Simone Biles went to therapy right before winning gold at the Olympic team final

• Before she won a gold medal at the Olympics on Tuesday, Simone Biles was in a therapy session.
• The gymnast opened up about her mental health struggles after she experienced "the twisties" at the Tokyo Olympics.
• A study has found that mental health costs the US economy more than $280 billion annually.

Before she led the US gymnastics team to Olympic gold on Tuesday, Simone Biles was at therapy.

"At the beginning of the day, I started off with therapy this morning, so that was super exciting. I told her I was feeling calm and ready and that's kind of exactly what happened," Biles told reporters after the competition, per People. "After I finished vault, I was relieved. I was like, 'Phew,' because no flashbacks or anything."

Biles — along with her teammates Jade Carey, Jordan Chiles, and Suni Lee — earned the US its fourth Olympic gold during the women's artistic gymnastics team event. Hezly Rivera, the team's youngest member, didn't compete in the final but also received a medal.

Tuesday's win marks Biles' eighth Olympic medal, making her the most decorated American gymnast in the games' history.

It's a huge comeback from the Tokyo Olympics, where she withdrew from five events after experiencing "the twisties" — a phenomenon where athletes get disoriented in the air.

And part of her preparation for the Paris Games involved taking care of her mental health.

In an episode of the "Making Space with Hoda Kotb" podcast, which was released on Wednesday, Biles reflected on her mental health journey.

"I feel a lot more free, especially going to therapy and doing those sessions so that physically and mentally I feel better, and I know that's an important part of my routine. So just staying on top of that, it lightens the load a lot," Biles told host Hoda Kotb.

Instead of pushing down her trauma, as she did in the past, she learned to speak about it so that she could release it, Biles said.

"I think we used to think of therapy as a weakness, and now I think of it as a strength. And if there's somebody that can help me deal with what I'm going through, then that's what I need to do. And now it's a daily part of my routine," she added.

Biles isn't the only athlete who has spoken publicly about their struggles with mental health.

Other athletes open up about mental health

Michael Phelps, the most decorated Olympian of all time, has talked about his struggles with depression and suicidal thoughts before. In 2014, his second DUI left him contemplating if he should "just end it all," he said on the HBO Sports documentary, "The Weight of Gold." He later admitted himself to a rehabilitation center.

Phelps told Business Insider in 2021 that exercise and focusing on what he can control has helped him cope with his mental health struggles.

After dropping out of the French Open and withdrawing from Wimbledon, Naomi Osaka penned an essay for Time in which she addressed the anxiety and the bouts of depression she was struggling with.

Nearly 50 million Americans are experiencing a mental illness, according to 2022 data from nonprofit organization Mental Health America.

According to a joint study by researchers from Columbia Business School, the University of Wisconsin, and Yale University, mental health costs the US economy more than $280 billion annually.

While mental illness can affect anyone, Olympic athletes may be particularly susceptible to mental health issues.

A 2019 consensus statement from the International Olympic Committee found that rates of anxiety and depression may be as high as 45% in elite athletes, including Olympians.

A representative for Biles did not immediately respond to a request for comment sent outside regular business hours.