As we witness increasingly more athletes discuss mental health, panic attacks are one of the more common concerns they identify — especially how panic attacks impact athletic performance. Regardless of how naturally talented an athlete is, if the athlete struggles with anxiety and panic attacks, then athletic performance will almost certainly suffer. While no athlete wants to experience a panic attack, many athletes do, and when I talk to athletes about this topic I am often told that they do not know why panic attacks happen — or how to stop them when they occur.
What are panic attacks?
Panic attacks are a form of anxiety described by mental health experts as sudden, often unexpected feelings of fear where the body experiences shortness of breath, a racing heart feeling, dizziness, chest pains, and/or increased sweating. Some athletes have reported to me that they never know when they will experience a panic attack, while others (over time) begin to notice patterns that leave them susceptible to panic attacks (i.e. moments before the start of a game when feeling pressure to perform). Panic attacks can last a few seconds to as long as 10 minutes, and can be triggered a number of different ways including drug/alcohol induced, biologically (i.e. “hard-wiring” predispositions), or what I most commonly see — cognitive distortions that prompt a “fight or flight” bodily response.
Drilling deeper with cognitive distortions for a moment, it’s important to note that how we uniquely see and perceive the world around us constantly dictates to our minds and bodies how to prepare and respond to stimuli. For example, when athletes welcome competition and learn to play comfortably and freely, their bodies generally respond with better synchrony and less risk of a panic attack occurring. Conversely, athletes who experience a lot of fear, uncertainty, and pessimism can, in theory, trigger the “flight” mechanism internally, sometimes resulting in anxiety that goes beyond basic pre-game jitters into a full-blown panic attack.
The mystery of panic attacks
Just why one athlete experiences panic attacks while another doesn’t isn’t fully understood, and why some athletes merely experience bothersome (but controllable) nerves, while another seems almost frozen by his or her own body locking up is equally confusing. On the surface some may suspect that only less-capable athletes are at-risk for panic attacks, but many elite-level athletes have reported struggles with panic attacks (and other mental health issues). Furthermore, if athletic talent (or more specifically, lack thereof) caused panic attacks, the majority of athletes would experience panic attacks as there are far more athletes with average or below-average abilities than superior athletes.
So if it’s not talent level, what is a more realistic and plausible reason for panic attack vulnerability? The answer, in all likelihood, has to do with how each one of us subjectively experiences the world around us, and how our emotional, irrational thinking can quickly replace logical thinking, resulting in the mind and body reacting in a panicked state. Using this theory, it doesn’t matter how talented a person is at something (objectively speaking), but instead has everything to do with how the individual self-evaluates and thinks about the tasks he or she faces in the future. For example, if a super-talented athlete still thinks that he or she may not be up to the task on any given night, the odds for anxiety to spike increases, as does the risk for a panic attack occurring.
How to treat panic attacks
As a cognitive-behavioral therapist myself, I strongly encourage athletes to first seek counseling with a professional who practices using a cognitive-behavioral approach. Unlike other therapeutic modalities, cognitive-behavioral counselors are trained to help athletes understand their thinking (particularly when it becomes irrational), as well as teach invaluable behavioral skills (like deep breathing, self talk, and progressive muscle relaxation) to protect against panic attacks. As the athlete learns more about his or her thinking and how the body directly responds to thinking, future changes can be made designed to help improve focus and confidence, while minimizing nerves and anxiety. I do not generally recommend pharmaceutical medications, and have found that the vast majority of athletes experience significant improvement when working with a trained cognitive-behavioral counselor and following through on homework assignments (a common cornerstone to cognitive-behavioral counseling).
Final thoughts
Panic attacks are more common in sports than you might think, and they can quickly develop with little to no warning. The good news, however, is that panic attacks (and generalized anxiety) is quite treatable and athletes committed to improvement typically see results quite quickly. Remember, you are not a weak athlete if you experience panic attacks, but you may be forever challenged to reach your full athletic potential if you don’t take the steps necessary to improve upon how you deal with anxiety.
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