TrueSport: May 2022 - Mental Health & Wellness

What to expect from a volunteer coach, how to cope with disappointments in sport, how parents can manage their own sport anxiety, mental wellness of a young athlete and concussion recovery and nutrition, this month from TrueSport.

Athletes: How to cope with disappointments in sport

Maybe you’ve heard your coach tell you to ‘walk it off’ or ’shake it off’ when something went wrong during a game, or you lost a critical competition. While that advice is usually coming from a well-intentioned place, unfortunately, it makes many athletes feel like it’s not right to feel sad, mad, or disappointed. But if you never feel disappointed, you’re missing out on an important emotional experience. That might sound strange at first, but disappointment can be a springboard to making progress and improving in sport (and in life).

"I always tell athletes that successful athletes are the ones who normalize any emotional experience that comes from competition, and who learn to deal with those emotions in productive ways,” says TrueSport Expert Kevin Chapman, PhD, clinical psychologist and founder of The Kentucky Center for Anxiety and Related Disorders. Here, he shares ways to cope with -- and move beyond -- disappointment.

Feel your feelings

"Dealing with anxiety, frustration, sadness, anger, disappointment and so on is part of being an athlete,” Chapman says. “So first of all, normalize that at some point, you will have those feelings, but they aren’t bad.” Remember, disappointment with how a game went or even how you played shouldn’t equate with being disappointed in yourself as a person. Your self-worth shouldn’t be linked to your athletic achievements.

Make disappointment work for you

Disappointment hurts in the moment, but it provides us with a valuable learning experience. “Ask the million-dollar question when you’re feeling disappointed,” says Chapman. “What did I learn today?” Being able to answer this question can change disappointment from a negative emotion into the fire to come back stronger in the next round. Chapman recommends coming up with three takeaways that you can bring back to practice to work on, or in the case of a tournament, that you can bring into the next round.

Focus on the process

“Watch what happens to your outcome if you have a process-led mentality,” he adds. “Focusing on ‘What can I change?’ will lead to a better outcome. And having that process-focused mindset also avoids a lot of drama and disappointment that comes from situations outside of our control. Because process goals are oriented around things you can control, you won’t be disappointed as long as you’re putting in the effort.

Talk to your coach

If you’re struggling to find three takeaways or things to work on at practice but you’re still disappointed in your performance, give it some more time. It takes a lot of self-awareness and a lot of knowledge of the game, training, and tactics to figure out what you can do to improve.” Luckily, your coach will likely have picked up on some of the issues you’ve been having, and together, you can develop a process-focused plan to improve. Ask your coach if you can sit down together and create a plan for your next few practice sessions.

Write it out

"Come up with five positive affirmations that you can tell yourself before, during, and after practices or competitions,” says Chapman. “Learn how to rehearse and recite those affirmations in your head." When coming up with affirmations or mantras, it’s important to focus on things that are related to your skills, where even if you have a bad performance, they can still be true. For example, statements like “I am fast” rather than “I will win” are more helpful.

You can take this to the next level by writing them somewhere you’ll see often, and even putting a word or two like ‘fast’ or ’smooth' on your equipment. You can also use a dry erase marker and write these affirmations on your mirror at home or draw them on a piece of posterboard and hang it above your bed so you can’t miss it. Seeing these reminders regularly will help you start believing them, and then, even when you are disappointed in a performance, you’ll still know you are more than any one game.

Reinforce effort and reward your extraordinary performances

We know that positive reinforcement is meant to increase a behavior, while punishment is meant to decrease a behavior. If you’re disappointed in your performance, it’s important to not punish yourself for that performance. Punishing yourself for something that’s already upsetting you just compounds the problem, and this is far too common in sports. Often, athletes who are frustrated or disappointed will do things like skipping a meal or afterparty. But by depriving yourself, you’re just creating a more negative headspace that will be harder to come back from. Instead, have some kind of reward for any event where you tried your best, regardless of the outcome. Disappointed with the match? You can still have that post-competition ice cream, says Chapman. But since we do still want to reward and reinforce positives, have something extra-special planned for when you do have those once-in-a-season performances.

Takeaway

Disappointment in sport is completely normal, and in fact, it can help lead you to improvements and better performances. It’s important to allow yourself to feel emotions like disappointment after a tough game, understand why you’re disappointed, and pinpoint ways to avoid the same situation happening in the future.

Parents: How parents can manage their own sport anxiety

If you’re an athlete's parent or guardian, you likely feel the same pre-competition nerves and jitters that your athlete does. You may notice that in the minute before the competition starts, your heart beats just a bit faster, or you struggle to sleep soundly the night before nationals. That’s normal, but your anxiety can unfortunately have negative impacts on your young athlete if you don’t find ways to regulate it.

Here, TrueSport Expert Kevin Chapman, PhD, clinical psychologist and founder of The Kentucky Center for Anxiety and Related Disorders, explains how your anxiety can impact your athlete, and how to best handle it in an honest, thoughtful way

Why your anxiety matters

“First and foremost, a parent needs to know that what they model and communicate to their athlete is what is important,” says Chapman. That means your anxious behaviors can make your athlete feel more anxious. “Unfortunately, children with an anxious parent are up to seven times more likely than a child of a non-anxious parent to develop an anxiety disorder,” he adds. “But anxiety itself is not transmitted to a child genetically. Rather, the predisposition to respond to emotions in a dysregulated way is what is being modeled to that child in these formative years. That’s how the anxiety is transmitted from parent to child."

How to handle your anxiety

1. Pregame: Talk to your athlete

If you’re nervous about your athlete’s big game, they may be nervous as well, and that’s okay. In addition to understanding how your anxiety impacts your athlete, you can also focus on how nerves and anxiety are, in fact, completely normal feelings to have. “Successful athletes recognize that anxiety is normal,” says Chapman. “Anxiety is a normal part of competition. So it's not a matter of not being anxious when you compete. It's about normalizing the anxiety and understanding that it’s there to prepare you for the future threat, in this case, of not performing well. But there is an optimal level of anxiety that will help you, so regulating it and putting it in an optimal range is going to be what's important.”

Have a conversation with your athlete about how they’re feeling -- and how you’re feeling! Let them know that it’s okay to be anxious, and that anxiety is there to help them prepare for competition. Often, that conversation helps them feel less anxious about their anxiety!

Need a quick catchphrase to give your athlete? Try telling them that the only difference between anxiety and excitement is their interpretation of the situation.

2. During the game: Relax

It comes as no surprise that during the game, the best thing that you can do as a parent is to relax and try to stay calm and positive. Remember, as Chapman says, young people are incredibly skilled at picking up on the emotions of the people around them, especially the people who matter most to them. So if you’re on the sidelines hiding your face, frowning, shaking your head, yelling or looking horrified, they’re going to notice. Focus on taking slow, deep breaths to stay calm and try to develop positive habits to keep you busy, like taking photos of the game (if that’s allowed). You can also task yourself with writing down five things your athlete does well in the game, which will force you to focus on the positive.

3. Postgame: Don’t assume you know what your athlete is thinking

If a game didn’t go well, you might assume that your athlete is devastated, and that might make you feel anxious. But before you panic, remember that your athlete’s interpretation of the game could be completely different. Maybe you didn’t realize that he actually made a shot that he’s really proud of, or that she ran a personal best time. “Do not fall victim to catastrophizing and blowing mistakes out of proportion,” says Chapman.

“Parents need to remember that that process leads to outcomes. And if they can help their athlete recognize the process -- things like learning skills, mechanics, technique, tactics, and strategy -- then that's going to be the most important thing to be thinking about after a game,” he adds. "For example, my daughter was in the middle of a volleyball tournament and they lost a set. She was pretty upset about it, and as a parent, it’s easy to just try to empathize with her instead of helping her. But I told her, ‘I understand why you’re upset, but what did you learn?’ That’s a process question, and it took her out of that emotional state and back to thinking about what she needed to do to improve in the next set. She won the next match.”

4. Reward your athlete

Reinforcement is meant to increase a behavior, while punishment is meant to decrease a behavior. “Because of this, reinforcement is always more powerful than punishment when we're looking for behavioral change,” says Chapman. “So, it's super important to reward yourself after spectacular performances. But you also need to avoid punishing your athlete for a performance that wasn’t the best.” His advice? Find something fun you can do with your athlete after every competition, like renting a new movie, and have an extra special reward for extraordinary performances, like actually going out to the movies.

5. Handling extreme anxiety

While avoidance is something that Chapman doesn’t typically recommend, if your presence at a game makes you anxious and that negatively affects your athlete, you may need to avoid being at the competitions. You could also consider driving separately and ensuring that you sit out of sight of your athlete. "I'm not a fan of avoidance, but if a parent is going to be so emotionally dysregulated that they're going to do themselves not only a disservice but they're also going to do the athlete a disservice, staying home might be the best thing,” Chapman says. “But ultimately, the goal should be to learn to regulate your emotions so you can be a part of your athlete’s sporting life.”

To manage these feelings of anxiety, ask yourself why you feel this way. Is it because typically, you only show up for the biggest games of the season and there’s a lot at stake? If that’s the case, consider trying to attend some practices or smaller competitions to see if lower stress settings ease your nerves. You can also seek expert help for yourself, says Chapman. Talking to a therapist about your anxiety will not only be good for your mental health, it may benefit your young athlete as well.

Takeaway

Your anxiety around your athlete’s competition and performance can translate to your athlete, so it’s important for you to address it and ensure that it doesn’t negatively impact your athlete’s performance or mental health. Nervous feelings around competition are natural, but if you do struggle with anxiety, consider sitting out of sight of your athlete during competitions and even driving separately if it’s a problem.

Coaches: Is my young athlete mentally well?

Mental wellness can be difficult for parents, coaches, and other guardians to cope with when it comes to young athletes. Is a bad grade on a test just because an athlete didn’t study, or is it a sign of something deeper? Is an athlete who’s been tired at practice all week a bit overextended, or are they struggling with insomnia and depression? Coaches and parents should be on the lookout for signs that an athlete’s mental health is suffering, and while they may not be equipped to help the athlete, guardians can help connect an athlete with the right professionals.

Here, TrueSport Expert Kevin Chapman, PhD, clinical psychologist and founder of The Kentucky Center for Anxiety and Related Disorders, shares red flags to look for when it comes to an athlete’s mental well-being, and explains how to intervene when you do suspect that there is an issue.

What are some common mental wellness red flags?

Parents identifying these mental wellness problems with their athletes need to think about several different factors, says Chapman.

  1. Personal distress. "In other words, is the athlete bothered, and saying they're bothered?” Chapman asks. “That’s the easiest one, where your athlete is telling you that they are in distress and need help."
  2. Impairment in functioning. “Whether it be competition, school, friendships or anything your athlete normally does at a certain level, any unexplained drop could signal that something may be wrong,” Chapman says.
  3. Physical changes. "Sleep disturbance is a big warning sign, since young athletes typically sleep well. You may notice your athlete is sleeping constantly, or that they’re struggling to fall asleep and suffering from insomnia -- sleep changes in either direction are concerning. Eating is similar: Big swings in how much your athlete is eating can be a warning sign."
  4. Increase in worry. “If you notice your athlete acting more anxious and worrying more than usual, that can be a red flag,” says Chapman. Some worry is normal -- if finals are coming up, for instance -- but if the worry seems more generalized, that’s cause for concern.
  5. Change in aggression and other external behaviors. “If your athlete is suddenly acting more aggressive, crying, yelling, or generally acting out, that can be a sign as well,” says Chapman.

However, these signs and potential symptoms rely on you knowing your athlete’s baseline. Some athletes are naturally more prone to dramatic tears and short bursts of anxiety that go away when finals week is over. Some athletes naturally sleep 11 hours each night, while others are bouncing out of bed after six hours. Pay attention to your athlete before there’s an issue, so that you’ll be able to notice when changes happen.

What is the first step a parent should take?

Rule number one is to talk to the athlete first, rather than skipping that step and going beyond the athlete,” says Chapman. “If I'm an anxious parent, I could be reading into something that's not even a problem. It could be that your child had a fight with a best friend, or didn’t study for a test and failed, or just had a tough week at practice. We don’t want to hold an intervention where we bring in an expert and make things overly dramatic. The key is talking to the athlete first to gauge if the problem you suspect is clinically significant.” If your athlete says that things are fine, consider setting up a weekly check in for you to chat about how they’re feeling, voice any concerns and see if the situation has changed. And make sure that your athlete understands that you’re here to help, not to accuse them of bad behavior.

When is seeking help necessary?

Unfortunately, there’s no single right answer for who to go to first when seeking help for your athlete. But you can start with searching for a counselor to speak with, or if you’re concerned about your athlete’s health -- maybe because there are eating or sleeping issues as well as emotional dysregulation -- you should also consult your primary care physician.

“If you’re looking for a therapist, I recommend looking online at the Anxiety and Depression Association of America, or the Association for Behavioral and Cognitive Therapies to find someone in your area who specializes specifically in emotional symptoms. Going to the right person does matter,” Chapman says. If you still aren’t sure what to look for, consider asking your athlete’s school guidance counselor for some local recommendations.

If your athlete is unwilling to admit that there’s anything wrong but you’re still seeing warning signs, consider asking them to go to a counselor with you to discuss the situation. Keep continuing the conversations as well. Maybe your athlete is just going through a rough adjustment period or a tough time that’s a normal part of adolescence, and the symptoms you’re noticing will gradually fade. But if the behaviors persist, consider consulting with a counselor to voice your concerns and discuss potential next steps.

When is medication necessary?

It should come as no surprise that while medication can certainly help many young people deal with depression, anxiety, and other mental wellness issues, it shouldn’t be prescribed as a blanket approach to dealing with any issues, and should always be discussed with a doctor. Additionally, finding a form of talk therapy or counseling to accompany any medication-based intervention is important. “The first-line approach to dealing with symptoms of emotional difficulties tends to be medication,” Chapman says. “You can start by discussing options with a pediatrician, but you may also want to consult a psychiatrist for a second opinion, since they’ll be more specifically versed in how to best help your athlete.” Lastly, not every athlete struggling with a mental health issue is going to require medication. Some will benefit from talk therapy alone, so don’t assume a diagnosis of anxiety immediately means medication.

Takeaway

Don’t wait for your young athlete to ask for help. Pay attention to warning signs like sudden, drastic changes in behavior and mood, and even if it’s not a comfortable topic, bring it up with your athlete. Make sure that your athlete knows they have your full support, and work with your athlete to find them the right professional help.

Nutrition: How athletes can support concussion recovery with nutrition?

Unfortunately, young athletes may find themselves on the sidelines for days, weeks, or even full seasons after concussions. These injuries can be frustrating since there’s no simple rehabilitation timeline, and as the brain heals, the body might feel ready for sport when the brain is not. As a parent or coach, you can help your athlete by ensuring that they focus on the things that they can control in the healing process, like their nutrition.

Here, TrueSport Expert Kristen Ziesmer, a registered dietitian and the owner of Elite Nutrition and Performance, along with Michele LaBotz, TrueSport Expert and sports medicine physician, provide some basic guidelines to follow as your athlete recovers from a concussion. But make no mistake: While helpful, nutrition is not a replacement for rest and following a doctor’s return to play guidance.

There’s no way to supplement away a concussion

While you may have seen advertisements or spotted a tweet or Instagram post touting a certain powder, pill, or other supplement as ‘brain food’ or a way to speed up healing from a concussion, the truth of the matter is that we simply don’t have enough information about concussions to safely recommend any one supplement. As Ziesmer points out, the bulk of the studies being referenced by supplement companies are being done on rats and mice. And when a supplement has been studied in humans, it’s almost always prior to the concussion, not after. So adding a supplement following a concussion is not recommended, and in general, it’s good to be cautious of supplements.

Eating enough is important

Many young athletes struggle post-concussion to eat enough. The brain is an energy-hungry organ, requiring plenty of calories. But when your athlete is suddenly on the bench, their appetite may drop significantly to match their now-sedentary state. In addition to that, some athletes who are in sports that value low body weight -- cross-country, running or gymnastics, for example -- might be tempted to start restricting calories in order to maintain weight while they’re unable to train. If your athlete has a history of disordered eating or body image issues, LaBotz notes, this is extremely important to watch for. While a bit of fluctuation in appetite is normal, your athlete does need regular meals and snacks to help their brain to heal.

Concussion symptoms don’t just impact the brain

An athlete might experience stomach issues. Nausea is a common symptom in the days to weeks following a concussion, and in addition to watching hydration status, following a bland yet healthy diet immediately after may be helpful as well. “There can be a lot of nausea, or even some vomiting, and the appetite is often going to be reduced,” says LaBotz. In these cases, athletes often tolerate small, frequent meals and snacks throughout the day rather than the more traditional and larger meals at breakfast, lunch and dinner.

Hydration is also critical

Especially in the first few days post-concussion, if symptoms like nausea are present, your athlete may not be feeling thirsty or hungry, but drinking enough is vitally important to the recovery process. “Plain water can be nauseating, because the water sits in the stomach for longer than something that has a little bit of carbohydrate in it,” says LaBotz. “I typically recommend using a rehydration solution or sports drink -- not an energy drink -- for hydration.” She recommends urging athletes to take small sips, and you can play with the ratio of water to sports drink to improve stomach comfort. Alternatively, athletes can dilute apple or other fruit juices with water by half, which will produce the same concentration of carbohydrates as can be found in commercial sports drinks.

Add antioxidants and anti-inflammatories… on your plate

You likely have heard the nutritional advice to ‘eat the rainbow,’ meaning to fill up a plate with as many different colors of fruits and vegetables as possible, since those whole foods tend to be packed with anti-inflammatories and antioxidants. "A low inflammation, high antioxidant diet might help speed up recovery time, though we still don’t have enough research to confirm that,” says LaBotz. “But a diet that’s rich in fruits and vegetables is always a good idea, and may help decrease inflammation throughout the body as it recovers.”

Boost protein intake

“During periods of reduced activity, there's the potential for some muscle loss,” says LaBotz. “But if your athlete gets some form of protein every two to three hours, that can help to mitigate the muscle loss.” Good sources of protein include chicken, fish, dairy, nuts and seeds, and tofu. Aim for roughly 15 to 20 grams per serving, and spread intake throughout the day for the best results. Eating 100 grams of protein in one sitting does less for muscle repair and function than eating five 20-gram servings over the course of 12 hours.

Get omega-3s from food sources

While some studies have shown that omega-3 fatty acids may play a role in concussion recovery, the research is still very limited. But adding omega-3s from whole food sources is a good nutritional practice anytime! Ziesmer and LaBotz recommend food-based sources of omega-3s, including most nuts and seeds, high-quality olive oil, fatty fish and even some eggs and dairy that are fortified with omega-3s.

Be mindful of ‘junk food’

For very young athletes, you may be tempted to soothe bad moods and grumpiness with fast food favorites and desserts for dinner. Older athletes who are feeling upset about missing out on play time might also turn to chips, candy and cookies as a way to make up for what they’re missing. Fried and ultra-processed foods can unfortunately increase inflammation and fill your athlete up so that the fruits, vegetables and proteins get skipped. While some ‘fun food’ is fine -- even encouraged! -- make sure that your athlete is still eating primarily nutritionally balanced meals. There’s room for indulgences, of course, but every night doesn’t need to be pizza and ice cream.

Takeaway

While nutrition alone can’t heal a concussion, it can be a helpful tool. Make sure that your athlete is eating enough, first and foremost, to give the brain energy to heal, and to fuel the body through the recovery process. Hydration is also key. Finally, ensure that your athlete is eating a nutritionally dense diet that includes plenty of antioxidant and anti-inflammatory fruits and vegetables, along with plenty of protein and omega-3s from whole food sources.


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