Abstract
The monograph by Bissell and colleagues reveals many insights. Nevertheless, I find myself reverting to a continuing quandary that must be addressed when instructing sports media professionals on how to cover stories about mental health: To what degree are these stories similar to—or different from—stories of physical health, or lack thereof? There is a delicate line to walk. I would argue that we should convey that mental health is just as important as physical health when we are reporting on elements of athletic performance but also that mental health is demonstrably different from physical health in a plethora of ways. Elevating mental health to the equivalence of physical dimensions is key, but so too is the need to separate out the parameters within this equivalence. Right now, the sameness of sport-based mental health narratives does a disservice to the long-term infusion of mental health narratives and support of overall wellness. Instead, differentiation is necessary. Bissell and colleagues focus on the ways these stories unfold for women athletes as opposed to the predominant male athlete stories in sports media. In doing so, they highlight how these parameters (a) are different from what we encounter for physical injuries and (b) manifest differently based on gender norms and biases in sport-specific spaces. I will focus on each of these two prongs in this commentary.
First, the dimensions of a mental health story in sports media inherently are different from how physical injury is reported. For instance, physical injuries tend to have general parameters for recovery as well as expectations for whether one can ultimately perform at the same level as before the injury. If an athlete tears an anterior cruciate ligament (ACL), 6 to 9 months of recovery time is expected. This generally definitive timeline helps the ebb and flow of a news story: Reporters do not need to ask about a return to competition until this window has reopened. However, such timelines are simply not relevant for athletes experiencing mental health issues. The result is that coverage of elite athletes such as U.S. gymnast Simone Biles tends to be precisely what Bissell and colleagues chronicle. Biles experienced the “twisties” to the point that she could not compete in portions of the 2020/2021 Tokyo Summer Olympics, including the Women’s All-Around, where she was the defending gold medalist. Because her return had no timetable, the media drumbeat carried on, day after day, amplifying and prolonging the story that inherently would have no clear answer. Whether a mental health issue involves a panic attack, clinical depression, or a plethora of other issues, rendering that story to mass audiences inevitably involves advancing a narrative that is less appealing than what sports reporters and athletes would desire. When will the athlete return? No one truly knows.
Mental health stories are unmistakably different from physical health stories in other forms as well. Doctors and coaches often relay news of physical injury to media at press conferences and other forms of media availability. Mental health provides a stark contrast again in this regard. If a coach or other team official is asked about the mental health of an athlete at all, the response is rightly muted and evasive, as that spokesperson (typically) knows that stories of an athlete’s mental health are not for them to render. Unfortunately, the result of these deflections is a magnified focus on the athletes experiencing a mental health challenge; they are then asked to relay details leading up to their absence from competition or their diminished performance when participating. Moreover, athletes who opt to come forward to share aspects of their mental health often are asked to speak about it for years down the road as they become part of a cohort advancing a more empathetic narrative in the media. The fact that this narrative is becoming more compassionate is laudatory, but it must not come at the expense of the athletes who do not wish to continually revisit what often is one of the darkest moments of their life. It is exceedingly commendable when athletes such as Michael Phelps and Kevin Love launch their own foundations to bolster mental health in the sporting realm. So too is it admirable when someone like Simone Biles is named Chief Impact Officer for a mental health company like Cerebral. However, we cannot expect these types of long-term commitments to the cause to become the norm for all athletes who have ever experienced a challenge with their mental health. Sometimes they just wanted to share something in a single social media post, and that needs to be accepted. Media professionals (and fans and other sports stakeholders) must not expect these athletes to revisit a personal struggle to again reopen that often painful vein.
Many other elements must be rendered differently for the mental difficulty than for the physical ones. For instance, we must accept that sometimes what an athlete is experiencing has no formal name—or at least no known term at the moment they are experiencing it. We also must educate the public on the debilitating nature of these illnesses. For example, far too many people believe that while an athlete cannot play through a hamstring injury, they could be expected to play through a panic attack. Such propositions are lunacy but are nevertheless fed by a public that presumes an athlete will be willing to “play through the pain” and, therefore, sees an athlete that lacks physical limitations and believes performance is not hindered. Education is key in such narratives to reshape expectations. To some, Simone Biles’ diagnosis of the “twisties” can sound almost colloquial; the truth is that performing when experiencing it would be highly dangerous, including the possibility for focal dystonia and other elements that can permanently paralyze an athlete who routinely goes higher in the air than twice her overall height.
Turning to the gender-specific insights that Bissell and colleagues advance, some of the findings track with athletes writ large, such as the immense amount of self-pressure and heightened expectations that an elite athlete experiences. However, other elements appear to specifically unfurl differently for women athletes, mostly because of their continual struggles to counteract entrenched hegemonically masculine paradigms within sporting culture. For instance, all athletes feel burdens to convey invincibility, infallibility, and impermeable focus. Mental health issues create cognitive dissonance in this regard but appear to be particularly concerns for women who are continually battling to be seen as equal to their male counterparts. When women athletes are continually told they do not get equal pay, treatment, media coverage, or fan devotion because they are somehow lacking in terms of toughness, determination, concentration, and grit, it is predictable that they are less likely to cede any perceived limitation to their performance that they believe divulging mental health struggles would facilitate. Sports culture is generally built on toughness to the point of absurdity; Tiger Woods once won the U.S. Open with a torn ACL and 2 stress fractures but did not reveal the diagnoses until after the tournament as he did not want his competition to think he had any weakness. Amid such sentiments that embody the sports world, no one should be surprised that women athletes facing mental health challenges often try to “rub some dirt on it” and move on as if nothing were happening.
Bissell and colleagues highlight another commonality in these cases—that these athletes feel isolated, lonely, and separated from an outside world that they believe does not properly understand them. While some may believe this to be endemic within all of elite sport—it is hard for someone like Gracie Gold to discuss the mechanics of her work landing a triple Lutz toe loop combination jump—particular aspects of this isolation appear to manifest more readily for women athletes. For example, while many of the most widely-known U.S. men athletes (e.g., Patrick Mahomes, LeBron James, Steph Curry, Bryce Harper) play team sports, many of the biggest U.S. women athletes (e.g., Serena Williams, Simone Biles, Naomi Osaka) play individual sports (albeit while often being on cross-sport teams, such as the Olympic Team USA). Revealing an aspect pertaining to one’s mental health is often viewed as potentially more problematic as the athlete fears they would be seen as letting the team down or altering team momentum and long-term goals. However, discussing one’s mental health in team-oriented spaces has been shown to bolster support for overall mental well-being. The support group in such contexts typically emerges quite organically. In contrast, an athlete in an individual sport may have coaches, managers, and other parts of their “team,” but each is an individual stakeholder whose work is predicated on continued outstanding athletic performance. Without formal teammates, these individual sport athletes can sometimes see peers as synonymous with competitors, which not only breeds the aforementioned isolation but also can hinder even revealing any aspect related to one’s mental health.
Finally, if one considers the sports in which all five of these athlete case studies participates, one can see that the five all participate in sports in which the length of one’s career is presumed to be significantly truncated. Serena Williams obviously enjoyed an exceedingly extended career for her sport of tennis, but she is—by far—the exception and not the rule in terms of career longevity. Most of these athletes occupy spaces in which retirement in one’s mid-twenties is highly common; the fact that Simone Biles is potentially competing in the 2024 Paris Summer Olympics at the age of 26 years is considered an aberration. Why does this matter in regard to mental health? Because athletes often view a mental health struggle as something to hold inside until their career is complete. Someone who sees the finish line plainly in slight may tend (both inside and outside of the sport) to plug ahead and deal with the consequences of the stress of doing so later, when the task is complete. Thus, it is noteworthy that this sample of cases is filled with outliers who may have revealed aspects of their mental health at least partially because (a) they had already established their names and general goodwill with the public and (b) they had garnered greater perspective that comes from being a veteran competing in a sport beyond the typical career span. Considering this possibility less optimistically, it could also mean that a much larger cohort of elite athletes who retired at an earlier (and more typical) age may have crossed the finish line and only then navigated mental health issues that they had delayed for far too long.
Overall, this monograph presents a significant step forward in our knowledge of mental health at a timely and opportune juncture. It is much too soon to declare the floodgates to be open for a new, more evolved sports culture that embraces athletes disclosing aspects of their mental health. But these cases show that mental health in sports is having much more than a “moment” and instead could be classified as a groundswell that encapsulates athletes of all genders, positions, and sports. This monograph seemingly begs the question of whether these same cases would have advanced in the manner they did had they occurred at the start of the century instead of in recent years. I am sure we would have fewer number of cases, if any. If they did percolate within the sports media sphere, they would have been likely advanced with less sensitivity, more troubling language, and a higher degree of skepticism than what we are currently experiencing. That, in my mind, is a noteworthy and heartening development in its own right. What Bissell and colleagues then provide us is an extension of that principle, showing how mental health in sport is not a single story, but many with complementary elements. These stories are siblings, not twins; as such, for media professionals to move beyond unidimensionality and into multidimensional realms is crucial.