Merkblatt: Sportpsychiatrische und -psychotherapeutische Aspekte im Leistungssport in Zeiten der COVID-19-Pandemie

Mental and social stress, like physical load, are part of competitive sports. Until a few years ago, it was assumed that there can be no serious mental problems or illnesses in competitive Sport, and that mental strength concurrently equals mental Health (3). We know now thanks to a growing number of publications that mental stress and illnesses are frequent health problems in competitive ports, which manifest sport-specifically and can reduce performance (5). In their courageous interviews, successful top athletes have also taught us hat their mental strength and competitive personality do not guarantee long-lasting mental Health

In the Editorial “Psyche and Sport in Times of COVID-19”, we already addressed the current stress and risks for mental health in the general population (1), which of course also affect competitive athletes. The COVID-19 pandemic is a further source of stress and risk for the mental health of top athletes (2, 6), and is the specific focus of this fact sheet.

- Changes – in some cases practically overnight - of daily structures and habits which have been established for years or even decades

- Isolation, loneliness and training far away from the familiar environment and training or team colleagues 

- Interruption of the competition season and cancellation or postponing of events are coupled with missing goals, “planned” successes and lead to uncertainty, monetary incalculability and loss of motivation 

- Unanswered questions about the meaning of daily activity, which normally is focused on and motivated by clear goals 

- Questions of extending contracts, loss of sponsors and advertising income and the attendant existential and financial anxiety 

- Long-term decrease in performance capacity due to limited training possibilities, with the resultant consequences.

- Subclinical mental problems and illnesses (like lack of self-confidence, anxiety disorders or depression), often well-compensated by intensive training, athletic success and recognition, may become manifest in the current situation 

- Worries about continuing the athletic career and financial anxiety, lack of daily structure, few social contacts and loneliness, with the attendant stress, may be associated with depressive moods and sleep disturbance 

- The danger of substance abuse and development of addiction, including behavioral addiction, such as obsessive video games (gaming) must also be taken into consideration 

- In esthetic and weight-dependent types of Sports, there may be marked changes in eating habits and exacerbation or new onset of eating disorders. 

- All of the complaints listed above, which are more serious than worries about mental strength, require qualified help.

- Maintain daily routines and conscious structuring of the day, with (lower) goals which can realistically be attained and rewarded on completion. Generate new challenges and tasks which can be performed at home. 

- Try new forms of training which can be implemented under the current limitations: alternative training forms bring new experience which may lead to new knowledge for the post-pandemic period. 

- Limit information from unreliable media, for example articles in the paper or internet which are sensational and usually of scientifically dubious content. Stay in regular contact with your peers, for example by telephone or video meetings with teammates, both outside and during training sessions at home.

- Make sure you get enough sleep, regular recovery and relaxation times. Practice appropriate methods such as autogenic training or progressive muscle Relaxation. 

- Speak openly about your own state in critical situations and don’t think it’s a sign of weakness. Pay attention to changes in your mental state.

 - Ask your trainer for help in setting goals that can be adapted to the current situation and continue training. Following this goal can be a stabilizing factor for your mental Health.

- Use the possibility of experiencing and developing not only your competitive personality but, with practice, also the social competence or creative capabilities of the entire personality - again, it’s the task of trainers and coaches to set appropriate stimuli.

In times of crisis, competitive athletes require more sports-medical care. In addition to physical complaints, mental complaints should be actively addressed and recognized in regular contact. Regular and intensified sport-medical care can thus help many athletes to maintain mental health. In addition, an intensive interdisciplinary exchange among all professionals engaged in competitive sports [selected list:] Sportsphysicians, physiotherapists, sports psychologists, mental Trainers and sports psychiatrists and chotherapists.

- Mental and social stress are a fixed component of competitive sports, just like physical stress 

- Mental strength and mental health are not the same thing and must be distinguished from one another 

- Mental illnesses are frequent health problems in competitive sports, may manifest sports-specifically and reduce performance capacity. 

- Mental and physical health cannot be viewed independent of one another, and mental well-being and (athletic) performance capacity are reciprocal. 

- Mental stress and illness in sports may influence Performance, increase the risk of physical injury and prolong Rehabilitation (5). 

- Injuries in turn influence the performance and are stress and risks for mental Health. 

- Bio-psycho-social model and understanding of mental disease: Maintenance of mental health (in competitive Sports) demands qualified handling of all three aspects, the physical, mental and social, in equal measure. 

- Prevention, that is the maintenance of health, like diagnostics and therapy, is a genuine medical task which must run through all areas of medical activity. 

Sports-psychiatric and psychotherapeutic concepts to maintain mental health in competitive sports in clubs and leagues play a central role especially in the current time of crisis, but even beyond (4). We recommend that these concepts include the following: 

- Regular and annual sports-psychiatric and psychotherapeutic consultations and examinations 

- Coordination sites for sports-psychiatry and psychotherapy in every larger club and sports federation 

- Informational and instructional talks with parents of under- age athletes 

- Interdisciplinary cooperation with neighboring disciplines and cooperative further training 

- Intervision groups 

- Networking of sports-psychiatric and psychotherapeutic caregivers 

- Contact data of qualified consultants via the websites of national societies of sports psychiatry and psychotherapy; in Germany additionally via the Department of Sports Psychiatry and Psychotherapy of the German Society of Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN).