Pre-performance jitters and butterflies in the stomach are a common occurrence before a big event. However, what do you do when there might be something more going on?
Do yourself a big favor. Sit down, think about the last two weeks, and honestly respond with how often you may have been bothered by the following problems:
- Feeling nervous, anxious or on edge?
- Not being able to stop or control worrying?
- Feeling down, depressed or hopeless?
- Little interest or pleasure in doing things?
These questions are from the PHQ-4, which is a commonly used screening tool for depression and anxiety. If you answered one or more of the 4 question with at least several days a week, you might be dealing with depression or anxiety (more than just the anxiousness that happens before a performance). And please be aware, you are not alone.
This is not intended to increase any feelings of sadness, fear or feeling out of control. Rather, this blog is intended to empower you, to reduce feelings of isolation, erase stigmas, and make you more aware of the value of emotional health.
If at any time you feel you might have depression, anxiety or any other emotional or mental health concern, please immediate contact a healthcare professional for urgent evaluation. If you have thoughts of harming yourself or someone else, or thoughts of suicide, immediately go to your nearest emergency room. The National Suicide Prevention Hotline at 1-800-273-8255 is confidential and available 24 hours a day.
What exactly is depression?
More than just a bout of the blues, depression isn’t a weakness and you can’t simply “snap out” of it.
Symptoms of depression may include:
Feelings of sadness, tearfulness, emptiness or hopelessness- Angry outbursts, irritability or frustration, even over small matters
- Loss of interest or pleasure in most or all normal activities
- Sleep disturbances, including sleeping too much or too little
- Tiredness and lack of energy, so even small tasks take extra effort
- Reduced appetite and weight loss or increased cravings for food and weight gain
- Anxiety, agitation or restlessness
- Slowed thinking, speaking or body movements
- Feelings of worthlessness or guilt, fixating on past failures or self-blame
- Trouble thinking, concentrating, making decisions and remembering things
- Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
- Unexplained physical problems, such as back pain or headaches
Feelings of sadness, tearfulness, emptiness or hopelessnessWhat is anxiety?
Again, according to Mayoclinic.org, People with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks).
These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time.
Symptoms of anxiety include:
- Feeling restless, wound-up, or on-edge
- Being easily fatigued
- Having difficulty concentrating; mind going blank
- Being irritable
- Having muscle tension’
- Difficulty controlling feelings of worry
- Having sleep problems, such as difficulty falling or staying asleep, restlessness, or unsatisfying sleep
Depression and Anxiety in the Athletic World
Exercise can reduce some signs and symptoms of depression and anxiety.
You’ve likely lived highs – winning the big game, learning new moves and performing well with a following standing ovation amplifying a sense of positive emotional health.
However, you also have likely experienced low points that can intensity feelings of depression and anxiety:
- The regular failure that happens – literally and figuratively falling down – and trying to get back up again
- Regularly hearing about inadequate technique and appearances from coaches and instructors
- Those inevitable comparisons to others about talent, skills and body shape
- Mental and physical fatigue that comes from an enormous time investment in practices, classes, games, and performances
- Trying to balance your craft with school, work, family and other social/community commitments
- That drive to excel can also be the same drive that leads to depression
- Your sense of identify seemingly dependent on scoring that goal, making the home run, basket or touchdown, hitting that last jump, or earning that key role
- Being forced out of activity due to injury
- Not earning a desired role can intensify feelings of inadequacy, isolation and sadness
The regular failure that happens – literally and figuratively falling down – and trying to get back up againSpending a tremendous amount of time with fellow performers and coaches/instructors may reveal emotions and behaviors that may not be seen by outsiders. This unique perspective can in itself be stressful and at times frightening.
You will watch others act (or yourself may feel) stressed out, anxious, and down in the dumps.
Some of that might be “more normal”, or it might be a sign of a more serious emotional concern.
If you feel, or see one or more of the following situations, this is the time to ask for help:
- Showing less connection with others and appearing distant or preoccupied
- Missing more practices, classes and rehearsals
- Voicing multiple complaints of pain or frequent injuries
- Injuries that appear to take longer to resolve
- Sleeping too much or too little
- Loss of energy and endurance
- Having a plateau or reductions in technical skills
- Recent major injury
- Recent life stressor (family change, illness, loss of key role or position)
- Increased use of prescription or recreational drugs or alcohol
- Readily apparent change in body weight (namely weight loss)
Maybe you might now actually may be more aware that you are depressed or anxious but are afraid to share concerns with others. You may fear that no one else understand, or that others will cast judgement and you might lose roles, identity, and prestige.
And even if you honestly feel that you are doing okay, maybe a close friend or teammate is going through depression or anxiety. Perhaps they feel alone, that no one else understands their feelings too.
Final Thoughts
If you suspect a potential issue, don’t be afraid to dig deeper, even if it might seem personal, overly critical, or even nosy. You might be the next step to getting yourself or someone close to you important help. Maybe reading this will allow you to get help yourself or someone close to you out.
If you identify concerns, offer assistance, support, and help seek qualified expert healthcare evaluation and treatment. Here at Active Kid MD, Anaheim CA Pediatrics, we offer support and assistance to identify and treat anxiety and depression.
If at any time you feel out of control or feel scared for your safety or the safety of someone else, dial 911 or immediately go to the nearest emergency room.
Medical treatment is essential and may include behavioral therapy and possibly medications that can lead to a higher level of emotional health.
How can teams and groups support emotional health?
- Establish relationships with local sports medicine and mental health resources to foster efficient and expert responses to athletes with immediate needs
- Open and regular discussions about emotional health should be encouraged
- Acknowledge failure as a regular part of performing, and place emphasis on best efforts and learning from mistakes
- Routinely asking about big picture things like school, family, and outside lives
- Fostering recovery from injury or illness with an empathetic response that gives a greater sense of personal control
– Allow injuries or ill performers to help decide how involved they want to be during their recovery period. Some will want to attend practices and classes or games to remain part of the group, others may favor time away.
– Offer professional medical and emotional support and continually ask about needs
Coaches and instructors should be prepared to support colleagues or students in need. Performers with supportive communities feel more enabled to report mental health issues, seek qualified care and ultimate be able to enjoy better performances and overall higher life satisfaction.
No one should be ignorant to the signs and symptoms of depression and anxiety.
No one should ever feel the need to go solo with emotional health concerns.
No one should never be afraid to seek help.
