Biles spoke candidly with reporters about her decision, saying she wasn’t in the right state of mind to compete and she believed leaving the competition would give her team the best chance at a medal. The U.S. women’s gymnastics team won silver. “I say put mental health first,” Biles told reporters at a press conference. “Because if you don’t, then you’re not going to enjoy your sport and you’re not going to succeed as much as you want to.” Biles did go on to compete and win a bronze medal on the balance beam during the second week of the games. She also revealed in a press conference that her aunt had died unexpectedly over the course of the games. “At the end of the day, people don’t understand what we are going through,” she told reporters. Biles’s decision to step down from the Olympic stage due to her mental health follows several recent examples of prominent athletes speaking out about and prioritizing their mental health, recognizing the critical role it plays in their performance. Tennis great Naomi Osaka withdrew from the French Open earlier this year, also citing her mental health. Biles qualified for four additional individual events scheduled for next week. She has not confirmed whether or not she will compete in those events. RELATED: The Olympic Games Begin! But Under the Cloud of COVID-19
Biles’s Decision Is a Huge Step for Mental Health
Jamey Houle, PhD, a sports psychologist at the Ohio State University Wexner Medical Center and the lead sports psychologist for Ohio State Athletics, says Biles set a precedent by deciding to withdraw from this week’s events. “The decision to focus on her mental health made a huge step forward for parity between mental and physical health,” Dr. Houle says. With a physical injury, the impact can be immediate and the limitation posed to physical performance may be more visible. But mental health conditions, left unacknowledged or untreated, can have significant consequences, too, and Biles’s actions spotlighted that. “When people try to ‘power through’ a mental health problem, they are denying their experience, whether that be their thoughts or feelings,” Houle says. Denying how you’re feeling or thinking can actually make things worse. As more athletes speak out about mental health issues, they pave the way for it to become more normal and acceptable to speak about our mental health needs, Houle adds. “They are showing that it is okay to not be okay.” “My heart goes out to Simone Biles. I applaud her for taking time out to take care of her mental health needs,” says Patrice Harris, MD, a psychiatrist and Everyday Health’s medical editor in chief at large. “Our athletes, particularly world class athletes on the Olympic stage, are under a lot of pressure, and typically they power through — but sometimes at a cost to their mental health. Biles is leading by example that whether you’re a world class athlete or an individual participating in sports at any level, we should all prioritize our mental health,” Dr. Harris says. RELATED: Can Getting Mentally Tough Up Your Game? In All Sports, the Answer Is Yes
Biles Sheds Light on the Pressures Athletes Face
For decades, the type of support athletes could get off the field centered on improving academic and athletic performance, not mental health, says Timothy Neal, the director of the athletic training program at Concordia University in Ann Arbor, Michigan. Yet athletes are not immune to mental health disorders, Neal says. Research shows that as many as one in four adults in the United States suffer from a diagnosable mental health disorder in a given year, according to Johns Hopkins Medicine. If anything, the unique stressors elite athletes face to stay at the top of their game may place them at greater risk than other people for developing or exacerbating mental health disorders, Neal says. There are pressures from an early age to be successful, to be a starting player, and to be selected for scholarships. Later on there are pressures to continue your success, to be profitable, and then to be under constant media scrutiny once you do reach that elite level. “All of these are contributing factors,” Neal says. Helping athletes navigate these stressors on and off the field has become more of a priority in recent years, says Tamara Valovich McLeod, PhD, a professor of sports medicine and the director of athletic training programs at A.T. Still University in Mesa, Arizona. For example, Brian Hainline, MD, made mental health his top priority — ahead of concussions — when he became the chief medical officer for the NCAA last year, Dr. McLeod notes. And the National Athletic Trainers Association and the American Medical Society for Sports Medicine have both put out statements urging coaches, trainers, and clinicians to prioritize athletes’ mental health. “Collectively, perhaps we are making progress,” McLeod says. But a lot of young athletes, particularly if they aren’t on Division I college teams, may not have access to athletic trainers or have coaches who recognize the importance of mental health, McLeod says. The 24-hour scrutiny on social media amplifies these pressures. “Criticism from social media is increasing tremendously, particularly among young athletes,” says Brad Donohue, PhD, a licensed clinical psychologist and psychology professor at the University of Nevada in Las Vegas, who studies how mental health affects athletic performance. Before the rise of the internet and social media, there was downtime when athletes could go without scrutiny, but that’s no longer the case, Houle adds. “At times the pressure can be too much, for sure.”
Will Biles’s Decision Redefine What Athletic Heroism Looks Like?
Before this week, a memorable moment in gymnastics history was the day the U.S. gymnast Kerri Strug broke her ankle on the vault at the 1996 Olympics in Atlanta. From the sidelines, her coach, Bela Karolyi, urged her to complete a second vault on the broken ankle. She did, helping the women’s team win gold; Karolyi then carried Strug off the mat. Strug was held up as a national hero for displaying perseverance, “powering through,” and putting the needs of the team first, says Sharon Chirban, PhD, a clinical sports psychologist and owner of Amplify Wellness & Performance, a Boston-based clinical psychology practice that specializes in working with athletes. This week Biles was hailed for a very different kind of bravery. “At times athletes power through injury and emotional stress, and can sacrifice their well-being due to expectations from others,” says Dr. Chirban, who also serves as a mental health provider for the NBA Player’s Association. Instead, Biles’s decision exemplifies how important taking care of your own needs really is. “It’s okay sometimes to even sit out the big competitions to focus on yourself, because it shows how strong a competitor and person you really are, rather than just battle through it,” Biles told reporters. USA Gymnastics was quick to praise Biles for making her mental health a priority. “We wholeheartedly support Simone’s decision and applaud her bravery in prioritizing her well-being,” USA Gymnastics said on Twitter. “Her courage shows, yet again, why she is a role model for so many.” Biles’s frank acknowledgment of the role mental health played in her withdrawal from events in Tokyo follows the courage she has already shown in disclosing depression stemming from past sexual abuse by USA Gymnastics team doctor Larry Nasser, says Michael Lindsey, PhD, MPH, the executive director of the New York University McSilver Institute for Poverty Policy and Research in New York City, who researches adolescent mental health and suicide prevention. “She is continuing that bravery with her latest revelations and decision to place her mental health and well-being first above other considerations,” Dr. Lindsey says. “Simone Biles joins an increasing number of top athletes — Naomi Osaka, Michael Phelps, Kenny Stills, to name a few — who are being open about their mental health struggles,” Lindsey adds. “The courage of these athletes helps to dismantle the stigma against addressing mental health.” RELATED: 7 Fitness Pros Who Have a Totally Balanced Approach to Wellness
