Alexi Pappas Is Out to Change How Mental Health Is Seen In Sports
The Olympic runner is teaming up with health care platform Monarch to help make access to mental health services easier for those who need it.
Take one look at Alexi Pappas' resume, and you'll ask yourself "what can't she do?"
You might know the Greek American runner from her performance in the 2016 Summer Olympic Games when she set a national record for Greece in the 10,000-meter race. But, as if her athletic triumphs weren't impressive enough, the 31-year-old is also an accomplished writer and actress. In 2016, Pappas co-wrote, co-directed, and starred in the feature film Tracktown. She later went on to co-create and star in the movie Olympic Dreams, which premiered at SXSW in 2019, alongside Nick Kroll. In January 2021, she released her debut memoir, Bravey: Chasing Dreams, Befriending Pain, and Other Big Ideas, with a foreword by comedian Maya Rudolph.
While Pappas' life may sound idyllic, she is the first to tell you it hasn't been easy. At 26, she was at the top of her running game, but, as you learn in her memoir, her mental health was at an all-time low.
In a 2020 op-ed for The New York Times, she shares that she first noticed that she was having difficulty sleeping and felt anxious about what was next for her career. At the time she was trying to run 120 miles in a week while averaging one hour of sleep at night. The exertion mixed with exhaustion led her to tear a hamstring muscle and crack a bone in her lower back. Pappas soon began to experience suicidal thoughts and was diagnosed with clinical depression, she shared with the paper.
Fighting Depression When Life Looks Perfect
"For me, it was particularly surprising because it was after the  Olympics — the biggest peak of my life," Pappas tells Shape exclusively. "The moment after felt like a cliff — I wasn't aware of the extreme mental and adrenal fatigue associated with chasing such a singular dream."
Experiencing a decline in your mental health after a big life event is more common than you might think — and you don't have to be coming down from a gold medal win to experience it. Promotions, weddings, or moving to a new city can sometimes be accompanied by an emotional aftermath of sorts.
"Even when you're facing a positive life event, including one that has been planned and worked for, you are likely to experience stress and tension in working toward something that big," explains Allyson Timmons, a licensed mental health counselor and the owner of Envision Therapy. "Upon completion of your goal, your brain and body will experience negative effects of that stress and tension despite being born out of a positive achievement." These effects can contribute to an increased risk of depressive symptoms, adds Timmons.
While Pappas says her depression came as a bit of shock, she wasn't a stranger to the pain that accompanies mental illness. Shortly before her fifth birthday, she lost her mother to suicide.
"[My] biggest fear was that I might end up like my mother," says Pappas of coming to terms with her own diagnosis. But her own depressive symptoms also provided a window into the struggles her mother once experienced. "I understood her in ways I never wanted to," says Pappas. "And I have empathy for her that I never had before. [My mom] wasn't 'crazy' — she just needed help. Unfortunately, she never got the help she needed." (Related: What Everyone Needs to Know About the Rising U.S. Suicide Rates)
The Mental Health Conversation In Pro Sports
Without knowing Pappas' story, you might be quick to assume she is invincible. Athletes are often viewed as superheroes. They run at a record speed such as Pappas, tumble through the air like Simone Biles and create magic on tennis courts such as Serena Williams. Watching them perform such astonishing feats, it's easy to forget they're simply human.
"In the sports world, people tend to see mental health challenges as weakness, or as a sign that an athlete is unfit or 'less than' in some way, or that it's a choice," says Pappas. "But in reality, we should simply view mental health the same way we view physical health. It's another element of an athlete's performance, and it can get injured just like any other part of the body," she says.
The picture of mental health among professional athletes is beginning to become clearer, forcing both fans and long-standing institutions to take note and seek change.
For example, in 2018, Olympic swimmer Michael Phelps began opening up about his own battle with anxiety, depression, and suicidal thoughts — despite also being at the height of his career — which he elaborates in the 2020 HBO documentary, The Weight of Gold. And just this week, tennis champ Naomi Osaka announced her withdrawal from the French Open citing her mental wellbeing. This, after being fined $15,000 for opting out of media interviews, she previously explained was to protect her mental health. The 23-year-old star player revealed she's had "bouts of depression" since the 2018 U.S. Open, and "gets huge waves of anxiety" when speaking to the media. On Twitter, she spoke of her hopes to work with the Women's Tennis Association Tour about ways to "make things better for players, press, and fans." (Pappas spoke out on IG touting a quote she gave to The Wall Street Journal on the subject, saying "I believe we're on the cusp of a mental health renaissance and I'm grateful to women like Naomi for helping lead the way.")
While Pappas says she feels the culture and conversations around mental health are improving, there's still a lot of work that needs to be done in the world of professional sports. "Sports teams need to include mental health professionals on their support rosters, and coaches need to embrace mental health maintenance as a key piece of high performance," she says.
The professional runner has now made it a goal to advocate for the importance of prioritizing mental health — including easier access to proper care. She continues to open up about her own experiences on social media, through public speaking, and in various media interviews.
"When I was writing my book Bravey, I knew I wanted to tell my full story, and my epiphany about seeing the brain as a body part is central to who I am today," says Pappas. "I honestly believe it's the reason I'm still alive."
Pappas' advocacy is a helpful step toward change, but she knows that building awareness is only one part of the equation.
Breaking Boundaries to Mental Health Care
The profusion of charming Instagram squares and TikTok posts about mental health may offer the illusion of a destigmatized world, but despite the increase in awareness online, stigmas and barriers to access still widely exist.
It's estimated that one in five adults will experience a mental illness in a given year, yet "the barrier to entry for finding a mental health doctor can be so high, especially for a person who is suffering from depression, anxiety, or other mental health injuries," says Pappas. "When I was sick and finally realized that I needed help, navigating the complex world of insurance, different specialties, and other variables felt overwhelming," she explains. (See: Free Mental Health Services That Offer Affordable and Accessible Support)
What's more, many people across the U.S. face a shortage of available mental health care options. More than 4,000 areas across the US, with a total population of 110 million people, are faced with a lack of mental health professionals, according to Mental Health America. What's more, a 2018 study by the National Council for Mental Wellbeing and the Cohen Veterans Network found that 74 percent of Americans do not believe mental services are accessible.
Cost (with or without insurance) is another major barrier to treatment. In a survey by the National Alliance on Mental Illness (NAMI), the organization found that 33 percent of respondents had difficulty finding a mental health care provider who would take their insurance.
It was her own intimate understanding of these hurdles that led Pappas to partner with Monarch, a newly-launched national online network of therapists. Through the platform, users are able to search its digital database of more than 80,000 licensed mental health professionals by specialty, location, and accepted in-network insurance. You can also view a therapist's availability and book appointments IRL or via telemedicine all within the Monarch site.
Monarch was created out of the need to provide patients with an easy tool to find access to mental health care, explained Howard Spector, CEO of SimplePractice, a cloud-based electronic health record platform for private practitioners, in a press release. Spector says he felt therapy seekers were "left out in the cold when it comes to seamlessly being able to find, book, visit, and pay for care in the way they can for nearly everything else," and that Monarch is there to "remove so many of the obstacles that stand in the way of getting therapy when you need it most."
In the future, Monarch plans to roll out therapist matchmaking to help users find a mental health professional who is most compatible with their needs. Pappas, who uses Monarch herself, says she feels "at ease and supported" when using the platform. "Monarch makes it possible for anyone to get help, no matter their experience or abundance of outside support," she says.
Remembering That Mental Wellness Is a Commitment
To be clear, maintaining your mental health doesn't end after a few sessions with a therapist or when symptoms subside. Notably, at least 50 percent of those who recover from their first episode of depression will have one or more additional episodes in their lifetime, according to a paper in the Clinical Psychology Review. While Pappas was able to work through the worst of her depression following the Olympics, she now treats her brain like any other body part prone to re-injury. (Related: What to Say to Someone Who's Depressed, According to Mental Health Experts)
"I've had pinched nerves in my back before, and I know now how to recognize the very early symptoms and take the proper steps to recover before it becomes an injury," says Pappas. "It's the same with depression. I can notice when certain indicators, like trouble sleeping, start happening, and I can press pause and self-diagnose what I need to adjust so I can stay healthy," she says.
"You probably wouldn't hesitate to go see a physical therapist if you tweaked your knee on a run or if you hurt your neck in a car accident, so why feel weird about seeking out a mental therapist because your brain is feeling off?" asks Pappas. "It's not your fault that you are injured, and we all deserve to be healthy."