Escalating Athlete Stress: Creating a Plan to Cope with the Mental Health Needs of Your Athletes

summarized by David DeWinter
YouTube player



Dr. Lonnie SarnellSports Psychologist, Psy.D.

The 3-Sentence Summary

Anxiety takes many forms for student-athletes, including performance anxiety, panic attacks, and generalized anxiety, and the symptoms and coping strategies are different for each. More than 1 in 4 student-athletes reports having anxiety, so you should have a basic understanding of these symptoms and both proactive and in-the-moment coping strategies. Sports psychologists can be great resources for your team, but if you don’t have access to one, you can still do emotional check-ins with your athletes to help them stay on top of their mental health.


1:00 Introduction – Dr. Lonnie Sarnell: started as a lacrosse goalie, heard about book Thinking Body, Dancing Mind and found the mental skills training insightful. I experienced performance anxiety as a junior athlete and didn’t know the resources available to me for coping and managing anxiety and attaining optimal performance.

3:03 Overview

  • What can we learn from the current mental health data?
  • What are your current systems for supporting athletes?
  • How can we better understand athlete mental health and performance anxiety?
  • What are strategies we can utilize in the moment?
  • What are proactive strategies we can utilize?
  • What’s your plan to better support your team?

Current Data

4:46 Present day

  • 21% of adults and 17% of youth experience a mental health disorder. 19% of mental illnesses are anxiety disorders.
  • Average delay between symptom onset and treatment is 11 years
  • 32% of adolescents had an anxiety order (38% female, 26% male)
  • 30% of male and 25% of female student-athletes report having anxiety.
  • 33% of college students experience significant symptoms of depression, anxiety, or other conditions and 30% seek help
  • Only 10% of college athletes with known mental health conditions seek counseling
  • 35% of elite athletes suffer from disordered eating, burnout, depression, and anxiety

8:21 Pandemic Breakdown

  • Spiked anxiety & depression rates over 30 percentage points from Jan – Jun 2019 to Dec 2020.
  • 76.2m more cases of anxiety disorders

Current Systems

10:17 Questions to reflect on

  • What are the challenges that you’ve encountered with athlete mental health and performance anxiety?
  • What do you do when an athlete experiences performance anxiety?
  • What do you do when an athlete exhibits symptoms of an anxiety disorder?
  • What systems do you have in place to help your athletes with performance anxiety or other mental health concerns?
  • Do you have any mental health professionals or sports psychologists that work with your athletes?
For every hour of sleep missed, adolescents felt a 38% increase in hopelessness.

Better Understanding

13:42 Ways anxiety can present:

  • Performance anxiety: extreme nervousness before competitive or evaluative situation; athletes freeze up
  • Panic attacks: Sudden episode of intense anxiety that triggers severe physical reactions
  • General anxiety disorder: Chronic, excessive, uncontrollable worry about a number of events or activities

16:15 Several symptoms from the fight or flight response: headaches, chest pain, rapid heartbeat, fatigue, withdrawal from activities, outbursts, aggression, difficulty falling asleep…

18:07 Cycle of Anxiety: The more that athletes lose confidence in their ability to cope with anxiety, the more anxiety they will experience.

19:09 Performance Anxiety Example: Every stroke has to be perfect.

  • Moderate anxiety/stress is actually needed for optimal performance, but too much can cause athletes to shut down.

21:39 Panic Attack Example: Erg test anxiety to the point of almost passing out

  • The main issue is misinterpreting/catastrophizing the symptoms of anxiety, which leads to more adrenaline and eventually panic.

23:54 Generalized Anxiety example: Thinking in worst-case scenarios

Coping Strategies in the Moment

25:20 Examples

  • Relaxation techniques: deep diaphragmatic breathing and paced breathing (extend exhale to slow heart rate, 4-5 counts)
  • Support and validation: Share stories of how you’ve performed when nervous. Ask about when they’ve felt nervous and performed well.
  • Distractions: conversation, watch a funny video, play games
  • Pep-talks: Ask what their strengths? Tell me why you’re prepared
  • Make a plan with them: gives them something to focus on.
  • Balanced thinking: worst case, best case, most realistic?

31:10 What can athletes do when they start to panic in the middle of a test?

Distraction first to calm down. Break things down into pieces.

34:51 Key Strategies for different scenarios

  • Performance Anxiety: diaphragmatic breathing, balanced thinking, make a plan
  • Panic Attacks: Distraction, Explaining the cycle of panic/false alarms, Paced breathing
  • Generalized Anxiety: Balanced thinking, pep-talks and simple goals, write down worries, schedule worry time

Proactive Coping Strategies

36:42 Normalize talking about it.

  • Naming your emotions can lessen their intensity.
  • Make space for your emotions–talk about it, write about it, etc.
  • Gently manage your emotions. Don’t worry about controlling them; realizing they will stray and you can gently guide them back to where you want to be.

39:45 Listening Strategies:

  • Let athletes vent
  • Ask open-ended questions and mirror their words
  • Allow for silence, don’t try to fix things
  • Validate and help them label feelings
  • Emotional check-ins can help athletes recognize their emotions when they’re not in crisis. Prompt questions like, “How do you recharge when you have time off?”

41:37 Perspective: the Hall of Fame exercise. What will people say when you’re inducted into the Hall of Fame? How can you live by those values? This gets them to focus on those values instead of the numbers.

43:16 Skills vs. Strategies List (See slide)

Plan for your Team

46:33 Ideas to incorporate into your team

  • Use a sports psychologist if you have access to one
    • Sometimes they don’t click with your athletes. It’s more important to find someone that athletes connect with than the best psychologist in the world.
    • Bring someone in virtually so you’re not limited by geography.
  • Normalize feelings of anxiety before performances. (Don’t say “it’s not a big deal.”)
  • Emotionally check-in with your athletes. Ask questions about how they’re recharging.
  • Email some resources to your team.

52:48 Resources

  • Finding a psychologist: (1), (2)
  • Mental Health Information: (1), (2)
  • Mindfulness apps: Headspace, Calm
  • Sport Psychology Books: EndureSacred Hoops, Mind GymThe Happiness Trap

54:15 What warning signs should coaches look out for so they can address performance anxiety freeze-ups before they happen?

  • Looking for symptoms of anxiety: athletes looking withdrawn
  • Practice high-stress situations so you get a baseline of how athletes respond. Look for anomalies.

56:54 Contact info

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