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All twisted up

Even champions may need to take a mental health break.

Article Author: Johnny Woodhouse

Article Date:

Teen athletes may feel stressed out under pressure.

Simone Biles, the most decorated American gymnast of all time, removed herself from the 2021 Olympic Games team competition last month after only one event.

She posted on social media that she felt “the weight of the world on her shoulders.”

The four-time Olympic gold medalist said she has been struggling with what gymnasts call the "twisties," a mental block that causes them to lose spatial awareness while performing. This disorienting sensation can lead to serious injury.

Biles cited the enormous pressure she was under to perform at the highest level of her sport and the fear that she might hurt herself if her mind and body weren’t in sync.

“You have to be there 100 percent or 120 percent because if you’re not the slightest bit, you can get hurt,” she said. “We have to protect our mind and our body.”

Biles has won more than 30 Olympic and World Championship medals and has four gymnastic skills named after her on the floor, beam and vault, but she’s still only human.

Francesca Varallo Sims, PsyD, director of education and training for Baptist Behavioral Health, said today’s young athletes and scholars are under immense pressure to perform well in various domains of their lives.

“They may feel compelled to be perfect to accomplish goals and have a significant fear of failure, whether that be in class or on the field,” Dr. Varallo Sims said. “If left unchecked, these feelings can lead to emotional and physical exhaustion, also known as burnout.”

Warning signs of burnout

  • Agitation, irritability, frustration or acting out
  • Loss of interest in participating in extracurricular activities
  • Persistent statements of self-critique or negative evaluations of performance
  • Social isolation, appearing withdrawn, or a drastic change in personality
  • Problems concentrating and overall decreased attention
  • Significant decline in grades
  • Trouble sleeping through the night and feeling fatigued
  • Feeling restless and unable to relax
  • Under-eating or over-eating
  • Physical complaints (i.e., headaches, nausea, dizziness or generalized pain)

Dr. Varallo Sims said parents, teachers and coaches often play a vital role in moderating potential psychological harm from competitive stress and excessive training loads.

Tips to help reduce the impact of stressors

  • Encourage open communication related to their emotions and coping with stressors. Parents and other adults can find free tools and resources to start these conversations at On Our Sleeves, a national mental health program brought to the community by Wolfson Children’s Behavioral Health.
  • Listen, support and validate their feelings or concerns.
  • Promote healthy habits at home (i.e., set a bedtime to get enough sleep, eat a well-balanced diet, and keep hydrated).
  • Express how they are a multidimensional person that is more complex than awards, grades, wins or medals.
  • Highlight and praise other strength-based aspects of their identity that are not tied to competition, achievement or performance (i.e., kindness, honesty, helpfulness, funny, bravery, optimism, creativity).
  • Normalize taking breaks for mental health when needed. Reinforce that it’s OK to step back from activities to honor their emotions and heal.

After her fellow gymnasts brought home the silver medal in the team competition, Biles reflected on her decision to sideline herself.

“Once I came out [to compete], I was like, ‘No, mental is not there, so I just need to let the girls do it and focus on myself,’” she said.


Your mental and emotional health is important to your well-being. Baptist Behavioral Health offers a full range of inpatient and outpatient programs to fit your needs. To make an appointment with a mental health provider, call 904.376.3800.

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