"Sports and mental health don't necessarily have to be at odds. We just have to stop talking about it like they are."
Author and journalist Julie Kliegman talks about her book, Mind Game: An Inside Look at the Mental Health Playbook of Elite Athletes and what we get right—and wrong—about mental health in sports.
I admit that I’m a sucker for the Olympics.
Maybe it’s just being in awe of the ridiculous things these athletes are able to do. Maybe it’s because, historically, the Olympics are the one time when women’s sports and women’s athletes would get as much attention as the men’s side. Maybe it’s just the human stories behind the athletes—who they are, what it’s taken to get to this stage, the tremendous number of people who support their pursuit of sporting excellence.
The thing that I’ve noticed most during the TV broadcast is how much more mental health is part of the overall conversation.
Simone Biles saying that “being in a good mental spot. Seeing my therapist every Thursday” was a big part of what led her back to qualifying for her third straight Olympics gymnastics team.
Nikki Hiltz, who is transgender and non-binary, discussing so openly and candidly how they didn’t feel like they belonged in the sport and how hard the last three years have been as they’ve rebuilt their confidence. They won the women’s 1500m at the Olympic trials, notching the second fastest time by an American in one of the most exciting races.
Noah Lyles saying, “I’ve said it all season but it helps to not have depression,” he told NBC in the post-race interview. I thank God every day ... for getting me through each and every round. Healthy, mentally and physically,” after winning the 200m finals at the Olympic Trials.
Broadcasters discussing the challenges both Simone Manuel and Caleb Dressel faced out of the pool as they made the Olympic team.
The intersection of mental health and sports is something that I’ve been thinking about for a long time and it’s heartening to see the conversation become more normalized, especially in sports. One person who has helped move that conversation forward is Julie Kliegman and Julie was kind enough to chat with me recently.
Julie is a writer, editor, and author of the book Mind Game: An Inside Look at the Mental Health Playbook of Elite Athletes, which came out in March 2024 from Roman & Littlefield Publishers. Get a signed copy from Astoria Bookshop and sign up for Julie’s newsletter to keep up with her work. Julie also recently announced that a second book is in the works about former pro tennis player Renee Richards.
Christine: Can you introduce yourself, your work, and what you cover?
Julie: The simplest way to put it is I’m a sports journalist and author. Most recently, I worked for Sports Illustrated for four years as copy chief. I really try to focus on how sports and pop culture intersect with things like gender, sexuality, mental health, and other social justice issues.
Christine: Why write this book and why now? What inspired and motivated you?
Julie: I've been writing about mental health and sports for a number of years before the idea for this book occurred to me. I've always been interested in sports and I have mental illness myself so the idea of marrying those two subjects always made sense to me. I pegged it as something that was being under discussed at the time, or not discussed at all.
It became apparent that the timing was right for a book like this when the pandemic started and we saw so many more people struggle with their mental health, both people who were athletes and those who weren’t and people who hadn't necessarily ever struggled with mental illness before. Something seemed to be shifting with regard to that and combined with more and more athletes coming forward to talk about their struggles, it seemed like now is the right time.
Christine: Let’s start with defining some terms because there are so many—mental health, mental illness, mental wellbeing, mental toughness. When you talk about mental health within the context of sports, what do you mean? Could you tease apart what the differences are between those terms?
Julie: Mental health is one of the more broad terms you could use to discuss the kinds of things I write about. A lot of experts will say the refrain: Everybody has mental health. And it's true, even if your mental health has never bothered you, which, I have so many questions for you, but mental health is something that we all deal with. We all have to take care of.
Mental illness is when your well-being starts giving you some trouble. When we talk about mental illness, we can talk about things that are diagnosable, like anxiety and depression, which are two of the most common mental illnesses, but we can also talk about OCD or eating disorders or any other number of things that might affect a person, whether they're an athlete or not.
And then, a lot of the book focuses on mental performance, which is something that athletes have to think about. Mental performance is what athletes can do on and off the field to benefit their in-game or in-competition results. Like mental health more broadly, it’s something that any athlete can experience, regardless of whether or not they've ever been mentally ill.
Christine: For a long time, it seemed like when we talked about mental well-being, we talked about it in terms of sports psychology or “mental toughness.” I’ve always had trouble with the term “mental toughness” and its implications that you have to ignore your emotions, pain, or anything that might get in the way of your performance and how it can enable abusive behavior.
But you write about how it’s a scientific concept that’s positively correlated with better mental health and other outcomes. What do we get wrong when we talk about and think about mental toughness versus what the research actually says?
Julie: I first came across this when, a few years ago, one of my editors at Sports Illustrated asked me to write an essay about mental toughness. I was like, oh boy. It's just such a fraught issue and I realized pretty quickly there were people who specialized in this, who study the concept because it is a real concept.
Their perception of what mental toughness is, insofar as they agree—which experts themselves do not necessarily agree among themselves—doesn't line up with what pundits and talking heads and the public necessarily think of as mental toughness.
For the most part, I think we see it as such-and-such athlete has to suck it up. They have to play through their injury. They have to disregard that their father died yesterday or whatever it could be.
And experts, on the other hand, see mental toughness as what gives you the strength to get from point A to point B, to achieve your goals. It's a much more specific thing. It's not inherently bad to be mentally tough. It's not necessarily toxic like the way it sounds when we talk about it. It's actually a good thing that's correlated with positive mental health outcomes. But you’d never know it by just listening to sports media.
Christine: What is it about sports and system of sports that does place athletes in this seemingly precarious position where it can be really harmful to their mental health?
Julie: Athletes are celebrities in a sense and I think that automatically puts you in this sort of precarious position where everyone's watching you. Or you want everyone to be watching you if they're not yet. There's a lot of pressure, not just on you to keep your body perfect, which can lead to mental health issues itself, but also pressure to keep your mind focused, to get that sort of incorrect definition of mentally tough down. You're under spotlight and, at the same time, you're pushing your body to its limits, and that's going to take some toll on you.
Christine: As you know, this newsletter focuses on women’s sports and I’m curious what you found in your research and reporting on what are the biggest challenges or pressures those who identify as girls and women experience in pursuit of excellence in sports? What do you think it is about the experience of being a girl or woman in sport that makes mental health such a salient issue among this population?
Julie: There are a number of factors here with girls and women in sports in particular. One is that, in a sense, they are “free” to show more emotion, at least to a certain extent, than their male counterparts. Girls and women are socialized to feel like they can express themselves and show “weaknesses,” unlike men. So I think in one sense, it's almost easier for girls and women to have these conversations.
But then they kind of get punished for it, right? They get told, “You're so weak,” or “You're so frail,” or “You can't handle this.” And of course, that's not true, but it's the way a lot of people still, unfortunately, see it.
Then there's the question of resources and I think those are very different between men's and women's sports. We've only recently seen a number of the big men's sports leagues on the professional level, for example, that cater to athletes mental health by bringing in sports psychology professionals. A lot of women's leagues just don't necessarily have those resources. Or the women have advocated for a long time for those resources, in some cases.
It's this interesting thing where women are perhaps more willing to talk about their struggles, but are less likely to have the resources they need. And, of course, they're making less money on average than the men. So how are they supposed to take care of themselves?
Christine: There’s a lot of more talk about mental health care in sports now. The NCAA is saying that it’s taking it seriously among student athletes. Are they doing enough? Is it just lip service? Because I feel like universities will say, we have these mental health resources athletes can make use of but then it's still on the athlete to actually step up and seek out that help.
Julie: The NCAA’s efforts, for me personally, fall somewhere in between just lip service and true change. I think they're trying. Brian Hainline, who recently stepped down as chief medical officer, made a big push. But I know a lot of athletes, and I've talked to a lot of athletes for the book, who don't think it goes far enough.
I was never an NCAA athlete, so I take their word for it. They feel like a) they should be paid and that would help fix some problems, and a lot of these athletes still deal with coaches or teammates who aren't supportive. Particularly, and I want to emphasize this because it’s a hiring decision by the school, if a coach doesn't seem like they're open to hearing about your pain or if you think they might threaten to like bench you because of what you tell them, that's not great. I think we’re still undergoing this revolution where we're prioritizing coaches who are more caring and more thoughtful about these issues, and I don't think we're necessarily all the way there yet.
It's hard. At the end of the day, no one can help an athlete if the athlete doesn't indicate that they need help. So I struggle with that a lot because as much as we want these facilities to do more, there's a limit to everything.
I've read some good research about arguments that at the beginning of every season there should be mental health intake forms and assessments for athletes in college, just like there are physical ones. Establish a baseline. Make it part of the normal process on the school and team levels. I think that's a good idea.
But we're also not talking about one universal experience. It depends on what school you go to. If you go to Alabama, that's different than going to a non-Power Five school, which is different than going to a Division II or Division III school. So it's really, really tough to establish a baseline of what resources should be available and what support systems athletes have.
Christine: I appreciate that you made the point that it's not like Naomi Osaka or Simone Biles started these conversations about mental health. These conversations have been happening. What gives you hope in these conversations or the way the conversation seems to be shifting?
Julie: That's a great question and something that I don't get to think about enough. I would say what gives me hope is that the number of people coming forward is clearly increasing. More and more people are coming forward to talk about their mental health. Even though it is a conversation with deep roots, the roots haven't always been spread so widely as you could say they are now.
You see more and more athletes calling for change, to reporters, to their schools, to their professional teams. Every generation of athletes seems to care a little bit more about this, which is necessary for their survival, but they're also looking out for each other. And I think that gives me a lot of hope that we're headed in the right direction.
Christine: Can sports and mental health, mental well-being, coexist? I mean sports in general, not just at the highest level because I feel like this does affect athletes all the way down the chain.
Julie: I do think they can coexist. And I think that's why a lot of people get into sports in the first place because they see mental health benefits from the exercise, from the camaraderie, from the self improvement opportunities, from the leadership opportunities. They don't necessarily have to be at odds. We just have to stop talking about it like they are. By we, I mean, people on television and coaches who don't get the memo.
Christine: This is a question that you said you asked in almost every interview, and I wanted to ask you. What do you want the future of mental health care and the conversation surrounding it to look like for athletes?
Julie: I would like to see every athlete on the NCAA or Olympic or professional level have funding to go outside of their sport entities for support, whether that's a psychiatrist or a psychologist. We're not there yet, and I know not every athlete feels comfortable going to a team or a school resource. Some really like that and that's great. I want that option to be available.
But I also want to make sure that where athletes have the income and the funds specifically dedicated toward taking care of their mental health that they can go and see the provider that they most want to see, regardless of who that is.
As for the conversation surrounding mental health in athletes, I would most like to see us pushing the boundaries of stories beyond such-and-such athlete came forward and said they deal with depression or anxiety or bipolar disorder—whatever it is—and taking a step further to say, and then what? What can we do about that? What are the patterns we're seeing among athletes? To not keep the storytelling on an individual level, but rather look for trends, see why these stories are happening, see what do these athletes want, and find the commonalities so that we can talk about problem solving a little bit more than we are now.
Christine: That's a really great point. Obviously, the one-off stories are powerful, but being able to step back and put it in context and be able to understand what is happening on a broader level is really important. The cynical side of me is also thinking that it would also be great if there were actually more outlets reporting on these kinds of sports stories.
Julie: That's a whole separate conversation. But no one covers sports well anymore. It's really upsetting
Christine: One last question because I'm always curious how people do this: How did you decide what to include in the book and how to shape and structure it?
Julie: Honestly, so much of it was just driven by time constraints. I wish I had an artier answer but it's really just what could be done in the time I had to write this book. How many people can I talk to in that timeframe?
I'm not sure this speaks to my self-editing very well, but almost everyone I talked to did end up in the book in some capacity, whether it's a line or a whole chapter, because it was just so hard to pick and choose. I didn't really want to be the arbiter of which stories “mattered the most,” even though, of course, who I reached out to in the first place is me kind of deciding who to prioritize.
There's always more you wish you could have done. I wish my timeline and Simone Biles’ timeline had linked up a little bit better stuff. There's always going to be more you wish you include.
Christine: I felt similarly when I was trying to figure out what the heck to include in my book. Because you don’t want to just skim the surface and you want to dig into it more since you have more space and words to be able to do that but it’s really hard. I feel you very much on the time constraints because that very much shaped what I included in my book too.
Julie: Thank you for understanding because I feel like some people either have much longer runway than maybe you or I did or they're just magicians.
Christine: Julie, I love hearing a little bit more about your thoughts on all of this. Thank you for chatting with me.
Links & Things
Speaking of Simone Biles, this is one of the most candid interviews I’ve heard from her about what happened in Tokyo three years ago. It was recorded before the Olympic Trials and before she was officially selected as a member of the US Women’s Gymnastics team.
The leotards the US team will wear in Paris features thousands of crystals and costs $3,000 a piece. This cool feature story details how they are made.
How women’s sports is leading the conversation around reproductive health.
Thanks for being here. More soon.
Christine