by Mena Mirhom, MD, FAPA, AFH Chief Wellbeing Officer
The Winter Olympics showcase extraordinary physical precision. What they also reveal, increasingly, is something just as powerful: the psychological cost of elite performance.
For decades we celebrated mental toughness in athletes without examining what it actually meant. Today, Olympic athletes are reframing the conversation. Mental health is no longer treated as a private struggle or a secondary issue. It is being recognized as a performance variable and a human imperative.
This year also marks the 20th anniversary of Athletes for Hope — and we have seen this evolution firsthand. Over two decades, we’ve watched athletes move from whispering about their struggles to leading national conversations. What was once stigmatized is now increasingly normalized. Athletes are speaking up not only for themselves, but for their teams, their communities, and the young people who look to them for guidance. The ripple effect extends far beyond sport.
As a sports psychiatrist who works with high performers, I see this shift as overdue.
The Data Behind the Podium
Clinical research consistently shows that elite athletes experience mental health challenges at rates comparable to or higher than the general population.
A 2019 meta-analysis found that approximately 34 percent of current elite athletes report symptoms of anxiety or depression. Rates of sleep disturbance range from 26 to 38 percent. Burnout is common in sports requiring early specialization. Retirement from sport is associated with increased risk of depressive symptoms, particularly when athletic identity is rigid.
Among Olympic-level athletes specifically, studies conducted through the International Olympic Committee report that:
- Around one in three elite athletes experiences significant mental health symptoms during their career.
- Injury increases risk of depression and anxiety.
- Overtraining syndrome is strongly associated with mood disturbance.
- Social media abuse correlates with measurable increases in stress biomarkers.
High performance environments amplify certain psychological risk factors: perfectionism, identity fusion with outcome, chronic evaluation, public scrutiny, financial instability between cycles, and abrupt career endings. When you compress four years of work into a two-minute performance on a global stage, the nervous system feels that compression.
Winter Olympians Speaking Out
At the 2026 Winter Games, American figure skater Alysa Liu reflected on stepping away from the sport to prioritize her mental health before returning to win gold. She emphasized that protecting her inner peace and staying grounded were essential to her performance. Her return was not simply technical. It was psychological.
Ilia Malinin, after a disappointing skate in individual competition, acknowledged that the mental pressure affected his execution. He later used a gala performance to process the emotional weight of the moment. That kind of transparency is clinically significant. Naming performance anxiety reduces its isolating effect.
Alpine skier Mikaela Shiffrin has spoken openly about working with a psychologist to desensitize herself to Olympic pressure. She described intentional exposure to high-stress scenarios in training so that competition would not overwhelm her. That is textbook cognitive behavioral strategy applied at an elite level.
Snowboarder Chloe Kim has discussed burnout and the need to reframe her relationship with the sport so she would not be defined solely by medals. That reflects a protective factor we often cultivate clinically: diversified identity.
These athletes are describing adaptive mental health strategies that come out naturally in an interview, but are a result of many hours of mental training.
Why This Cultural Shift Matters
From a clinical standpoint, stigma is one of the strongest barriers to help-seeking behavior. When elite athletes speak publicly about anxiety, burnout, therapy, or psychological preparation, they normalize intervention.
Research shows that visible advocacy from respected public figures increases help-seeking intent in young populations. In suicide prevention campaigns, celebrity disclosure has been associated with short-term increases in crisis line utilization. When athletes discuss mental health openly, they influence cultural norms around vulnerability and support.
The Olympics are uniquely powerful because they reach a global audience across age groups and cultures. When a gold medalist discusses therapy, it reframes mental health as compatible with excellence.
The Role of Athletes for Hope
For the past 20 years, Athletes for Hope has mobilized athletes to serve communities and champion causes, including mental health advocacy. Through initiatives such as AFH Wellbeing and Athlete Mental Health Week, we emphasize that athletes are not simply performers but people with inner lives, developmental journeys, and influence.
Individual resilience is insufficient if the structure remains silent. Sustainable change requires education, peer modeling, and community integration. We leverages athlete credibility to reduce stigma, increase literacy, and connect sport to service.
When an Olympian speaks about anxiety and then partners with a mental health initiative, the message becomes reinforced. Advocacy becomes embodied through their leadership.
Mental Health as a Performance Variable
There is a misconception that focusing on mental health detracts from the competitive edge but the clinical evidence actually suggests the opposite.Psychological flexibility, emotional regulation, sleep optimization, and cognitive restructuring correlate with improved performance consistency. Teams that incorporate integrated mental health support show lower burnout rates and better long-term athlete retention.
Mental health is not separate from performance but is rather foundational to it.
At the Winter Olympics, we see the visible product of physical preparation. Increasingly, we are also seeing the psychological architecture behind it.
When athletes like Liu, Malinin, Shiffrin, and Kim speak honestly about mental strain and emotional growth, they are redefining strength. They are modeling that courage includes self-awareness and preparation includes psychological care. And we aim to extend that message beyond the arena into communities, youth programs, and future generations.
The medal ceremony lasts minutes. The cultural shift toward mental health in sport may last decades.
References
- Gouttebarge V, Castaldelli-Maia JM, Gorczynski P, et al. Occurrence of mental health symptoms and disorders in current and former elite athletes: a systematic review and meta-analysis. Br J Sports Med. 2019;53(11):700–706.
https://pubmed.ncbi.nlm.nih.gov/31097451/ - Reardon CL, Hainline B, Aron CM, et al. Mental health in elite athletes: International Olympic Committee consensus statement (2019). Br J Sports Med. 2019;53(11):667–699.
https://pubmed.ncbi.nlm.nih.gov/31097450/ - Gouttebarge V, Bindra A, Blauwet C, et al. International Olympic Committee Sport Mental Health Assessment Tool 1 (SMHAT-1) and Sport Mental Health Recognition Tool 1 (SMHRT-1): toward better support of athletes’ mental health. Br J Sports Med. 2021;55(1):30–37.
https://bjsm.bmj.com/content/55/1/30 - Rice SM, Purcell R, De Silva S, et al. The mental health of elite athletes: a narrative systematic review. Sports Med. 2016;46(9):1333–1353.
https://pubmed.ncbi.nlm.nih.gov/26896951/ - Alysa Liu interview discussing mindset and mental health at the 2026 Winter Olympics. Glamour. 2026.
https://www.glamour.com/story/alysa-liu-milan-olympics-beauty-interview - Ilia Malinin reflects on Olympic pressure and emotional journey. People. 2026.
https://people.com/ilia-malinin-olympic-skating-gala-makes-return-to-ice-2026-winter-olympics-11911426 - Mikaela Shiffrin on working with a psychologist to manage Olympic pressure. Business Insider. 2026.
https://www.businessinsider.com/mikaela-shiffrin-alpine-skier-olympics-psychologist-desensitize-pressure-mental-health-2026-2