Mercedes Perez struggled to breathe. Her heart raced. Her right eye twitched.

The junior at Woodcreek High near Sacramento had never felt this way. It was the end of March, a few weeks after her high school cheerleading season was put on hold because of the coronavirus pandemic, and her anxiety had risen while stuck in her room at home. To this point, she had maintained control and tried to stay positive. But now she was having an anxiety attack.

“It feels almost like you’re drowning,” said Perez, 16.

Since that night in her bedroom, Perez estimates she has endured about 20 anxiety attacks. When she experienced anxiety in the past, cheerleading helped soften her nerves. But with high school sports around the country going on hold, Perez no longer had that outlet.

Around the country, high school athletes said they’ve experienced depression and anxiety since sports in their states were canceled — losing the structure, identity and stress relief they’ve relied on much of their lives. In response, high schools have taken extra measures to provide resources and combat the stigma. Many young athletes are now discussing their mental health for the first time.

“It’s not some awkward thing that comes up in conversation now,” Perez said. “If you walked up to somebody and was like, ‘I have really severe anxiety,’ they’d be like, ‘Oh, that’s kind of weird.’ But now it’s like, ‘Oh, tell me about it.’ ”

A widespread issue

In May, Timothy McGuine, a scientist for the University of Wisconsin School of Medicine and Public Health, studied how the loss of sports affected Wisconsin high school athletes’ mental health. According to the results McGuine provided, 68 percent of participants reported showing symptoms of depression, and 65 percent reported showing symptoms of anxiety.

It has now been nearly a year since high school sports paused. Some locations brought back sports in the fall, but others, including D.C., have not held athletic events since last March. In Maryland, three counties started playing sports in October before halting in November.

In places where activities have not returned, students — who count on sports for exercise and camaraderie — strongly feel the absence. While the coronavirus has attacked older age groups physically, young adults are the most prone to depression and anxiety, researchers have found.

“High school students’ experiences are often not given credit because often it’s seen as just teenage angst or something that young adults will grow out of,” said Alison Malmon, founder of Active Minds, a nonprofit supporting mental health awareness and education for students. “Oftentimes, high school students are not really taught to recognize that what they’re dealing with might be an actual struggle that they can’t just pull themselves out of, but it’s an … actual diagnosable disorder that needs and deserves help and treatment.”

Even if students suspect they need help, school counselors are overstretched.

According to the American School Counselor Association’s most recent data (from the 2018-19 school year), for every school counselor, there are 474 students in D.C., 362 students in Maryland and 345 students in Virginia. The ASCA recommends a ratio of 250 to 1.

The pandemic complicates counselors’ jobs further because of the lack of face-to-face exposure. “It’s a lot harder to get them to talk to you [online] than it is to get them to just stop in,” said Katherine Spicer, a counselor at Magruder High in Rockville, Md. “But we know that they need it and that they want it.”

Starting the conversation

When Perez’s mother, Cindy, signed up her daughter for Cooley Middle School’s cheerleading tryouts in 2016, Perez was angry. She was 12 at the time and never wanted to be a cheerleader. But when Cindy picked her up from tryouts two hours later, a huge smile stretched across Mercedes’s face.

Perez joined her high school’s junior varsity cheer and stunt team as a freshman. Before cheering at games, she would get ready at a friend’s house. And for good luck, she would bump backs with her teammates. That smile became almost permanent, helping to brighten the mood in times of stress.

When sports were halted, her thoughts spilled out of control. She wondered how she would have a chance to be recruited for college without competitions. She was concerned how friends would handle the cancellation. She was set to be on varsity the next fall, but she feared the pandemic would cancel that, too. One night in late March, she was up around 3 a.m., her mind racing, when the first anxiety attack arrived.

Even after her anxiety attacks continued for the next few months, Perez didn’t know what she was dealing with. In August, after she said she had experienced about six anxiety attacks, which lasted anywhere from 15 minutes to an hour, she told her mother. Her mom, who said she also had anxiety attacks growing up, informed her what the episodes were.

Malmon said many high school students who begin experiencing symptoms of depression and anxiety don’t understand what they’re enduring or where to turn for help. In response, some schools have created mental health support groups.

At Winters Mill High in Westminster, Md., students and school counselors created a group called “Falcons of Strength,” a program for students and staff members to discuss their mental health. Athletes say Falcons of Strength, which is four years old, has been especially beneficial for students during the pandemic, even as it has moved to Zoom. Multiple schools in Virginia’s Fairfax County and Maryland’s Montgomery County offer similar programs.

“It really gets stuff off your chest when you don’t want to talk to anyone else about it,” said Rachel Ross, a freshman and multisport athlete at Winters Mill. “It’s just a good relief, and it also brings up my confidence.”

Destigmatizing it

Athletes, Malmon said, are conditioned to act tough and hide their emotions. Because of that tendency, any perceived stigma of depression or anxiety can be heightened.

There is momentum to change that culture, though.

In January, the D.C. Interscholastic Athletic Association organized a 90-minute Zoom meeting for its athletes to discuss mental wellness. About 40 athletes, coaches and athletic directors were on the call, which featured mental health professionals and professional athletes dealing with mental health struggles.

“If you have a sad mood, depressed mood that lasts longer than two weeks … get help,” Janet Taylor, a psychiatrist, said to students in the meeting. “Help is there. We have to lose the stigma as Black and Brown people about getting help, but help is there. Depression is something that will stop you, but it’s treatable. It doesn’t mean you’re weak; it doesn’t mean you’re bad. It just means you need help, and we all need help sometimes.”

These sessions are some of the few resources targeted to athletes. Unlike college and professional teams, few high schools employ a sports psychologist, which means a high school coach often doubles as an untrained mental health professional.

At Riverdale Baptist in Upper Marlboro, Md., football coach Jahvon Gordon realized the crisis his team was in when the pandemic and the unexpected death of a teammate in March devastated his players. Gordon talked to his team about mental health and set up avenues for therapy — something he also did pre-pandemic when he noticed players displaying symptoms of depression.

Kristen Conques, the girls’ lacrosse coach at Highland School in Warrenton, Va., also has been attentive to potential mental health issues after one of her former players and assistant coaches, Morgan Rodgers, died by suicide in 2019. For weeks, Conques, 35, wondered how she could have helped.

Now, the topic of mental health comes up regularly in Conques’s conversations. Every week, the team holds a Zoom meeting that lasts over an hour. Conques often joins the meeting early so players have another opportunity to chat with her. She texts or calls each player weekly, and she assigns her captains to do the same.

Coping strategies

For Mercedes Perez, mental wellness is prominently acknowledged and discussed. Two of her friends attempted suicide during the pandemic, Cindy Perez said, making the topic a regular part of the daily conversation. In a recent Centers for Disease Control and Prevention study, one in four young adults said they had suicidal thoughts in the past 30 days.

Perez has made strides to control her anxiety. When she’s stressed, she sits in a corner of her backyard and listens to the sounds of rain and wind in her earphones. Some nights, she and her mom will binge-watch Netflix.

Memories of their favorite performances have provided some athletes hope. Perez remembers being 12 and competing for the first time, at the Anaheim Convention Center. When the music started playing, her nerves vanished, and she fell in love with the sport. “I want to do that again,” she told her teammates afterward.

In March, Perez was unsure whether her anxiety would diminish with sports paused. She was scared to talk about her struggles. But as her friends encountered similar issues, Perez opened up, which she said has eased her anxiety. That has been the case for many athletes.

“We’re all in a bad place right now,” said Nina Crull, a volleyball player at Wisconsin’s McFarland High. “If we don’t talk about it, then it only gets worse.”

Last week, California’s high school athletic association announced football could return next month. For Perez, that means she is likely to return to cheerleading for games. If her anxiety intensifies in the future, she said she’ll find strength by recalling how she withstood one of the toughest periods of her life.

“People are a lot more open about the subject because there are so many people who are struggling with the same issue I have,” Perez said. “I’ve noticed it come up more openly and comfortably in conversation rather than it being some secret people hide. It’s a really good thing to come out of [the pandemic].”