Op-Ed: Are youth sports harming our kids’ mental health?

In the darkest days of the COVID-19 pandemic, I swore I would never again complain about carpools driving my kids’ rock-climbing team through traffic in Seattle. Medical science has long promoted the physical and mental health benefits of children’s sports. Add social interaction, and youth sports will feel like a one-stop solution to the pandemic.

But with the return of youth teams and leagues, it’s worth examining what our kids have already been up to. Youth sports are no longer the neighborhood games of American tradition. In recent years, children under the age of 6 and 7 have increasingly begun enrolling in high-level sports programs with professional coaches and competition schedules throughout the year.

By age 13, up to 70% of children have dropped out of organized sports. I was sure the stats wouldn’t apply to my family – until the withdrawal of two of the best and strongest older athletes on my boys climbing team.

Evidence suggests that as young people compete more intensely in sports, mental health gains may be superseded by the mental health challenges of competitive athletics. In the pre-pandemic period, up to 20% of college athletes experienced major depression. For young athletes competing at the national and international levels, anxiety and depression were 20% to 45% – higher in some cases than those in age-appropriate control groups. In one study of elite Canadian swimmers, 68% of viewers met criteria for depression.

Supporting the psychological well-being of young athletes is especially urgent as we emerge from a pandemic that may have affected everyone’s mental health in some way. Sports medicine experts are just beginning to seriously study the mental health problems seen in youth sports, but it’s increasingly clear that constant competition, year-round training, and injuries can all contribute to anxiety and depression in athletes.

Humans have an ancient nervous system that activates a “fight or flight” response to perceived danger – the kind of adrenaline rush that can also occur through playing at sporting events such as track meets and soccer games. Athletes who do not learn to manage the stress of repetitive competition can experience anxiety and decreased performance – often referred to as suffocation. Feeling not living up to one’s potential can undermine confidence and optimism, which can lead to athletes dropping out.

Injury is one of the strongest risk factors for mental health problems in athletes. It is associated with depression and can trigger thoughts about low motivation and laziness. Even after returning to play, the possibility of breakage may be a concern. Young athletes who train year-round in one sport have a higher risk of injury compared to athletes who play multiple sports. Ultimately, anxiety and depression can interfere with training and performance and alter an athlete’s physiology.

As a teenager, I would play tennis for my high school team and in the outdoor tournaments, I would chase rankings in an era where athletes played a different sport each season. In the end it burned. So far, picking up the racket looks like pulling out a tooth.

While recent research identifies fatigue, overtraining, and depression as potential causes of youth sports fatigue, the mental health of athletes can be supported at home and in practice.

Athletes must be honest and realistic about goals. Parents are a valuable sounding board but they must respect the goals the athlete chooses. Balancing academic and social commitments with a serious training schedule can be a source of chronic stress that school peers and parents may not be able to relate to.

Athletes and coaches can focus on playing and developing skills, rather than on who came first. Mental techniques can also be trained to manage the stress of competition—and may also provide a competitive advantage. Pay attention to whether the sport is no longer enjoyable for the player. Look for signs of depression or anxiety, including significant changes in sleep or eating habits.

Parents, coaches, colleagues, and peers need to talk – and listen – to the student-athletes in their lives. It can help more than might guess. Ask open-ended questions that allow the person to feel comfortable expressing their feelings. Being able to talk about the stresses of team dynamics or competition can be helpful. Once spoken, people can sometimes decide what next actions they should take.

Research shows that writing about difficult moments and situations can also improve mental health. Some athletes make it a practice to write about goals and think regularly about their feelings about challenging events. The practice may feel daunting at first as difficult emotions arise, but in the coming days and weeks their brains may be in a better place.

If speaking or writing does not progress, reach out to a healthcare professional such as a trusted pediatrician or mental health professional, and get guidance on how to help the athlete’s mental health.

Exercising should be fun. Playing sports Should Feel mentally healthy. Some of us didn’t play the long game with our childhood sports. It can be different for our children.

Audrey Young, MD, is a board-certified internal medicine physician in Seattle and a member of the USA Climbing Medical Committee.

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