The Fall of the Gods: Mental Health and Psychological Well-Being in Sport

La Caída de los Dioses: Salud Mental y Bienestar Psicológico en el Deporte

For decades, we could even say centuries, elite athletes have occupied a pre-eminent place among the deities of the different peoples and tribal groups that human beings have formed in their evolution. They have represented the most select and unattainable of different societies, and also have incorporated the highest virtue by combining an excellent body with exemplary conduct. Citius, altius, fortius… the Olympus of the gods. Fall or twilight? Being faster, taller, stronger rarely leaves room for manifest, or even latent, human weaknesses.

The power of the culture of success, the “if I wish enough, I can”, the “immortality”, has been hit at the waterline of the very essence of sport… we thought not, but our gods suffer, and sometimes they fall from their high pedestal. They are human, even if they had (they have) to represent a deity that disguises impulses, emotions, loneliness, sometimes deep hidded, and perhaps for that reason, the discovery is really cruel.

The more or less recent cases of athletes who have publicly expressed mental health problems have helped to make visible a fact that, if it occurred, was denied or at best had to be dealt with privately. It has been evident that - as in the general population - the stigma of suffering from a psychological disorder has represented a barrier to the assumption of this problem and the search for solutions provided by health professionals (Rose et al, 2007).

Simone Biles, Álvaro Morata, Ricky Rubio, Michael Phelps, Andrés Iniesta… and other athletes who have publicly expressed their problems have helped to raise awareness and address the issue through public debate, undoubtedly reducing this fear of stigmatization. These cases represent concrete examples of the epidemiological data that the latest scientific studies have revealed, indicating that active athletes have a significant prevalence of mental disorders, specifically depression between 17 and 57%, anxiety between 21 and 48%, and eating disorders and/or alcohol abuse of 19% (Armino et al., 2021).

Furthermore, women report a higher percentage of mental disorders than men, and more than half of athletes report a lifetime prevalence of mental health disorders, with age being a relevant factor (Gwytter et al, 2024), as symptoms manifested early and recurrent episodes were common (Åkesdotter et al., 2020). Troubles are in sports, as in the general population, emotional problems, psychological distress, and mental health disorders. Gods are human.

But we must ask ourselves, is high-performance sport a breeding ground for emotional, psychological and mental problems that did not “exist” before and now emerge as a defining part of sports practice? We should not, (rigor in hand) demonize sports practice, whether elite, performance or simply competitive. Sports practice is beneficial for mental health and psychological well-being, from many points of view. There is abundant literature and empirical evidence, of the various benefits of practicing physical exercise or sport, to improve symptoms of depression (Dishman et al., 2021;Stanton, & Reaburn, 2014); anxiety and distress (Singh et al., 2023) in a wide range of populations, including the general population across the age range, as well as in people with diagnosed mental health disorders, or people with chronic physical illnesses.

In fact, some authors (Pearce et al., 2022; Singh et al., 2023) go so far as to state that physical activity should be a fundamental approach in the treatment of depression, anxiety and psychological distress, and that various health professionals should be sufficiently trained to try to encourage any increase in physical activity with the aim of promoting psychological well-being and - if applicable - improving mental health.

At this point the ball is in our court, and it involves the entire group of people (athletes, coaches, technicians, psychologists, doctors, etc.) and institutions (sports federations, governments, regional councils, etc.) involved in sports practice, without forgetting the media, both general, sports and scientific.

So, can something be done? What can we contribute to promote Mental Health and Psychological Wellbeing in the sports field? Without a doubt, the answers to these questions must be inscribed in a broad and ecological framework of the sporting event, where, in addition to the athlete, their entire context and their interaction with it are taken into account.

In this sense, the International Society of Sport Psychology (ISSP) made proposals and work recommendations derived from the discussion and consensus of international experts (Schinke et al., 2022) for the promotion of mental health and which have been recently revised (Schinke et al., 2024), expressing the need for a greater clinical understanding of the mental health of athletes; knowing the role of the sports environment; analyzing the weight of mental health in relation to the careers of athletes, and attending to cultural considerations in relation to sports practice.

Specifically, ISSP suggests (a) promoting new conceptual, theoretical and methodological developments, research findings on elite athletes’ mental health and applied directions through education, supervision, publications, expert groups and other public debates in sport psychology involving sport science professionals, athletes, coaches, managers, sport policy makers and the media; (b) further developing existing lines of mental health research on the prevalence of mental disorders among various groups of athletes; forms of treatment; on healthy and unhealthy sport environments; or analysing the existence and why of successful and/or crisis transitions; (c) promote emerging lines of research on the above points but from a cross-cultural perspective, as for example occurs with the stigmatization of psychological problems, especially in non-Western countries; (d) further promote the integration of holistic, developmental and ecological approaches in research and practice to better understand the interaction between risk and protective factors for the mental health of elite athletes and, based on this, carry out evidence-based interventions; and, (e) increase the role of sports psychology professionals in multidisciplinary support teams in relation to mental health monitoring, increasing mental health knowledge of athletes themselves, and trying by all means to eliminate the stigma, and above all, the barrier that it represents to facilitate the complex step of seeking professional help.

From the point of view of this editorial, all these recommendations are absolutely relevant for the promotion of psychological well-being and the prevention of mental health problems in high-performance athletes. Although we could say that we are perhaps talking today demigods, we can think that the fire of Prometheus, the victory of the Olympians, has allowed us to open a Pandora's box that should no longer be closed: we have to work clearly and openly so that the mental health and psychological well-being of athletes will be an unquestionable and faithful companion, the Argos of Ulysses, of the search for performance, and of the practice of sport and exercise, whatever the demands to which we submit ourselves.

References

Author notes

* Correspondence: Aurelio Olmedilla, olmedilla@um.es

Additional information

Short title: Sport and Mental Health

How to cite this article: Olmedilla, A., & García-Mas, A. (2024). The fall of the gods: mental health and psychological well-being in sport. Cultura, Ciencia y Deporte, 19(62), 2354. https://doi.org/10.12800/ccd.v19i62.2354