It's hard for Royce White to convince people he's freaked out. On the court, the Houston Rockets' top draft pick, a 6-foot-8 power forward, is a proven scorer and strong rebounder. But off court, White suffers ceaseless anxiety. He's afraid to fly (in fact, he cut a deal with the Rockets to bus to games). When he drives, he constantly scans the road for danger. If he feels a muscle twinge in his chest, he's certain it's a heart attack. On a good day, White suffers from general anxiety, exaggerated worry, and tension, even though there is little or nothing to provoke it. On his worst days, he has suffered upward of three panic attacks – his heart racing in his chest, convinced he will die.
"I've been terrified," says White about such attacks. "But I'm always worried, or more like abnormally cautious, pensive, and looking for things that might be a threat in everyday situations."
White is not alone in his dread. Lately, the issues of panic and anxiety have been bubbling up in pro sports – with White's recent demotion to the Rockets' development team and pro golfer Charlie Beljan's very public panic attack on the green. "A lot of people suffer acute anxiety, whether it's social anxiety in crowds or in business meetings, standing on line in a coffee shop, or just hanging out with friends," says Abby Fyer, a clinical psychiatrist at Columbia University and an expert on anxiety. But White and Beljan have more extreme cases, made all the more difficult by jobs that require them to play in front of thousands of people, under pressure to beat the clock or get that birdie. The 40 million Americans who suffer from anxiety disorders can learn a lot from these troubled athletes.
White suffered his first panic attack when he was 16 years old, after smoking pot with friends at a lake house near his Minneapolis hometown. The attacks came in waves afterward, until doctors put him on Prozac at 18. He's still on it. To cope with his anxiety, he's developed an obsessive-compulsive disorder, as many sufferers do. He alphabetizes everything: his shoe boxes (style first, brand second), his DVDs (by genre followed by titles), and the folders and subfiles on his computer desktop. The clothes in his drawers and closets are color-coordinated, and the hangers are all evenly spaced. "I need things to be ordered and organized," says White. "If there's a piece of paper in the middle of my floor, that is going to give me a major issue."
Surprisingly, the one place where Royce's anxiety recedes is on the basketball court. First and foremost, experts say, this is likely because physical activity can help allay anxiety. The mind is focused on the game, so he can't obsess about other things. "I don't have time to really think about it at all," he says.
For athletes competing in triathlons, marathons, and events in the Olympic Games, an anxiety rush can derail their gold medals or their careers. And yet, most cannot compete without it. "Nervousness is your friend," says JoAnn Dahlkoetter, a Stanford Medical Center sports psychologist who's treated Olympians as well as Fortune 500 businessmen. "It's a normal reaction to an important moment in your life." Anxiety is basically an adrenaline dump, your body's fight-or-flight response. It's telling you that you are ready to compete – or that you'd better get the hell out of there. This natural response goes off the rails when the body gets run down or is already ridden with stress. Hangovers are a known trigger for panic attacks: A heavy night of drinking can lead to fatigue, dehydration, too much caffeine, and not enough food. But piling on the stress – say, playing a PGA tournament after being up with a newborn all week – is the most common trigger.
That's exactly what happened to Charlie Beljan. The 28-year-old pro golfer was headed into the second round of the PGA's Children's Miracle Network Hospitals Classic this past November when panic struck. Out of nowhere, his throat tightened and his heart jackhammered. As a TV audience watched, he struggled through 18 holes, a medical team monitoring his skyrocketing pulse. "I thought, 'This is it, I am going to die right here,'" says Beljan. Instead, he carded a 64, the second-best score of his rookie season. Then he was hauled off in an ambulance to spend the night in a hospital hooked up to a heart monitor. The next day, he returned to face those same crushing feelings and struggled through – with paramedics in pursuit – to an eventual final-round win. "It was just one shot at a time," says Beljan. "I still can't believe it worked for me."
Both White and Beljan have learned that the most effective way to inhibit their internal fears and fend off a panic attack is to breathe. Full-blown panic attacks occur when there is an imbalance of oxygen and carbon dioxide, says Karen Cogan, a psychologist who works with athletes at the U.S. Olympic Training Center in Colorado Springs. Slow, deep breathing gets much-needed oxygen to the brain. This is why Cogan prepares her athletes by teaching them "square breathing." The technique is simple: Breathe in deeply on a count of four and then exhale completely on a count of four, repeating three or four times. "The key is to exhale all the way," says Stanford's Dahlkoetter, who also advocates breathing techniques. "You can't take in air unless you completely empty out your lungs."
Another technique is to try making the sudden flush of anxiety your ally – a reflexive strategy for most competitive athletes. "It's important to distinguish between being worried and being psyched," says Dahlkoetter. She also suggests practicing mental visualization: See yourself doing exactly what needs to be done – the tennis strokes you'll use, your approach shots, your line game. But also visualize distractions, upsets, and other scenarios. If you're running a marathon, envision how you'll do with rain, with wind, if your nemesis shows up and outpaces you.
Of course, game day is not always the enemy – White and Beljan both cite watching television on the couch as a place where their anxious thoughts get the best of them – and a lot of what sufferers feel cannot be beat by the conscious mind. The usual mood-altering drugs, Valium or Prozac, can help. But the problems can run deep, from childhood trauma to pent-up anger at a loved one or a boss. White cites playing on courts in a drug- and violence-prone neighborhood as a kid as contributing to his anxiety today.
"People ask me about anxiety – I tell them to get diagnosed and get help," says White, who has started his own website, Anxious
Minds.org, to educate anxiety sufferers. "You can't just take Tylenol to deal with it. Being able to be level with people, being honest about your problem – that is a huge help."