Athletes and anxiety

Written By Molly Anderson

Mental health matters

Mental health is a culmination of our psychological, social, and physiological well-being. Having a positive relationship with our mental health means that we are able to cope with obstacles in our everyday life, internalize our own autonomy, and develop strong relationships in our communities(World Health Organization, 2022). The way we think about our own mental health matters. By talking about our own mental health with our communities, we are helping to remove the stigma from mental health and increase access to emotional communication between athletes and their teams, families, and communities.

34%

of elite athletes have depression or anxiety

(Gouttebarge et al., 2019)

 

“We take care of our bodies, so why don’t we take care of our minds?”

-Serena Gordon, Liv Cycling Collective Professional Cyclist

 

Anxiety in endurance sport 

(Yerkes & Dodson, 1908)

Pressure and performance are directly linked. A moderate amount of arousal increases attention and interest, whereas too much arousal can lead to anxiety and impaired performance. A certain amount of stress can drive increased attention, presence, and eventually performance. However, when our system is flooded with anxiety, it becomes difficult to focus on the task at hand.

Zuleger, 2021

Anxiety is very common in endurance athletes, as with many sports. It is a part of sport that is a reaction with external stressors that are outside of the athletes control. Not being able to prepare or expect these obstacles can be very anxiety-inducing for endurance athletes. Researchers found that pre-race anxiety can impair performance among male professional cyclists (Spindler et al., 2018). It is important to understand what it means to work on attention regulation in the context of endurance sport racing, so that the athlete learns to maintain “focus forward” attention so that they can perform at their highest level (Weinberg & Gould, 2014).

SIGNS OF SPORTS RELATED ANXIETY

(Swaim, 2022)

  • Adrenaline and cortisol can cause your heart to beat faster

  • You can feel a tightness that makes it feel as if you are choking or unable to take full breaths

  • You may feel abnormal tightness and unexplained pain in your muscles.

  • Anxiety can cause your body to switch into fight, flight, or freeze mode. This can trigger intestional cramping and diarrhea or constipation.

  • As anxiety is a future-based response, it can cause you to question your abilities and value in sport.

  • When you experience anxiety, your mind/body connection limits your ability to focus on the present task at hand as it thrusts you into worrying about the future. Researchers revealed that specific metacognitive beliefs were differentially predictive of anxiety and concentration in triathletes (Love et al., 2018).

  • Anxiety can decrease your self-worth which can increase fear of disappointing others, letting teammates down, or being made fun of/embarrased.

The Sport Competition Anxiety Test (SCAT)

The SCAT is designed to measure competition anxiety among athletes. The test has 15 indicators, 10 of which measure anxiety and 5 that are bias controls. A score of less than 17 indicates a low level of anxiety, 17 to 24 an average level of anxiety, and more than 24 a high level of anxiety. If you reported higher levels of anxiety, you should bring it up with a coach, athletic trainer, or sport psychologist. You do not have to live with the low self-esteem, frustration, and pressure that anxiety causes.

Martens, (1977)

managing anxiety

Mindfulness-Based Cognitive Therapy

Mindfulness-Based Cognitive Therapy harnesses the athlete’s attentional state during sport to help treat anxiety by increasing recognition on events of the current moment instead of shifting to “what if” thoughts and feelings that can cause anxiety(Baron et al., 2013). Mindfulness is incredibly powerful in increasing the athletes enjoyment, and decreasing athletically driven anxiety and sport-specific pessimism. It is important to create mindfulness and mediation practices that are specific to cyclists and triathletes that help them connect more genuinely with the practice (Scott-Hamilton et al., 2016). 

Passion and coping strategies

Athletes who are managing to cope with anxiety through self-regulatory processes that are unique to every individual’s disposition and personality. The type of passion that an athlete has for sport can positively or negatively affect sport anxiety. Harmonious passion comes from a sense of autonomy and joy of the activity without any contingency. However, obsessive passion originates from pressures effecting self-esteem or self-worth and the sport becomes intertwined with the athletes identity and value. Harmonious passion is helpful in coping with anxiety as it leads to approach-based coping strategies whereas obsessive passion leads to avoidance-based coping strategies (Verner-Filion et al., 2014). How we talk about ourselves and our skills is helpful in guiding ourselves into positive and harmonious passion rather than relying on athletic success for our identity. For example, if you are having a bad training day, it is better to say “I feel tired today” instead of saying, “I am worthless.”

Stress Inoculation Training

Anxiety causes individuals to worry about the future. In the context of athletics, they may be worrying about things outside of their control. Stress Inoculation Training is an approach that combines imagery, self-talk, and relaxation to help individuals cope with feelings of heightened arousal and anxiety. Imagery is used to gradually consider stressful encounters and then pair them with a calming resolution. For example, a cyclist may worry about a tight corner on the course and would imagine approaching that corner in the peloton at speed and using their skills to make it through the corner safely and in a good position. When the athlete is tested in a real life scenario, the intensity is decreased as they have been building coping skills for this situation (Baldock et al., 2021).

  1. Phase 1: Learning about the nature and impact of stress, become aware of autonomy, think adaptively

  2. Phase 2: Learn new coping skills (ie, visualization and imagery)

  3. Phase 3: Utilize coping skills in real life situations with stressful stimulus

Resources for support

  • Licenses & Certifications:

    ● Licensed Psychologist
    ● PhD in Counseling Psychology, University of Houston, 2009
    ● MA in Engineering Psychology, New Mexico State University, 2003
    ● BA in Psychology and English, New Mexico State University, 1999

    Licensed in New Mexico


    Population the therapist mostly serves:
    ● Bisexual Allied
    ● Gay Allied
    ● Lesbian Allied
    ● Transgender Allied

    Specialties:
     Eating Disorders, Depression, Anxiety

    Types of Therapy:
    ● Cognitive Behavioral (CBT)
    ● Eclectic
    ● Interpersonal
    ● Mindfulness-Based (MBCT)
    ● Person-Centered
    ● Psychological Testing and Evaluation
    ● Solution Focused Brief (SFBT)
    ● Strength-Based

    Cost per session: $100 / session

  • Licenses & Certifications:
    ● LPC, LMHC, LISAC, SAP, IC&RC

    Licensed in Arizona

    Population the therapist mostly serves:
    ● Black and African American and Native American

    Specialties:
    Mood Disorders, Addiction, Depression

    Types of Therapy:
    Mindfulness based treatment approach as well as Motivational Interviewing, Transpersonal, Cognitive Behavioral Therapy, Emotionally Focused, Family/Marital, Humanistic, Play Therapy, Solution Focused Brief Therapy, and Dialectical Behavior Therapy.

    Cost per session: $185 / session

  • Licenses & Certifications:
    ● LMFT, Licensed Marriage and Family Therapy, State of Connecticut
    ● M.A., Marriage and Family Therapy, Fairfield University
    ● B.A., Psychology, Skidmore College
    ● Gottman Method Couples Therapy - Levels 1 and 2
    ● Gottman Method Couples Therapy - Level 3 Practicum
    ● Emotionally Focused Couples Therapy - Externship
    ● Harvard Medical School - Meditation and Psychotherapy, Deepening Mindfulness with Thich Nhat Hanh
    ● Vulnerability, Courage, Shame, and Empathy: The Living Brave Continuing Education Course
    ● Certified Clinical Trauma Specialist - Individual (CCTS-I)
    ● Certified Domestic Abuse Counselor
    ● AAMFT, Clinical Fellow
    ● CTAMFT
    ● Gottman Relationship Checkup, Approved Member

    Licensed in Europe, Connecticut

    Population the therapist mostly serves:
    ● Expats, adults, adolescents

    Specialties:
     Counseling for Anxiety

    Cost per session: 90 euros / session

  • Licenses & Certifications: ● Licensed Psychologist ● PhD in Counseling Psychology, University of Houston, 2009 ● MA in Engineering Psychology, New Mexico State University, 2003 ● BA in Psychology and English, New Mexico State University, 1999

    Licensed in New Mexico

    Population the therapist mostly serves: Women, Athletes, people struggling with disordered eating or body dysmorphia

    Specialties: Eating Disorders, Associated anxieties

    Cost per session: ranges

    EATING DISORDER TREATMENT CENTER, LLC (505) 266-6121

  • Psychology Today is an international database of licensed therapists. You can search by proximity and specialty.

DEFINITIONS

  • Anxiety is an irrational response to either a pecieved or real threat that includes a variety of physiological and psychological symptoms such as excess worry, autonomic arousal, difficulty breathing, dizziness, muscle tension, and fear leading to minor or severe impairment (Barton, Karner, Salih, Baldwin & Edwards, 2014).

  • Mindfulness is a practice of deliberate nonjudgemental awareness of present moment thoughts, feelings, body sensations, and the environment. Practicing mindfulness helps us find new ways to react to our thoughts without judgement so that we can stay in the moment and create more intentional and present awareness with our daily life (Mannion, 2021).

  • The 8 Traits of Flow
    1. Complete concentration on the task;

    2. Clarity of goals and reward in mind and immediate feedback;

    3. Transformation of time (speeding up/slowing down);

    4. The experience is intrinsically rewarding;

    5. Effortlessness and ease;

    6. There is a balance between challenge and skills;

    7. Actions and awareness are merged, losing self-conscious rumination;

    8. There is a feeling of control over the task. (Csikszentmihalyi, 2009)

  • Visualization is a method of imaging their athletic performance as a way to work through both ideal and potential obstacles that may be encountered so that when the athlete is competiting, they have already been exposed to stressful stimulus as well as flow-state (Baldock et al., 2021).

References

5 pros share how they manage their mental health while racing at the highest level. Bicycling. (2022, April 19). Retrieved April 20, 2023, from https://www.bicycling.com/culture/a37669486/pro-riders-share-their-mental-health-journeys/  

Baldock, L., Hanton, S., Mellailieu, S. D., & Williams, J. M. (2021). Understanding and Managing Stress in Sport. In Applied Sport Psychology: Personal Growth To Peak Performance. essay, McGraw-Hill Higher Education. 

Baron, D. A., Reardon, C. L., & Baron, S. A. (2013). Mindfulness, Attention, and Flow. In Clinical sports psychiatry: An international perspective (pp. 125–126). essay, Wiley. 
Barton, S., Karner, C., Salih, F., Baldwin, D. S., & Edwards, S. J. (2014). Clinical effectiveness of interventions for treatment-resistant anxiety in older people: A systematic review. Health Technology Assessment, 18(50), 1–60. https://doi.org/10.3310/hta18500  

Csikszentmihalyi, M. (2009). Flow: The psychology of optimal experience. Harper and Row. 

Gouttebarge, V., Castaldelli-Maia, J. M., Gorczynski, P., Hainline, B., Hitchcock, M. E., Kerkhoffs, G. M., Rice, S. M., & Reardon, C. L. (2019). Occurrence of mental health symptoms and disorders in current and former elite athletes: A systematic review and meta-analysis. British Journal of Sports Medicine, 53(11), 700–706. https://doi.org/10.1136/bjsports-2019-100671  

Love, S., Kannis-Dymand, L., & Lovell, G. P. (2018). Metacognitions in triathletes: Associations with attention, state anxiety, and relative performance. Journal of Applied Sport Psychology, 30(4), 421–436. https://doi.org/10.1080/10413200.2018.1440660  

Mannion, J. (2021). Mindfulness in Sport. In Applied Sport Psychology: Personal Growth To Peak Performance (pp. 334–347). essay, McGraw-Hill Education. 

Martens, R. (1977). Sport competition anxiety test. PsycTESTS Dataset. https://doi.org/10.1037/t27556-000  

Scott-Hamilton, J., Schutte, N. S., & Brown, R. F. (2016). Effects of a mindfulness intervention on sports-anxiety, pessimism, and flow in competitive cyclists. Applied Psychology: Health and Well-Being, 8(1), 85–103. https://doi.org/10.1111/aphw.12063  

Spindler, D. J., Allen, M. S., Vella, S. A., & Swann, C. (2018). The psychology of elite Cycling: A systematic review. Journal of Sports Sciences, 36(17), 1943–1954. https://doi.org/10.1080/02640414.2018.1426978  

Swaim, E. (2022, March 9). Why sports anxiety happens and how to cope. Healthline. Retrieved April 26, 2023, from https://www.healthline.com/health/sports-performance-anxiety  

Weinberg, R. S., & Gould, D. (2019). Foundations of Sport and Exercise Psychology. Human Kinetics. 

Verner-Filion, J., Vallerand, R. J., Donahue, E. G., Moreau, E., Martin, A., & Mageau, G. A. (2014). Passion, coping and anxiety in sport: The interplay between key motivational 

Yerkes, R. M., & Dodson, J. D. (1908). The relation of strength of stimulus to rapidity of habit-formation. Punishment: Issues and experiments, 27-41.

World Health Organization. (n.d.). Mental health. World Health Organization. Retrieved April 26, 2023, from https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response  

Molly Anderson
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