Simone Biles might be the most high-profile athlete to draw attention to the link between mental health and athletic performance. Biles withdrew from several events in the 2021 Olympics to focus on her mental health.
She described the experience as feeling like she “just got a little bit lost in the air.” Media reports at the time referred to her condition as the “twisties.” That’s not a medical term or diagnosis, but it refers to an experience where gymnasts lose the sense of where their bodies are in the air and could injure themselves when they land.
Biles spent two years working on her mental health and returned as a leader in her sport in 2023, dominating and winning four gold medals in the World Gymnastics Championships, marking her historic 34th medal and sixth world all-around title. Her courage and openness about her mental health issues have raised awareness of these challenges in athletes.
Biles isn’t alone in her struggles. There are often times when athletes have sudden, unexplained performance anxiety or an inability to perform at their typical level.
Another common form of performance anxiety you may be familiar with is known as the “yips.” For example, if you’re a Ted Lasso fan, you may remember that Dani Rojas struggles to return to soccer after a penalty kick took an unexpected turn (no spoilers here).
Athletes in a wide range of sports have reported experiencing the yips. Other examples include a golfer having trouble putting or a baseball pitcher throwing wild pitches.
These problems can be frustrating. They can happen to anyone – even athletes who have performed at the top of their game for years.
“People who are prone to being anxious, overthinkers or perfectionists may find themselves suffering from performance anxiety more than others. There is limited research on who is most at risk, but those who are older and have been doing the activity for a long time may be more prone to unexplained performance anxiety,” said Sierra Dimberg, PhD, a sports psychologist with Banner Sports Medicine Scottsdale.
What causes sudden performance drops in athletes?
These problems could stem from a combination of physical and mental issues.
“Most performance anxiety can be explained. There is a lot of debate and unknowns regarding what people call the yips or twisties. But there appears to be either a psychological component, a neurological component or both,” Dr. Dimberg said. “The neurological component, commonly called focal dystonia, includes involuntary motor behavior. The psychological component is anxiety.”
“With performance anxiety, there is both cognitive and emotional impact, because they are intertwined. Thoughts influence emotions and emotions influence thoughts,” Dr. Dimberg said. “Overthinking or perfectionism could lead to feeling anxious, or the feeling of anxiety could lead to overthinking or perfectionistic thoughts. If the cycle persists, it can affect performance.”
Understanding the emotional impact
If your teen athlete is struggling with an unexplained drop in performance, they could have a range of feelings:
- Frustration: They may feel like they’re not good enough or that they’re letting themselves or their teammates down.
- Discouragement: It can be hard for them to stay motivated and positive when they are struggling to perform skills that they have been able to do easily for years.
- Embarrassment: They may be afraid of what their teammates, coaches or fans think of them.
- Guilt: They may feel guilty about letting their teammates and coaches down and about missing out on opportunities to compete and perform at their best.
Strategies to help your teen athlete cope
Reassure your teen that it’s normal to feel frustrated and discouraged. But athletes can – and do – overcome performance anxiety. Building mental resilience and focus can help.
“If I had to give one recommendation for reducing performance anxiety, it would be to learn and practice mindfulness,” Dr. Dimberg said. “Teen athletes can learn to better manage or control their thoughts and, in turn, regulate their emotions so they can better handle anxiety-provoking situations.”
Encourage your teen to practice mindfulness by paying attention to the present moment without judgment. Mindfulness exercises can include focusing on the breath, body scanning or walking meditation. You can find many apps that can guide you as you get started.
Here are some strategies your teen can try:
- Relaxation methods: Deep breathing, meditation or progressive muscle relaxation may help lower stress and anxiety.
- Visualization: Mentally practicing a skill or performance may help athletes build confidence. Have them close their eyes and imagine performing their task perfectly, paying attention to their body, breathing and mental state.
- Positive self-talk: Challenging unproductive thoughts with more productive ones may help athletes stay motivated and focused. For example, when athletes catch themselves thinking “I’m going to choke,” they can recognize it and change the thought to “I’m prepared and I’m going to perform my best.”
- Gratitude: Ask your athlete to share something they are thankful for within their sport. That could be a teammate, moving their body, a coach or practicing in the sunshine.
- Professional help: A sports psychologist can help identify the causes of performance anxiety and develop strategies for overcoming it.
Practical tips for overcoming performance anxiety
Lots of athletes have used these strategies to overcome sudden drops in performance. You can share them with your teen:
- Identify the triggers that typically cause problems: When they know what their triggers are, they can start to develop strategies for coping with them.
- Practice under pressure: Creating conditions similar to competitions or practicing in front of a crowd can help.
- Encourage them to not be afraid of making mistakes: Help them move on to the next task if they make a mistake.
- Remind them that they are not alone: Many athletes have successfully overcome these challenges. With patience, persistence and support, they can too.
It’s also important for your teen to try to have a positive attitude. You can encourage them to:
- Focus on their progress instead of on their mistakes. Celebrate their successes.
- Set realistic goals. Overcoming performance anxiety like the yips and twisties can take time. They need to be patient and persistent. There’s no quick fix.
- Ask for help. A coach, sports psychologist or trusted adult can offer support, encouragement and guidance.
Building coping skills can help your teen athlete keep performance anxiety from coming back. “Anxiety is normal and might still occur, but they will be better equipped to handle it with these tools,” Dr. Dimberg said.
“We are seeing more professional athletes discuss their mental health or difficulties with performance anxiety, so hopefully that reduces stigma and others will seek help if they need it,” she added.
The bottom line
Athletes of all ages, including teens, could develop performance anxiety like the yips and twisties. Mindfulness and coping skills can help them return to the court or the field.
“Some performance anxiety is normal,” Dr. Dimberg said. “But if it becomes debilitating or negatively affects a teen athlete’s performance, they should seek help.”
If your teen is struggling with performance anxiety in sports, talk to their pediatrician for advice or reach out to a Banner behavioral health provider.