Elite athletes can't 'tough it out' when it comes to stress: UHCL expert explains

August 20, 2021 | UHCL Staff

Simone Biles isn’t the first Olympic elite athlete to compete through extreme stress. But by stepping back from her events on the world’s most watched stage, she has forced a spotlight on the issue of how mental health affects even elite athletes’ performances, and how their coaches, teammates and fans respond when the “star” athlete doesn’t feel able to compete. 

In this Q&A, Clinical Director of University of Houston-Clear Lake’s Health and Human Performance Institute Joe Hazzard discusses how and why elite athletes find themselves overwhelmed by stress, anxiety or depression. 

Q: How is the stress faced by elite athletes different from other athletes’ stress?
A. All athletes in competitive environments deal with stress, but just because they may outwardly appear to have dealt with it doesn’t mean it’s true. Either they have inadequate skills to deal with stress from the beginning, or they have developed an inappropriate way of dealing with their stress. 

That means, they can simply get tired of processing their competitive stress, in the same way they can get tired of training. There’s a balance between the stress force placed upon an athlete and how poorly or how well they perform, and that is about figuring out coping mechanisms. Ultimately, the amount of stress athletes feel from external forces, like coaches or parents, and the fear of constant evaluation by a significant person or group, is what elite athletes must process all the time. 

Most times, they deal with this effectively. But sometimes, they’re asked, “What’s wrong with you today?” Maybe they’re just tired. Or maybe they’re just tired of trying to cope. 

This is clearly what Simone Biles said. Her statement was, “I truly do feel like I have the weight of the world on my shoulders at times.” This is not made up. In that moment, she no longer had a strategy to cope with that weight. 

Q: These athletes have been training most of their lives to compete at the highest level. Isn’t it their job to “tough it out” when the pressure becomes intense?
A: Michael Phelps is the most decorated Olympian of all time. He said his frustration and agitation with the level of scrutiny directed at him was because he was “being gawked at, like an animal in a zoo.” There is no greater way of expressing the feeling of being dehumanized than that. 

When an athlete feels this, they’re saying they don’t feel as though they are connecting with others as normal human beings anymore. Our society says people who can succeed in this arena are superhuman, but in the end, they’re still human. They can’t meet all these expectations. As a society, we enjoy our famous actors and athletes as long as they’re meeting our expectations. There’s a fine line between loving the sports and hating the athletes.

Q: What exactly are the “twisties?” Is this real, or is this just in the athlete’s head?
A: You’d think this was an inner ear or vestibular problem, but it’s not. Simone Biles has practiced her routines thousands of times. She went to the Olympics and was about to perform them, and she lost her ability to remember the physical movements she needed to do the routines successfully. 

Consider a musician who goes out on stage and suddenly can’t remember the words to a song they’ve performed a hundred times. In the world of athletics, physical and mental exhaustion is the same. There was something about performing in these Olympics that was just too much for Simone, and it was enough to trigger her being unable to successfully cope with a situation she’d faced hundreds of times. 

Twisties are triggered by stress or anxiety. It’s the principle that the expectation for the demands far outweigh the ability to cope and meet those expectations, and as the importance of the event elevates itself, it becomes even more important. 

Q: Do you think Simone Biles’ experience will change the way mental health problems are handled in elite athletics?
A: After all the talking we’ve done, there’s still such a stigma around mental health. You can see an athlete wearing a cast. We understand broken bones or torn ACLs. If you’re suffering from depression, no one will see it until it shows up in behavior, and even then, it might not be acknowledged. 
Simone Biles’ withdrawal did cause a knee-jerk response from the Olympics. I think they’re going to decide they need to develop a better program to prevent these kinds of breakdowns — but that’s not how this works. 

Coaches are accustomed to controlling every element of training their athletes to get to success. This can’t be controlled by developing a program. All they can do is prepare and create awareness so people can get help before they have a crisis. It’s always a crisis by the time it’s addressed, and in Simone’s case, she had hers on the world’s biggest stage. There should have been no reason for it to happen that way. Whatever was stressing must have been ongoing—she did not show up in Tokyo and suddenly have a breakdown. 

Athletes have to be able to initiate a request for help. Mental health needs to be seen as an issue that is as legitimate as any medical problem they’ve ever had. 

In this recurring feature, University of Houston-Clear Lake faculty answer questions about current events that impact our community. For more information about UHCL’s Health and Human Performances Institute, go online.