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The 2021 Olympics Have Put Mental Health at the Forefront

Sports and athletics are important to many; they’re entertainment but can be so much more. They inspire millions, motivating young people to strive for achievement and individual and team excellence. The Olympic games might be the purest distillation of athletic achievement; representing one’s country and achieving personal glory puts athletes in the history books and makes them admired. However, all the accomplishments and glory can come at a high price, one that’s not discussed often enough: the athletes’ mental health.

2021 just might be the year when everything changed.

The Press Withdrawal That Shook the World

Think about how often you’ve seen an athlete take time off for a physical injury or prepare for important games by resting. As an example, in the NBA there has been a trend toward “load management,” where players will sit out games to help them recuperate from nagging injuries or to keep themselves fresh. These players are not fined by the league, nor do they get labeled as “lazy” or “prima donnas.”

Contrast that with Naomi Osaka’s decision to withdraw from the French Open and Wimbledon tennis tournaments this June. Osaka, the world’s #2 ranked player and the highest-paid female athlete in the world, skipped a press conference during the French Open due to mental health reasons, namely her struggle with depression and social anxiety. The sport’s ruling body fined her $15,000 and she was pilloried in many press services, leading her to withdraw from the Wimbledon tournament.

Her high-profile punishment has had an unforeseen positive effect though; it’s raised awareness about athletes and mental health. Previously overlooked in sports journalism, athletes’ mental health is being addressed more than ever – and it might be the defining topic of this year’s Olympics.

Athletes Are Standing Up for Their Mental Health

The flood gates opened by Osaka’s actions have made it easier for the athletes at the Tokyo Olympics to speak about their mental health in ways that have rarely been seen before. More athletes are realizing that mental health is as important as physical health when it comes to competition. And beyond competition, it’s becoming clear that good health – mental and physical – is worth more than gold.

Osaka competed in the Olympics, her success and preeminence in the tennis world leading to the honor of lighting the Olympic flame (she lost her match in the third round). However, the biggest story regarding mental health in this Olympiad has centered around perhaps one of the greatest Olympic athletes of all time – Simone Biles. Biles, a multiple-time college champion and four-time gold medalist in gymnastics, pulled out of the team gymnastics in an effort to protect her mental state.

“We also have to focus on ourselves, because at the end of the day, we’re human, too,” Biles said, according to The Associated Press. “We have to protect our mind and our body, rather than just go out there and do what the world wants us to do.”

Biles’ explanation has highlighted the intense pressure on athletes at the top levels of competition. For many, they have been expected to perform without exception, will all the expectations of their family, coaches, spectators, and themselves, since early adolescence. It takes a toll – many athletes have struggled with mental health issues such as depression and anxiety during their careers and long after they have retired. Substance abuse and the incidence of eating and exercise disorders such as anorexia nervosa and bulimia nervosa are also more frequent in athletes under intense scrutiny than in the general public.

The stress can also take away the joy of movement and competition for many. As Biles said after the US team had struggled in early rounds of competition,

“It’s been really stressful this Olympic Games,” Biles said. “Just as a whole, not having an audience, there are a lot of different variables going into it. It’s been a long week. It’s been a long Olympic process. It’s been a long year. So just a lot of different variables, and I think we’re just a little bit too stressed out. We should be out here having fun, and sometimes that’s not the case.”

Who’s Affected by Mental Health Issues?

Although we’ve focused on prominent female athletes, top-level athletes from all genders and walks of life can be affected by the pressures to perform and the general lack of empathy for mental health struggles. A male US sprinter, Noah Lyles, has taken his time in the spotlight to put his take on mental health in the foreground.

“I always said the day I wasn’t having fun with this sport, I’m going to leave it,” he told reporters, according to The Washington Post. “And for a little bit, I wasn’t having fun this year. I did want to leave. I had to make a decision. I was like, I got to get better. I can’t let this control me.”

Some former Olympic greats have also given their support for the increasing awareness about mental health and athletics. Swimming great Michael Phelps, in reaction to Biles’ announcement, said,

“This is an opportunity for all of us to really learn more about mental health, to all help each other out,” Michael Phelps told TODAY after Biles withdrew from the individual all-around competition. “For me, I want people to be able to have somebody that can support them, who’s non-judgmental and who’s willing to hold space. There’s a lot that we can do to help one another and we have to start. We can’t brush it under the rug anymore.”

Gracie Gold, a 2014 figure skating bronze medalist for the US team, also spoke up about the importance of maintaining mental health in the face of intense pressure for athletes.

“I felt like it was really brave for her to say that, because it would be much easier to say ‘I tore something,'” Gold said about Biles. “As I said, most people don’t question physical injuries in the way that they question mental injuries so to speak. Fracturing your psyche is just as valid and as real and as detrimental as a fracture anywhere else in your body.”

Gold herself struggled with depression, anxiety, and an eating disorder during her career, which was highlighted in a 2020 HBO documentary called The Weight of Gold.

Eating Disorders, Body Image, and Athletics

The increase in awareness about mental health during the Tokyo Olympics has also shed light on eating disorders and athletes. Many sports put a premium on weight control and weight loss. Sports with weight limits such as wrestling and boxing can provoke disordered eating habits, for example, and virtually every sport allows for the risk of excessive exercise. Another complicating factor is that elite athletes typically begin training in their early teenage years, which is also the most common age of onset for most eating disorders.

Biles herself has been a strong advocate for body positivity, having been through the trauma of body shaming during her career in gymnastics. As a teenager in 2013, her coach told her she was “fat.” Fortunately, she was able to overcome this shaming and embrace body positivity.

“It was really hard because growing up I never felt overweight or fat, so it shocked me like, ‘Why would he say that?’” Biles said. “But in a way, it actually shaped me for the better because it just taught me to rise above and love my body no matter what.”

Although some Olympic sports tend to promote body dissatisfaction and can trigger eating disorders, any top-level athlete is at risk for developing an eating disorder. Seattle Mariners catcher Mike Marjama has also outlined his difficulties with body image and eating disorders in an interview with NEDA:

Marjama: “I first realized that I might have a big problem when I started resorting to extreme methods of calorie restriction (bulimia primarily). But my struggles with eating disorders only got worse. I was a perfectionist and didn’t want to admit that I needed help.”

Eating disorders are more common in transgender individuals than other groups, and transgender athletes are among the most outspoken about the importance of eating disorders and mental health awareness. Our own advisory board Fellow, Schuyler Bailar, was the first trans athlete to compete in any sport on an NCAA D1 men’s team, in men’s swimming and the only to have competed for all four years. His recovery from an eating disorder has led him to become a tireless advocate for eating disorder awareness as well as promoting trans rights in all fields.

His experience points to an awareness about the importance of putting mental health first – for athletes and everyone else.

Towards the end of my senior year in high school, I switched to a new therapist who told me frankly, “I can’t help you. You need residential treatment. Rehab. You can’t go to Harvard in the fall, you need to take a gap year.” She went on to remind me that not taking care of myself would only result in further misery. In continued misery. So, despite the panic that I felt in hearing this – I was supposed to put my whole life on hold for a year for mental health?? I had never been taught to prioritize this, what was I going to tell my coaches?? – I knew she was right.

Prioritizing mental health has always been important; the 2021 Tokyo Olympics are only highlighting that fact. If you’re struggling with a mental or behavioral health issue such as depression, anxiety, or an eating disorder, take advantage of the world’s increased awareness and get started on recovery. Help is always available.


Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.