Without a doubt, I loved my coaching career. Coaches do not know everything, but athletes often believe we do. Over time, though, coaching teaches you a great deal about competing, pressure, failure, resilience, and human behavior. In this piece, I am sharing what I have observed as both a former coach and an athletics-informed psychotherapist.

Athletic minds: Why are some athletes so good when they do not “look” like they should be?

Even casual sports fans have seen it: an athlete who excels in a way that seems hard to explain. They may not fit the physical archetype for their sport or position. Maybe they are not the tallest, fastest, strongest, or most explosive athlete on the roster, yet they consistently outperform teammates who seem to have more obvious physical gifts.

Why does that happen?

Part of the answer is almost certainly mental. Their confidence may be steadier. Their attention may be sharper. Their decision-making may be calmer under pressure. Their nervous system may recover faster after mistakes. Meanwhile, another athlete with more measurable physical upside may struggle with self-doubt, fear of failure, perfectionism, or anxiety.

We have long accepted body training as essential: speed, strength, conditioning, recovery, nutrition, and skill repetition. But too often, the mental side of performance is still treated as mysterious, untrainable, or limited to clichés and pep talks. That view does not hold up well anymore.

High-pressure decision-making in a fraction of a second

Take hitting a baseball. A 90-mph fastball reaches home plate in about 0.4 seconds, and a hitter needs roughly 0.25 seconds to identify and react to it. That leaves very little margin for hesitation, intrusive thoughts, or emotional dysregulation. Researchers at UC Berkeley have shown that the brain handles this by predicting where moving objects will be, not simply by reacting after the fact. In other words, performance at a high level depends on attention, anticipation, pattern recognition, and trust under pressure, not just physical mechanics.

That is why the “mental side” of sport is not fluff. It is not optional. It is part of the performance itself.

When decision-making must happen this quickly, even a brief anxious thought can matter. A flicker of fear, self-consciousness, overthinking, or panic can disrupt timing, commitment, and execution. This is one reason an athlete who is physically superior in practice may still underperform in competition.

Stress, pressure, and anxiety: looking beyond performance

Athletes are not just performers. They are people. And distressed athletes are still distressed human beings.

The death of Stanford soccer player Katie Meyer brought national attention to the pressure student-athletes can carry behind the scenes. In January 2026, Stanford and Meyer’s family announced a resolution that included a new initiative focused on the mental health and well-being of student-athletes, along with broader student support measures. That response reflects a growing recognition that athlete mental health is not a side issue; it is central to safety, development, and care.

At the college level, this is not a fringe concern. The NCAA says it serves more than 520,000 student-athletes, and its nationally representative Health and Wellness Study included responses from more than 23,000 student-athletes. In findings released in late 2023, 44% of women’s sports participants reported feeling overwhelmed and 35% reported feeling mentally exhausted. Among men’s sports participants, 17% reported feeling overwhelmed and 16% reported feeling mentally exhausted. The NCAA also updated its Mental Health Best Practices in 2024, and member schools across divisions are required to provide mental health resources and education consistent with those standards.

Among elite athletes, a large meta-analysis found prevalence estimates ranging from 19% for alcohol misuse to 34% for anxiety and depression symptoms in current elite athletes. The same review noted that elite sport careers can involve more than 640 distinct stressors. That number alone should end the myth that high performers are somehow immune to mental health strain.

What about youth athletes?

This is where we need to be careful and honest. Research does not clearly show that youth athletes are always more mentally unwell than their non-athlete peers. In fact, a 2024 review noted that the evidence is still inconclusive on whether young athletes are more or less likely than non-athletes to experience mental health disorders overall. However, that same review emphasized that youth athletes face sport-specific risks, including performance anxiety, perfectionism, burnout, injury-related distress, and the psychological effects of concussion.

So the better question is not, “Are sports always good or always bad for mental health?” The better question is, “What kind of sports environment is this athlete living in, and how is their mind responding to it?”

One 2022 study of adolescent athletes found that 16.9% showed clinically meaningful depressive symptoms, and 2.5% reported thoughts that they would be better off dead or of hurting themselves. That does not mean sport causes these struggles. It does mean we should stop assuming that active, talented, busy athletes are automatically doing fine.

At the same time, sport and physical activity can be genuinely protective. The CDC notes that regular physical activity can improve memory, support emotional balance, and reduce anxiety or depression. Team environments may also offer an additional buffer: one study of adolescent athletes found anxiety or depression was reported by 13% of individual-sport athletes compared with 7% of team-sport athletes. That does not make team sports universally safer, but it does suggest that belonging, shared pressure, and social support matter.

So what does athletic psychotherapy actually do?

Athletic psychotherapy is not just about “getting an athlete motivated.” It is about understanding the athlete as a whole person and helping them function more effectively under stress.

That can include:

performance anxiety,
fear of failure,
perfectionism,
identity issues outside of sport,
sleep disruption,
injury recovery,
frustration tolerance,
emotional regulation,
communication with coaches or parents,
pressure tied to expectations, scholarships, starting roles, or social media,
and the transition out of sport when competition no longer defines daily life.

Sometimes the goal is improved performance. Sometimes the goal is mental stability. Often, it is both.

Athletic psychotherapy: Are we all on board?

For adult athletes, the answer can be simple: if you are ready, you can begin.

For youth athletes, there are a few important questions to consider.

First: Does the athlete want help, or are they being pushed into it?
A parent absolutely should act when something looks wrong, but meaningful outcomes are usually stronger when the athlete has at least some personal buy-in.
Second: Is the family ready to play its role?
Parents and guardians are part of the athlete’s ecosystem. Their expectations, reactions, communication style, and own relationship with stress all affect the athlete. Sometimes the work is not only helping the athlete regulate emotions, but also helping the adults around them stop unintentionally escalating pressure.
Third: What level of support is actually needed?
Some athletes need a short stretch of weekly sessions to address mindset, anxiety, or confidence. Others need a more structured, longer-term therapeutic relationship because the issue is not just sport performance, but depression, trauma, identity strain, family conflict, grief, or emotional dysregulation.

What might distress look like in an athlete?

It can look like much more than “not playing well.” Warning signs may include:

sudden changes in mood,
unusual irritability or shutdown,
burnout or loss of interest in their sport,
fear of losing or intense distress after mistakes,
sleep problems,
appetite changes,
anxious or depressed presentation,
withdrawing from family or friends,
increased reliance on substances,
or any meaningful shift in behavior that feels out of character.

Sometimes the athlete who is struggling the most is still practicing, still competing, and still producing.

The conclusion

I want to end with this: a struggling athlete is still a struggling person. Whether or not a therapist is athletic-informed, a distressed athlete deserves care.

But there is also a strong argument for being proactive, not just reactive. Do not wait until an athlete is in visible distress to address the mental side of their life. There is only upside in teaching emotional regulation, stress tolerance, healthy identity formation, and better ways to respond to pressure before a problem becomes a crisis.

We would never question the value of strength training, nutrition, film study, or skill repetition. At some point, we have to stop treating mental health and mental performance as separate from development. The body and mind are not competing priorities in sport. They are partners.

If an athlete is in immediate emotional crisis, call or text 988 (USA only) for free, confidential support.

Written by: Todd Nall, M.Ed., LPC