Rewind to that moment when Simone Biles, without question the greatest gymnast of all time, landed a vault awkwardly in the team competition at the Olympics.

Consider if, following that vault — and Biles’ decision to pull herself out of the the rest of that competition and the individual all-around one as well — it was revealed that she had sprained her ankle. Or had a stress reaction in her foot. Or had torn her anterior cruciate ligament.

The universal reaction would be one of shock and disappointment, both that she couldn’t compete and that we couldn’t see her compete. Because we all understand that if something went wrong with her body then, of course, she couldn’t compete.

Now consider what did happen. In the wake of her decision to pull herself out of the team competition, it was revealed that she did so for mental health reasons, the same reasons she decided to pull herself out of the individual all-around competition set to start later this week.

“Whenever you get in a high stress situation, you kind of freak out,” Biles explained to reporters on Tuesday. “I have to focus on my mental health and not jeopardize my health and well-being. It just sucks when you’re fighting with your own head.”

The reaction — at least in some corners — was incredulous: She was letting her team down! She was letting herself down! She just needed to tough it out and things would get better!

What Biles’ withdrawal highlights is the yawning gap between how we think about and treat physical illness versus mental illness. And our ongoing — and demonstrably false — belief that the two are not interrelated.

Consider an example far from the Olympics.

In my late 30s my left ankle started bothering me. I went to a doctor. He told me I had loose cartilage and bits of bone floating around in there — from years of pickup basketball and rolled ankles. He advised surgery to clean it all up. I had the procedure. I went to physical therapy. I got better. I told anyone who asked why I was limping about it — and they all understood: Hurt his ankle, got it fixed.

Fifteen years earlier, it was my mind that was bothering me. I had panic attacks and anxiety so crippling that I had to force myself to leave the house. I told no one. And no one asked about it because I was able to put on a mask when in public that made everyone think I was fine. But the anxiety impacted how I worked and how I lived far more than my ankle ever would.

Eventually I sought help. And talking to a psychologist did — and does — help. But it took a lot longer for me to get that help than it did when my ankle started to ache. Because I had internalized the the stigma of mental health in this country — where admitting you had a mental illness felt like one step from being locked in a rubber room while acknowledging you had a physical illness was a stay-home-from-work card and a good movie.

Societally we’ve come a long way since even my anxiety onset in the early 2000s. Thanks to celebrities, athletes and other high-profile people speaking out about their own struggles with mental illness, the stigma for the average person has lessened.

Which is a good thing! Because, according to stats from Johns Hopkins an “estimated 26% of Americans ages 18 and older — about 1 in 4 adults — suffers from a diagnosable mental disorder in a given year.”

But the reaction to Biles’ decision suggests we simply aren’t where we need to be when it comes to understanding mental illness.

Think about what the tough-it-out crowd wanted her to do: Continue to compete in a sport in which flips, jumps and twists are required when she openly acknowledged that she was not in the right mind space to do so and expert analysts said it was clear that she had become disoriented while in the air on that vault.

Which would mean that Biles would be attempting some of the most difficult — and dangerous — skills in the sport while struggling, at minimum, with her ability to effectively know where she was in the air. That’s a recipe for injury and, given the flips and spins Biles is able to do, potentially serious head and neck damage.

Still think physical health and mental health are unrelated?

In the end, Biles’ class and grace in the face of armchair critics who couldn’t do a single flip if their lives depended on it, shone through — and can, hopefully, teach us all a lesson about the importance of treating mental health just like we treat physical ailments.

“We also have to focus on ourselves, because at the end of the day we’re human, too,” Biles said. “We have to protect our mind and our body, rather than just go out there and do what the world wants us to do.”

Simone Biles of Team United States stumbles upon landing after competing in vault during the Women’s Team Final on day four of the Tokyo 2020 Olympic Games at Ariake Gymnastics Centre on July 27, 2021 in Tokyo, Japan. (Photo by Jamie Squire/Getty Images)