Risk Factors
Most mental health challenges occur due to interactions between the person's genetic makeup and various environmental factors.1 The athlete's environment may include factors protecting them from mental illness, such as social support, healthy eating habits, access to mental health care, and physical activity. These are protective factors that help people withstand life stressors. Risk factors are parts of the person's environment that can increase their risk for mental illness. Researchers have found a variety of risk factors for mental illness among the general population, such as alcohol use, traumatic brain injury, history of abuse/trauma, ethnic minority status, cannabis use, living a solitary way of life, work stress, stressful events in adulthood, and lack of sleep.1 Risk factors do not cause mental illness: rather, they can put the person at an increased risk for mental illness. The interaction between the person's genetics, personality traits, protective factors in their life, and risk factors all play a role in mental health outcomes.
It is important to be aware of risk factors related to the athletic experience in order to facilitate a balance between protective factors and risk factors among athletes. Certain stressors involved in the athletic experience commonly impact mental wellbeing and/or trigger mental health challenges. Risk factor awareness will help coaches to refer athletes to appropriate resources and provide social support when athletes need it the most. These preventative measures will help athletes to cope with life stressors in an advantageous way and avoid symptom worsening or maladaptive coping strategies such as alcohol use and risk-taking behavior. Developing awareness about how stressors impact mental well-being can also help coaches to better understand behavior and performance changes resulting from a stressor in the athlete's life. You can be a "protective factor" in the lives of your athletes.
More information:
Research shows that college students endorse a breakup as one of the most significant non-death-related loss events in the past 12 months.5 They also identified breakups as a significant stressor in their lives. Often, these non-death-related losses, though exceptionally painful and challenging, are prone to being invalidated, minimized, and disregarded by others.5 Invalidating and minimizing someone else's pain only makes it more painful. As a coach, it is important to recognize the stage of development your athletes are in during college. According to Erickson's Stages of Psychosocial development, the Young Adulthood Period is when individuals experience either isolation or intimacy, where they aim to meet a lifelong partner and/or develop close friendships.6 Most college athletes are in this stage. As they make big life decisions, they are also searching for lifelong friends and intimate partners. Painful breakups of friendships and romantic partnerships are inevitable and exceedingly challenging in this stage of development. If you hear that an athlete has experienced a loss of friendship or romantic partner, it is important to understand the athlete's pain and validate it. There is no need to get too involved in the athlete's personal life. Rather, show them that you care and encourage them to get help if they need it.
More information:
Changes and transitions are key stressors that may impact athlete mental health. An athletic injury is a transition between a competing role to a recovery role. A loss of a relationship is a transition from spending time with a specific person to losing their support, finding other things to do, and developing other relationships. Times of transition are difficult because the athlete faces the unknown and experiences a disruption in routine. When an athlete is going through a transition, their need for support will change. It is important to show them you care, refer them to resources if needed, and encourage them to find routine in their life (even in small ways) to keep them grounded. Here are some transition examples to be aware of.
Health habits such as nutrition, sleep, exercise, social participation, and self-care are important mental health factors. In the general population, poor health habits present a major risk factor for mental illness. These risk factors may include alcohol use, cannabis use, living a solitary way of life, obesity, smoking, and lack of sleep. Protective factors include a healthy diet, adequate social support, and regular physical activity.1 Encouraging athletes to develop healthy habits around sleep, substance use, eating, and social participation will help the athletes avoid a number of mental illness risk factors. These healthy habits will be positive for their performance mentally and physically. The habits will also help to set them up for positive mental health outcomes later in life.
More information:
References
1.Latalova, K., Sery, O., Hosakova, K., & Hosak, L. (2020). Gene-Environment Interactions in Major Mental Disorders in the Czech Republic. Neuropsychiatric disease and treatment, 16, 1147–1156. https://doi.org/10.2147/NDT.S238522
2. 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
3. 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
4. Hughes, L., & Leavey, G. (2012). Setting the bar: Athletes and vulnerability to mental illness. British Journal of Psychiatry, 200(2), 95-96. doi:10.1192/bjp.bp.111.095976
5. Reimer, J.E. & Estrada, A.R. (2020) College Students' Grief Over a Breakup, Journal of Loss and Trauma. doi: 10.1080/15325024.2020.1757992
6. 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/
Developed 2021 by Quinn DeStefano, OTD Student
Reviewed 2021 by Aaron Grusonik, MA, Psy.D
It is important to be aware of risk factors related to the athletic experience in order to facilitate a balance between protective factors and risk factors among athletes. Certain stressors involved in the athletic experience commonly impact mental wellbeing and/or trigger mental health challenges. Risk factor awareness will help coaches to refer athletes to appropriate resources and provide social support when athletes need it the most. These preventative measures will help athletes to cope with life stressors in an advantageous way and avoid symptom worsening or maladaptive coping strategies such as alcohol use and risk-taking behavior. Developing awareness about how stressors impact mental well-being can also help coaches to better understand behavior and performance changes resulting from a stressor in the athlete's life. You can be a "protective factor" in the lives of your athletes.
Athletic Injury
Athletic injuries are common among athletes, and present a key stressor for athletes.2,3,4 The psychological impact of an injury can include isolation from teammates, low motivation, depression, loss of confidence, loss of identity, worry about returning to pre-injury level of competition, and performance decrement.2,4 Injuries can trigger depression and other problematic responses such as alterations of appetite, sleep disturbances, irritability, disordered eating, sadness leading to depression, lack of motivation leading to apathy, disengagement leading to alienation, pain behaviors, excessive anger or rage, frequent crying or emotional outbursts, and substance abuse.3 When an athlete experiences an injury, there is a lot going on in their head. As a coach, this is a key time to be one of the athlete's protective factors and support their mental health. You can be proactive by checking in with the athlete, asking the team psychologist and/or trainers to check in with them, and encouraging the athlete to remain involved in athletics as they recover from their injury. Keep in mind that you are not the athlete's therapist, you are their coach. Encourage them to get help if they need it, and show them that you recognize the difficulty of their situation and care about their well-being.More information:
- MSU Bobcats: Coping with Injury
- MSU Bobcats: Mental Health Conversations
Loss of Relationships
Research shows that college students endorse a breakup as one of the most significant non-death-related loss events in the past 12 months.5 They also identified breakups as a significant stressor in their lives. Often, these non-death-related losses, though exceptionally painful and challenging, are prone to being invalidated, minimized, and disregarded by others.5 Invalidating and minimizing someone else's pain only makes it more painful. As a coach, it is important to recognize the stage of development your athletes are in during college. According to Erickson's Stages of Psychosocial development, the Young Adulthood Period is when individuals experience either isolation or intimacy, where they aim to meet a lifelong partner and/or develop close friendships.6 Most college athletes are in this stage. As they make big life decisions, they are also searching for lifelong friends and intimate partners. Painful breakups of friendships and romantic partnerships are inevitable and exceedingly challenging in this stage of development. If you hear that an athlete has experienced a loss of friendship or romantic partner, it is important to understand the athlete's pain and validate it. There is no need to get too involved in the athlete's personal life. Rather, show them that you care and encourage them to get help if they need it.More information:
- MSU Bobcats: Loss of Relationship
- MSU Bobcats: Mental Health Conversations
Transitions
Changes and transitions are key stressors that may impact athlete mental health. An athletic injury is a transition between a competing role to a recovery role. A loss of a relationship is a transition from spending time with a specific person to losing their support, finding other things to do, and developing other relationships. Times of transition are difficult because the athlete faces the unknown and experiences a disruption in routine. When an athlete is going through a transition, their need for support will change. It is important to show them you care, refer them to resources if needed, and encourage them to find routine in their life (even in small ways) to keep them grounded. Here are some transition examples to be aware of.
- From competing in high school to the collegiate level. This transition can result in reduced playing time or reduced role on the team. It can create stress or a negative view of oneself, especially if the athlete's identity is defined by success in their sport.2
- Transition out of college sports. Preparing for this transition and going through it are both difficult. Exploring career options outside of athletics can be difficult due to busy schedules and the fear that coaches may view them as less committed if they explore career options outside of professional sports.2 They also may experience a loss of identity and isolation when they leave athletics.
- Going into quarantine for COVID-19. This disrupts roles and routines and increases social isolation, impacting mental health.
- Change of role on the team. When the athlete is no longer on the traveling team, loses their scholarship, or spends more time on the bench, these changes can be mentally challenging. The athlete may be experiencing stressors such as perceived failure, identity loss, and/or pressure to improve their performance.
- Conflict-related housing change. When roommates "breakup," the athlete may be experiencing loss of friendships, relationship stress, isolation, and the stress of finding a place to live and moving there.
- Transferring between universities. The athlete may experience disruptions in routines, social isolation, change of major, change of athletic culture, and/or difficulty with developing a new support system.
Health Habits
Health habits such as nutrition, sleep, exercise, social participation, and self-care are important mental health factors. In the general population, poor health habits present a major risk factor for mental illness. These risk factors may include alcohol use, cannabis use, living a solitary way of life, obesity, smoking, and lack of sleep. Protective factors include a healthy diet, adequate social support, and regular physical activity.1 Encouraging athletes to develop healthy habits around sleep, substance use, eating, and social participation will help the athletes avoid a number of mental illness risk factors. These healthy habits will be positive for their performance mentally and physically. The habits will also help to set them up for positive mental health outcomes later in life.More information:
- MSU Bobcats: Nutrition & Mental Health, Fueling
- MSU Bobcats: Sleep
- MSU Bobcats: Alcohol Consumption
References
1.Latalova, K., Sery, O., Hosakova, K., & Hosak, L. (2020). Gene-Environment Interactions in Major Mental Disorders in the Czech Republic. Neuropsychiatric disease and treatment, 16, 1147–1156. https://doi.org/10.2147/NDT.S238522
2. 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
3. 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
4. Hughes, L., & Leavey, G. (2012). Setting the bar: Athletes and vulnerability to mental illness. British Journal of Psychiatry, 200(2), 95-96. doi:10.1192/bjp.bp.111.095976
5. Reimer, J.E. & Estrada, A.R. (2020) College Students' Grief Over a Breakup, Journal of Loss and Trauma. doi: 10.1080/15325024.2020.1757992
6. 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/
Developed 2021 by Quinn DeStefano, OTD Student
Reviewed 2021 by Aaron Grusonik, MA, Psy.D
