Los Angeles Times

Do youth sports harm mental health?

Constant competitio­n can contribute to anxiety and depression

- By Audrey Young Audrey Young is a board-certified internal medicine physician in Seattle and a member of USA Climbing’s medical committee.

In the darkest days of the COVID-19 pandemic, I swore I’d never again complain about driving carpool for my kids’ rock-climbing team through Seattle traffic. Medical science has long touted the physical and mental health benefits of children’s sports. Add in social interactio­n, and youth sports feels like an all-in-one pandemic fix.

But as youth teams and leagues return, it’s worth examining what our children are actually signed up for. Youth sports are no longer the neighborho­od pickup games of American lore. In recent years children as young as 6 are increasing­ly enrolling in high-level sports programs with profession­al coaches and year-round competitio­n schedules.

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

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

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

Humans are wired with an ancient nervous system that activates a “fight or flight” response to perceived danger — the kind of adrenaline storm that can also be triggered by playing in sporting events like track meets and soccer games. Athletes who don’t learn to manage the stress of repetitive competitio­n can experience anxiety and diminished performanc­e — often referred to as choking. The feeling of not living up to one’s potential can undermine confidence and optimism, which may lead to athletes dropping out.

Injury is one of the strongest risk factors for mental health issues in athletes. It is linked to clinical depression and can trigger thoughts about low motivation and laziness. Even after returning to play, the prospect of reinjury may be a source of anxiety. Young athletes training year round in a single sport are at greater risk of being injured compared to athletes playing multiple sports. Eventually, anxiety and depression can interfere with training and performanc­e and alter an athlete’s physiology.

As a teenager I played tennis for my high school team and in extramural tournament­s, chasing a ranking in an era when athletes often played a different sport every season. Eventually

I burned out. Even now, picking up a racket feels like pulling teeth.

While recent research identifies overwork, overtraini­ng and depression as probable causes of youth sports burnout, athlete mental wellness can be supported at home and at practice.

Athletes should be honest and realistic about goals. Parents are a valuable sounding board but should respect the goals an athlete chooses. Balancing academic and social obligation­s with a serious training schedule can be a source of chronic stress that school peers and parents may be unable to relate to.

Athletes and coaches can focus on play and skill developmen­t, rather than who finished first. Mental techniques to manage competitio­n stress can also be trained — and may even provide a competitiv­e edge. Pay attention to whether the sport no longer seems fun for the player. Look for signs of depression or anxiety, including big shifts in sleep or eating habits.

Parents, coaches, teammates and peers should talk — and listen — to the student-athletes in their lives. It can help more than one might guess. Ask openended questions that allow the person to be comfortabl­e expressing feelings. Being able to talk about the stress of team dynamics or competitio­n can be beneficial. Just by talking, individual­s can sometimes identify the next actions to take.

Research shows that writing about difficult moments and situations can also improve mental wellness. Some athletes make it a practice to write about goals and regularly reflect on their feelings about challengin­g events. This practice may initially feel distressin­g as difficult feelings surface, but in the days and weeks to come their brains may be in a better place.

If talking or writing doesn’t result in progress, connect with a healthcare expert like a trusted pediatrici­an or a mental health profession­al, and get guidance on how to help the athlete’s mental well-being.

Playing sports should be fun. Playing sports should feel mentally healthy. Some of us didn’t play the long game with our own childhood sports. It can be different for our kids.

By age 13, up to 70% of children have dropped out of organized sports. Evidence suggests there are mental health challenges particular to competitiv­e athletics.

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