Maintaining mental health a daily challenge for those inside the NBA bubble

ORLANDO, FL - AUGUST 25: Montrezl Harrell #5 of the LA Clippers arrives to the arena before Round One, Game Five of the NBA Playoffs against the Dallas Mavericks on August 25, 2020 in Orlando, Florida at AdventHealth Arena. NOTE TO USER: User expressly acknowledges and agrees that, by downloading and/or using this photograph, user is consenting to the terms and conditions of the Getty Images License Agreement.  Mandatory Copyright Notice: Copyright 2020 NBAE (Photo by Jesse D. Garrabrant/NBAE via Getty Images)
Being away from family and friends for a prolonged period of time can take a toll on one's mental health. (Photo by Jesse D. Garrabrant/NBAE via Getty Images)

When the NBA announced their restart plans, there were immediate concerns about the viability of operating inside a bubble in the middle of a global pandemic. In the days leading up to the players arriving inside the Walt Disney World campus in Florida, the state was setting record breaking numbers for COVID-19 cases on a daily basis. The skepticism of whether the league could finish their season inside the bubble was warranted.

Several months later, and without a single positive COVID-19 case reported inside the bubble since July, the plan has been a success. Setting aside the excitement of the postseason so far, the bubble has worked. As we wait for a vaccine and a potential return of fans at arenas next season, the Disney campus provides an alternative template of how sports will play out for the foreseeable future.

Life inside the bubble hasn’t been easy for the players, coaches and traveling members of each team. As the novelty of living inside a campus has worn off, players have openly spoken about the boredom that has set in. Until last week, they were physically isolated from their family and friends for almost two months. They’ve also been separated from the real world altogether. While daily testing can give us a definitive measure of how the league is keeping the virus from entering the bubble, evaluating the mental health of everyone inside is a much tougher task. Every individual presents a unique case.

The NBA and NBPA were well aware of this, and have worked together to provide mental health services and have licensed professionals available both onsite and offsite since the start of this campus experiment. Teams have also brought their own mental health specialists as part of their travel party.

From an outsider’s perspective, the one immediate concern that jumps out is the extended time away from friends and family, especially in such uncertain times. Katy Kamkar is a clinical psychologist based in Toronto and an Assistant Professor within the Department of Psychiatry at the University of Toronto. “The term isolation has a different definition for every environment,” Kamkar says. “We need to look at protective factors to build resiliency. It helps minimize duress for mental health.”

One of those protective factors is social support. While players and coaches have been physically distanced from their family and friends, it has been mitigated by technology and the ability to interact through phone and video calls. Last week, players who are still at the campus were allowed to bring guests into the bubble to join them (although coaches were excluded from this privilege, which understandably made Denver Nuggets head coach Mike Malone very upset), which further eases the concerns on that front.

Kamkar also points to the return of basketball and pursuing a common goal with winning a championship as another form of social support. “Despite the isolation from the outside,” Kamkar says. “The players are working together as a team so there’s a sense of meaning and achievement.”

Even though the league has tried to incorporate many off-court activities into the bubble, including golfing and the occasional fishing trip, players have found boredom setting in. After a playoff loss in the first round, LeBron James said “there’s nothing to do here besides play basketball.”

While team-organized activities can help to pass the time, it is also important to give the players their own space while they’re living inside the bubble. Dr. Kimberley Amirault-Ryan, a performance consultant to the NHL and NBA, has spoken to people inside both bubbles.

“The teams that are doing their best are creating some physical space [for the players],” Amirault-Ryan says. “So, this might mean a full day where there are no team meetings. People are getting overwhelmed with having no physical space. You’re always around the same people. You want to ensure players have their mental space.”

Amirault-Ryan has worked at five Olympic Games, and sees similarities between the NBA bubble and what Olympic athletes have to go through. From her experience, developing a routine under these circumstances is especially important. “Having the sleep, getting the exercise in, taking the time to step away from electronics and eating well,” Amirault-Ryan says. “It’s teaching them to have a routine and schedule.”

NBA players are creatures of habit. Many players around the league have incorporated meditation and yoga as part of their game-day routines for years. Others use phone apps like Headspace to manage stress and anxiety. Sometimes those routines include not inviting family and friends into the bubble, as Jimmy Butler did, referring to the bubble as a business trip. For veterans, adjusting to the bubble might be easier in this regard, while rookies and younger players are still finding their own routine.

During their downtime, Amirault-Ryan also recommends discovering new hobbies. “You always want to be learning,” Amirault-Ryan says. “What are things away from the sport that can still use the emotional, expressive side of your brain.” Inside the bubble, we’ve seen players finding ways to occupy themselves with other hobbies, whether it is Damian Lillard releasing an album while carrying the Portland Trail Blazers to the playoffs or Matisse Thybulle and numerous other players starting their own YouTube video channel to give fans a glimpse into what living in the bubble entails.

Even with mitigating factors in place, circumstances can change quickly. In the wake of the police shooting of Jacob Blake in Kenosha, Wisconsin, players around the league expressed their anger and frustration on their daily calls with the outside media. There was a sense of hopelessness amongst the players, especially since many of them took to the streets and participated in social justice protests prior to arriving in the bubble.

George Hill of the Milwaukee Bucks openly questioned whether the players should have come to the bubble in the first place. A few days later, Hill and his teammates boycotted their game against the Orlando Magic. Basketball came to a complete halt, and after several meetings among the players in the bubble, followed by discussions with the league and team owners, the players opted to return to play after agreeing to an action plan with the owners.

Even as we still find time to escape into being sports fans when players take the court, it is harder than ever to separate it from real life. The most poignant example of this came after the Utah Jazz saw their season end at the buzzer in Game 7 of the first round against the Denver Nuggets.

ORLANDO, FL - SEPTEMBER 1: Jamal Murray #27 of the Denver Nuggets hugs Donovan Mitchell #45 of the Utah Jazz after Round One, Game Seven of the NBA Playoffs on September 1, 2020 at AdventHealth Arena in Orlando, Florida. NOTE TO USER: User expressly acknowledges and agrees that, by downloading and/or using this Photograph, user is consenting to the terms and conditions of the Getty Images License Agreement. Mandatory Copyright Notice: Copyright 2020 NBAE (Photo by Andrew D. Bernstein/NBAE via Getty Images)
Jamal Murray and Donovan Mitchell embrace following the conclusion of their seven-game series. (Photo by Andrew D. Bernstein/NBAE via Getty Images)

Minutes after the most heartbreaking loss of his career, Donovan Mitchell put everything into perspective. “This is a game,” Mitchell said. “People lost their family members to police brutality and racism and s--t. I can only imagine. I wanted to say that. I wanted to get that out there because the way that I’m feeling right now is nothing compared to that.”

We’re all facing an uncertain future while living in a global pandemic. For NBA players, there’s no set date or agreed-upon plan on when next season will start, and where it will take place. From a mental health perspective, everyone inside the bubble is figuring it out one day at a time.

“There isn’t a roadmap to this,” Amirault-Ryan says. “We’re all doing the best we can.”

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