Mental health and the Olympics: How the USOPC is preparing for more than the physical toll (2024)

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When Simone Biles pulled herself out of the Tokyo Games because she believed it was no longer safe for her to launch her body into the air, the world learned about “the twisties.” Biles was feeling disoriented and getting lost in the air, a mental block that put her at great risk of serious injury. It was a condition she was battling that none of the rest of us could see.

There are no surgeries or physical rehabilitation plans to address mental health challenges. They do not leave scars or require casts. For so long, elite athletes felt like they couldn’t talk about it — that it was taboo to tell people they were struggling or that they were anxious or depressed. That their head mattered just as much as their body, if not more.

High-profile athletes in all sports have begun speaking out, both to seek help for themselves and also to lessen the stigma around mental health issues. Professional teams and college athletic departments have hired mental health coaches (not just sports psychologists who are more focused on performance) to work with athletes and make sure they feel supported and healthy as human beings.

But the Olympics is different from other elite-level competitions. Everything is even more magnified, as the entire world turns its attention to the sporting event just once every four years, so your career-making success or career-defining failure lingers. The difference between earning a medal and going home empty-handed could be crossing a finish line mere thousandths of a second after your competitor. And you would have to train essentially every day for four years to even be in a position to redeem yourself at the next Games.

It is a pressure-cooker. It is also the brightest spotlight many of these athletes will ever perform in. When the Games end, it can be suddenly dark and disorienting.

“Was it everything you dreamed of? Or was it nothing you thought it would be?” said Dr. Jess Bartley, the U.S. Olympic and Paralympic Committee’s senior director of psychological services. “Athletes might go back to their hometown and be in total obscurity, or they might be a mini-celebrity.

“Sometimes, it feels really anticlimactic.”

Twenty-three-time Olympic gold medalist Michael Phelps has said he had suicidal thoughts and multiple bouts of serious depression amid what outwardly would be described as the most successful career any athlete could have. Phelps has made mental health a huge focus in retirement, trying to help others avoid the feelings he endured.

Biles’ withdrawal from the Tokyo Games prompted yet another conversation about the pressures and anxieties that Olympians endure privately. Swimming star Caeleb Dressel took an abrupt eight-month leave from his sport in the aftermath of the same Olympics for mental health reasons as well, chasing perfection and beating himself up when he couldn’t achieve the unachievable. They aren’t alone in these experiences.

With another Olympics approaching in the coming days and weeks, both the athletes themselves and their governing bodies are preparing for not just the physical performances — but the mental, too. Those challenges may last years or even a lifetime, so preparation and access to resources is critical.

Bartley, who has worked with the USOPC since it created a mental health task force in 2020, said that her main goal over the past four years has been building out the organization’s infrastructure for therapy for mental health needs. Now, there are 15 psychological service providers — meaning those qualified to work on mental health, mental performance or even sleep.

More than 1,200 athletes worked with those providers in 2023, Bartley said, which included more than 5,500 therapy sessions and consultations. The USOPC also offers its services to athletes who do not qualify for the Games.

“Sometimes, trials is the hardest part,” Bartley said. “We have one of the strongest teams in the world, so just making it to the Games is so difficult. One of the things we work with athletes is: What is the place that sport has in your life? How is your identity tied up in this? What are all the different pieces? What does it mean to make the Olympic Games or not make the Olympic Games?

“We’re just understanding that these are whole human beings.”

The USOPC’s goal now is to become familiar to the athletes and remove barriers for those who might want help. Athletes, including Phelps, had criticized the organization in years past for seeming not to care about athletes beyond what they could do in a pool or on a track or on a field. Now, the governing body is trying to do more in an era in which elite athletes are more open about therapy than ever before.

At swimming trials, most athletes who spoke to the media shouted out their therapists and mental health coaches for helping them get to the precipice of an Olympics. Dressel said he has seen his therapist at least once a week for the past two years. Gretchen Walsh, who qualified for Paris three years after just missing the Tokyo team, raved about her confidence coach.

Swimmer Lydia Jacoby opened up about the severe depression she experienced after winning a gold medal in Tokyo as a 17-year-old. She felt like everyone wanted a piece of her, and she couldn’t say no. She couldn’t tell which people around her genuinely cared about her well-being and which just wanted to be associated with a gold medalist. There were days and weeks she didn’t want to get out of bed back home in Alaska.

She had been warned about the post-Olympic depression, but she didn’t think it would hit her — until it did. She sought help, and that not only helped her feel better, it helped her process disappointment at the 2024 trials, when she missed out on qualifying for Paris by finishing third in the 100-meter breaststroke final. Only the top two make the roster.

“I was feeling like my identity was locked up in sports,” Jacoby said. “The biggest thing for me lately is (remembering) that being a swimmer is something I do. It’s not something I am. I have so many interests and passions. I have amazing friends and family outside of the sport. Remembering those things is a big thing for me.

“A lot of people outside of sports see this and think this is everything. It’s important that people realize, yes, this is something I do, and I’m very invested in it. Obviously, I put a lot of emotion into this, and it is pretty devastating. But at the end of the road, it’s not going to change my life.”

That has been a common refrain across sports, that one’s worth should be tied to who they are as a human, not just who they are as an athlete. Dressel said he used to view bad performances as indicators that he wasn’t a good person. He’d created a monster inside his own head.

“It’s really tough,” Dressel told The Athletic last month. “It’s embedded in me — where you always want to look for ways to get better. I’m still doing that, but I’m not becoming obsessed and so fixated on it that I lose sight of what’s actually fun with the sport. It’s hard, and it’s not like I’ve all of a sudden gotten to figure it out this year. There are things that I’m really proud that I’ve done differently, like being able to enjoy parts of the sport without just crapping on myself for not being perfect.

“It is still very much a work in progress.”

Therapy is part of his progress. It’s not something he’s ashamed to say, and plenty within the U.S. Olympic movement hope comments like Dressel’s will lead to even more athletes seeking help. The USOPC offers a 24/7 helpline for acute needs, teletherapy and also a registry that will help athletes find healthcare providers near them. The USOPC also ran workshops after the Tokyo Summer Games and the Beijing Winter Games to help athletes struggling with the agonizing decision to continue onward or to retire, providing support for the decision-making process. The USOPC knows it can’t force its athletes to use its resources, but it wants to let them know what’s available. And 14 mental health providers will be on hand in France.

Biles is back, too. She’s as dazzling as ever in the gym, and she will be favored to win all-around gold yet again. And while there’s some chatter about her physical health, most everyone just wants to know if she feels OK this go-around. That’s the most important part.

“She’s mentally and physically fit,” her coach, Cecile Landi, said last month. “I don’t know if we can see it. But she’s way more relaxed and enjoying competing and having fun. And truly, I think she really found why she’s doing it. And I think for the very first time, it’s truly for her.”

The Athletic’s Dana O’Neil contributed to this report.

(Top illustration: Dan Goldfarb / The Athletic; photos: Tim Clayton / Corbis, Francois Nel / Getty Images)

Nicole Auerbach covers college football and college basketball for The Athletic. A leading voice in college sports, she also serves as a studio analyst for the Big Ten Network and a radio host for SiriusXM. Nicole was named the 2020 National Sports Writer of the Year by the National Sports Media Association, becoming the youngest national winner of the prestigious award. Before joining The Athletic, she covered college football and college basketball for USA Today. Follow Nicole on Twitter @NicoleAuerbach