Four medical professionals and a national championship lacrosse athlete shared their insights about mental health in Tuesday’s second US Lacrosse panel series webinar.

Over 46 million people are living with mental illness in the U.S., and athletes are not immune. With pressures to perform in competition in addition to academic and personal pursuits, being an athlete can be incredibly challenging for one’s mental health.

Additionally, the coronavirus pandemic and stoppage of play could further exacerbate these conditions. The panelists provided guidance on what can parents, coaches and teammates can do to foster a culture of awareness and understanding.

The panelists were Dr. Blair Evans (Penn State), Dr. Tim Herzog (MedStar Health), Dr. Arman Taghizadeh (Mindset Training Institute), Dr. Andrew Wolanin (US Lacrosse Sports Science and Safety Committee), and collegiate player Nikki Sliwak (Univ. of Maryland). US Lacrosse Magazine’s editor-in-chief, Matt DaSilva, served as the moderator.

“The two primary areas of mental health concern are depression and anxiety,” said Wolanin, a licensed sports psychologist and a member of the US Lacrosse Sports Science and Safety Committee. “The key features of depression are sadness, withdrawal, poor sleep and eating habits, and hopelessness. Anxiety differs in that it’s more about uncertainty, fear of failure, and a lot of worry. There are some overlaps between those mental health concerns, but depression is more of a withdrawal, and anxiety is more of a constant state of ‘what’s going to happen next?’”

 

Research findings indicate that being an athlete is a significant part of self-identity for some individuals.

“Generally speaking, based on larger views of the research that has been done around anxiety and depression, compared to their peers, athletes tend to experience fewer of these symptoms,” Evans said. “But being a lacrosse competitor is a huge part of an athlete’s life, and a key predictor of anxiety and depression was based on how much their athletic identity had changed during COVID-19. For those athletes that were able to maintain that part of their identity, it seemed like they were managing better. But those athletes who reported losing more of their identity did experience it more.”

“Our research shows that about 25-percent of college athletes have significant depressive symptoms, and an NCAA self-report survey showed that during COVID-19, there was a 150 to 250-percent higher rate of mental health concerns,” Wolanin said.

Even during normal seasons, there are a number of risk factors that can contribute to an athlete’s mental well-being. The lacrosse shutdown caused by the pandemic has added additional risk factors for some athletes.

“Some of the risk factors for poor mental health issues are injury, poor performance, social isolation, career termination, and other sudden loss,” Wolanin said. “During COVID-19, some of the other additional risk factors that are triggering things are the decrease in physical activity, a decrease in structured activities, and obviously, social isolation, as well as family stress, economic stress, and no opportunities for athletes to perform or compete as they normally did.”

The panelists noted that coping with anxiety transcends the stereotypical athletic philosophy of simply being mentally tough.

“We need to distinguish between resilience and mental toughness,” Herzog said. “I think that term, mental toughness, gets used too frequently. I think resilience is a much more useful construct, and not just during COVID-19. It’s really important that kids experience a feeling of safety, and that’s going to look different depending on the kid and depending on the family.”

“I like to re-define mental toughness and make it more equivalent to resiliency,”
Taghizadeh said. “Part of that is teaching kids how to deal with adversity. That’s part of sports. We talk about it a lot, but we don’t teach kids how to manage it. We have to teach kids how to trust in their own skills and their ability to train without a coach. The ability to train without teammates and fitness equipment. We want to empower kids to be more resilient and mentally tough. We want them to learn how to push themselves.”

The panelists noted that the phased-in return to play is equally as important for mental health as it is for physical well-being.

“As we are venturing into this unknown, there are going to be elements that we don’t know about yet that are going to be anxiety provoking,” Herzog said. “A little bit of anxiety is not necessarily a bad thing. We just don’t want people white-knuckling their way through the experience. Taking steps to reduce the sense of threat, maybe by talking about the science that we do know, and by boosting a kid’s sense of coping, can be useful as we dive back into the fray.”

“It’s not a light switch that we turn on and off,” Wolanin said. “We need to have a progression to returning that allows for coaches, players, parents, and officials to ease into what it’s like to be back on the field. We also need to have an open forum for athletes to discuss their reactions to what it’s like to be back on the field, and what it was like during the pandemic.”

As a senior lacrosse player at Maryland, Sliwak has been forthcoming about her own issues with anxiety and depression. She noted the importance of having a strong support system.

“I know exactly how it feels, and for me, the biggest thing was having a really supportive family,” Sliwak said. “Having an environment where you can allow your kid to be vulnerable and want to open up to you as a parent. I was thankful to have a mom who was like a therapist to me and we would talk through it together. Even if you’re not seeing signs with your kid, just check in every once in a while. My mom never gave up, and I think that’s the most important thing. You are there for them when they fall, and you are there for them through the journey.”

Finding the right environment for discussion can facilitate better communication between parents and kids.

“Try to create a space that doesn’t feel like a therapy session,” Herzog said. “We’re just hanging out. I’m not your therapist, I’m your parent. And with that, show empathy. It’s okay to have discomfort. Hang in there with that discomfort.”

“There are often free resources available that can help,” Evans said. “Learning more about anxiety and depression can help parents as well.”

One tactic that the panel endorsed in coping with the sense of loss and mourning over a lost season is to write a letter to your sport. This therapeutic activity can be done individually or collectively with teammates to help provide closure.

“Treat your sport like a loved one that you lost,” Taghizadeh said. “Write about what it meant to you, what you enjoyed, what was hard, what was great. This exercise can help articulate the feelings and get them out. And it helps you get an understanding of all the things you gained.”

“Honoring the grief is really important, and we know that grief is often not a linear process,” Herzog said. “Not jumping straight to the silver lining, but first making room for the emotion, is fine.”

“Just because you don’t get your last season in doesn’t diminish everything you’ve done over your past three years,” Swilak said. “You still have all the memories. They don’t just go away. Just being able to take a step back, to take a breath, and to look at the positives, is helpful.”

The third and final presentation in the panel series will be Tuesday, June 16, as US Lacrosse addresses the topic, “College Recruiting in the COVID-19 Era.”  

Register here