Episode #123

Athlete: Paige Madden

“Swimming Through Hashimoto’s Disease”

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Stef: 

Today on the Voice in Sport Podcast, we are joined by Paige Madden, professional swimmer for team USA. She is a three-time Olympic medalist with two silver medals in the four by 200 meter freestyle relay and a bronze medal in the 800 meter freestyle. She's also a four-time NCAA champion and set seven Alabama state records.

During her time in high school while earning these amazing accolades, Paige was quietly battling something bigger. At the age of 13, Paige was diagnosed with Hashimoto's disease, an autoimmune condition where the immune system mistakenly attacks the thyroid gland.

In today's episode, we dive into Paige's story of dealing with her autoimmune condition and the mental and physical challenges that come with it throughout her athletic career so far. She discusses her diagnosis and how she felt after finding out she would continue to live with this autoimmune condition, 

Paige: 

It was kind of just thrown on me like, okay, you have this autoimmune condition. Which to me, as a young athlete, I was, kind of in denial because I'd been healthy like my whole life 

Stef: 

She opens up about one of her lowest moments, struggling with the effects of her condition and poor mental health. 

Paige: 

I had that crap in 2022 and my symptoms were, you know, I couldn't even. Clean my room, like I was so tired. contemplated quitting then,

Stef: 

And she emphasizes that she wished she would've opened up about her emotions and struggles when she was younger, and how not addressing those feelings early on can create bigger issues. 

Paige: 

I think when we push things down, they always find their way to come out. And for me, it wasn't until several, several years later that it finally came to a head and everything kind of came crashing down.

Stef: 

Paige's story is a powerful example of what it means to persevere through both visible and invisible struggles. Whether you are battling the effects of a health condition or grappling with mental health struggles, Paige's story offers both comfort and courage, inspiring athletes to keep moving forward with resilience.

Before we jump in, don't forget to give us a rating and review on Apple Podcasts and Spotify, and be sure to sign up@voiceinsport.com and download the new VIS app, which is the ultimate resource for women athletes. 

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Paige, welcome to the Voice in Sport Podcast.

Paige: 

Thanks, Steph. Yeah, I'm super excited to be here.

Stef: 

Last time I saw you was in Paris, so it's good. See you again. 

Paige: 

Yes. Right under the Eiffel Tower, actually. 

Stef: 

Not a bad place to meet, very romantic.

Paige: 

Not a bad place to meet. It was a beautiful day too. A crazy day, but Yeah, it's nice to see you again. 

Stef: 

Absolutely. Well, we're really excited to dive into this topic today with you around your own mental health struggles but also with your diagnosis of Hashimoto thyroiditis. So let's start all the way back when you were 13, when you were diagnosed with this autoimmune disorder. And I'm sure it was really difficult because it comes with a lot of invisible challenges, especially for athletes.

It affects roughly 5% of the United States population, and women are 10 times more likely to get it than men. So for those who are listening who may not be familiar, could you explain what Hashimoto disease is? 

Paige: 

Yeah, absolutely. So Hashimoto's it's an autoimmune condition. So basically my body attacks my thyroid gland, which controls a lot of your hormones. So in turn it. Kind of affects your entire system. And there's a lot of different side effects associated with it. For me, the main ones are fatigue tiredness. I sleep all the time. You can have a little bit of low mood and depression. That's definitely affected me. And among other things like hair loss skin dryness, I haven't experienced much of that, but every, you know, everyone kind of experiences it differently.

Stef: 

When did you first realize something wasn't right with your body? 

Paige:

 That's a good question. I think from a young age I kind of always knew like something was a little bit off. There was times in practice where I couldn't. Pushed as hard as I wanted to, but I think I was lucky that I was diagnosed at a very young age and I'd actually gone to the doctor 'cause I was really sick with the flu.

And he did a routine exam and then realized that my thyroid was swollen I didn't even know what that was. And he recommended that I tested and I did, and my results came back positive and it was kind of just thrown on me like, okay, you have this autoimmune condition.

Which to me, as a young athlete, I was, I was kind of in denial because I'd been healthy like my whole life and took very, even though I was only 13, like I. I, I took my nutrition very seriously, sleep very seriously, and of course, like training in and out the pool. 

Stef:

Can you describe a moment, maybe at a meet or practice where your body wasn't responding the way you knew it would or that you knew it could and what that felt like inside?

Paige: 

One particular instance that stands out to me is when. I was 17 and I was prepping for the 2016 Olympic trials, so pretty stressful time for me. And that's when I noticed a lot of my symptoms flaring. And I remember doing this one set when I was in high school. We would always do the same sets before a big meet when you taper as we call it, as swimmers. So I knew, like I knew exactly what the set was. I'd done it probably like 15 to 20 times before this. Like it was kind of, kind of a regular, regular at the set. And my heart just started beating so, so fast after one of the first rep. And I remember panicking and breathing super fast. Then I began to get upset and because of that, then like the breathing increased, the heart rate increased, and it was sort of this snowball effect.

And my coach could tell that something was wrong and he was like, okay, like we're gonna stop, take a break and come back to this. But I think that was kind of. One of just the manifestations of all the stress that I had put on myself. You know, even though I was, I was only 17 and I had no real shot at the time of making the Olympic team.

Like I was kind of just going for fun or for the experience, but I still had high goals and expectations of myself, and it was just the terminology of Olympic trials, put a lot of weight on my shoulder. And I think because of that then, like my physical symptoms manifested. 

Stef: 

Yeah, it's definitely difficult, I think to ever have, you know, even just to have an injury in sport, but then to have something that is an autoimmune disease that might, that will stick with you for a long time.

That's a hard thing to hear at age 13 and then process. Mm-hmm. But you kept going and you kept working hard. That doesn't mean it was easy along the way. But if you think back to that moment, I guess when you. Were diagnosed and you were 13 and sort of those early years in your teens, like what, what was that emotional process like for you?

What was the hardest part of hearing, like you have Hashimoto's at that age? 

Paige: 

Yeah. To be perfectly honest, I don't think I processed it really at the time. I kind of just pushed it under and I didn't tell anyone except for my family. It wasn't something that came up in conversation. It wasn't something that I told my coaches.

I kind of just it was just this underlying thing and it was kind of just okay, I have this. I think I was in denial because I wanted to be the best of the best in sport, and I probably felt like this was something that was gonna hold me back. And I didn't want it to define me. And so my response was to just push it down, push it down, push it down.

Stef: 

And what did that result in over time, pushing it down like that and not confiding in others about really what was going on with you? 

Paige: 

Yeah, so I think when we push things down, they always find their way to come out. And for me, it wasn't until several, several years later that it finally came to a head and everything kind of came crashing down.

That actually wasn't until after I'd made my first Olympics and it was, you know, a year after that I think. I had gone through all of these really exciting events that produce a lot of emotion, and then the come down from that really manifested again my physical symptoms. 

Stef: 

So that's a really long time to kind of suppress, you know, something that's really now integral part of your life from age 13 to 22 when you made your first Olympic team. So looking back on that, you know, time in your life now what do you wish you would've done differently?

Paige: 

Looking back on it, I think one of the biggest things I wish I would've done differently is I. Communicate upfront with my coaches, kind of like, Hey, I have this autoimmune condition. I don't want it to define me. I'm still ready to come to practice and train really hard, which for that period of time I was, I, I pretty much just grinded it out every single day.

And of course there were were some days where I wasn't perfect and I had my own setbacks. I think every fall I would always enter some sort of slump, but I think that was pretty normal for any college athlete. But I also wish I would've dissected it with my. Therapists. So when I was in college, I, I started going to sports psychology on a regular basis.

And even to them, I don't think I ever brought it up. I don't think it ever came up in conversation. I think I was speaking to them. Really? Yeah. And you know, I was just dealing with the normal troubles of any college girl, any college athlete. And so that's kind of what I spent my time talking about.

And I think that was part of my denial, like not even bringing it up with. A confidential source. 

Stef: 

Wow. I mean, that's, that's so interesting. You know? And where do you think that really stemmed from? What was it, were you afraid to, to bring it up? I know you already mentioned you didn't want it to define you, but why were you scared to talk about it more?

Paige: 

I think by talking about it more, it made, it made it more real and then it would've made me, I. Or so I thought, I felt like it would've made me more aware of my symptoms, which would then affect my training and interfere with my life. And for me, I think pretending like nothing was wrong was the solution, which we now know is not the correct solution.

But at the time that that was the way my, my brain processed things. 

Stef: 

Well, can you share a moment with us when a coach really did get it or completely didn't get it? And then how that really shaped how advocated for yourself now? 

Paige: 

Yeah, so. I was lucky that I had a female coach for five years starting my freshman year of college and she really got me and she, she knew me like the back of her hand and she could tell.

When I was sick before I could even tell if I was sick. And it was after, it was like, you know, about six months post 2021 Olympics. And I was really struggling in training and I finally complied to her and was like, Hey, like I'm gonna go to the doctor, get my blood tested, check all my levels and everything.

Because I'm not feeling well. And she was pretty responsive to that and pretty understanding. I don't know if there was like a certain moment in practice where I like had broken down. There was one practice where she had asked me to leave because I was struggling so much. And at the time I was just so frustrated.

But looking back, I'm like, That was a good, a good decision on her end. 'Cause I think she kind of understood the importance of recovery and the way I was feeling and she really responded to me emotionally, which was really good. 

Stef: 

Would you say looking back in your career, that you pushed yourself and, and never took days off and didn't really appreciate rest and recovery?

This is something that at VIS we're often trying to like re-engineer young athletes' brains that it is okay to take a day off and rest and recovery is part of your training, but, but when you're young, it's really hard to think that that's gonna help you get to the top level like the Olympics. you know, you, on top of being an elite athlete and someone who had really big dreams, you know, you also had this condition. So at what point in your life and in your career did you realize and recognize like, all right, rest and recovery is a big part of how you become successful as an Olympic athlete?

Like when did that start happening for you and then was it, is it something that you had to pay even more attention to because of your condition? 

Paige: 

Absolutely. I I think I always prioritize sleep and rest outside of the pool, but whenever I was at the pool it was always like, go, go, go. And. I hated recovery practices.

Those were my least favorite practices. I, just thought to myself, why this is a waste of time. And I think it wasn't until my college years where I. They really drilled it into us and educated us about the physiology. I was also a kinesiology major, so I think that really helped in learning physiological adaptation.

And so because of that, I did take my Sundays like very seriously, like never work out on Sundays. Again, I would still show up to practice and then just grind everything out. I feel like my coaches did a really good job of, Managing workload. Like they, the program that I was in was known for really high intensity, but we didn't do a lot of volume.

And I loved that. Like for me it was great. But yeah, definitely, definitely took a lot of naps when I had time in between classes. I remember as a, a freshman, the first time that my roommate and I were able to take a nap that was. Was, that was the best day ever.

But yeah, I think it was something that was learned over time. 

Stef: 

Well, having self-belief is like a key, I think key to success as an athlete. You have to have that confidence and you build that confidence over time for you. When you had hard moments with your condition and, you know, recovering and getting back and having those dips, like you said in your year, was there ever a time that you wanted to quit and what pulled you back to keep going?

Paige: 

Definitely. I remember really struggling in high school I would crash a lot during practice and I thought about quitting then. And I think looking back, I think it was again, a stressful time had just come off of Olympic trials and it was college recruiting season, and I remember not being as excited to go to practice as I once was.

And I think part of that was just really looking forward to college and ready to move on to something else. So, what kept me going was knowing that that was coming and that that was gonna change the game for me, which it did. And then it wasn't until after college swimming that I, that I felt that way.

That I had that crap in 2022 and my, my symptoms were, you know, I couldn't even. Clean my room, like I was so tired. I contemplated quitting then, and I did take an extended break, but I think what brought me back was knowing that I loved the sport so much deep down, and not wanting to end on that note, not wanting to end with a bad relationship with the sport.

And so. That's when I kind of changed mindsets and fell back in love with swimming, which was really, really cool. 

Stef: 

Yeah. It's so interesting. I think that some people, maybe from the outside to see people like yourself that have all these accolades from high school and into college like you did, like you had a very successful.

High school career setting, various Alabama state records, and the 50, the a hundred, the 200, the 500 yard freestyle. A hundred yard butterfly, a hundred yard backstroke, the 200 yard individual medley. So you were, you know, seemingly doing the best in the state and committed to the University of Virginia where you went on to have a lot of success there too.

So. From the outside, it seems like everything's going great, but you did go through university and then after covid, which was very tough for everybody. You. Went on and took a break, and this was in 2022. So I wanna, I wanna talk a little bit about what happened there and how you came to that decision to have that break because it's, you know, it is very common.

We know in elite athletes, almost like half of elite athletes, they struggle with mental health problems at some point in their lives. And oftentimes taking a pause can be the best thing for you, but one of the hardest things to do. So walk us through that, I guess that moment 2022, when you made that decision, why? And then what happened next? 

Paige: 

I think I had hit a low point following 2022 World Championship trials, so I just missed the team and. I also got Covid right around that time too. So because of that, I was confined to my room and my roommate at the time was a healthcare provider.

I didn't wanna get them sick, so I just pretty much just stayed in my room and just went through a, a pretty bad depressive episode because it, you know, I had banked on making that team both like. From a logistics standpoint, that's kind of what my whole summer was gonna revolve around.

And a financial standpoint like at the time I was a pro swimmer, like that was my livelihood. And so I didn't really know what I was gonna do. And so I spent a lot of time just in bed just thinking and thinking and thinking. And I did a lot of journaling then too. And I think that kind of.

Made me realize that, okay, swimming it's not about the travel or these big meets or the accolades that you get. I realized like at that time that because I, I couldn't work out at Covid. Like I loved that endorphin release and without that, like I was sad. So I wanted to come back because of that, and I also just knew, like I would regret it for the rest of my life if I had just stopped it.

I knew that I had more to give, that this was just like a bump in the road and something that I had to get over. And it, it did take me over a year to kind of get past that. But I, I do think the break was really good for me both physically 

Stef: 

And mentally. And during that time did you see a sports psychologist and start opening up a little bit more about your condition and sort of like how that might be part of, of why you also needed a break?

Paige: 

Yeah, absolutely. cause I, I, I had gone, eight or nine months without seeing a sports psychologist because I lost access to it. 'cause I graduated college and I was seeing our, our college psychologist regularly. But it was definitely a wake up call and. That's when I, I started to search for a sports psychologist again and seeing them regularly, and I think that really, really helped me, like work through things.

And looking back, I, I should have done that earlier, especially coming off of Tokyo. But hindsight is 2020. 

Stef: 

Well, you got back and you came back and to win in Paris in 2024. And it was really incredible to see. And I wanna go back from you know, I guess the kind of two to three years leading up to Paris.

You know, outside of seeing your sports psychologist, which is a great way and a great tool to have to help build up the mental skills for competitions like the Olympics, what other mental health tools and practices did you start integrating more into your weekly routines to kind of get you prepared for Paris?

Paige: 

Yeah, I started. Journaling a lot more. I had this one, this one journal that asks you questions at the end of each day and it kind of gauges your, the way that you're feeling. And I think that's something that I really struggled with, like before that. 'cause I just never really put much thought into you know, why, why do I feel this way?

Like, why am I in a bad mood? What's wrong with me? That definitely, really helped. I think also I took some time away from. Keeping up with the sport. Like I, I stayed off of social media, I stayed off of swimming websites and I realized like how little it affected others' lives cause for me it was sort of, you know, I lived in Breeze swimming, and then when I kind of took a step away from it, it was like, okay, it's not as extreme as I thought. There are other things out there. And then I went back to school, which was really great. I had always been a student athlete, like leading up to that. And so I think that really helped me like kinda redefine myself.

but I, I think more than anything, definitely working with the sports psychologist. 

Stef: 

Let's talk a little bit more about that experience that you had in selecting a school when you were going to college. Because when you had your condition, you know, you knew you were going into a, a program that was gonna be really intense.

You were, you knew you were going to vision one, but you also knew that you had the condition. So like how did you, I guess, approach picking a school to make sure that there was enough of support in terms of the healthcare the coaching staff. For picking your school or was that even part of your selection process?

Paige: 

I think for me it was two folds. 'cause I did have the autoimmune condition, but like we were talking about, I was kind of suppressing it. But I think I also have my own interest in healthcare and I think it definitely, I was, I wanted a school that had a good healthcare system from an academic standpoint.

And because of that, I think that also meant that they had a really good support system for their athletes. I remember specifically my school really supported one swimmer who had a shoulder injury and she was taking a red shirt year because of that. And the, then she in turn got to do five years of college swimming.

This was before, you know, they had the covid red shirt. And so that was something that really stuck out to me. But for the most part, I think it was mainly academic driven, but. It definitely paid off. 'cause UVA had some of the best like cardiologists, like surgeons, whatever you need, like they have it there.

So that was definitely very helpful. 

Stef: 

That's amazing. Well, when you look back at like your, your whole journey from when you're like 13 years old till now, winning an Olympic medal at the Paris Olympics. What do you think is so key, I guess, for young girls to know and understand if they're also facing some sort of autoimmune disease in their journey, like what would you wanna share with them?

Paige: 

I would tell them that it's okay to talk about it and that It'll pull you back. If you let it pull, pull you back. And after I started talking about it, I felt even more empowered in sport because it was like, I realized I had achieved all these things despite having this condition.

And it wasn't something that was going to define me long term. It just was something that, I had to overcome everyone is, is facing something whether they talk about it or not. if you are able to talk about it, then it just, it just helps you process things and yeah, like I said, it really will only prevent you from achieving things if, if you allow it to.

Stef: 

What advice would you have for young girls out there that might be struggling with their mental health in their journey? 

Paige:

Yeah, I would say definitely seek, seek help. I think it can be a little bit hard, especially as a young girl to kind of talk, talk about that stuff or, or share with your family or coaches or whoever, because, it can be a bit taboo, especially from a young age, but I'm so happy to see that it's becoming less and less taboo and that more athletes are speaking out about it, which in turn inspires the younger athletes and the younger generation. it is a problem, right? Because.

A lot of times these, these young athletes don't necessarily have the resources to go and, and talk about their mental health until maybe they get to college and that was sort of the case for me. You know, you get to college and they have a sports psychologist on staff and I wish that I had that as a high school athlete.

Stef: 

Well, what you just described is why I'm building vis, right? Yes. So we have absolutely, we have a hundred sports psychologists and registered dietitians on the platform for those girls.

That's something that I didn't have when I was younger either in high school. Mm-hmm. And I feel like if I had access to those types of experts along my journey, I could have worked through so many of the issues I was, I was facing. And that's ultimately what we're trying to do here for, for all of these young girls, is hopefully make it more accessible. And make it less scary.  

Paige: 

Yes. Because it is scary. And a lot of times You don't even know how to process your emotions or you don't know that you're feeling down or that. You might be having some mental struggles. it's a confusing time growing up and yeah, had I had access to VIS, like that would've been so cool. So shout out to you guys.

Stef: 

Thank you so much for all of your incredible advice and sharing your story. You know that you have had what, you've worked through all these years. It's really incredible to see what you've accomplished, and I'm excited to keep watching you win. 

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Paige: 

Thank you, Steph. I really appreciate it.

Stef: 

See you next time. 

This episode was produced and edited by VIS creator Mackenzie Sullivan. Paige's story exemplifies strength, courage, and resilience. Many girls in our community can relate to Paige and how timid she was in speaking up and telling her coach about the struggles she was having, out of fear of looking weak. But Paige's experience proves that you can face challenges, be vulnerable, and still see success. If this episode resonated with you, hit that share button and send it to another athlete that you think might need to hear Paige's message.

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