Simone Biles’s recent withdrawal from the Olympics, citing the need to focus on her mental health, is a reminder that mental health is inseparable from physical health. If there was any doubt about it, Biles reminds us that physical performance and mental well-being are intrinsically linked. And yet, half the population (mostly male) has spent a good part of the last week critiquing Biles’s choice as weakness while the other half (mostly female) has spent a good part of the last week celebrating her courage. I think this phenomenon has more to do with misunderstandings about the nature of mental illness, than it has to do with issues of sexism and race. Though, of course, it is also about sexism and race.
We understand that physical injury can manifest in many forms. Gymnastics can be an incredibly dangerous sport. As Maggie Astor wrote in the New York Times, the media often writes about Kerri Strug’s broken ankle, but seldom writes about the many women who died or who were paralyzed after breaking their necks. Even if we don’t talk about it, we accept that physical injury can manifest in many forms, and that each of these forms can potentially result in an athlete’s withdrawal from the Olympics. In Tokyo this year, the risks include everything from strains and sprains to catching COVID-19.
What we don’t talk about are the many ways that mental health concerns can manifest. The first association many people have when they think of mental health is “depression,” but mental health is a nuanced subject. It doesn’t just encompass depression, though a great many Americans suffer from it. Mental health is a broad umbrella that can encompass issues including anxiety, stress, social withdrawal, sleep, self-concept, body image, self-esteem, mood, perception of reality, and more. The brain can be as nuanced as the body, and the mind influences the body. Extreme anxiety can result in a loss of your kinesthetic awareness, or the “twisties,” as some have called it when describing Biles’s recent confusion in the air.
Severe anxiety can result in panic attacks. While few panic attacks are life-threatening, I can’t imagine it safe to have one while trying to perform dangerous aerial maneuvers. I’m not suggesting the Biles suffers from panic attacks. I’m just noting that a range of mental health conditions can manifest physically. Along those lines, depression can do more than just make you sad. It can reduce your energy level, and even affect your ability to sleep or feed yourself. I can’t imagine trying to summon the will to perform on a world stage while also experiencing depression.
Extreme stress can cause you to freeze, and given the complexity of a gymnastics maneuver, I don’t imagine the average viewer would even be able to perceive those minute moments of hesitation. Some disorders can result in a person losing touch with reality or cutting social ties. These disorders can also have as much an effect on the body as they do on the mind.
Social isolation (something which many athletes are experiencing because their families couldn’t be present at this Olympic games due to COVID-19), also has real emotional and physical effects. According to Cleveland Clinic, when a person experiences loneliness, their cortisol levels can increase. Cortisol is a stress hormone. In athletes who have calibrated everything about their performance from diet to sleep, we can’t underestimate the effects that even a slight uptick in cortisol could have. Athletes train for pressure, but many have not trained to endure high pressure without social support of family and loved ones, as they will have to do in Tokyo.
As someone who has experienced anxiety, depression, stress, problems sleeping, and more throughout my life and at different points in my life, I can say that sometimes anxiety and stress can express itself physically as literal nausea. I’m not a gymnast, so I can’t say for sure, but I imagine it would be very hard to complete a vault while feeling that way. I am a rock climber though, and I have experienced anxiety while climbing. I have, on a couple of occasions, almost seriously injured myself trying to push through anxiety. There were many days where I’d sit at the bottom of a climb doubled over in pain from the anxiety. These days, I know better than to push on when I feel like that. But knowing better is a skill that comes from experience. I worry about younger athletes who have been trained to perform at all costs. They may not have that wisdom unless it is taught as part of their training. Perhaps Simone Biles’s greatest legacy will be this. It’s not trivial.
We often deny that the pain we experience when we are going through emotional pain is real pain. Harvard Health notes that extreme stress has real physiological effects that can include inflammation, high blood pressure, insomnia, and changes in appetite. And when we are grieving, there are physical changes that take place in our hearts and blood vessels that can put us at greater risk of a heart attack.
Maybe athletes will be the first among us to fully articulate the close relationship between the mind and the body. The New York Times, in a piece of journalistic video excellence, features Alexi Pappas, an Olympian who was diagnosed with clinical depression after her Olympic run. Pappas explains that the training and motivation that prepared her for the Olympics may not have initially prepared her to tackle depression, but that after seeking help, she was able to re-think her approach to mental health. She asks: “What if we athletes approached our mental health the same way we approached our physical health?” And what if it wasn’t just athletes, but people in general? What if we all treated our mental health with the same care and diligence with which we’d approach a broken bone or a bad flu?
We all may not be Olympic athletes but in America today, we live in a culture of overwork, a culture that celebrates the all-nighter, and the hustle. Athletes push themselves hard, but so do people in the arts, who often do their day jobs, and then their arts jobs after. In fact, many industries celebrate this idea that if you’re not sleeping, you’re doing it right.
Pappas writes in more detail about her depression in her book Bravey, explaining that the same relentless pursuit for excellence she applied to the Olympics she used in her creative pursuits and also in her healing from depression.
There are many ways a person can wear herself thin. In creative or physical pursuits, there’s always a fine line. There’s pushing yourself, and then there’s hurting yourself. There’s motivating yourself and then there’s ignoring pain. Pappas writes: “Chasing a dream is a never-ending negotiation.” Part of that negotiation is knowing when to step away, or when to take a break.
Simone Biles was courageous in stepping back from the Olympics. But I think she did more than that. Given the sheer difficulty of the maneuvers she had been trained to attempt, she not only was courageous, she also probably saved her own life.
Bravey: Chasing Dreams, Befriending Pain, and Other Big Ideas by Alexi Pappas at Amazon.com (affiliate link)
Bravey: Chasing Dreams, Befriending Pain, and Other Big Ideas by Alexi Pappas at Bookshop.org (affiliate link)
About the Writer
Janice Greenwood is a writer, surfer, and poet. She holds an M.F.A. in poetry and creative writing from Columbia University.