William D. Parham, Ph.D., ABPP
Anxiety is a widely studied phenomena. Despite differences in definition, there appears to be some agreement regarding its key features. Anxiety is a natural, adaptive, self-protective, emotional and physiological survival response. It is experienced by people globally and influenced by a combination of factors including but not limited to gender, age, culture, race, ethnicity, sexual orientation, disability, faith-based practices, and other dimensions of personal identity. Lived experiences of anxiety play out within contexts of everyday life challenges. Some life challenges are experienced as minor inconveniences, daily hassles and situations people choose to put up with temporarily. When seen in this way anxiety may be experienced as ‘normal’ with minimal physiological arousal and, overall, clearly manageable.
At the other end of the spectrum are life challenges that can surface as fear, dread, confusion, emotional disequilibrium, obsessive ruminations, increased irritability, compromised decision-making, and a host of physiological reactions including, but not limited to, nausea, muscle tension, and increased blood pressure. When this latter constellation of symptoms emerges, also known as the “fight or flight” response, it represents evidence that people are perceiving their immediate environment and personal space as being attacked, under threat and in danger. The body, having received signals that danger and harm are immanent, prepares to engage the threat or flee from the scene. Either decision is fueled by increased energy (e.g. adrenalin, increased heart rate, increase flow of blood to deep muscles, increased production of white blood cells) to accomplish the chosen goal.
It is important to note that a person’s perception of threat relative to an event triggers the kind, strength, intensity and duration of the emotional and physiological reaction that is subsequently experienced. Further, the accuracy of a person’s perception of threat to an event is not a prerequisite for the innate fight or flight system to be activated. Athletes’ believability about the immediate situation or circumstance in which they find themselves, and the real or perceived threats and dangers therein, represents the stimuli which triggers the fight or flight response.
For example, an athlete’s poor performance during competition might be experienced as unfortunate and seen as a learning experience. Alternatively, that very same athlete could interpret a poor athletic performance in the same event as devastating and evidence that they need to lower future performance expectations. The meaning athletes’ assigns to situations coupled with their assessment of the availability of internal and external resources believed to be sufficient to meet the demands imposed by the event, determines the level of stress athletes are likely to experience. In short, athletes have the power to manage emotional ups and downs. They have the cognitive wherewithal to change how they think, the affective mechanisms to regulate their emotions, and the behavioral repertoire to execute actions that are consistent with handling both the psychological and physiological responses.
Anxiety manifests in various ways. With respect to athletes, anxiety can be disruptive at home, work, school, prior to and during competition, while managing injury, in anticipation of flying to and from competition, while initiating, maintaining and ending interpersonal relationships, when acknowledging health challenges, when needed to manage family problems, or during any other life challenge that demands an athlete’s focused attention. Symptoms of anxiety might include sensitivity to worrying, difficulty concentration and staying focused, increased irritability, feeling agitated, scattered, and on edge, sweating, shortness of breath, light headedness, difficulty falling and staying asleep, increased muscle tension and appetite disturbance and stomach distress.
The complex and ongoing interaction of several factors contribute to athletes feeling vulnerable to experiences of anxiety. Environments (e.g., athletic, familial, social-political) wherein athletes learn, develop, and mature and from which they draw emotional nourishment and find life’s purpose represent one category of factors that shape how they think, feel, and behave in response to life’s challenges. Coaches, teammates, health, fitness and nutritional personnel, referees, fans, booster clubs, sports journalists, and athletic department/program administrators represent athletic environment factors. Parents, siblings, extended family, community, and spiritual/religious/devotional upbringing are examples of familial environmental factors. Visual, auditory, print, and social media as well as local, regional, national and global economic and political climates collectively represent social-political environmental factors that influence responses to life challenges. Early-age traumatic experiences occurring within any of the above environmental contexts, left unaddressed, manifest as anxiety and surface symptoms of decreased performance inviting further exploration by trained mental health professionals.
It is important to note that anxiety surfaces as symptoms that may feel problematic and intrusive in athletes’ lives. If left unchecked, symptoms of anxiety could lead to further adverse consequences. While anxiety may be problematic, however, it is never the problem. Anxiety is a symptom that other concerns and issues need to be addressed. Assessment by trained mental health professionals can be helpful relative to confirming diagnostic impressions about anxiety and ruling out other co-occurring mental health challenges, such as depression, that may be adding to the symptom profile. The good news about anxiety is that it is treatable. Ample evidence-based interventions exist providing choices relative to tailoring treatment plans that meet athletes’ needs. Interventions include, individual counseling, deep breathing exercises, cognitive reframing, progressive relaxation exercises, and autogenic relaxation exercises represents examples of interventions employed to rouse and inspire mental and physiological peacefulness. Mindfulness meditations, the practice of stillness, Tai Chi, Qigong are reputable interventions.
Physical exercise, sound nutritional practices, quality sleep, balancing life with hobbies or other outlets and developing and maintaining social support systems and spiritual practices are parts of a holistic mental health and wellness regimen. When the above options are implemented in combination and as lifestyle practices versus as techniques to use when feeling overwhelmed emotionally, athletes are then in position to reap maximum benefit.
Medications represent viable options for treating anxiety. Because some medical conditions produce symptoms that mimic anxiety healthcare personnel will rule out the presence of medical conditions (e.g., hyperthyroidism, low blood sugar), other medications, including prescription and over the counter and withdrawal from illegal substances as factors in the current reactionary profile. Decisions to treat anxiety as a preventative measure or as a remedy for managing symptoms are also considered. Some types of anxiety drugs are habit-forming necessitating consideration of either a short-term prescription or prescribed to be taken on an as needed basis.