We talk to Sports Psychiatrist Dr Amit D Mistry about his work with ASICS to help athletes achieve physical and mental equilibrium

In collaboration with ASICS 

If an elite athlete is performing to their highest level, the likelihood is they will have focused on both their mental and physical wellbeing. The impact of a sound mind in a sound body cannot be overstated and it is the founding philosophy of ASICS.

Dr Amit D Mistry, an award-winning Consultant Sports Psychiatrist, knows the significance of that correlation and provides mental health support for all of ASICS’ sponsored athletes when they’re in need, a service that is offered in their contracts.

Based at the Nightingale Hospital in London, Mistry provides mental health advice within the elite sport space and stresses the importance of looking at the unique needs of each athlete. He also consults ASICS FrontRunner, a global running community with over 600 ambassadors from over 30 countries across the world.

AW spoke to him about how he came to partner with ASICS and the biggest observations and learnings from his work.

What does Sound Mind, Sound Body mean to you?

Sound Mind, Sound Body embodies parity of esteem between physical and mental health, a fundamental concept within mainstream healthcare systems.

Both should be equally respected, yet holistically treated as one. It encapsulates everything that I truly believe in as a Consultant Psychiatrist who's gone on to work within sports and exercise.

In my clinic, I advocate for enjoyable exercise in moderation alongside other evidence-based, tailored treatment options. I was quite excited when I was contacted by ASICS in 2023. I am proud to partner with them, given their authenticity and founding principles being based on Sound Mind, Sound Body. In my opinion they are doing groundbreaking work in delivering this key message for all.

Can you explain more about the work that you do?

To run through the journey, an initial conversation with someone takes around one to two hours – just to understand their needs, not just in a sporting context but their day-to-day life.

Based on that we then do a formulation to understand what’s driving any mental challenges and then we create a Biopsychosocial plan. Off the back of that, we provide therapy depending on their needs.

Depending on the athlete, you might focus on cognitive therapy or you could look at dialectical therapy, which is where you’re thinking about managing emotional stress. How do we support someone in that moment to work on better behaviours or techniques if they’re struggling with their mental health?

You also have to look at the performance versus purpose narrative. When I meet athletes, the ones who prioritise the purpose element will tend to fare better from a wellbeing perspective, whereas those that are purely focused on metrics – i.e. personal bests, gold medals or podiums – can be at a disadvantage.

What are some of the important facets to look at in this area?

In the elite sport setting, athletes can be rigid with calories or with their physical activity when competing. That kind of lifestyle can be functional for an athlete during a time sensitive period, as long as they are able to switch off in the off-season.

It becomes a problem if it’s an ongoing issue and we’re talking about repeated over-exercise or malnutrition throughout the year. That’s when we may insidiously end up with an eating disorder like anorexia or relative energy deficiency (RED-S). You could also pick up both localised and systemic injuries, such as osteopenia (thinning of the bones) or osteoporosis (high risk of fractures) for example.

People who are in relative malnutrition tend to experience low mood, as well. They can have anxiety and burnout because they are so depleted of energy that it impacts on their moods and mental health. On the exercise spectrum, you can go from recreational physical activity, which we know has an anti-depressant effect, to compulsive exercise without sufficient rest. The latter is where you’re at risk.

What are some of the biggest observations from your work?

What I’ve found most fulfilling is when we have consensus from the support team as well as the athlete. That might be the coach or their family and loved ones. If we have that clear communication from the start, we know that it creates that accountability. Whether it’s a short or long-term goal, we’re very open about what we’re trying to achieve together.

For example, in relation to eating disorders, it’s about being transparent about what the dietetic meal plan is, what we’re looking for in blood tests and the metrics from a physical health perspective.

Looking at exercise more generally, how significant is it in improving someone’s mental health?

It’s a topic that has fascinated me and it’s what got me into this space of sports and exercise psychiatry in the first place. During my training I was part of Public Health England between 2014-15 and that was purely designed to support physical activity for severe mental illness. At that time the evidence base was quite robust, in that we live in a sedentary society, with a big focus on commuting and office jobs.

Between 2015 to 2020, there was an explosion of papers focusing on the correlation between exercise and overcoming mental health conditions. ASICS’ own research shows that just 15 minutes and nine seconds of exercise is enough for someone to achieve a mental uplift.

I’m not saying it’s the only tool to use as there will be people with severe depression who might not have the motivation and concentration to do physical activity. But if it is something we can utilise for somebody, just a little bit of exercise is better than nothing. We know that those that are the most sedentary have the most to benefit.

In March 2022, UK mental health charity Mind released its Mental Health in Elite Sport report, supported by ASICS. The landmark report draws on the insights of organisations and athletes from across the sport sector. The report highlights the progress being made to tackle mental health in elite sport, but also highlights key areas to focus on including, more work to tackle stigma and more funding to treat mental health problems.

Hayley Jarvis, Head of Physical Activity at Mind, said: "We know from our own research that more needs to be done to tackle stigma and encourage athletes to speak up and seek help. So, it’s fantastic to see ASICS shine a light on mental health in elite sport, help to normalise conversations about it and, crucially, provide mental health support to their athlete ambassadors. We want to help create a sporting culture where athletes can not only compete but thrive."