“Being an athlete at the top of your game can be a lonely and dark place,”
explains Michael Caulfield, a sports psychologist with The Sporting Edge and
former chief executive of the Jockeys Association. “It can be absolutely
heartbreaking when something doesn’t go your way – when your body lets you
down, for example. All those tears we see on the podiums; that’s when they
realise all the sacrifices they’ve put themselves through to get there.”

In 2005, Olympic champion Dame Kelly Holmes revealed that she, like Pendleton,
used to self-harm. A year before winning two gold medals in Athens in 2004,
Holmes, then 34, repeatedly slashed her body with scissors, leaving scars on
her arms and stomach. She said she was taking out her frustration after a
calf injury had left her unable to run. “I made one cut for every day I’d
been injured,” she said. “With each one I felt I was punishing myself, but
at the same time I felt a sense of relief that drove me to do it again and
again. It was a cry of despair.”

Athletes deal with this despair in different ways – from engaging in benign,
harmless rituals before they compete, to developing extreme psychological
problems that can be dangerous and life-threatening. What they share, says
Caulfield, is a fear of failure. “When they go on to that pitch or those
starting blocks, they have no idea what’s coming next,” he says. “That can
make them feel incredibly insecure.”

At the least extreme end of the spectrum are athletes who develop obsessive
traits, sometimes the beginnings of obsessive-compulsive disorder (OCD), to
help combat lack of confidence. Spanish tennis player Rafael Nadal lines up
his water bottles on the side of the court before playing, much as
footballer David Beckham (who has admitted to having OCD) lines up the Pepsi
cans in his fridge. Novak Djokovic, the Serbian tennis player, refuses to
use the same shower twice during tournaments, while Olympic silver medallist
Rebecca Adlington only sets her alarm clock or the television volume to an
even number.

It’s easy to dismiss some of these as silly superstitions; but they can
conceal deep-rooted vulnerability. Stuart Holliday, a trainee sports
psychologist with his own consultancy, says these minor neuroses provide
athletes with comfort and confidence in an otherwise unpredictable
profession. Unable to control what happens on the track, in the pool or on
the pitch, they crave control in their personal lives. “If it’s worked in
the past, they’ll repeat it,” he explains. “They know what they’re doing is
irrational but it can become a coping strategy to deal with the stress of
competing.”

For others, pre-performance routines aren’t enough. The pressure of
professional sport drives some athletes to devastating afflictions:
self-harm, anxiety, depression – even suicide. Former England captain
Freddie Flintoff famously suffered from depression during his cricket
career, and stars including Jonny Wilkinson, the England rugby player,
footballer Stan Collymore and Celtic manager Neil Lennon have spoken
publicly about their psychological battles off-pitch. In 2009, the football
world was shocked when German goalkeeper Robert Enke committed suicide after
a long, private battle with depression.

“It’s a numbers game – if one in 10 people suffers from anxiety or depression,
some of those will be athletes,” says sport psychologist Dr Victor Thompson.
“It’s a surprise because they look like they have it all. Sport can offer so
much, but at times it can be devastating and destroying. Athletes need a way
to cope, whether that’s drugs, alcohol, punching the wall, having a tantrum
– or worse.”

One of the worst secret afflictions among athletes is anorexia. Colin Jackson,
the former Olympic hurdler, has admitted that he was “bordering on anorexia”
leading up to the 1993 world championships, and five out of seven runners in
the British junior cross-country team in 1996 were revealed to have an
eating disorder. Nearly two decades later, studies by researchers at the
University of Leeds show that as many as one in 10 of Britain’s 250 leading
female runners has an eating disorder. The issue of the “perfect” body
reared its head at the London Olympics: both Tom Daley and Jessica Ennis
were labelled “fat” in the run-up to the Games.

Worryingly, experts say the prevalence of eating disorders in sport may be
linked to the sense of control it gives athletes over their bodies. When
everything in their lives is so rigorously controlled by others – from their
daily routine to the time they go to bed – what they eat in their own time
is down to them. “Athletes like being able to choose something for
themselves,” explains Caulfield. “This may be the music they listen to on
their iPod or the colour they dye their hair.”

Pendleton’s account of her battle with self-harm is an insight into a side of
elite sports we know alarmingly little about. Phil Johnson, founder of Sport
and Performance Psychology, says many athletes struggle psychologically
because they don’t have anyone to talk to about what they’re going through.
“Victoria would have found it difficult to express her feelings within a
context of safety, understanding and confidentiality,” he explains. “Lots of
athletes wouldn’t think of going to a sports psychologist, and some experts
aren’t trained to deal with these problems.”

Help is at hand for athletes who competed in the London Games. UK Athletics
has an agreement with the Priory hospital group, whose experts have pledged
to provide mental health support – on issues including stress, anxiety,
depression and eating disorders – to sportsmen and women from Team GB. For,
behind many of those tearful victory ceremonies and beaming faces atop
podiums will have been hidden stories of pain and heartbreak on the road to
success. One can only hope that Pendleton, nearly a month into her
retirement, is now in a better place.