How important is it to prioritise mental health in sports? How can athletes be mentally healthy while performing at their best?

Sports and exercise medicine physician, clinician and academic researcher, Dr Lervasen Pillay, joins Ayanda Charlie once again to unpack this layered topic. This polarising issue existed long before Simone Biles stepped back from competing in the Tokyo Olympics but her decision highlighted why this conversation is vitally important.

[00:00:00] Ayanda Charlie: Welcome to The Sports Series, powered by Mediclinic. I’m your host Ayanda Charlie. As a multimedia content producer with a love for journalism, I am here to ask all the questions you might have, chatting to the specialists to get real answers. Keep looking out for our future episodes as we have a great line-up of doctors and other experts to support you with all the information you need for your fitness journey, no matter what level of sports you play!

[00:00:27] Ayanda Charlie: Please note that the views shared by any of our guests in this podcast, may not necessarily reflect the views of Mediclinic, so please consult a medical professional if you have concerns.

[00:00:39] Video Clip: Gymnast, Simone Biles, the greatest of all time is withdrawing from another Olympic event to focus on her mental health. The women's individual all around competition is scheduled to take place tomorrow morning, but the team now says it will happen with her.

[00:00:50] Ayanda Charlie: Today we'll be speaking about the importance of prioritizing mental health in sport. Simone Biles, one of the most [00:01:00] decorated gymnasts in history, made headlines during the 2020 Tokyo Olympics when she withdrew from several events to prioritize her mental health.

[00:01:08] Ayanda Charlie: Biles’ decision brought the issue of mental health in sports to the forefront and sparked a much needed conversation about the importance of prioritizing mental health over athletic success. By speaking openly about her struggles. Biles set a powerful example for athletes around the world.

[00:01:26] Video Clip: Yeah, I say, um, put mental health first because if you don't, then you're not gonna enjoy your sport and you're not gonna succeed as much as you want to. So it's okay sometimes to even sit out the big competitions to focus on yourself because it shows how strong of a competitor and person that you really are.

[00:01:42] Ayanda Charlie: Her decision to withdraw also highlighted the need for better mental health support and resources for athletes. As we look at this important topic today, we welcome back Dr Lervasen Pillay to share his insights.

[00:01:54] Ayanda Charlie: Welcome Dr. Pillay. Dr Lervasen Pillay: It's great to be back. Ayanda Charlie: Now, before we [00:02:00] begin, uh, would you like to introduce yourself for those who may not have listened to the other episodes, and share briefly about the work that you do.

[00:02:07] Dr Lervasen Pillay: My name is, uh, Dr Lervasen Pillay. I'm a sports and exercise medicine, uh, physician, and I'm a clinician as well as an academic and a researcher.

[00:02:16] Ayanda Charlie: Speaking of academic and researcher, you're currently working on a paper on the subject of mental health in professional male football in Europe. In your opinion, how important is mental health for athletes and how does it impact their performance on the field or court or wherever they do their thing?

[00:02:34] Dr Lervasen Pillay: Mental health has always been an underestimated aspect of, uh, sports performance and in recent years it has come to the forefront of discussion with regards to performance, but, uh, saying that, we've noticed the trend over, over the years of aspects of mental health, uh, and I think it's important to differentiate between, uh, some aspects of mental health.

[00:02:56] Dr Lervasen Pillay: There's, there's some things called mental health disorders. Which is an [00:03:00] actual diagnosis where we use the diagnostic and statistical manual criteria to make a diagnosis of a disorder like anxiety or depression or eating disorders, and it affects them within their functional space. And then there's mental health symptoms, which are often the precursors of a disorder.

[00:03:19] Dr Lervasen Pillay: And where we often miss the boat is actually identifying these symptoms and these precursors before they actually turn into actual disorders that need more intense medical treatment.

[00:03:28] Ayanda Charlie: That's interesting. So I've never heard anybody kind of explain it as something that can be mitigated, right? I, I've always thought that a mental health kind of condition or disorder is something that you simply have from the get-go or you don't.

[00:03:43] Dr Lervasen Pillay: So lots of research has shown that some people may be more prone to developing mental health disorders. However, it's also related to all these stresses that you're exposed to in life. So from an athletic perspective, whether it's a junior [00:04:00] athlete or a senior athlete, we are looking at things like injuries, illnesses.

[00:04:05] Dr Lervasen Pillay: We are looking at, uh, peer pressure within playing in a team environment, pressure from coaches, pressure from parents. Then you also looking nowadays as well, things like racism and discrimination within the sporting environment. So all these things are all stress factors that contribute to someone's mental health.

[00:04:24] Dr Lervasen Pillay: It's a very holistic thinking that someone has to have when considering someone has a mental health related issue.

[00:04:30] Ayanda Charlie: And have you found that in the sports professions it's often overlooked? Um, and if so, why?

[00:04:36] Dr Lervasen Pillay: I don't think it's overlooked, but I think it's downplayed. That's what we've noticed. Ah, when someone has a performance dip, it's always blamed on some physical related issue.

[00:04:48] Dr Lervasen Pillay: And I think not only as healthcare providers, but also as parents, as coaches, sometimes we don't spend the time to actually ask athletes, “What is the problem?” [00:05:00] And an often simple, frank question like that brings on a whole two hour conversation of issues that they may be having with their spouses, their kids, their parents, uh, looking after extended families, et cetera.

[00:05:14] Ayanda Charlie: And in recent years, doctor, have, have you noticed changes in, in, in how mental health is being addressed and prioritized in the world of sports?

[00:05:20] Dr Lervasen Pillay: Most definitely. And I think a lot of teams are moving in the direction of having on board psychologists, especially within the sports environment, uh, if not traveling with them, at least these athletes will have access with them, uh, to these professionals.

[00:05:38] Dr Lervasen Pillay: Uh, uh, we, we saw a lot of this starting to show specifically during Covid Lockdowns and when sports resumed. In fact, there's lots of research and I was also part of one of the papers where we published showing that the Covid 19 lockdowns actually significantly affected people's mental health, uh, especially athletic populations, uh, from the [00:06:00] female perspective.

[00:06:01] Dr Lervasen Pillay: So I think nowadays we've become a bit more sensitized towards mental health issues and we don't simply just say, oh, well just, uh, relax and take it easy and you'll be fine tomorrow. We start look delving a little bit deeper into try and actually solve the primary problem instead of just treating with the symptoms.

[00:06:21] Ayanda Charlie: Now, what steps can you know people like coaches and, and sports organizations take to better support the mental health of their athletes and maybe overall reduce the stigma around mental health issues in sports?

[00:06:35] Dr Lervasen Pillay: So first of all, that's the first thing that coaches and and federations, et cetera, can do is try and avoid people's to think that having a mental health related issue is a stigma.

[00:06:45] Dr Lervasen Pillay: It'll happen to almost everyone at some point in their lives. Anxiety, depression, distress, et cetera. And sometimes when athletes start having these symptoms, they start moving towards other mental health [00:07:00] disorders to try and disguise the primary problem. So for instance, someone that is anxious or depressed will start drinking a lot.

[00:07:07] Dr Lervasen Pillay: They'll start not practicing mindfulness, not thinking about what would be the consequences of certain actions of this. And these are the kind of symptoms where coaches and medical professionals, as well as, uh, fellow athletes should actually start educating themselves about, uh, to notice these subtle signs and symptoms and start calling them out and chatting with the individual themselves.

[00:07:32] Dr Lervasen Pillay: I think a lot of times, especially many years ago, it was a stigma, but I think mental health issues have become so much in the forefront, not only with uh, teams looking after athletes, but also from a perspective of performance showing that how mental health can actually affect performance. And if you look at the sporting industry, even though it's an entertainment industry, There is some financial gain for various stakeholders, so it's important [00:08:00] to make sure that your, your athletes are always performing at their best.

[00:08:03] Dr Lervasen Pillay: And, and, and one of those little angles that need to be looked after is mental health. Access to healthcare professionals, whether it's counselors, whether it's psychologists, et cetera, is important, and also continuity of medical care within the team setting. Most people, if you sit in and you have multiple medical professionals looking after an individual, they don't feel comfortable trying to speak about their issues.

[00:08:32] Dr Lervasen Pillay: They start sweeping them under the carpet, so to speak, and uh, no one actually recognizes because there's no continuity of care. So I think once you have one healthcare professional, constantly noticing, listen, this guy is looking like there's a problem here. Pull them aside, have a chat with them. And like I said, we need to learn to be frank and ask the straight out question, what is wrong?

[00:08:55] Ayanda Charlie: And I think it's so interesting that you mentioned, you know, how you approach the [00:09:00] subject, because I've interviewed some athletes recently who said, you know, it's a sensitive, you know, subject, you know, to bring it up as the athlete or even for, you know, a coach to bring it up with you. It's not an easy subject to broach. What have you found in your research?

[00:09:15] Dr Lervasen Pillay: Well, yes. Uh, not so much in the research thus far, but a lot in clinical practice. I think that is an important aspect. Mental health should be given the respect that it should deserve when looking after an athlete. And once that door of discussion is open, it should be taken up with the seriousness of the condition itself.

[00:09:35] Dr Lervasen Pillay: Like most people, even in the general public, when you feel that you have a mental health related issue, whether it's distress, anxiety, depression, which are probably the most common according to the World Health Organization of conditions that we find. People do not tend to, because of the stigma associated with it.

[00:09:54] Dr Lervasen Pillay: They start feeling that they may be, um, thought of being weak and unable to [00:10:00] handle pressure, et cetera. And once this discussion starts, we need to understand in the athletic environment, there's lots of other people that need to know about this condition. It's your coach. It's the management staff, it's, uh, other healthcare professionals within the setting because from, for instance, a performance perspective, which is what management and coaches are always looking at.

[00:10:24] Dr Lervasen Pillay: Only why is this athlete not performing or together like he normally does? And once you explain to them that, listen, this, there are some issues and concerns and we need to deal with him. And the only way to deal with him is to make sure that his support structure around him is as supportive as it can be.

[00:10:44] Dr Lervasen Pillay: Instead of just feeding you negative commentary, start feeding you more commentary to try and rebuild that, uh, trust within the system and rebuild trying to say that people are here helping me, trying to help me with [00:11:00] anxiety, with depression, with eating disorders as well.

[00:11:04] Ayanda Charlie: I would imagine that eating disorders are quite common in the world of sports specifically?

[00:11:08] Dr Lervasen Pillay: Yes, and mostly in the world of sports. Yes. In the world of sports especially, and eating disorders, especially within the female industry of sports. So sports like gymnastics, et cetera, where young gymnast girls start getting told by coaches, parents and colleagues, oh, you're a little bit pudgier than normal, et cetera.

[00:11:28] Dr Lervasen Pillay: So they start developing the stigma to say, well, the media says it, the pictures on the internet says it. Social media says it that if I'm a gymnast, I have to look this way. So they become pressurized by all these external factors, and that's what leads to these eating disorders in the athletic population.

[00:11:46] Ayanda Charlie: And I mean, maybe stepping away from sports a little bit, it doesn't sound very farfetched. Anybody who is working somewhere and who understands that, you know, the output is, is. Is the most important thing to the employer is going [00:12:00] to be nervous about showing any kind of, you know, weakness, um, that might indicate that, you know, they won't be able to deliver right at their optimum at work. [00:12:09] Ayanda Charlie: Right? Like it's, it's not, it's not a unique thing. If you are at work, you want to be seen as, uh, a capable employee. And, and so I guess that's the logic that should apply, right? In sports as well.

[00:12:19] Dr Lervasen Pillay: And it's exactly the same logic because the only difference is that within sports instead of just your five teams, your colleagues noticing any change in your function at work, now you have an whole lot of people on television, on the internet, et cetera, watching you, and that puts a little bit more pressure as to why you need to sort out your mental health and, and, and, and, and it also exacerbates the issue if you don't address it.

[00:12:45] Dr Lervasen Pillay: Yes. Yeah. I mean, look at the, a general working space environment. Uh, a manager will come to someone and say, listen, there's something happening with your performance. Why has your performance been dropping so far? And this, and, most of the [00:13:00] time in the work setting, your employee of a junior level will not want to tell your employee of a senior level what exactly is going on because of it being personal circumstances.

[00:13:10] Dr Lervasen Pillay: Yes, but sometimes it is necessary to tell your senior line managers to say, listen, this is what's going on. This is what's happening with me, and I need some help with this here. And that's when you can start activating all these support programs that can be made available to you. And the same goes for in the sports environment.

[00:13:28] Ayanda Charlie: Can you tell me about other, you know, underlying psychological stresses that might affect an athlete and, and, and when I say athlete, I mean even people in amateur sports as well, not just professional athletes. [00:13:42] Dr Lervasen Pillay: Very importantly, injuries and surgery. So most sports is chronic, repetitive overload. Or they’re contact related sports, which invariably leads to either chronic and acute injuries.

[00:13:58] Dr Lervasen Pillay: Or acute injuries. [00:14:00] So, for instance, the ligament within the knee called the anterior cruciate ligament, we normally call it an ACL. That's its, uh, abbreviation when someone sustains an ACL injury and plays a cutting sport like rugby or football. Uh, even though the new science says that you don't always need to repair this, uh, some patients and some physicians will choose to repair this.

[00:14:24] Dr Lervasen Pillay: And when this medical condition is addressed by surgical means, there's a couple of things that go on. Number one, you just have to hope that your body heals at the same rate that you would like it to heal at. Number two, you need to be really strongly motivated to do your rehabilitation because it's a slow process and there's some, there's certain, uh, points that you need to pass to go to the next level of rehabilitation, and it can take you anything from six months, nine months to 12 months.

[00:14:56] Dr Lervasen Pillay: So during that period of rehabilitation, the physical [00:15:00] rehabilitation as well as the mental rehabilitation is very important.

[00:15:04] Ayanda Charlie: It sounds like there's such a connection. Right? And, and, I think it's one that we forget, right? As obvious as it might seem, but there's such a connection between the mind and the body and, and they seem to, to affect one another, right? Like you can't have one be, you know, in great health while the other one is, is suffering.

[00:15:22] Dr Lervasen Pillay: Very much true. And I mean, remember the brain is a very neuroplastic, what we call neuroplastic. It's able to adjust, et cetera. It controls every single function of ours and if you, if you put it very simply, if you've got a sore, so a, a very sore shoulder, and you're supposed to be carrying your laptop on that shoulder every day, what's your natural reaction?

[00:15:45] Dr Lervasen Pillay: Either don't carry your laptop on the shoulder, put it on the other shoulder, and hurt the other shoulder. And that's what happens with the brain. We start trying to find ways of trying to protect ourselves. And sometimes in protecting ourselves, we cause more problems and [00:16:00] concerns for ourselves and we try and catch up trying to manage these conditions from a mental perspective, trying to find the motivation to go onto the next day.

[00:16:08] Dr Lervasen Pillay: So there's definitely always a link between brain and body.

[00:16:12] Ayanda Charlie: Now, doctor, what are some warning signs, right, for athletes that they're perhaps, you know, struggling with mental health? What should I look out for?

[00:16:20] Dr Lervasen Pillay: That same athlete that used to be very timeous all the time. He'll arrive at training 30 minutes before everyone else is already changed, ready to take on the day, et cetera.

[00:16:31] Dr Lervasen Pillay: Now strolls in exactly when training starts, or is a few minutes late. So that's, that becomes, uh, sign number one. Sign number two, when you look at their energy on the field of play and the field of training, et cetera, they don't have the same robustness that they usually do have. So you're getting all these physical representations of things.

[00:16:52] Dr Lervasen Pillay: Then from a, uh, behavioral perspective within the change room where they would normally be person that starts off [00:17:00] singing before match kicks off, et cetera, they're the same guy that's sitting in the corner of the change room, uh, and doesn't interact with much people unless he's interacted with. Those are all signs to say, listen, there's something going on with this person.

[00:17:13] Dr Lervasen Pillay: And we need to address it and we need to try and take them aside and get to the root cause of this.

[00:17:19] Ayanda Charlie: We'll be back with Dr. Pillay shortly, But first, we wanted to share the details of the Mediclinic 24/7 Helpline. You can call the number +27 86 023 3333.

[00:17:32] Ayanda Charlie: The 24/7 Helpline is no longer only for medical enquiries but can even go as far as assisting you with making a booking for the doctor. Back to you, Dr. Pillay. Now doctor, what if you are, you know, a recreational or or professional athlete who's just learned not to let anybody see you sweat, right? Who's learned to be consistent and not maybe display any kind of behavioral changes when you are struggling mentally?

[00:17:57] Ayanda Charlie: How do I either as a coach or as a parent [00:18:00] find, you know, be able to identify signals of mental health struggle?

[00:18:04] Dr Lervasen Pillay: I think that's an important aspect to determine, especially with your development athletes, et cetera, and your recreational athletes. Uh, people that are normally involved in these kind of high level sports somehow develop these mechanisms to shell themselves from the world.

[00:18:20] Dr Lervasen Pillay: And, uh, with regards to teenagers, adolescence, um, there's a word that we call, uh, that we use for trying to identify these things. It's called parenting. And I think parenting is very important because parents are probably the most important people that can pick up these little minuscule changes within their child's behavior.

[00:18:42] Dr Lervasen Pillay: And then the other people that we forget around us that we can find out to see if they feel there's a problem going on. Teachers see their children more often than parents, see the children, and then also look at your religious leaders. From a priest to a pastor, et [00:19:00] cetera, and the child may interact and go to them for advice and assistance without going to their parental structures.

[00:19:07] Dr Lervasen Pillay: Trying to find some guidance. Peers often will not show these kind of, uh, concerns with their other peers as well, because as you've mentioned, it's all about trying to show this face of strength, et cetera. So, uh, usually you won't find that issue. But yeah, between the parents, the, uh, uh, care providers of the teachers, as well as religious leaders that look after, uh, families and, uh, communities, et cetera, these are probably the people that will identify these, uh, issues sooner.

[00:19:40] Ayanda Charlie: I think, and we touched on this in, in, in, in the first episode about, you know, kids who feel a great deal of pressure from, from the adults around them, from parents to coaches, to teachers, especially in, in the academic space where, you know, you could win a scholarship if you perform really well, that kind of pressure, um, how does that impact a [00:20:00] child?

[00:20:01] Dr Lervasen Pillay: So that kind of peer pressure from, uh, not only your own colleagues, from your parents, from your teachers, et cetera, to try and perform to your best. It has to be very well controlled. So there's a line that you shouldn't be crossing, and it's always important to motivate these children to perform at their best in whatever they're trying to do, but at what expense?

[00:20:20] Dr Lervasen Pillay: At the expense of losing sleep, at the expense of becoming anxious every time you're involved in these kind of scenarios, at the expense of causing lots of distress. Simple other physical and behavioral changes can be noticed. These children may start developing things like ticks where maybe they get a little habit, where they twitch their eye during certain scenarios, so without showing an obvious physical symptom, they have those kind of things.

[00:20:46] Dr Lervasen Pillay: Start biting on their nails, uh, start biting on their lips. And these all become little subtle signs to say, listen, there's this, there's this. Maybe we’re pressurizing this, this person a little bit too much, and let's step back a little bit. Let's give them [00:21:00] time to breathe and let's give them the option of saying, what do you want to do? Not what do we want to see you do?

[00:21:07] Ayanda Charlie: And if I'm the child, um, And I'm trying to think of ways to bring it up to my parents. Let's say they haven't noticed, um, these kind of telltale signs that you've just listed. And I'm thinking, you know what? I, I, I wanna tell my parent, I know you know that the stakes are high, but I wanna be able to broach the subject. How might a young person bring this up?

[00:21:27] Dr Lervasen Pillay: It's very difficult for a child to bring this up towards the teacher, coach, or parent in a very closed space and environment cause they still feel a bit threatened. What I often see, and, and, and this happens on a regular basis with my school going athletes, uh, that are high performers, is when they present to me with some kind of medical related issue or a, uh, injury or something of that sort.

[00:21:51] Dr Lervasen Pillay: And when we start identifying that they've been either over training, uh, pushing a little bit too hard, too fast, et cetera, and we bring this topic [00:22:00] up, that becomes almost like a bit of a gateway for the child to say, see, I told you so. And that becomes an opportunity for the child to, and, and, and it often happens within the consultation.

[00:22:12] Dr Lervasen Pillay: The child will tell the mom, see, mom, I told you I can't play soccer, cricket, hockey, and do rowing all in one week. It's too much. So, so they find us as, they find us as healthcare practitioners becoming a bit of a crutch, and suddenly the parent now opens up their eyes because now they understand things a little bit more and they realize, oh wait, listen, maybe I have been, uh, living my dreams through my child and let me give them their own opportunity to explore their own interests.

[00:22:42] Dr Lervasen Pillay: And, uh, some of them do access professional psychologists and counseling psychologists to help them get through this, to make them understand their children.

[00:22:49] Ayanda Charlie: Lastly, doctor, what strategies or techniques do you recommend for athletes to manage their mental health Right? while they're recovering from something like an injury?

[00:22:59] Ayanda Charlie: [00:23:00] Right. When I don't have, um, if I'm an athlete, I no longer have access to, to my sport, which might have been helpful for me to process things, you know, um, and heal mentally. But now I'm sitting at home, I'm suffering from an injury. How do I, how do I, you know, find an outlet?

[00:23:17] Dr Lervasen Pillay: So that's where they need to speak to the people that are looking after them from a medical perspective to try and find out what works for them.

[00:23:24] Dr Lervasen Pillay: So the first thing you do is stay away from social media. Because if you, if you a high level athlete that has injured themselves and going through a rehabilitation process, the last thing that you need to see on a newsfeed somewhere every day or every second day on end is they're busy healing.

[00:23:43] Dr Lervasen Pillay: They're busy healing. They're busy healing. Initially it might be motivating, but as the days progress, it starts becoming more of a toll to say, see, I'm being pressured to actually return sooner. So that's number one. Stay away from social media. Number two, find good support structures around you, [00:24:00] whether it's your wife, your parents, your kids, et cetera.

[00:24:05] Dr Lervasen Pillay: Divert your attention away from that injury for that, for that short period of time, just to actually be a bit of a normal person for a change. Sit down, watch some normal television with your kids. Spend some time, learn about your kids, learn about your spouse, et cetera. And then start adapting simple relaxation techniques.

[00:24:26] Dr Lervasen Pillay: Things like yoga may be helpful for some where some people find yoga too boring. Maybe reading a book may be better. Where others may find a new skill, like doing some artificial intelligence thing, which is the new age of doing all this research nowadays, et cetera, but getting involved in something to divert your attention for that moment in time to say, right, while I'm focusing on everything healing, and before I actually start my rehabilitation, let me use this opportunity to almost take a step back and what I like [00:25:00] saying, um, ‘woosa’ to ‘woosa’ a little bit and just calm down a little bit.

[00:25:05] Ayanda Charlie: It sounds like having a life outside of the sports kind of helps because then, then you don't have to kind of recreate all these uh, uh, uh, uh, kind of mechanisms because you have a rich full life that doesn't just revolve around the sports.

[00:25:21] Ayanda Charlie: And so when you are sitting at home due to an injury, you, you're not just stuck. Looking at what's not going on and you can focus on what else is going on your on in your life.

[00:25:30] Dr Lervasen Pillay: Exactly. And that's why it's important to start doing that while you're in this, this athletic environment. We often see in retired players that once they've passed the stage of playing and they've retired, they were so used to jumping on a plane, going over here, playing a match, coming back, recovering, flying over there, playing another match, recovering, not going out on a Saturday with their friends, et cetera.

[00:25:53] Dr Lervasen Pillay: And focusing only on their sport so much. And before you know it, when they’re 26, 27, [00:26:00] they've retired from the sport and now they realize, well, all my friends have moved on. Mm. Uh, my wife does her own thing. She's got her own routine in her life. I'm actually all alone now, and they get depressed. Mm-hmm. So trying to start making people realize, and, and when you work with, with, with elite athletes, and not only elite athletes, just people that are, uh, in the public spotlight all the time.

[00:26:24] Dr Lervasen Pillay: Everyone that, people that don't know, people of this world always think they’re these super humans and they can do so many things, et cetera. Those of us that do work with people of these public figure, uh, um, spaces realize these are normal people and they should be treated like normal people. And sometimes that's what athletes want.

[00:26:45] Dr Lervasen Pillay: They want to be treated like a normal person and not because I am X so I deserve this. They want to be treated like a normal individual. Stand in a queue and pay for something and not just get someone to do it for you.

[00:26:57] Ayanda Charlie: Well, Dr. Pillay, thank you so much for, for, for joining me yet [00:27:00] again and sharing your insights.

[00:27:02] Ayanda Charlie: You've certainly highlighted the importance of a greater focus on mental health, and you've given me so much to think about. I hope it's the same for our listeners.

[00:27:10] Dr Lervasen Pillay: Yes, and I hope so too. For the listeners, the parents out there, the professional athletes and the recreational athletes. To make people realize that mental health is not an issue to be taken lightly and you need to learn to develop some self-reflection, some introspection, and some mindfulness when it comes to these issues, and knowing that having a mental health issue is not something that is a stigma.

[00:27:36] Ayanda Charlie: As Olympic medalist and mental health advocate, Michael Phelps, once said, “It’s okay to not be okay. It’s okay to ask for help.”

[00:27:45] Ayanda Charlie: For me, his words really do emphasise how necessary it is to break down the stigma and silence surrounding mental health in sports and to encourage athletes to seek support when they need it. By prioritising mental health and creating a supportive and inclusive environment, athletes can improve their overall wellbeing and performance – and so can you or I!

[00:28:03] Ayanda Charlie: Mental health is a crucial aspect of overall wellbeing and  performance. If we can create an environment that supports the mental health of athletes, they will be able to take the necessary steps to maintain their mental health and perform at their best. And if we can be intentional about taking care of our own mental health and that of our families, friends and colleagues, we can flourish in our own sports and fitness journeys too.

[00:28:27] Ayanda Charlie: Thank you again to Dr Levarsen Pillay for being with me today. And to all of you who joined me in listening to this episode of The Sports Series podcast, powered by Mediclinic. If you haven’t yet done so, subscribe to our podcast channel and sign up for the Mediclinic Prime newsletter, packed with great health articles; a bi-weekly series of newsletters focused on young families – the link is in the show notes too. Until next time.