What coaches should know: Identify signs & symptoms of mental health issues

When we think of an athlete’s health, we probably are thinking primarily of the person’s physical condition. An athlete’s “mental health” might be viewed as secondary to physical health; however, it is as important. The daily pressure associated with athletes’ lifestyle can create intense emotional responses. The time and effort athletes put into improving their skills can result in imbalances in other areas of life.

Administrators, doctors, coaches, athletic trainers, sport psychologists and strength and conditioning coaches play a critical role in creating an environment that supports the mental health and well-being of athletes. Every day they spent a considerable amount of time with athletes and they should be aware of the signs and symptoms of some of the most common mental health issues.

Today we will cover some of the most common mental health issues athletes can face, we will identify the signs and symptoms that the coaching staff should be aware of and what they can do to help the athletes.


Signs & symptoms

• Low or sad moods, often with crying episodes.
• Irritability or anger.
• Feeling worthless, helpless and hopeless.
• Eating and sleeping disturbance (reflected in an increase or decrease).
• A decrease in energy and activity levels with feelings of fatigue or tiredness.
• Decreases in concentration, interest and motivation.
• Social withdrawal or avoidance.
• Negative thinking.
• Thoughts of death or suicide.


Signs and symptoms:

• Feelings of apprehension or dread.
• Feeling tense or jumpy.
• Restlessness or irritability.
• Anticipating the worst and being watchful for signs of danger.

• Pounding or racing heart and shortness of breath.
• Sweating, tremors and twitches.
• Headaches, fatigue and insomnia.
• Upset stomach, frequent urination and diarrhea.

Substance abuse

Signs and symptoms:

Behavioral Signs
• Drop in attendance and performance.
• Frequently getting into trouble (fights, accidents, illegal activities)
• Engaging in secretive or suspicious behaviors.
• Changes in appetite or sleep patterns.
• Unexplained change in personality or attitude.
• Sudden mood swings, irritability, or angry outbursts.
• Periods of unusual hyperactivity, agitation, or giddiness.
• Lacking of motivation.
• Appearing fearful, anxious, or paranoid, with no reason.

• Bloodshot eyes and abnormally sized pupils.
• Sudden weight loss or weight gain.
• Deterioration of physical appearance.
• Unusual smells on breath, body, or clothing.
• Tremors, slurred speech, or impaired coordination.

• Sudden change in friends, favorite hangouts, and hobbies.
• Legal problems related to substance use.
• Unexplained need for money or financial problems.

Eating Disorders

Signs and symptoms

• Obsession with food and exercise.
• Denying self of food to the point of starvation.
• Binge eating and purging behaviors.
• Compulsive exercise beyond what is good for sport performance and health.
• Social withdrawal.
• Fear of eating in public.

What the coaching/medical staff can do:

All members of the staff needs to be aware of all the possible symptoms and signs and be able to recognize them as early as possible. If you think an athlete is showing any of the above-mentioned signs consider taking these additional steps:

  1. Talk to the athlete. Sharing your concerns with your athlete is the respectful, ethical and appropriate thing to do. Have an honest discussion with him/her indicating that you have some concerns and you would like him/her to seek further assistance. Remember as athletic staff you don’t have the skills, knowledge or training to diagnose, treat or cure some or any of the issues he or she is presenting. DO NOT provide any solutions, offer treatments or give any suggestions. It is unethical and unlawful.
  2. Refer the athlete to a mental health professional. Athletic staff should have developed a network of mental professionals that they can refer athletes to, in case they suspect an athlete experiences some mental issue. Do not hesitate to reach out, ask for help and raise your concerns to a mental health provider.
  3. Keep in touch with the mental health professional and educate yourself. In order to provide adequate future service, you will need to know more about the condition and progress of the athlete. Get feedback on how to communicate and support and what you need to do moving forward. What you do and what you say matters.
  4. Be available physically and emotionally, don’t abandon the athlete. As an athletic staff you probably spent more time with the athlete and know him/her better than the mental health provider. You will need to maintain this close relationship and be there for support. Show that you care, this is a very fragile time and they need any help and comfort they can get.
  5. Be mindful and keep an eye on the athlete moving forward. It takes time and effort to get over mental health issues. The athletic staff should be aware of triggers and stressors that can impact an athlete’s mental state and be in constant communication with the athlete and mental health professional in case symptoms get worst.

Source: NCAA – Sport Science Institute

About the Author

Dr. Alex Barkouras is the founder of Sport Nous, a mental training consulting firm in Los Angeles California.
Over the last 18 years, Alex has worked with different age groups and athletes of all levels. He specializes in basketball but has worked with athletes, teams and coaches in many different sports.
His areas of expertise are mental preparation, performance enhancement and team building. He also conducts coach education and parent education workshops.
Alex is also a Physical Education Teacher and a Strength & Conditioning Coach at Oakwood Secondary School in North Hollywood, California. He received his Ed.D in Physical Education with emphasis in Sport Psychology from the University of Houston.

Feel free to contact Alex with any questions or inquires at

Get notified about our new articles

We will only contact you when we have something to say!

Share this article

More articles

Share your thoughts