If we had to take a shot for every time I’ve mentioned “anxiety” on this blog we would all be fucked up, blacked out, in some sort of alcohol induced comatose state probably after two posts. I promise, it’s not just me harping on anxiety. It’s actually one of the most discussed and studied factor in sports psychology. Anxiety is unique in that it is such an all-consuming topic; it impacts thoughts, feelings, and behaviors. As a result, anxiety disorders are some of the most prevalent mental health issues in athletes and the general population. In athletes, at the clinical and subclinical levels, anxiety can negatively impact performance.

You know Alice from Twilight? Yes, the little brown haired vampire able to see into the future who was dating the “ex”-confederate soldier. Well, I bring her up because anxiety is kind of like our version of her gift. It’s our brain’s best attempt at seeing into the future. A 2002 study, defined anxiety as, “a future, oriented mood state associated with preparation for possible upcoming negative events.” The “feeling” of anxiety is more than just words or thoughts, it’s truly a state. There are three components of anxiety: cognitive, somatic, and behavioral. The cognitive component involves how we think. So, negative thoughts, worry, and overestimating threats all have to do with the cognitive aspect. The somatic aspect concerns our physical “fight or flight” response. This would include increased heart rate, muscle tension, blood pressure etc. Finally, the behavioral aspect concerns what we do as a result of our anxiety. For example, if you get really bad anxiety from public speaking you would avoid situations in which you need to do that. Avoiding would be the behavior. Anxiety exists as a way for our body to prepare for danger. It’s primal, instinctual, and necessary.

The world can be a dangerous place. It is kind of cool that our body has a built in detection system to prevent us from encountering this danger. However, anxiety disorders rank as some of the most prevalent mental health issues in both the general population and athletes. A 2019 meta analysis reported, about 10-12% of the population and about 9% of athletes deal with anxiety disorders. Clearly, there’s some point in which this Twilight- adjacent super power of anxiety becomes more like a curse. According to the American Psychiatric Association, anxiety disorders are “a group of mental health conditions characterized by excessive fear or anxiety and related behavioral disturbances.” It seems when anxiety and fear persist at levels that are out of proportion with situations we start to see a potential risk of an anxiety disorder.

Here’s a list of some of the anxiety disorders recognized by the DSM-5:

There has been research into those factors associated with subclinical and clinical symptoms of anxiety. In both the general population and athletics, there are certain trends we notice with anxiety. Firstly, in both populations we notice that the onset of anxiety is usually in adolescence and younger athletes are more likely to suffer from anxiety symptoms. We see that the more experienced, older athletes are less likely to have issues with anxiety. Secondly, in both the general and athletic populations, females are more likely than males to develop an anxiety disorder. Also, in both groups, recent adverse life events were associated with higher levels of anxiety. For athletes, retirement could be considered a serious life change and could lead to increased likelihood for anxiety, especially in those unprepared for the shift away from sport. A few studies also pointed to some athlete-specific risk factors to anxiety including injury and career dissatisfaction. Injured athletes, suffering from either musculoskeletal or concussion injuries, were significantly more likely to suffer from anxiety, a systematic review and meta analysis revealed. Also, those athletes who were unhappy with their careers showed an increased likelihood for anxiety symptoms.

Some studies have shown deeper trends within athletics. For example, there have been reported differences between individual and team sports where athletes in individual sports tend to be at a greater risk for the development of an anxiety disorder. A 2023 meta analysis proposed that these athletes may be more likely to be perfectionists, internalize failure, and experience less social support potentially predisposing them to anxiety. Further, those in aesthetic sports tend to be at a greater risk for anxiety disorders. It was suggested that those athletes that participate in gymnastics, figure skating, etc. may feel a greater pressure to look a certain way and to please judges.

Precompetitive anxiety is probably the most common mental issue that athletes face. Precompetitive anxiety is negative feelings usually of nervousness, worry, and tension prior to a performance. It is often accompanied by those symptoms of somatic anxiety. Whether this exists as part of a bigger anxiety disorder or something that’s just limited to sport, the effects of anxiety are quite literally the undoing of everything we train in sport. Anxiety has the ability to trigger our nervous system into fight or flight. This leads to increased heart rate, increased muscle tension, decreased attentional focus, and impaired decision making. Studies have shown that higher levels of anxiety are associated with negative performance and increased risk of injury.

There is literally no way to avoid anxiety in sport, it’s inevitable. But, we’re not all running around having panic attacks, shaking, or nervously sweating before every game. So, there has to be some threshold in which anxiety’s impact isn’t detrimental to performance. Research has shown that the threshold for anxiety is actually individual. That is, each person could operate best under different anxious conditions. A lot of that has to do with an individual’s perception. For example, those who perceive those symptoms of anxiety as readiness rather than nervousness or fear are less likely to have their performance negatively impacted. It seems that we don’t need to try to avoid anxiety in sport. In fact, that would be impossible. Maybe the solution to counteracting the negative effects of anxiety is to acknowledge our own personal threshold, work on strategies that keep our anxiety within this manageable level, and change our perception of anxiety’s symptoms.

Due to the prevalence of anxiety disorders and the relationship between anxiety and performance, there has been much research into those strategies that may help to lessen the symptoms of anxiety or help individuals reframe thoughts to change the perception of symptoms. The three mental skills that I have had the best experience with in terms of managing my anxiety are imagery, meditation, and mindfulness. I’ve written a whole other post about imagery, so I won’t go too into the nitty gritty of everything. Basically, imagery is a deliberate, planned mental mapping of an event. For me, I like to use imagery during my walk on the field before the match. I go to my place on the field and I imagine opening off goal kicks, breaking the press with entry balls, or even making crucial tackles. Meditation is a mental skill that involves relaxing and focusing the mind to achieve clarity. I often find myself taking time to meditate the night before the match just to calm any nerves I might have about the next day. I find that breathing exercises, and guided meditations help me to achieve a level of clarity and calm. I think mindfulness goes hand in hand with meditation. It is a state of being focused in the present moment while practicing “nonjudgement.” For myself, I find that meditation is kind of a form of mindfulness. For me, meditation involves taking like 20 minutes to sit quietly and relax myself whereas mindfulness is more like a state of being. I try to practice it all the time, but especially during the match. I try to “be where my feet are” when I play. Not so caught up in what’s around me, but only on what I am doing in the moment. Once the moment has passed I move on, focusing on the next right action. I put a big focus on nonjudgement, so any mistakes I make I try to let pass without worrying too much as well. Often, I use all three of these strategies together. They combat anxiety symptoms by attempting to ease worrisome thoughts, change our appraisal of these thoughts, and calm physical side effects.

Anxiety is natural and necessary. Even in sport, some level of anxiety is helpful. It indicates a readiness to perform. However, many individuals, athletes and the general population, struggle with anxiety that exceeds necessary levels. When these elevated levels persist in inappropriate situations there is a risk of anxiety disorders. Further, symptoms of anxiety, at subclinical or clinical levels, can have negative effects on athletic performance. Practices such as imagery, meditation, and mindfulness can be effective tools for athletes looking to reduce negative side effects of anxiety.