‘Pain is Weakness Leaving the Body’ and Other Lies I’ve Been Told: A Reading List on Mental Health and Sport

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Over two miles into my first Division I cross country race, I felt buoyant. My legs turned over like a well-oiled machine and my chest fluttered with promise: as a freshman, I was in third place for my team. I dug the metal teeth of my spikes into dirt and focused on maintaining an even clip. Lost in the reverie of the race, I almost didn’t see my coach standing on the sideline, her blond hair pulled back, face shadowed in a hat.

“Get your shit together,” she seethed as I ran past. Focused and faster than anyone anticipated, I glanced over at her, unsure whether she was speaking to me or someone else. But I was alone. “Move your fucking ass.”

The feeling of calm in my chest dissipated with her words, as if a balloon had been pricked, all the air let loose. Rather than ruminating on the strength in my legs, the smooth swish of my uniform against inner arm, my mind reeled. What was I doing wrong? I was already on pace for a significant personal record — was I supposed to be running faster? Had I appeared unfocused as I ran past?

When I look back at that first race, I always remember those words, the way the tension crept into my limbs. And the feeling stayed throughout the season. Nothing ever seemed good enough for Coach — she’d tell us we were a fucking shit show as a team when we didn’t run as fast as anticipated or when our outfits didn’t match or when we took too long on warmup. Before a race, we could either be a fucking hero and get our shit together or not. There was no in-between. I was 17 years old at the time, adjusting to life halfway across the country from my family, new food, a new sleep schedule, higher mileage, and learning the contours of socializing with my team, but those were not factored into my performance, nor was there any acknowledgment that adjusting to college — especially as a Division I athlete — can be a difficult, and stress-inducing situation.

My coach’s words were not unfamiliar to me. As an athlete, I’d been told iterations of get your shit together my entire career. In high school, no matter what our emotional state was, we were trained to say every day is a great day! The phrase, one my coach used to yell into the sunrise while he biked next to me, is scrawled all over the margins of my training journals, even when the descriptions of my runs read “hurt a lot,” “windy,” or “bloody toe.” Shirts at cross country meets featured sayings like pain is weakness leaving the body; champions train, losers complain; and seven days without running makes one weak. These slogans, intended to be humorous in some cases, emphasized the mentality that many sports do: athletes should be tough enough to overcome anything. If you don’t, it means you’re weak.

I internalized that way of thinking while growing up. I’ve been competitive as an athlete since I was in third grade, and I learned to ignore my emotions, focusing instead on external measures of time, pace, and mileage. My strategy earned me respect from coaches as someone who would train through anything — sickness, shin splints, a bone that grew threw my big toe — and place well in races, no matter what was happening in my personal life. When I placed well, I told myself I was satisfied. And when I didn’t, my entire sense of self-worth came tumbling down. I’d vow to work harder in practice, and the whole cycle would repeat itself ad nauseam; I was always chasing an invisible goal that remained just out of reach.

Midway through my freshman year, I began experiencing neurological issues. As I’d learned to do throughout my years of training, I tried running through the symptoms. Even when this ended in me collapsing on the track, I’d try and try again. To quit seemed unthinkable, but eventually I did. I experienced an acute bout of depression. Without running, who was I? Why hadn’t I been strong enough to push through? I berated myself for being weak, for symptoms out of my control, for losing a sport that had been my entire identity.

Eight years have passed since then, and I am finally learning to run in a way that honors both my physical and emotional health. I am growing more comfortable talking about my experiences with depression, and the way that running played a role in my self-worth for such a long period of time. In speaking about it, I have also realized that I’m not alone. Many athletes struggle with mental health issues, but the culture of sport — especially at the top tiers of competition — often emphasizes physical performance over holistic wellbeing. The culture is changing in ways, yes, but the rhetoric of athlete’s “overcoming” anything is still deeply ingrained in the language of coaches, and the way athletes speak to themselves.

In the following essays, athletes testify on their experiences with mental illness, factors that exacerbate mental illness in sport, and ways that we as a culture can begin to change our language and training in an attempt to support wellness emotionally as well as physically.

1. When athletes share their battles with mental illness (Scott Gleeson and Erik Brady, August 30, 2017, USA Today)

As Scott Gleeson and Erik Brady report, nearly one in five Americans experience some form of mental illness and, for athletes, because of the stressors of the sport, experiences with injuries, and overtraining, the percentage may be even higher. Testimony from a range of athletes — Michael Phelps, Jerry West, Brandon Marshall, Allison Schmitt, among others — about their experiences with mental illness and sport are featured in this piece, all of them urging athletes to speak up about their experiences, seek professional help, and change the culture of sport for the better.

“Sometimes, I walk in a room and regret being so naked and vulnerable, but this is bigger than me,” Imani Boyette says. “I believe my purpose is to talk about the things that people are uncomfortable or afraid to talk about.”

2. Everyone Is Going Through Something (Kevin Love, March 6, 2018, The Players’ Tribune)

On November 5th, at a home basketball game against the Hawks, 29-year-old Cleveland Cavalier Kevin Love began to experience what he now knows was a panic attack. In the days and weeks that followed, after medical testing and conversations with his team, he began to see a therapist, which is something he never envisioned himself doing, particularly because of his identity as a pro basketball player.

“Nobody talked about what they were struggling with on the inside. I remember thinking, What are my problems? I’m healthy. I play basketball for a living. What do I have to worry about? I’d never heard of any pro athlete talking about mental health, and I didn’t want to be the only one. I didn’t want to look weak. Honestly, I just didn’t think I needed it. It’s like the playbook said — figure it out on your own, like everyone else around me always had.”

In this candid and moving essay, Love breaks the silence surrounding mental health, particularly in regard to sport, and, as the title of his essay makes clear, recognizes that “everyone is going through something.”

3. U.S. Athletes Need Better Mental Health Care (Martin Fritz Huber, May 16, 2018, Outside)

After DeMar DeRozan of the Toronto Raptors tweeted about his depression and Kevin Love of the Cleveland Cavaliers penned a viral essay about his experience with panic attacks, the NBA, as Martin Fritz Huber reports, created a position for a director of mental health and wellness.

“I think that’s the biggest burden on American sport culture,” says Brent Walker, an executive board member with the Association for Applied Sport Psychology. “I’ve heard repeatedly from professional and elite athletes how they don’t want to admit having to having a weakness—mental [illness] being one of those.”

Huber breaks down how other countries approach mental health in relation to sport, and asks what it might take to adjust the current system in the U.S. so that athletes are supported.

4. No, Running Isn’t Always the Best Therapy (Erin Kelly, July 23, 2018, Runner’s World)

“Phrases like ‘Running is cheaper than therapy!’ and ‘I run because punching people is frowned upon,’ are routinely splashed on running-themed bumper stickers, social memes, and apparel, and reinforce the idea that running offers a healthy mental outlet.”

Though studies show that running has positive benefits on wellbeing and mood, Erin Kelly, in this well-researched personal essay, pushes back against the notion that running can cure everything. Instead, she advocates that athletes reflect on why they’re participating in sport, and seek therapy when needed in addition to logging miles.

Related Read: When a Stress Expert Battles Mental Illness (Brad Stulberg, March 7, 2018, Outside)

5. The WNBA Needs Liz Cambage, but She May Not Need It (Lindsay Gibbs, August 20, 2018, The Ringer)

As Lindsay Gibbs reports, toxic effects of systemic racism, unequal pay in the WNBA, and a string of losses left Australian Liz Cambage, who plays for the WNBA’s Dallas Wings, depressed.

“When she returned to Melbourne, Cambage ghosted almost everyone in her life and retreated into a world of depression and anxiety. She said she heavily self-medicated with prescription pills and alcohol. She said that she isn’t surprised by her on-court success this season.”

Cambage credits honesty — with herself and others — as the reason she’s emerged from the dark place where she was.

6. Split Image (Kate Fagan, May 7, 2015, ESPN)

Social media allows us to curate images that tell a certain narrative — one that’s not always the most honest. As Kate Fagan reports, Madison Holleran, formerly a runner at Penn, seemed like she had the perfect life based on her Instagram and texts.

“But she was also a perfectionist who struggled when she performed poorly. She was a deep thinker, someone who was aware of the image she presented to the world, and someone who often struggled with what that image conveyed about her, with how people superficially read who she was, what her life was like.”

After Madison committed suicide, her family and friends scoured old posts and texts for clues about what was wrong and the warning signs they missed. Ultimately, this piece asks us to consider what lurks beneath the surface of social media’s veneer.

Related read: Are Female Long-Distance Runners More Prone to Suicidal Depression? (Emily De La Bruyere, February 3, 2014, The Daily Beast)

7. Talent. A Football Scholarship. Then Crushing Depression. (Kurt Streeter, November 15, 2018, The New York Times)

“What experts know is this: Recent studies place suicide as the third leading cause of death for college athletes, behind motor vehicle accidents and medical issues.

And nearly 25 percent of college athletes who participated in a widely touted 2016 study led by researchers at Drexel University displayed signs of depressive symptoms.”

In this profile of Isaiah Renfro, a top freshman wide receiver at the University of Washington who attempted suicide, Kurt Streeter writes about the pressures placed on NCAA athletes, what it means to quit sport after building an identity as a high-performing athlete, the important role that coaches play in supporting athletes off the field and on, and the hope that Renfro now feels for his life after seeking treatment.

8. Sports Stats May Be an Ideal Measure of Mental Health (B. David Zarley, October 17, 2016, The Atlantic)

At the University of Michigan’s School of Public Health, associate professor Daniel Eisenberg is leading a team of researchers at Athletes Connected in order to help athletes understand mental-health problems and track concrete data on the subject. As B. David Zarley reports, Eisenberg and other researchers collect weekly mental-health surveys which focus on academic and athletic performances and levels of anxiety and depression in order to pinpoint connections between the two.

“I think sports and celebrity are two places where we can begin to lift the mental-health stigma, by showing that real people who perform, and who are well valued by society through their athletic contributions, do also suffer from symptoms of ill mental health,” says Chris Gibbons, a post-doctoral fellow and the director of health assessment and innovation at the University of Cambridge’s Psychometrics Centre.”

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Jacqueline Alnes is working on a memoir about neurological illness and running. You can find her on Instagram and Twitter @jacquelinealnes.