Student-athletes at risk of mental distress, disordered eating, and eating disorders

Despite the fact that participating in athletics can and should be protective, for many student-athletes, it is harmful.

Many student-athletes struggle with anxiety, depression, and eating disorders at some point during their athletic careers. This is most likely due to a combination of the stress of participating in sports in today’s hyper-competitive environment and the fact that coaches and parents are not aware of how to spot a problem and support a student-athlete who is struggling with the pressures of competing.

As parents, we need to be aware of the dangers, signs, and symptoms to help our kids thrive as student-athletes, both on and off the field.

Mental health and student athletes

Anxiety, depression, suicidality, self-harm, substance abuse, and eating disorders are all on the rise for all teens and young adults. Almost 50% of Americans under the age of 18 experience mental illness before turning 18. [Pew Research Center, 2019]

And while exercise and the belonging experienced as part of a sports team have both been shown to have a positive impact on mental health, many student-athletes find themselves suffering than their non-athlete peers.

“Despite the well-documented benefits from exercise and sports participation on mental health, some athletes will at times experience psychological, emotional, and behavioral problems.” (Mann, et al, 2007).

“The professional consensus is that the incidence of anxiety and depression among scholastic athletes has increased over the past 10 to 15 years,” Marshall Mintz, a New Jersey–based sports psychologist who has worked with teenagers for 30 years, reported to The Atlantic.

A study by the National Athletic Trainers’ Association discovered that many adolescent student-athletes reported higher levels of emotional disruption and mental illness than non-student-athletes. [Neal, et al, 2015]

What makes student-athletes vulnerable to mental illnesses?

The reasons for student-athlete stress and increased rates of mental illness are many. Here are a few of them:

1. Athletics become the primary identity – Many student-athletes build their identity around being athletic. If they are naturally gifted in a particular sport, they often build their entire sense of self and worth around their performance in that sport. Athletics become the way they seek and receive positive feedback from parents, peers, and important adults like coaches. This is a risky way to identify the self since injury is common and a single injury can leave them bereft and feeling worthless.

2. Fear of falling behind – The better the athlete, the greater their sense of being either a “winner” or “loser.” The more games won, points scored, and medals received, the greater the fear of not performing as well next time. This leaves student-athletes in a constant state of fear: fear of letting their team, their coach, their parents, their peers down. It becomes impossible to imagine not giving everything they have to their sports performance, and they will sacrifice sleep, connection, grades, physical health, and mental health to the high-stakes game of winning.

3. Unrelenting intensity – High school sports were once confined to the season, but now most student-athletes compete year-round. They put in 2-3 hrs of practice every day (sometimes more) on top of schoolwork. Many don’t get home until 7 or 8 p.m., at which time they must complete several hours of homework. This schedule continues without a break as long as they want to stay “on top of their game.” Note that this schedule requires a 12-hour workday before homework. Add on homework, and our student-athletes are working 15-18 hour days, and more than 75 hours per week, which is many more than most adults.

4. Pleasing parents – Most parents don’t mean to push their kids too hard when it comes to athletics. Most do it subconsciously in an attempt to support their child along with their own ego. It’s wonderful when a child is naturally athletically talented, and usually, the child enjoys their sport tremendously in the beginning. But as they continue, many kids will keep playing even when they don’t enjoy themselves because they know how much their parents love their athleticism. Since their identity is wrapped up in their sport, they worry that they are not loveable without their sport. They also know how much their parents have sacrificed in both time and money for them to succeed so far. It’s hard to stop playing when you know how much your parents have invested in you.

5. Dangerous coaches – Coaches often spend more time with student-athletes than any other adult, including parents. They might be great at achieving athletic goals, but few coaches, especially pre-college level coaches, have any training in emotional intelligence. They tend to make massive and devastating mistakes when it comes to the emotional caretaking of our student-athletes. Coaches are incentivized to win, and their focus is on that outcome rather than any individual player’s health. In fact, coaches may ignore physical injuries and obvious mental distress in order to maintain a key player on their team. Coaches often criticize student-athletes and engage in emotional manipulation to meet their winning goals. And, of course, coaches want their student-athletes to look the part, which means lean and muscled. In some sports, weigh-ins lead to explicit weight goals. In others, coaches never need to explicitly state weight goals, they just make comments to make it clear that student-athletes must maintain a certain physique in order to be a part of the team.

6. Revealing uniforms – Uniforms can either increase or soothe body consciousness. The most challenging uniforms when it comes to body issues are swimsuits, leotards and the briefs worn for volleyball and running. In these uniforms, a student-athlete who is gaining weight has nowhere to hide, and many will simply drop out of a sport rather than continue to watch their bodies change in plain view. The uniforms perpetuate the concept that there are particular body types that are “built” for particular sports, and anyone who doesn’t “look good” in the uniform is shamed out of participating.

7. Dedication and perfectionism – The very same characteristics that make someone a great athlete also make them “good” at disordered eating and eating disorders. Great athletes are dedicated and passionate. They tend toward perfectionism and don’t shy away from following a “no pain, no gain” mentality to succeed. These qualities, which can help a person excel in their sport, also makes them very good at controlling their food intake and engaging in disordered eating and eating disorders. The number of subclinical eating disorders in student-athletes are virtually impossible to measure based on the fact that they appear “normal” and “healthy” in the student-athlete population. It is often only when they put their athletic careers behind them that student-athletes recognized how deeply disordered they were when they were competing.

Signs of student-athlete distress

No parent wants their child to suffer mental distress, and yet it often comes with the territory of being a student-athlete. It is possible to compete without suffering health consequences, however, all athletes should be carefully monitored for signs of mental distress.

Following are the major ways an athlete may experience stress, as described by Ray and Weise-Bjornstal (1999):

Affective signs and symptoms: anxiety, anger, guilt, depression, shame and feeling sorry for oneself. (Body hate fits in this category as well)

Behavioral signs and symptoms: sleep disturbances, restlessness, aggressive behavior, alcohol or drug abuse, sulking, crying, poor performance, absenteeism, and clenched fists. (Eating disorders and disordered eating fit in this category as well)

Biological or physiological signs and symptoms: muscle tension, increased heart rate, indigestion, stomach spasms, pain, and headaches.

Cognitive signs and symptoms: frustration, worries, distortion, exaggeration, unrealistic performance expectations, self-defeating statements, and self-handicapping.

Interpersonal signs and symptoms: withdrawal, manipulation, and argumentation.

Sensory signs and symptoms: tension, nausea, cold sweat, clammy hands, pain and butterflies in the stomach.

If your child is a student-athlete, you should monitor for these signs and be aware of their serious risks. Don’t wait for your child to expressly ask for help, and instead schedule a professional consultation with a therapist who has experience working with student-athletes. If possible, maintain a regular relationship with a therapist who can periodically evaluate your child’s mental health and support you in optimizing their environment for their mental health.

At some point, our student-athletes will no longer compete in their chosen sport. Our goal as parents must be to help them maintain enough of a sense of self, and enough positive mental health, that when they stop competing, they still feel worthy of love and attention without the prospect of winning a single medal or point ever again.

Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders and body hate.

She’s the editor of and a Parent Coach who helps parents handle their kids’ food and body issues.

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