How elite athletes can personally maximise their mental health and performance

Everyone aspires to feel fulfilment (5). Through life you will face challenging situations which are demanding and stressful. Every athlete fails, gets injured, experiences negative life events and retires. Some individuals have the capability to overcome these challenges, and others cannot cope and they suffer. The athletes that do not have the capacity to face extreme pressure will not thrive. In elite sport several athletes have struggled to cope with their mental health and have experienced problems which have led to mental illness and in some cases suicide (2).

“One in four of us in the UK will be affected by a mental health problem in any year and elite sports professionals are no different.” 

Hayley Jarvis, Head of Physical Activity for Mind

Throughout an elite athlete’s career they can be exposed to up to 640 stressors that may cause a mental disorder (1). Encountering this high amount of pressure comes from factors such as; recovering from injury, selection, and scrutinised by the media. It is also apparent that many elite athletes do not understand the importance of mental health and how to effectively optimise or maintain it (8). This is why they can be so prone to mental ill health and not thrive in their performance (23).

All of the ex elite athletes above have experienced or are still experiencing mental illness

BLOG AIMS

• What thriving is
• Why thriving is important to elite athletes
• The current situation with mental health in elite sport
• The personal facilitators needed for elite athletes to thrive in their mental health and performance
• How an athlete can utilise techniques to optimise and maintain their mental health and performance

THRIVING

Thriving is the process of development and success, which enables athletes to consistently function and sustain performance (5). Holistic functioning is the key to this as it means mental health and performance are both at a high level (19). This means that the athletes own individual factors (e.g. own mind-set) maintain their mental health and performance over a considerable length of time. 

THRIVING IN PERFORMANCE

Is the ability to execute skills at a high-quality level and sustain it for a long period of time, whilst maintaining high levels of well-being (5). Therefore, the athlete is physically fit and healthy, mentally healthy, socially competent and emotionally regulated to develop and succeed. This means the athlete is sound in all four corners of performance (i.e. physical, tactical, technical and mental) to reach the demands of their sport and life, have the resources and can thrive in an elite pressured environment (inside sport) and overall function as a human being (outside of sport) (20). Consequently, if the athlete is maximising their performance by executing their skills, but their mental health is at a low level, the thriving process will not be sustained. This can lead to negative outcomes such as injury and burn-out and if they do not have sufficient coping mechanisms the athlete will be vulnerable and suffer (17).

MENTAL HEALTH IN ELITE SPORT

Although, mental health awareness is increasing, there are still barriers. There is still a huge stigma towards mental health within sporting culture and this can lead to athletes feeling reluctant to speak out or seek support. This is because they can become worried about their sport’s staff, the general public or the opposition’s perception of them, particularly if they seek support because elite sport still holds onto a ‘mental toughness’ umbrella (3). This mental toughness culture can mean that athletes feel ashamed and embarrassed for being diagnosed with a mental disorder, it being perceived as showing ‘mental weakness’ (7). As a result many athletes don’t talk about their stress and mental battles which leads to further complications. They can go down the route of suppressing their emotions and even though they are experiencing an emotion like sadness they will present a happy demeanour or isolate themselves to avoid being judged negatively (22). As time goes on this coping mechanism can cause further problems for the athlete’s mental health and performance. This is because the demands they experience inside and outside of sport weigh on them and they do not have the internal resources to overcome their stress. Their coping strategies are unhealthy so their performance declines as their mental health is neglected.  In summary, an ‘illness-based lens’ is the way mental health is regarded which feeds into the stigma even more. This means that athletes struggle to understand what mental health clearly is in elite sport (12).

This year a sport specific definition of mental health was produced so that elite athletes could relate to it:

“mental health is not merely the absence of illness, but a state of well-being in which those involved in competitive sport realise their purpose and potential, can cope with competitive sport demands and normal life stressors, can work productively and fruitfully, can act autonomously according to their personal values, are able to make a contribution to their community and feel they can seek support when required” (4). 

To further increase knowledge and understanding of mental health these are the main signs of mental illness (14):

1.         Lack of interest and enjoyment in anything

2.         Lack of self-care

3.         Negative thoughts and feelings

4.         Irrational thoughts, feelings and behaviours

5.         Prolonged low mood

6.         Struggle to control emotions

7.         Isolation

8.         Struggle to maintain any type of relationship

9.         Highly stressed 

10.       Sleeping problems 

11.       Anxiousness

12.       Fatigued

13.       Low self-esteem 

14.       Self-harm

Taking into account the sport specific definition of mental health and the main signs of mental ill-health, leads to the personal facilitators of what athletes need to possess to thrive in their mental health and performance in an elite sport setting and outside of sport.

PERSONAL FACILITATORS

These contribute towards optimum performance and mental health. This means the athlete has the suitable internal resources to manage and overcome the challenges they face in their performance and everyday life (6). They are the qualities which the individual possess’ to positively influence their confidence, motivation, focus and overall mind-set so they can consistently commit and manage the stress and pressure of training, competition and everyday life. However, this can only occur if the athlete values, trusts and is committed towards their career development, and look after their mental health (5).

POSITIVE OUTLOOK

This is when an athlete is optimistic, feels confident in their own ability and has high self-esteem. They value who they are, what they can do and they believe in themselves. This mind-set is maintained when they experience any stress or face any challenges (20).

TECHNIQUES FOR A POSITIVE OUTLOOK

POSITIVE SELF-TALK (13)

• The inner voice in your head – this can be negative, but also positive
• Athletes can doubt themselves, feeling incompetent and feel low which can impact on mental health and performance
• The dialog in our minds can determine whether we think negatively or positively
• What we say to ourselves should be as positive as possible; “I am good enough”, “I am special”, “I am important”
• Thinking positively, and rehearsing these statements each day (e.g. when you wake up and when you go to sleep), over time will transform your mind-set into a positive one
• Put these statements in a visible place such as on your fridge or in a journal you take to work, to aid the process of positive thinking 

GRATITUDE (9)

• Realising how lucky you are
• Reiterating that the little things in life are a big deal
• A mindset of the glass being half full, not half empty
• An effective way to do this is by consistently (nightly) writing down three good things about yourself (e.g. “I work hard”), three good things that happened in your day (e.g. “My coach said he was proud of me”) and three good things to look forward to (e.g. “Holiday”) – scanning for positives rather than negatives
• This can be difficult, so some athletes might start with one or two for each and talk to someone you trust about what are the good things – increasing your self-awareness and widening your perspective
• When you can consistently complete gratitude for over four weeks this is a good time to start trying three
• Developing understanding that there is always blue sky beyond the clouds

PROACTIVE

These athletes strive to reach their potential by always wanting to learn and be open to new experiences. They want to challenge themselves, to grow, develop and succeed. Through this process they want to gain knowledge and skills for their performance, to reach its peak. Pushing themselves to their limits and highly passionate about their sport as they see it as meaningful and of value (10). The athlete accepts and takes responsibility for their thoughts, feelings and behaviours. Growth can only happen when they accept: their issues for what they are, that the past cannot be changed, that the present and future can be changed and are interested in new insights and information.

TECHNIQUES FOR BEING PROACTIVE

REFLECTION (15)

• Ask yourself questions – How can I move forward? Where do I see myself in the future?…
  • Understanding, accepting and taking responsibility of your emotions through reflective practice
  • Naming your emotions, processing why you feel a certain way, and why you react in a certain way 
  • Learning how to regulate your emotions by being more aware of your thoughts, feelings and behaviours
• Monitor your mood by journaling every morning and night for 3 months:
  • Note down your mood in the morning and night – draw a facial expression or mark 1-10 how you feel (1 being low and 10 being high)
  • Your daily uplift and daily hassle to determine what has either made you feel negative or positive – mentioning date, a rough time and place, what you were doing, who you were with, and how you felt physically, emotionally and what thoughts were in your head
  • What coping strategy you use for a negative mood
• Review your mood at the end of 3 months:
  1. To comprehend triggers (what causes a negative or positive mood)
  2. Patterns of behaviour – what makes you feel good or bad
  3. How you cope with your mental health
  4. Whether any changes need to be made 
  5. If changes need to be made then as a starting point follow the self-help techniques in the article and seek support (e.g. local GP)
  6. Continue to monitor mood

GOAL-SETTING (17) 

• By first reflecting and having high self-awareness enables you to identify what your mental state is like, what you need to improve on, where you are now and where you want to be
• Once an athlete goes through the process of acceptance you can move forward, create an action plan and goal set
• What you want to achieve in the short-term and long-term to reach your vision so that your mental health is optimised and performance sustained:
  1. Identify, specifically what is needed to be worked on (e.g. doing more self-care)
  2. Decide how much self-care you want to do each day (e.g. 30 minutes) – review weekly and monthly
  3. Making sure the targets are achievable, relevant and of appropriate duration (e.g. create a healthy sleeping routine – turn off all devices before 8pm, stretch, read, complete some expressive writing and a breathing exercise, and then sleep)

CONTROL

Having the ability to manage thoughts, feelings and behaviours under different conditions; high, medium or low pressure (20). The athlete is aware of how to respond appropriately and effectively to any situation as they focus on relevant information and do not get distracted. Having the skill-set to adapt and concentrate on what matters in the present moment and they execute their skills accordingly and consistently to a high level. Feeling in control enables the athlete to respond appropriately and effectively to others to build higher quality relationships and work more efficiently with them (24).

TECHNIQUES FOR CONTROL

MINDFULNESS (19)

• Staying present and feeling in control of your mind and body
• Fully focused in the here and now
• Calm and relaxed
• Less overwhelmed, anxious and more prepared and ready to train and compete
• A brilliant way to become more mindful and less anxious or stressed is by executing this grounding technique in and outside your sport:
  • Five things that you can see, four things that you can feel, three things that you can hear, two things you can smell, one thing you can taste

BREATHING EXERCISE (16)

• Include this in your morning routine, before training/competition etc
• Reduces somatic anxiety (e.g. heart rate and breathing rate), which enables the body to relax and athlete feel more in control
• Example of a breathing exercise routine:
  1. Close your eyes to minimise distractions
  2. Focus solely on your breathing – feeling your lungs expand with oxygen when inhaling and your diaphragm lowering as you exhale
  3. Ignoring all your thoughts, being in the present moment
  4. If thoughts do invade tell yourself to reflect on them afterwards and for now focus solely on your breathing
  5. Breathe in through your nose for up to five seconds, breathe out through your mouth and feel your body relax for five seconds, repeat this for at least three minutes each day

Can be included with imagery by:

• Imagine breathing in happiness, energy, optimism, and as you breathe out imagine breathing out all the negativity, pain, and discomfort in your life
• Imagine yourself in your own happy place:
  • Where all the good things in your life are (e.g. family and friends on a beach)
  • You are safe and well
  • You are in control
  • You can smell the sea air
  • You can hear the waves
  • You can feel the sand on your feet
  • You can picture yourself smiling, laughing and completely relaxed

BALANCE

It is virtually impossible to experience absolute balance in life as there are so many day-to-day factors and influences. As an elite athlete there are lots of training and competitions and with that comes high amounts of travelling, media work etc. This can make it highly challenging affecting ability to have a healthy routine, but there are lots of ways to make sure your looking after your mind and body. Therefore, the athlete does not over train, burn-out and has an identity outside of their sport. By having an identity within and outside sport creates a multidimensional purpose and increases their self-worth. This also accommodates the transition into retirement in the future (20).

TECHNIQUES FOR BALANCE (11)

TAKE THE EDGE OFF

• Sport does not dictate your life 
• Sport does not define you
• Have time for your needs  
• You cannot function on 0% battery
• Give yourself time to relax, replenish and recover from daily stressors
• Take the time to spend with your close ones; eating out, having a film night, going on a day trip
• Make yourself a hot bath
• Do a new hobby; knitting, golf, learn a new language, baking etc

DISCONNECT

• Cut down on social media activity e.g. log-out after 8pm each day, don’t go on it until after you’ve stretched out of bed, taken some deep breathes, made breakfast, got showered and ready and then reflected on the day ahead – starting with a productive and positive start to the day increases well-being and performance
• Before going to bed instead of watching TV or going on a device read a book, complete a breathing exercise, do some expressive writing etc

IMPORTANT

• Self-help techniques need to be consistently practiced to maximise benefits
• If struggling to access support – talk to someone trusted, ring a helpline, talk to your support team (e.g. coach and sport psychologist)

TAKE HOME MESSAGES

• To thrive in mental health and performance elite athletes need to accept, understand and look after their mental health
• Personal facilitators are essential factors for maximising mental health and performance at an individual level
• There are many techniques you can use for equipping yourself to have the required internal resources to be mentally healthy and perform