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Pressure and Performance: What We Can Learn From Elite-Level Athletes

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U.S. Olympic gymnast Simone Biles’ decision to withdraw from some Olympic competitions has brought attention to the pressure that elite athletes face and the mental health issues that may occur as a result. But are there lessons to be learned for the rest of us?

Absolutely, says UH sports psychiatrist Vincent Caringi, MD. There are steps we can take to help our family members, co-workers and friends when they are struggling with stress or pressure to do everything exactly right.

"It's impossible to be perfect. This is a topic that's getting some long-overdue recognition and discussion," he says. "My hope is that stories can be shared to amplify the support that's available when you do say, 'I need help.' "

How To Help Others Under Pressure

How can we help others around us who we think may be suffering in silence? Many people are reluctant to do anything for fear of doing something wrong. But Dr. Caringi says you cannot be wrong when your intentions spring from a place of true concern.

The first step is to check in with family members, friends or co-workers when it seems they’re not behaving as usual.

“We can ask people or acknowledge what we notice and check in with them to ask them if everything is ok,” he says.

“If you identify something that seems to be different than someone’s typical presentation, you can just point that out in a neutral way and ask them if everything’s ok. This gives them the opportunity to share with you if they’re comfortable.

“One of the strongest messages we are starting to hear over and over from Simone and also from the advocacy and support she is giving through people in similar high-performing positions is that it’s OK to not be OK.”

How Connecting Can Help

If the person you are trying to help does share their problem with you, it’s important to simply listen and resist the urge to quickly jump in with a response. Let the person talk themselves out. Then you might show you understand by sharing a similar story of your own, Dr. Caringi says. The important thing is to confirm and validate your friend or family member’s experience.

“For people who are feeling stress, simply having someone who has shared their similar experience that you can resonate with, that can actually have a positive impact on the outcome,” Dr. Caringi says.

“We see it across the board with different versions across all the extremes ranging from thoughts of death and suicide to sharing their sexuality preference, when someone is able to be vulnerable and open up, it actually can have a positive impact on someone who has shared as well as the person who has witnessed that sharing.”

Athletes and Performance Pressure

Performance pressure affects athletes at every level of competition, from high school athletes to elite Olympic competitors, says Patrick Runnels, MD, MBA, Chief Medical Officer for Behavioral Health at University Hospitals.

While elite athletes like Biles have high levels of resilience to deal with the stress, they still have emotions such as fear and worry like everyone else, he says.

Dr. Runnels says the stress of expectation weighs heavily on athletes, and in the case of Biles, many layers have likely added to her struggles.

“The higher levels you achieve as an athlete, the larger the potential scrutiny is,” Dr. Runnels says. “As you move further along and feel the pressure, ideally, you’ve learned how to assimilate that into how you have been trained.”

Dr. Caringi says he is hopeful that more athletes talking about mental health will lead to a cultural shift on this issue.

"I think we've seen a transition over recent years, where athletes are starting to see the world a little differently now," he says. “Mental wellness is an important component of performing at any level, and taking it seriously matters.”

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University Hospitals Sports Medicine takes a multidisciplinary approach that integrates care from medical experts who specialize in the diagnosis and treatment for athletes of all ages and abilities. Our fellowship-trained sports medicine specialists, primary care doctors, nutritionists, sleep experts and other healthcare professionals ensure the very best in health and medical care for athletes. Learn more about UH Sports Medicine.

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