When Olympic athletes’ laser-like focus turns to mental health hurdle

More than 10,000 elite athletes from around the globe are competing in the 2024 Paris Olympics, where they face incredible pressures to perform in front of an audience of billions.

For these Olympians, years of grueling preparation and training precede an event that leaves no room for error – mere seconds can mean the difference between a medal on the winner’s podium or being dropped from competition, retired Olympic speed skater Apolo Ohno told the PBS News Hour’s Amna Nawaz.

And even for those who win gold over and over again, there’s always a day when it’s time to say goodbye to their sport at the highest level – a challenge that can be as hard as any race, match or routine.

WATCH: Olympian Apolo Ohno on the pressure to compete and prioritizing mental health

When Ohno was competing nearly 15 years ago, the conversation about mental health among athletes was very different from the one today. “To be completely frank, we didn’t know what that even meant,” he said. “The words ‘mental health’ really was mental performance. That’s where we focused a lot of our time.”

Athletes are increasingly weighing their own mental health against the demands of sport and pressure to perform, said Jessica Bartley, senior director for psychological services for the U.S. Olympic and Paralympic Committee.

Postponing the 2020 Tokyo Olympics for a year during the COVID-19 pandemic was “one of the most notable times” in terms of athletes needing mental health services, Bartley said. That delay unleashed anxiety in many athletes, particularly more experienced competitors, because it allowed a new cohort of younger athletes to become eligible to compete against them, she noted.

When the Tokyo Games returned in 2021, Olympic gymnast Simone Biles helped jumpstart a global conversation about the importance of mental health awareness as she withdrew from team competition.

“We have to protect our mind and our body, rather than just go out there and do what the world wants us to do,” Biles told reporters then. When she participates at the Games this summer she does so on her terms and with a new honor – as the most decorated gymnast ever.

Pressure to perform

Olympians face daunting expectations, Bartley said. To reach the Games, many athletes started training for their sport almost as soon as they learned how to walk, and have dedicated much of their lives to just one thing.

Often, Bartley said, athletes have trained with the mentality that “you can’t take your eye off the ball or you won’t perform your best.” That can include not paying attention to your own mental health nor balancing the demands of your sport with the rest of your life.

A 2019 meta-analysis of British Journal of Sports Medicine studies found at least a fifth of current elite athletes struggled with alcohol and as many as a quarter of former athletes grappled with anxiety and depression.

In response to Biles’ call for the need to prioritize the mental health of athletes, the International Olympic Committee in 2023 issued an action plan that highlighted how elite athletes are “at increased risk of mental health problems, such as depression, anxiety and eating disorders.”

“While the global mental health burden is significant, we must recognize that mental health symptoms are treatable, and in many instances, preventable,” said professor Uğur Erdener, chair of the committee’s medical and scientific commission, in a statement when the plan was released. “By inspiring, encouraging and assisting stakeholders across the Olympic movement, we can help build a healthier world in and through sport.” The committee’s plan to address mental health challenges and boost well-being focuses on improving culture and leadership as well as using data and research, among other measures.

When Bartley’s staff checks in with athletes from Team USA each year, she said they routinely ask about mental health as well physical health, including questions about sleep, vaccination status and nutrition, as well as disordered eating, trauma, substance use, and anxiety and depression.

“We’ve really shifted to normalize us asking questions about mental health, checking in. We check before Olympic and Paralympic Games, and we’ll check in after,” Bartley said. “We’ll do a touchpoint with each of those athletes.”

Ohno has been speaking out in recent years to raise awareness about mental health needs and resources, including with his book, “Hard Pivot,” and in the 2020 HBO documentary “The Weight of Gold.”

The former speed skater stood up on the Olympic podium eight times, more than any other American winter athlete in history. But when he reflects upon the career he left behind at age 27, those moments of victory are fleeting.

Instead, his most powerful memories happened without any spectators, “when it was me against myself, digging, striving, trying to find that extra 1 percent.”

“While we might not always be able to control these outcomes, in that process is where the true prize can actually be,” he said.

Seeking help and moving forward

When late-career athletes reach out to Bartley and her staff for support, they usually mull the same questions.

They wonder if they can commit to four more years until the next Olympic games convene. Many have postponed attending college or graduate school. Some have waited to have a family so they could more fully commit to training for their next chance to compete, or they are watching their own parents age and contemplating how to step up for their caregivers.

“‘Am I ready to give it up?'” Bartley said athletes often ask her.

READ MORE: Are the 2024 Paris Olympics gender equal? That depends how you measure it

Change is inevitable. For Olympians, pivoting after sport comes relatively early in life, clinical and cognitive behavioral psychologist Jeff Brown of Harvard Medical School said. It may be out of their control, like when an accident completely alters their trajectory in a split-second. Or it can be a deliberate decision to quit sports and begin anew, which can also be traumatic.

“Identity gets so wrapped up into performance,” Brown said.

Growing up in Steamboat Springs, Colorado, Taylor Fletcher learned to glide down mountains on skis by age 4. To this day, that’s one way he relieves stress.

Fletcher’s parents, especially his mother, made sacrifices so he and his brother could join a local ski team coached by former Olympians who had developed a pipeline to the Winter Games. His journey to the Olympics was not a foregone conclusion, he said, but he worked his way up, pushed by his desire to join the national team. For years, Fletcher said, he focused on just one thing – “everything else took a step back.”

Looking back, having an athlete’s laser-like focus could mean “you can pigeonhole yourself into being stuck,” said the four-time former member of the U.S. Nordic Combined team.

When athletes are contemplating retirement, Bartley and her staff encourage them to reach out to their support networks, including family, friends and peers in their sport, she said, but also to reflect on what they want.

Over the years, Team USA developed its Pivot Program, designed to help athletes cope as they transition into the next phase of their life. Experts talk to current and former athletes about job training skills and financial literacy, preparation for higher education as well as mental health and well-being.

“That’s one thing I wish I knew,” Fletcher said. “While the sport is a big deal, it is not everything.”

In life after the Olympics, Ohno said he has failed countless times. What has helped him recover has been his desire to encourage people to “be open and receptive and vulnerable to listening with empathetic ears” and “to help others recognize and guide them to their own inner truths.”

“They can get back up, they can continue again,” he said. “It’s not too late, and starting today is better than starting tomorrow.”