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Alabama coach Nick Saban reflects on college mental health crisis, how young people can manage anxiety

High achievers can have unique risks for suicide. Here's what to look for and expert-backed tips to build a healthy balance.

If you or someone you know is in crisis, call the U.S. National Suicide Prevention Lifeline at 800-273-8255, text TALK to 741741 or visit for additional resources.

Back-to-school season is a stressful time for pretty much everyone involved. And student athletes may be facing unique pressures that can have serious impacts on their mental health, University of Alabama head football coach Nick Saban told TODAY.

Some of that pressure can be "self-inflicted," as Saban put it, "because you’re focused on results. (Do you) want to focus on winning a championship, or do you want focus on, 'What do I have to do each day to be able to be a champion, so we’ll have a chance to win the championship?' There’s a lot less anxiety in the second approach (and) a lot more anxiety when you’re worrying about what’s gonna happen in the future," he said. "We want them to focus on that ... and try to build on positive performance and not focus so much on the bad things that happen."

That's why Saban encourages players to take 24 hours to process a win or loss, and then they need to let it go. "We’re all going to have bad things that happen, but our ability to overcome those negatives is going to go a long way in helping us be successful," Saban added.

For defensive lineman DJ Dale, it was tough to admit to himself just how significantly a season-ending knee injury was affecting him mentally. But Saban understood and connected Dale with Dr. Bhrett McCabe, University of Alabama's sports psychologist.

"I didn't want (Saban) to think that I was weaker or turning my back against the team, but it was the complete opposite," Dale said.

Physical injuries like Dale's can definitely affect students' mental well-being, McCabe told TODAY, and perfectionism is a major factor. “Our kids are coming in with more pressure, more standards to perform and more expectations from the world around them. We don’t give people grace and time to grow into things as a society," McCabe said.

But it’s not as difficult to get athletes to talk about their emotions as it used to be, Saban said, and that's a positive change.

“I don’t think the players really look at it as ‘I have something wrong with me.’ They look at it more like, ‘Maybe I can use the help,’” he explained. “It’s always good to emphasize with people, 'Take help when help is there to be given.' It’s not a bad thing.”

And parents shouldn't underestimate the power of a simple gesture, McCabe said. "We need to let them know it's OK to not be OK," he said. "Sometimes all you have to do is send a text to your kid and just say, 'Thinking of you, love you.' And that goes a long way."

The conversation, along with the string of recent suicides among college athletes — including Katie Meyer, Arlana Miller, Sarah Shulze and Lauren Burnett — underscores just how damaging the pressure to live up to expectations can be. And it reinforces the importance of understanding how perfectionism, depression and ambition can set young people up for mental health challenges.

How does perfectionism become dysfunctional?

The two main elements of perfectionism are having high standards and being overly self-critical, Randy P. Auerbach, Ph.D., associate professor of medical psychology at Columbia University Medical Center, told TODAY.

"You can imagine that, for a lot of people, that can be motivating to a point," said Auerbach, who is also the co-director of the World Mental Health International College Student Initiative.

There are actually multiple types of perfectionism, in which people may direct those high expectations at others or themselves, or may feel that society has high expectations of them, Dr. Igor Galynker, professor of psychiatry and director of the Mount Sinai Beth Israel Suicide Research Laboratory, told TODAY.

Those who perceive their high standards to be coming from outside forces (also known as socially prescribed perfectionism) are at risk for mental health issues. "People with socially prescribed perfectionism set up impossible goals for themselves" as a result of what they believe is expected of them, Galynker explained. When perfectionists fail to achieve those goals, they "keep trying to the point that they can't look at anything else."

The link between perfectionism and suicide risk

“It is very concerning when people, especially teenagers, put all of their self-worth into their achievements,” Dr. Britta Ostermeyer, chair of the department of psychiatry and behavioral sciences at the University of Oklahoma, told TODAY.

Added Auerbach: “Your personal standards become more ethereal. They’re farther and farther away from you.” And, when it inevitably becomes less and less possible to reach those new heights, “you become more self-critical.”

Perfectionists can be so hard on themselves that when they don't achieve those goals, "it becomes a huge disappointment, a huge injury,” Ostermeyer said. For some, especially those with other risk factors, that kind of disappointment can lead to depression, she said. Those feelings can also manifest as anxiety about failure, or insecurity about never being enough.

When perfectionism becomes dysfunctional in this way, it can lead to mental health issues, and there's a long history of research that ties perfectionism to an elevated risk for suicide and depression.

Of course, not all perfectionists develop depression or deal with suicidal thoughts. But perfectionism among young high achievers can lead them to pursue their goals at the expense of all else. "The perfectionistic teenager who's driving towards success in this one domain may do it at the cost of sustaining peer relationships or familial relationships," Auerbach said.

In this way, perfectionism can directly cause mental distress. And it can also rob high-achieving adolescents of the support systems and skills they should develop to cope with life's inevitable ups and downs. Those who have other risk factors for anxiety and depression may be particularly vulnerable to the effects of extreme perfectionism, the experts said.

Signs to watch for in young adults

If your child is dealing with perfectionism that may become problematic, the right way to intervene depends on where they are on the spectrum and the degree to which it's taking over their life.

To start, notice if someone is spending a lot of time on one particular goal or activity, especially if it’s at the expense of friendships or other parts of their life, Auerbach said.

If someone is farther along on the continuum, they should get mental health help from a professional. They may be showing signs of depression or anxiety that are affecting their life at school or their relationships with family and friends. Depression is not a prerequisite for suicidal thoughts, Galynker noted, but it can be a major factor.

At the most extreme end, it's important to recognize emergency warning signs. Those can include changes in behavior, as well as voicing feelings of hopelessness or being a burden among many others, according to the American Foundation for Suicide Prevention.

Among perfectionists, that hopelessness may show up as "the feeling of being trapped in a no-win, unbearable situation generated by failing to achieve some kind of goal," Galynker said. His work focuses on suicide crisis syndrome, a term for this type of acute suicidal state in which someone may soon try to take their own life and is separate from someone’s lifetime risk for suicide.

One sign that someone is in the midst of suicidal crisis syndrome is that "they can’t stop thinking about their failures," Galynker said. "They feel like they’re controlled by their thoughts, and it’s incredibly painful.” They may have trouble sleeping and begin to withdraw from others. Those are all warning signs that someone needs help immediately.

Building a healthy balance of activities in young perfectionists

Even if a young person shows impressive skill at something, like a sport, it's important not to put all of their self-worth eggs in that one basket, experts told TODAY.

Not only does that set kids up for the ill effects of severe perfectionism, but it can keep them from developing important life skills and healthy coping mechanisms they should be learning during this time. “If we are singularly focused on one objective, and our self-worth is contingent on achieving that objective, it may come at the cost of really some other normative adolescent goals,” Auerbach said.

Balancing their time spent on that activity with other normal parts of adolescent life, whether that's spending time with friends or pursuing other hobbies, is crucial to help them develop the life skills they'll need.

Introduce kids to a variety of activities.

“Part of our role as parents is to bring new experiences to adolescents’ attention to try to show them the wide range of things that they could be doing as they expand their intellectual curiosity,” Auerbach explained.

He recommends parents take notice of how much time their children are spending on activities and try to introduce them to new hobbies to see if they take an interest. As a family, you might try cooking or hiking, for instance.

With a life full of different interests and opportunities, a setback in any one area has less of an impact. “It may be that you finish runner-up or your team doesn’t make a playoff, but you have all these other wonderful aspects of your life,” Auerbach said. “You’re pursuing different hobbies, schoolwork and friends because not everything rests on this one activity.”

Develop realistic goals.

If kids are particularly skilled at a sport or other activity, the adults in their life need to be careful not to instill the message that they're destined to be "the superstar of the family," Ostermeyer said. That may set them up to think that if they are anything less than the next Messi, they're a failure.

Of course, there is nothing wrong with having big dreams or lofty goals, but they need to still be achievable, she explained. "A support system needs to be there to catch them and be realistic. ... The family has to communicate that, 'This might work out fine. But if it doesn't, we love you. We respect you.'"

Reframe wins and losses.

Winning or losing a game is worth reflecting on. But it's also helpful to reframe those as just one part of an ongoing journey, Auerbach said. He also recommended commending adolescents on other parts of that journey, like the friendships and teamwork skills they're building, rather than focusing solely on the end result of a match.

Help young adults plan and advocate for themselves.

Adolescents need a balance of activities and healthy habits that, when they still live at home, might be naturally built into their day, Auerbach said. But as kids get older and go off to college, they are more autonomous and will have to build those routines for themselves.

Also, make sure kids know where to go if they need mental health help, whether that's a trusted teacher or coach or their college's counseling center.

If you or someone you know is in crisis, call the U.S. National Suicide Prevention Lifeline at 800-273-8255, text TALK to 741741 or visit for additional resources.