Depression, Authenticity and the Problem of Irreversible Revelations

The startup world has disproportionately high levels of people suffering mental issues. Take this from Business Insider:

Of the 242 entrepreneurs surveyed , 49% reported having a mental-health condition. Depression was the №1 reported condition among them and was present in 30% of all entrepreneurs, followed by ADHD (29%) and anxiety problems (27%). That’s a much higher percentage than the US population at large, where  only about 7% identify as depressed .

Throughout the course of launching Formisimo, I’ve met dozens of founders. Many of whom have become firm friends. Without fail they all deal with a huge amount of stress and pressure, and many suffer from depression and anxiety. Night terrors, the shakes, panic attacks, feelings of being an imposter, wildly out of their depth, terrified of failure, chronically depressed. Mental health issues are cruel, dark, and can be deadly… Why have I met so many founders who are battling anxiety and depression? There does seem to be a perfect cocktail of factors that might explain this:

1. Starting a business is really fucking hard
2. You often do it with other people’s money?—?whether from friends and family or professional investors, this shifts the dynamic away from simply ‘personal’ risk. And the sums of money are large?—?usually in the hundreds of thousands.
3. Start-ups are tied to your identity?—?you created it, you live and breathe it every day. The business becomes an extension of yourself, and your success, progression and identity become intertwined with the success of your company.
4. The ‘killing it’ culture?—?there’s a perception that in order to win sales, raise investment and attract staff, the idea is that your startup needs to be ambitious, have great tech and be flying, killing it. There’s a corresponding pressure to put up a false front and avoid discussing challenges or stresses openly and honestly.
5. 90% of startups fail. Regardless of initial optimism, traction, great product, great team, statistically your start up will probably fail.

The idea of ‘good failure’ isn’t helpful

Let’s dwell on that last statistic for a moment. There’s an oft reported mantra in startup-land?—?‘failure isn’t bad?—?it’s great!’. It’s often repeated; championed as one of the reasons Silicon Valley has succeeded. People there takes risks because they know failing is merely a learning experience.

This is fine to repeat ad nauseam, but it’s almost impossible to convince yourself of this if you’re already bought into the idea of wanting to succeed at any cost. It’s especially true if your current start up is your first. Someone who has tried and failed to build a business multiple times may have the benefit of experience to be able to make peace with failure, but for first time founders this is simply a state of mind that they have no experience of. It’s also not a habit you can form (like exercise for example); no one can deliberately fail so many times they get used to it. I certainly don’t want my startup to fail, despite the learnings I would undoubtedly get from that experience. Why would I want to aim for that?

So as founders the odds are stacked against us from the get go. And failing (and the threat of failing) can be harmful for the mental health of founders. So why then do startup founders not talk openly about their own mental health problems? If it’s a problem that we know is both damaging and highly prevalent in the community, why aren’t we speaking about it more, since speaking more openly can reduce the stigma surrounding it? Even when people do talk about it openly, it’s often anonymously, or for people that have ‘come through the other side’ and have achieved success at the end of their story. I’ll return to this point later.

If openness helps, why can’t we be more open (duh)?

The problem of irreversible admissions

Sometimes in life you can speak to people about issues you are facing?—?be they in relationships, health, work or anything else. For the lucky ones, even when we’re being honest and open with our closest friends, colleagues and family, these are often temporary setbacks or issues. Feeling frustrated with your job, going through a rough patch at work, talking about politics with someone you disagree with. These are all things that are temporary, you can discuss further, and often fade into the past.

But there’s a category of things that once said cannot be unsaid, and have consequences you cannot control. Admitting that you’ve been unfaithful to a partner, ‘coming out’ as gay, telling your family that you’ve been diagnosed with a terminal disease, admission of some terrible wrongdoing in the past. Once you’ve shared this information, you cannot rewind the clock, and often people’s reaction to these can be unpredictable, uncontrollable and in some cases, really really bad.

Suffering from chronic anxiety or depression is one of these things. Once you’ve let the cat out of the bag, you can’t put it back.

And given the nature of these conditions, there are potential impacts or worries on behalf of those around you on your ability to lead?—?for colleagues, investors, and employees. Whether consciously or subconsciously, questions might arise in them:

What if they get a bout of depression during a key stage in the company?

What if they tank an important meeting because of anxiety?

I don’t want someone heavily medicated in charge of an investment of mine!

What if their depression lasts for weeks or months?

Will we be left without a leader?

Will I have to pick up the slack of my cofounder?

Is my boss off work again, why?

I understand they have depression, but decisions need to be made!

These are cold, unempathetic, but ultimately legitimate questions. If the goal of those around you is to ensure the future prosperity of the business (and not your wellbeing), then surely, the logic goes, it would be safer and less risky to look to replace (overtly or otherwise), a leader suffering from mental health issues?

There has been some progress in the openness and honesty in talking about mental health. But I would argue this often comes from those who don’t still have skin in the game. They speak at the end of their career, or when they’ve reached a point where the company is self sustaining, and a loss of a founder wouldn’t be the end of the journey. Also there are those that speak of mental health issues of something they battled through, and have now conquered

But for many, mental health issues are not the second act of a play, narrative, film or life story. They are not a lull before a battle and ultimately a triumph at the end. Mental health issues pervade entire lives and careers in a constant ongoing fight with many smaller battles, some of which they lose, some of which they win.

So the stories of these high-profile people speaking out fall on, if not deaf, then numb ears.

Sure it’s great to hear the now retired CEO of a publicly listed company talk about mental health, but what about those trying desperately to raise capital for their first start up? Can they afford to be as authentic and honest about their struggles? Or would that be like petrol bombing the ship you’re trying to build before it’s even left harbour?

Authenticity and talking openly seem like good answers at first. But how authentic, and who to? Peers outside your start up? Your employees? Investors? And what happens if your honesty leads to stigmatisation, and wholly negative consequences?

Objectively mental health problems can have a direct impact on one’s ability to run a company. These effects can be managed, reduced, mitigated, but they do affect the company to some extent. So where does that leave us?

I think it’s important to remember that those that lead and build are often brilliant, bright, talented and remarkable people. We need to remember that mental illness is exactly that?—?an illness, not a weakness?—?and the reason we need to be supportive and understanding rather than dogmatic and stigmatising is that these people are uniquely placed to build the next incredible innovation in our lives. Indeed without understanding and support, we may lose the next genius and all the output and innovation that they could produce throughout a professional career.

I cannot overstate how incredible the strength and the depth of character that these founders have. Fighting mental health problems is an ongoing battle, and the courage and stamina to fight those AND continue to function as a founder of a business is nothing short of miraculous, and should be applauded, not stigmatised.

So what’s the answer?

This is a difficult problem to fix, and the difficulties of starting out are unlikely to disappear anytime soon. So rather than focus on this, we have to address the other side of this problem. Like all things feared because of lack of understanding and empathy, there’s a critical mass of discussion that needs to be achieved before we can truly be said to be making progress. Movements aren’t made by individuals, they are made by groups.

Openness and honesty is a good start for those of us with enough courage to speak about mental health issues. We should applaud their bravery and cherish their contribution to tackling a big problem. This should be supported by all people involved, from employees, to co-founders, to investors.

I think ultimately it’s about understanding that those leading startups are the best people to lead a new business forwards. To draw a final parallel; we all have friends and relationships in our lives with people that are flawed (sometimes deeply). We maintain those friendships because on balance they have a positive influence on our lives, in spite of their human flaws. Founders are the same. We need to understand that those at the top bring an overwhelmingly positive influence on a company, and their drive, passion, skills and ambition far outweigh the negatives associated with mental illness. When we realise this we can work to support and reduce the impact of any troubles they may be going through.

Once we’ve done this, the barrier of irreversible revelations lessens. If we know there’s a high probability that the reaction to one of these so-called admissions is one of support and understanding, we can be sure that more and more people will feel at ease with being honest, authentic and vulnerable. Companies aren’t built by robots (yet). We should celebrate that, and support those trying to build the future.