Athlete Mental Health in Boston: How Therapy and Sport Psychology Support Athletes
Being an athlete can be one of the most rewarding parts of a person’s life. Sport can teach you discipline, confidence, resilience, teamwork, and how to work toward something even when it gets hard. But there is another side to being an athlete that does not always get talked about. The pressure to perform, recover from injuries, stay in shape, manage expectations, and constantly improve can take a significant toll over time.
I work with athletes who are incredibly successful on paper but are struggling behind the scenes. They may be competing at a high level, getting good grades, succeeding professionally, or appearing confident to everyone around them while privately dealing with anxiety, perfectionism, burnout, body image concerns, disordered eating, or an overwhelming fear of failure.
That is why conversations about athlete mental health are so important. Mental health does not exist separately from performance. How you are doing emotionally affects how you train, compete, recover, relate to your teammates, and ultimately how you experience your sport.
For athletes in Boston and beyond, working with someone who understands both mental health and the culture of competitive athletics can make a meaningful difference. Therapy for athletes should account for the unique pressures that come with sport while still recognizing that the person sitting across from you is more than an athlete.
The Reality of Athlete Mental Health
When we talk about athlete mental health, it is easy to focus only on diagnosed mental health conditions. But mental health exists on a much broader spectrum. An athlete does not have to meet criteria for a disorder to be struggling.
Sometimes the signs are subtle. You might notice that you are constantly thinking about your next workout, replaying mistakes from practice, feeling guilty when you take a rest day, or struggling to enjoy a sport that you once loved. You may feel like you are never doing enough, even when everyone around you tells you that you are doing well.
Athletes are also often rewarded for behaviors that can become unhealthy when taken too far. Being disciplined, pushing through discomfort, staying committed, and being “mentally tough” are all qualities that can serve an athlete well. The problem is when those qualities make it difficult to recognize when you actually need a break or support.
I often encourage athletes to ask themselves a different question: What is the cost of performing at this level?
If being successful means you are constantly anxious, exhausted, restricting your food, avoiding social situations, losing sleep, or tying your entire sense of worth to your performance, it may be time to look at what is happening beneath the surface.
Why Athletes Sometimes Avoid Therapy
There is a complicated relationship between sport culture and asking for help. Athletes are taught from a young age to push through discomfort, stay focused, and keep going when things get hard. Those skills are incredibly valuable in competition, but they can become a problem when an athlete starts applying the same mindset to their mental health.
I hear athletes worry that going to therapy means they are weak or that it somehow means they cannot handle pressure. Some are concerned about what their coach, teammates, parents, or organization will think. Others have spent so much time being the person everyone else relies on that they do not know what it would feel like to admit that they are struggling.
There is also the issue of visibility. If you break your leg, people can see that something happened. You have an MRI, a treatment plan, physical therapy appointments, and a clear recovery timeline. Anxiety, depression, burnout, or an eating disorder may look very different. An athlete can be showing up to every practice and competing at a high level while struggling significantly on the inside.
That is one reason therapy for athletes can be so valuable. Therapy provides a space where you do not have to perform, prove that you are okay, or worry about being the “strong one.” You can be honest about what is actually happening and work with someone to figure out what you need.
Where Sport Psychology Comes In
Sport psychology is another important piece of the conversation. While therapy and sport psychology overlap in some ways, they are not exactly the same.
Sport psychology focuses on the mental and emotional factors that influence performance and an athlete’s overall experience in sport. Depending on the athlete, that might include working on confidence, concentration, performance anxiety, goal setting, visualization, emotional regulation, pre-performance routines, or learning how to reset after a mistake.
For example, an athlete who becomes overwhelmed after making an error may learn a specific reset routine that helps them acknowledge the mistake, regulate their nervous system, refocus their attention, and move forward instead of carrying the error into the next play.
That is the practical side of sport psychology that many athletes find helpful. It is not about simply telling yourself to “be confident” or “think positively.” It is about developing skills that you can actually use when your heart is racing, your thoughts are moving quickly, or the pressure feels particularly high.
At the same time, sometimes performance concerns are connected to something deeper. An athlete who is terrified of making mistakes may also be dealing with perfectionism, low self-worth, anxiety, or a belief that their value depends on their performance. That is where therapeutic work can become particularly important.
Therapy and Sport Psychology Can Work Together
One of the things I love about working with athletes is that there is rarely a clean separation between mental health and performance. The two constantly influence each other.
Take an athlete experiencing intense performance anxiety. They may benefit from learning breathing techniques, developing a pre-performance routine, or practicing imagery. Those are valuable sport psychology interventions. But if that same athlete is also dealing with perfectionism and believes that one bad performance means they are a failure, there is more work to do.
Therapy can create space to understand where those beliefs came from and how they are affecting the athlete’s life outside of competition. The goal is not simply to help someone perform better on game day. It is to help them develop a healthier relationship with themselves, their sport, and the expectations they have placed on themselves.
For some athletes, that means learning how to compete with confidence. For others, it means learning that they are still worthy when they do not perform perfectly.
The Mental Side of Injury
Injury is another area where the need for specialized support is often underestimated.
An injury can completely disrupt an athlete’s routine and sense of identity. Suddenly, you may not be practicing with your teammates, competing on the weekends, or doing the activities that have structured your life for years. You may be watching from the sidelines while everyone else moves forward, and even when people around you are supportive, it can still feel incredibly isolating.
There is also grief involved. Athletes may grieve the season they expected to have, the version of themselves they felt confident in, or the goals they had worked toward for months or years. They may worry about losing their position, not returning at the same level, or getting injured again.
Therapy for athletes can provide a place to process all of that while also helping an athlete navigate the practical and emotional challenges of rehabilitation. Staying connected to teammates, finding a sense of purpose during recovery, managing uncertainty, and rebuilding confidence are all important parts of the process.
Returning physically does not always mean you feel ready mentally. The psychological side of returning to sport deserves attention, too.
Body Image and Eating Concerns in Athletes
Body image and eating concerns are another important part of athlete mental health, particularly because some behaviors can be normalized within sport environments.
Athletes may receive frequent comments about their weight, body composition, appearance, or nutrition. Depending on the sport, there may be pressure to maintain a certain body type or weight. Social media can add another layer of comparison, while coaches, teammates, parents, and even well-intentioned professionals may unintentionally reinforce the idea that changing an athlete’s body will automatically improve performance.
This can make it difficult for athletes to recognize when something has crossed the line from sport nutrition into disordered eating.
An athlete might think they are simply being “disciplined” when they are actually restricting food, eliminating entire food groups, obsessively tracking what they eat, or feeling intense guilt after eating. Similarly, excessive exercise can sometimes be praised as dedication when there are more concerning behaviors underneath it.
This is where working with someone who understands both eating disorders and sport can be particularly important. Treatment needs to consider the athlete’s mental health while also understanding the realities of training, competition, recovery, and performance.
Why Boston Athletes May Seek Specialized Support
Boston has an incredibly strong athletic community, from youth and high school sports to collegiate programs, professional teams, running communities, and recreational athletes. It is also a city filled with high-achieving students and professionals who are balancing demanding careers, academics, relationships, and other responsibilities alongside their athletic goals.
That combination can create a unique kind of pressure. You may be trying to excel in school while competing at the collegiate level. You may be building a career while training for a marathon. You may be a former athlete who is struggling with what life looks like after competition ends.
Working with a clinician who understands that world can make it easier to talk about things that may feel difficult to explain to someone who has never experienced competitive sport.
You should not have to spend half of your therapy session explaining why missing practice feels like a much bigger deal to you than it might seem to someone else.
What Does Therapy for Athletes Actually Look Like?
There is no one version of therapy for athletes because no two athletes are the same. Therapy should be based on what you are actually experiencing rather than forcing every athlete into the same framework.
For one person, therapy might focus primarily on anxiety or perfectionism. Another athlete may need support around an eating disorder or body image concerns. Someone else may be trying to cope with an injury, navigate a difficult team environment, transition out of college athletics, or figure out who they are outside of their sport.
Sometimes the work is very practical. We may talk about strategies for managing pre-competition anxiety, handling a difficult interaction with a coach, or creating a plan for getting through a stressful week. Other times, we may slow down and explore patterns that have been present for much longer.
Most importantly, therapy is not about turning every conversation into a discussion about performance.
You are a person before you are an athlete. Your relationships, family, identity, career, friendships, and life outside of sport matter, too. Good therapy makes room for all of it.
When Should an Athlete Consider Therapy?
You do not have to wait until you are in crisis to seek support. In fact, many athletes benefit from therapy before things reach that point.
It may be worth reaching out if you find yourself constantly anxious about your performance, struggling to recover emotionally from mistakes, feeling burned out, losing enjoyment in your sport, or feeling like you are never doing enough. It may also be a good time to seek support if you are dealing with body image concerns, changes in eating behaviors, an injury, depression, perfectionism, or a major transition in your athletic career.
Sometimes the biggest sign is simply that you do not feel like yourself anymore.
Getting support does not mean that you are failing as an athlete. It means you are taking your well-being seriously.
Building a More Sustainable Version of High Performance
High performance should not require you to sacrifice your mental health.
The goal is not to make athletes less ambitious or convince them to care less about their sport. It is about helping them pursue meaningful goals without allowing performance to become the only thing that determines their self-worth.
That might mean learning to rest without feeling guilty, understanding how to respond to mistakes without spiraling, fueling your body without fear, asking for help when you need it, or developing an identity that extends beyond your results.
Sport psychology can give athletes practical tools for navigating pressure and performing when it matters most. Therapy can provide a deeper space to understand the thoughts, emotions, and experiences that may be getting in the way of feeling like yourself.
When those pieces come together, the goal is not simply better performance. It is sustainable performance and a healthier relationship with the person behind the athlete.
Supporting the Whole Athlete
The conversation around athlete mental health needs to continue expanding. Mental health is not something that should only be addressed when an athlete can no longer perform. It is part of the overall picture of what allows an athlete to train, compete, recover, and enjoy their sport over time.
Whether you are dealing with anxiety, burnout, body image concerns, an eating disorder, injury, perfectionism, or the pressure to constantly perform, you do not have to figure it out on your own.
For athletes in Boston and those seeking virtual care, specialized therapy for athletes can provide a space to work through the challenges of sport while also making room for everything else that makes you who you are.
You can be ambitious and still take care of yourself. You can want to perform at a high level without making your performance your entire identity. And you can ask for help without having to wait until things fall apart.
Papakyrikos Therapy & Performance is currently accepting new therapy and sport psychology clients in Boston, MA, as well as throughout Connecticut, Florida, Vermont, and Maine. Whether you are navigating anxiety, burnout, body image concerns, injury, performance pressure, or simply want support in finding a healthier and more sustainable approach to high performance, you do not have to navigate it alone. Reach out to learn more about therapy and sport psychology services and determine whether working together may be a good fit.