Naomi Osaka struggled to hold back tears in her first press conference since pulling out from the French Open over mental health concerns.

The 23-year-old broke down during a press conference at the Cincinnati Open on Monday when local reporter Cincinnati Enquirer columnist Paul Daugherty appeared to confront her about balancing having a big media profile and not speaking to the media.

"You're not crazy about dealing with us, especially in this format. Yet you have a lot of outside interests that are served by having a media platform," Daugherty asked during the zoom interview.

"I guess my question is: How do you balance the two? Daugherty added.

Osaka took a moment to gather herself before replying, "When you say I'm not crazy about dealing with you guys, what does that refer to?"

After a brief exchange, the Japanese said, "I'm not really sure how to balance the two. Like I'm figuring it out at the same time as you are."

But Osaka started tearing when another reporter asked tennis-related questions and the four-time Grand Slam champion left the room to compose herself.

Osaka then returned to the interview room to continue the press conference.