new motor patterns. They also must have the energy and speed necessary to perform. Finally, people with depression can experience physical aches, pains, and cramps that make training and competing difficult. Depression is also a particularly dangerous mental illness because suicidal ideation can happen with depressive symptoms. In fact, in a 2019 study, 12% of college student survey respondents endorsed that they have "seriously considered suicide" at any time in the past 12 months.1 That's more than 1 in 10! Depression negatively impacts wellness and performance in a significant manner, is a safety concern, and is worthy of a referral to counseling & psychological services.
- MSU Bobcats Signs & Symptoms: Depression
- MSU Counseling & Psychological Services: Depression Self-Help & About
- National Institute of Mental Health: Depression
- NCAA Mind, Body, and Sport: Depression and anxiety prevalence in student-athletes
Eating Disorders
Eating disorders are serious mental illnesses that can lead to other physical and mental illnesses.7 Eating disorder prevention is an ongoing concern for athletic trainers, coaches, and other individuals involved in athletic care. Finding an exact number of athletes experiencing eating disorders is extremely challenging, and the numbers may be unreliable.1,7 There are a couple of possible reasons for this phenomenon. In the athletic setting, it is typically celebrated as good work ethic and making athletic progress when athletes focus on healthy eating and exercising above and beyond regular training. This renders identification of disordered eating behavior and eating disorders challenging for researchers and people involved in athlete care.1 Additionally, people affected by disordered eating often do not seek treatment or even report disordered eating behavior.7 However, researchers have stated that college-age people and athletes are at increased risk for eating disorders.2 Effects of eating disorders on performance are extensive. Malnutrition is an obvious effect, where athletes who are not fueled properly have difficulty performing. They may experience fatigue, difficulty concentrating, and cardiac abnormalities. Another implication is an increased risk of athletic injury and stress fractures due to decreased bone mineral density and malnutrition. Death is another risk eating disorders pose for athletes. In fact, anorexia nervosa has the highest mortality rate of any mental health disorder. Although many people with this disorder die due to complications associated with starvation, others die of suicide.8 Eating disorders reduce overall psychological well-being and have significant physical health effects that damage the athlete's ability to perform in their sport.
- MSU Bobcats Signs & Symptoms: Eating Disorders
- MSU Bobcats Nutrition: Book an Appointment
- NCAA "Mind, Body and Sport: Eating disorders" An excerpt from the Sport Science Institute's guide to understanding and supporting student-athlete mental wellness
- Podcasts: Food Psych, Body Kindness, Peace Meal
- NCAA Nutritional, Sleep, and Educational Resources
Trauma
Post-Traumatic Stress Disorder (PTSD) can occur among individuals who have experienced a dangerous, scary, or alarming event. Athletes are not immune to mental health challenges related to traumatic experiences.10 Traumatic experiences may have happened during childhood, during college but outside of athletics, or during the athletic experience. Childhood experiences may include exposure to domestic violence, parental substance abuse or incarceration, and a history of child abuse and neglect. Such exposures may trigger PTSD and continue to adversely impact athlete mental health during college.9 It is also important to note that athletes have a life outside of athletics. They are not immune to traumatic events occurring during the athletic experience but outside of sport participation. Domestic/dating violence, witnessing adverse events, sexual assault, and other traumatic experiences can trigger PTSD and, without treatment, negatively influence athlete wellness and performance. Further, athletic injuries during participation in sports are common and can qualify as a traumatic event that provokes PTSD symptoms.11 Among athletes, symptoms of Acute Stress Disorder have been reported as soon as the second day after a traumatic physical injury and occur in 23%–45% of patients following injury. Of these athletes, up to 50% later met the criteria for PTSD. Early detection and treatment of trauma-related disorders among athletes is essential and can reduce the risk of progression to chronic conditions.9 Trauma influences performance in a number of ways. Athletes may experience flashbacks, bad dreams, or frightening thoughts, which can be accompanied by sweating and a racing heart. This is essentially re-living the trauma and can affect their ability to focus on their sport or to get the rest and recovery they need. Athletes also may experience avoidance symptoms, where they stay away from objects, places, and events that remind them of the traumatic experience. This limits what activities they are willing to participate in, and impacts their ability to participate in sports practice and competition, as well as leisure activities. Finally, they may exhibit mood symptoms, where they lose interest in the activities they used to enjoy, feel guilt or blame, or have negative thoughts about themselves and/or the world around them.10 Being engaged and interest in the sport and having a positive view of oneself and the world around oneself are essential for athletic performance. In these ways, post-traumatic stress disorders can have a severe impact on athletic performance, and require appropriate treatment.
- MSU Bobcats Signs & Symptoms: Post-Traumatic Stress Disorder
- National Institute of Mental Health: Post-Traumatic Stress Disorder
- NCAA Mind, Body, and Sport: The Haunting Legacy of Abuse
- National Institue of Mental Health: PTSD Pamphlet (PDF)
Alcohol Use
Student-athletes may be at a greater risk for abusing alcohol than their non-athlete peers.15 A recent systematic review also suggested alcohol abuse and related violence rates may be higher among athletic populations compared to non-athletes. Researchers noted that masculinity, violent social identity, and antisocial norms connected to specific sports could be potential factors that may impact this connection between sport and violence among athlete populations.16 Athletes also may experience more frequent negative consequences of substance abuse. For example, the "hangover effect" after a night of heavy drinking can reduce athletic performance by 11.4%. This decrease in performance can be extremely distressing for athletes. Student-athletes with the heaviest drinking patterns are also 6.15 times more likely to experience unintentional alcohol-related injuries compared to other athletes, including injuries that may be season- or career-ending.15 On the topic of injuries, substance use is a common problematic response to athletic injury. Often, substances (alcohol or other) are used to self-medicate in an attempt to improve the mood disturbances or depression often associated with the psychological effects of an injury.4 This can create a feedback loop, where athletes have an alcohol-related injury, then self-medicate injury-related mood disturbances with alcohol, get injured again, and so on. Additionally, alcohol is high in calories and low in nutrients. Drinking too much can lead to malnutrition and weight gain, further impacting athletic performance. In essence, athletes need to take extra caution regarding alcohol use and abuse, because the physical and psychological consequences can be quite severe. Developing awareness about moderating alcohol use is important for individuals involved in athlete care. - MSU Bobcats Signs & Symptoms: Alcohol Use Disorder
- MSU Bobcats Alcohol Consumption (effect on athletic performance, moderate drinking tips)
- National Institute on Alcohol Abuse and Alcoholism: Alcohol Basics
- NCAA Resource: For the Athlete: Alcohol and Athletic Performance Pamphlet (DOCX)
- NCAA Student-Athlete Substance Use Study: Executive Summary August 2014
- NCAA: Mind, Body, and Sport: Substance Use and Abuse
Loss of Relationship
According to Erickson's Stages of Development, most college athletes can be described by the Young Adulthood Period (Stage 6). This is when individuals experience either isolation or intimacy, where they aim to meet a lifelong partner and/or develop close friendships.11 The journey in finding the people they want to spend time with long-term can include difficult relationship losses. Breakups and relationship difficulties can be extremely painful in this developmental stage. For this reason, it is important for coaches to understand the impact these losses have on athletes. A common misconception is that feelings of grief only occur after the death of a loved one. However, losing any close relationship, such as breaking up with an intimate partner, can cause feelings of grief. Research shows that students endorse a breakup as one of the most significant non-death-related loss events of the past 12 months. College students have also identified breakups as a significant stressor in their lives.12 After a breakup, athletes may be experiencing grief symptoms such as a period of sadness, loss of sleep, loss of appetite, extreme tiredness, guilt, anger, emotional numbness, and loss of interest in life.14 Losing sleep damages the athlete's ability to recover from practice and learn new motor patterns. Changes in appetite affect the athlete's ability to fuel properly. Feeling tired makes it hard to get out of bed in the morning, come to practice on time, and put full effort into practice and competitions. Finally, loss of interest, anger, and emotional numbness render it nearly impossible to be engaged in practice, be a supportive teammate, do pre-hab and rehab in the training room, and go the extra mile outside of practice. For these reasons, breaking up with a friend or romantic partner can have a serious impact on athletic performance. More about grief in athletes HERE.- MSU Bobcats Signs & Symptoms: Loss of Relationship/Grief
- Psychology Today: This Is Your Brain on a Breakup
- Journal of Loss and Trauma: College Students' Grief Over a Breakup
References
1. Egan, K. (2019). Supporting mental health and well-being among student-athletes. Clinical Sports Medicine, 38, 537-544. doi: 10.1016/j.csm.2019.05.003
2. Ryan, H., Gayles, J. G., & Bell, L. (2018). Student‐Athletes and Mental Health Experiences. New Directions for Student Services, 2018(163), 67–79. doi: 10.1002/ss.20271
3. Hilliard, R. C., Watson, J. C., 2nd, & Zizzi, S. J. (2020). Stigma, attitudes, and intentions to seek mental health services in college student-athletes. Journal of American College Health, 1–10. doi: 10.1080/07448481.2020.1806851
4. Putukian, M. (2016). The psychological response to injury in student athletes: a narrative review with a focus on mental health. British Journal of Sports Medicine, 50(3), 145–148. doi: 10.1136/bjsports-2015-095586
5. Rice, S. M., Gwyther, K., Santesteban-Echarri, O., Baron, D., Gorczynski, P., Gouttebarge, V., Reardon, C., Hitchcock, M., Brian Hainline, & Purcell, R. (2019). Determinants of anxiety in elite athletes: A systematic review and meta-analysis. British Journal of Sports Medicine, 53(11), 722. doi: 10.1136/bjsports-2019-100620
6. National Institute of Mental Health (2018). Depression. Retrieved from: https://www.nimh.nih.gov/health/topics/depression/index.shtml#part_145397
7. McLester, C. N., Hardin, R., & Hoppe, S. (2014). Susceptibility to eating disorders among collegiate female student-athletes. Journal of athletic training, 49(3), 406–410. doi: 10.4085/1062-6050-49.2.16
8. U.S. Department of Health and Human Services, National Institute of Mental Health. (2016). Eating Disorders. Retrieved from: https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml#part_145414
9. Aron, C. M., Harvey, S., Hainline, B., Hitchcock, M. E., & Reardon, C. L. (2019). Post-traumatic stress disorder (PTSD) and other trauma-related mental disorders in elite athletes: A narrative review. British Journal of Sports Medicine, 53(12), 779-784. doi:10.1136/bjsports-2019-100695
10. National Institute of Mental Health. (2019). Post-traumatic stress disorder. Retrieved from: https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
11. Brassil, H. E., & Salvatore, A. P. (2018). The frequency of post-traumatic stress disorder symptoms in athletes with and without sports related concussion. Clinical and Translational Medicine, 7(1), 1-9. doi:10.1186/s40169-018-0200-y
12. Orenstein, G.A., & Lewis L. (November 22, 2020). Erikson's stages of psychosocial development. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK556096/
13. Reimer, J.E. & Estrada, A.R. (2020) College Students' Grief Over a Breakup, Journal of Loss and Trauma. doi: 10.1080/15325024.2020.1757992
14. National Cancer Institute. (2013). Grief, bereavement, and coping with loss (PDQ®): Patient version. Retrieved from: https://www.cancer.gov/about-cancer/advanced-cancer/caregivers/planning/bereavement-pdq#section/all
15. National Collegiate Athletic Association. (n.d.). Substance Use. Retrieved from: https://www.ncaa.org/themes-topics/substance-use#:~:text=Those%20student%2Dathletes%20with%20the,season%2D%20or%20career%2Dending.&text=Heavy%20drinking%20can%20result%20in,performance%20by%2011.4%20percent4.
16. Sønderlund, A.L., O'Brien K., Kermer, P., Rowland, B., De Groot, F., Staiger, P., Zinkiewicz, L., .Millera, P. (2013). The association between sports participation, alcohol use and aggression and violence: A systematic review. Journal of Science and Medicine in Sport, 17(1), 2–7. doi: 10.1016/j.jsams.2013.03.011
Developed 2021 by Quinn DeStefano, OTD Student
Reviewed 2021 by Aaron Grusonik, MA, Psy.D
