To counselors, it comes as little surprise that Joe Paterno died of complications from cancer so soon after the Penn State scandal broke.

Although reports indicate Paterno was happy with his accomplishments on and off the field, his identity was toppled and he was overcome by waves of disappointment and heartache.

Athletes and coaches whose public identities are redefined by scandal and poor performance suffer a devastating personal impact. Hometown heroes often get arrested or shamed.

Now what?

The psychological and physiological impact of traumatic shifts in lifestyle, confidence and esteem is well documented. In 2008, the National Cancer Institute published a fact sheet outlining the impact of psychological stress on cancer. Studies have indicated that stress can affect tumor growth and spread, although the precise biological mechanisms underlying these effects are not well understood. Scientists have suggested that the effects of stress on the immune system may affect the growth of some tumors.

Families across the U.S. and the world have seen loved ones fall victim to illnesses, both physical and mental, that have had a devastating impact on their lives and the lives of others. From presidents whose hair turns gray in four years to athletes who can’t cope with the pressure to perform and quit or never reach their potential, stress and pressure play no favorites. The National Cancer Institute’s study sheds light on the impact a positive outlook can have. Reducing stress and anxiety is directly related to overall quality of life, performance and the ability to maintain close, nurturing relationships.

The pressure to perform is overwhelming at times. We’re more stressed; our children and athletes are more stressed; employers and employees are more stressed. The demands of society today are greater than ever.

The American Institute on Stress lists 50 common signs and symptoms of stress. To name a few:

Fatigue is a funny one. I often wonder why parents place their children in three or four sports—waking up early in the morning to practice, attending school, practicing again in the evening and then staying up until 10 or 11 p.m. doing homework. It’s a wonder any of them succeed.

I estimate 85 percent of my clients (athletes or not) are burdened with significant stress and anxiety related directly to the amount of demands placed on them by teachers, parents, coaches and society.

This is not to say that encouraging athletes to multitask, compete at a high level or persevere isn’t worthwhile. But with added unnecessary stress comes illness. How many times have you said, “I’ve been stressed out lately and I know that’s why I’m getting sick”? It’s so common that we almost don’t pay attention.

The Unified Model of Psychological Preparation for Peak Performance emphasizes foundation attributes: personality, psychological and philosophical attributes. Without stability in these areas, athletes will fall short of their potential.

Paterno and thousands of other people stricken with terminal illness are victims not only of the illness, but also of their inability to cope. This is not to say they are weak, less capable or uneducated, but when faced with life-threatening circumstance, people react in ways they never imagined.

The seemingly feeble become strong and the seemingly strong become feeble. Pessimists become believers and believers become pessimists.

For years now, I have completed a stress appraisal on my athletes. It is meant to help identify the attributes that determine an athlete’s response to a stressor or challenge. Research has shown that for athletes who see the challenge as something to learn from and overcome rather than fear, the likelihood of success is significantly greater.

Athletes who perform the best during this appraisal almost certainly will perform the best when faced with significant life challenges.

Tim Webb is the founder of Agency for Sports and Individual Enhancement and works as an adolescent and family counselor at the National Counseling Group. He can be reached at sports@freelancestar.com