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The Women's Sports Alliance


Recognising Anxiety and Panic Attacks

Exclusively for our Advancement Zone community, our trusted mental health expert, Mark McGuigan - Mental Health Occupational Therapist - highlights the ways that a female athlete can best avoid and recognise mental health challenges.

Mark McGuigan

How should a female athlete should look after her mental health?

Take time out for you! Make sure you have time away from sport, even if it’s for a few hours a day to recharge your batteries. Do things that you enjoy; take time to be creative; maybe even try meditating.

Get enough sleep. There is a major link between sleep deprivation and poor mental health. Sleep is also so important for physical recovery. Go to bed an hour earlier and take naps where you can.

Surround yourself with good people. It is important to have a support group, particularly for female athletes who compete in individual sports. If it feels toxic, it might be the time to take a look at who is supporting you and make any necessary changes.

Talk to someone. If you notice that you aren’t feeling yourself - maybe your mood has been low; maybe you’ve been feeling worried or stressed - then speak to a team doctor; your GP; or a mental health professional.

How to spot early signs of mental health challenges?

The most obvious sign of an athlete experiencing mental health challenges is usually a subtle change in their presentation on a day to basis. Athletes can spend huge amounts of time with coaches; teammates and medical staff so it can be possible for them to recognise these changes. They may be more or less chatty than usual or maybe not being as bubbly as usual. They may appear more reserved, or even agitated. It is however important to note that there may not be any obvious indicators. This is why we encourage athletes and their coaches to have regular discussions about their mental health in order to make it easier to highlight when things aren’t going so well.

What are the classic symptoms of anxiety in a female athlete?

An athlete may have a sense of feeling nervous, restless or tense. There may be a sense of impending danger or doom, or fears related to upcoming matches; competitions etc. An athlete may find it difficult to sit still and may be highly agitated and restless. Being in a constant state of worry is one of the key symptoms of anxiety. Anxiety can impact upon sleep patterns, and it is common to be feeling tired or even exhausted. Anxiety can have a huge impact on an athlete’s ability to concentrate, either on or off the pitch. A common sign of anxiety is the need to use the bathroom on a much more frequent basis.

How can anxiety affect an elite female athlete's performance?

Anxiety can have a huge impact upon performance. Doubts can creep in about the athlete’s own ability, and unhelpful thinking styles can sink in, for example, catastrophising a mistake in training or in competition. I have supported many athletes who have been afraid that they may have a panic attack during competition, which can have an impact upon their ability to perform at the highest level . This can be a vicious cycle, in that fear of having a panic attack is often one of the main causes of having a panic attack. Another key factor to consider is the fact that elite female athletes do not necessarily have the same levels of security in terms of contracts; finances etc. as their male counterparts. This can also lead to an increase in anxiety which can impact upon their ability to be present, and perform to the best of their abilities, as there can be thoughts that mistakes, or not performing well enough may lead to contract offers being removed / not being renewed etc.

What is a panic attack, how does it present itself and how can an athlete deal with a Panic attack during competition?

A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. In essence, it’s when the fight/flight/freeze response kicks in when danger isn’t actually present. A panic attack usually starts with an increase in heart rate. This leads to a change in breathing - faster and more shallow - which can then trigger further symptoms including muscle tension; feeling lightheaded; sweating; blurred vision and headaches. Individuals can feel detached from reality, as if they are having an out of body experience. Panic attacks can feel very frightening, and many individuals believe that they are having a heart attack. One of the best ways to manage the symptoms of a panic attack is to focus on “getting grounded” and getting back to the here and now. A really good way to do this is to focus on your breathing. Long and controlled deep breathes in through the nose and out through the mouth can be really helpful. Breathe in for a count of four, and then out for a count of four. Repeat this until the heart rate lowers. You’ll start to notice that as the heart rate lowers, many of the symptoms of a panic attack will start to subside.

What does a coach need to understand about mental health challenges in athletes?

The first thing to consider is that mental health difficulties are far more common that we may realise. 1 in 4 people will experience a mental health problem in any year. Be mindful that athletes may be facing challenges outside of sport. Make efforts to ensure that the sporting environment continues to be a safe space.

Secondly, coaches can have a huge impact upon an athlete’s mental health, both positively and negatively. Consider your communication style; how feedback is given; and how an athlete may respond. No two athletes are the same, so they will respond to input from coaches in different ways. Try to utilise empathy, respect and demonstrate compassion at all times.

Thirdly, being an athlete does not reduce the likelihood of having a mental health problem. More and more research is pointing to an increased likelihood of an athlete facing mental health challenges, and this is often linked to the demands placed on elite athletes, as well as the practices of coaches and organisations.

Finally, as a coach, you do not need to have all the answers. Sometimes it can just be a case of listening. Encourage the athlete to seek support via their club or team doctor; by accessing their GP; or seek specialist support from organisations who specialise in providing mental health support to elite athletes.


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