Lydia Jacoby was for the United States at the last Summer Games, earning a gold medal in the 100-meter breaststroke and a relay silver. Part of what comes to mind from those heady days in Tokyo? "People talking about post-Olympic depression," she said.
She was 17 at the time, and her initial response when other athletes brought up the topic was: "Well, that doesn't apply to me."
"I essentially did not understand the topic of depression," she said. "It wasn't until after the Games that I was like, 'Oh. ... OK. Yeah, I'm feeling this a little.'"
Jacoby, who didn't qualify for the , is now fully aware of the phenomenon, went through it, moved past it, and discusses it casually, all of which points to the way things have changed in just a few years when it comes to mental health.
As the Paris Games open on Friday, followed by the Paralympics beginning August 28, athletes have more access than ever to resources in that once-taboo realm and sound more willing than ever to use them. That seems particularly significant given that Jessica Bartley, PsyD, the U.S. Olympic and Paralympic Committee's (USOPC) senior director of psychological services, says about half of the country's athletes at the past two Olympiads were flagged for at least one of the following: anxiety, depression, sleep disorders, eating disorders, substance use or abuse.
"We really are just a part of the conversation now," Bartley said, "and not an afterthought or something when someone's struggling."
Among the key questions now: Is everyone going to seek the help they need? And is enough help available?
As for the first, Bartley said: "I'd like to think we're over the hump, but we're still not quite there. I feel like there is still some stigma. I think there's still some connections to 'weakness.'"
And the second? "I do think there still could be more," said, "but, I mean, they're there."
Olympians Simone Biles, Naomi Osaka, and Michael Phelps Opened Doors
Three Olympians -- and , who participated in the last pandemic-delayed Summer Games, and are returning, and retired swimmer , who has more medals than anyone in any sport -- provided some of the loudest voices in the growing global conversation in sports and society at large about the importance of protecting, gauging, and improving the state of one's mind as much as one's body.
Phelps spoke about having suicidal thoughts at the height of his career and helped produce a documentary about depression among Olympians. He also called on the International Olympic Committee (IOC) and USOPC to do more.
"I do think there's something to be said when a lot of really, really good athletes kind of talk about the same issue. I know all athletes don't feel the same way; you have to be a certain type or in a certain head space. Some people just feel things differently," said Osaka, a four-time Grand Slam champion and former No. 1-ranked player in tennis who lit the cauldron in Japan.
She's been forthcoming about her bouts with anxiety and depression and was among the first sports figures to take mental-health breaks away from competition, paving the way for others.
Osaka, in turn, said she felt "very heard" when she listened to Biles and Phelps.
"I'm pretty sure a lot of different athletes also felt heard," Osaka said. "They didn't feel like it was a weakness or anything like that, so I'm really glad we all talked about it."
Biles, who redefined excellence in gymnastics and picked up seven Olympic medals along the way, drew attention and, from some, criticism, for pulling out of events in Tokyo because of a mental block -- -- that made her afraid to attempt certain dangerous moves.
That her explanations of what went awry came in such a public setting, as the biggest star in Tokyo, only made it all the more meaningful to other athletes.
"She didn't have to," said basketball player , a WNBA MVP. "She used her platform to help others."
What Biles did resonated with athletes like canoeist , a gold medalist in Tokyo, who said "anxiety, fear, stress ... are all going to be huge parts in competing at such a high level."
Biles made them see that there can be a way out.
"I was, at one time, in those shoes," boxer Morelle McCane said, "where I was just like, 'It's do or die! It's do or die!'"
How Different Is It for Today's Olympians?
Janet Evans won four swimming golds at the 1988 and 1992 Games and recalls the never-easing pressure to perform. In her day, she says, there wasn't nearly the empathy or outlets for help available as there are for today's Olympians.
"We didn't talk about the struggles. No one taught me that it was OK to lose, right? I mean, I was Janet Evans, and when I went to a swim meet, I was supposed to win," said Evans, the . "We talk about it now and we recognize it with our athletes. And I think that is an important first step."
Which means that even 38-year-old Perry Baker has seen changes since his Olympic debut at Rio de Janeiro in 2016.
"You had to tough it out. You kind of felt by yourself. You kind of felt like you couldn't talk to anyone," said Baker, who briefly was with the NFL's Philadelphia Eagles.
The balance national Olympic committees must strike between caring about athletes as people but making sure the medals pile up is "threading a needle," Evans acknowledged.
"We should go to the Olympics and Paralympics and win medals. But I don't think that should be at the cost of how we're preparing our athletes for the future," Evans said. "Both can happen."
That's where Bartley and her counterparts in other countries and at the IOC come in.
The Beijing Winter Games 2 years ago were the first with extra credentials issued for national Olympic committees to bring athlete welfare officers -- registered mental health professionals or qualified safeguarding experts -- and more than 170 from more than 90 countries will be in Paris.
"We didn't have it in Tokyo, and now it will be implemented for every Games," said Kirsty Burrows, head of an IOC unit focused on athletes' mental health. "Because we really see the impact."
There will be a 24/7 helpline with mental health counselors who speak more than 70 languages, a program started for the Beijing Games but now available to every Olympian and Paralympian until 4 years after the event. There's also AI [artificial intelligence] to monitor athletes' social media for cyberbullying, and a "mind zone" in the athletes village with a yoga area, low lighting, comfortable seating, and other tools "dedicated to disconnection, decompression," Burrows said.
The USOPC went from six mental-health providers 3 1/2 years ago to 15 now; 14 will be in France. Last year, 1,300 Team USA athletes participated in more than 6,000 therapy sessions set up by the USOPC.
"I expect the numbers to be even higher," Bartley said, "especially in a Games year."