Are Mental Health Issues Secretly Lurking Amongst Startup Founders?

Tesla & SpaceX founder Elon Musk once compared starting a company to eating glass and staring into the abyss.

In a world where startups and unicorn obsession are fuelled by shows like Shark Tank, it seems like young entrepreneurs in their 20s and 30s, armed with millions of dollars in investor money, are seen as the poster boys of the entrepreneurship revolution. They are seen as bad boys and girls & grace newspapers, trend on social media and appear to be living the dream. After all, what’s better than being your own boss and following your passion?

However, beneath the glittering facade, startup founders seem to face a silent health crisis that often goes unnoticed. There seems to be a mental and physical toll that entrepreneurship takes on these ambitious founders. It seems like behind the scenes, founders of startups are enduring immense pressure, whether they admit it or not.

The fear of failure, the quest for venture capital, the daily juggling of multiple roles and the ambitions of growth may put an extraordinary amount of strain on their physical and mental health. And despite the growing conversations around mental health, startup founders rarely admit to terms like depression, anxiety and insomnia. But, the toll on their well-being is said to be unmistakable. This is because the journey to success and riches may have these entrepreneurs trade comfort for chaos, all in the name of ambition.

Imagine having the pressure to succeed, worrying about failure, seeking funds, sorting out internal issues in the startup, dealing with customers. For one person to take the reins, when it comes to all of that, it would be quite difficult. And then, imagine a pandemic, like COVID-19, comes in and redefines and reshapes everything you thought you knew.

You wouldn’t know what to do.

But, you wouldn’t be able to stop, because customers and investors expect you to keep going. And then, imagine having to talk to your people about pay cuts and layoffs and then having to put on a brave face, even when it may not be anyone’s fault that revenues are going down.

And what if you don’t have the same spark as you used to, like before?

And imagine falling short of everyone’s expectations, having a lot of self-doubt and wondering if you’re the right person for the job. If the market wonders if you have compromised mental health, there’s worry it could hinder the startup’s future.

According to a study from the University of California, about 50% of entrepreneurs may be susceptible to mental health conditions. Startup founders may be more likely to suffer from depression, ADHD, substance abuse, bipolar disorder and even thoughts of taking their own lives. A First Round’s State Of Startups 2019 report outlines that 25% of startup CEOs were working with executive coaches. The percentage working with therapists or psychiatrists was, also, said to be low, with about 15% of male founders and close to 45% of female founders. Startup Snapshot’s April 2023 report outlines that close to 75% of founders report an impact on their mental health. Close to 55% said they were worried about the future of their company. Close to 45% of them had high stress, close to 40% of them had anxiety and burnout, close to 15% of them said they had depression and 10% of them said they had panic attacks.

Maybe, startup founders could develop the skill of choosing what they would stress about and what they would not stress about. This is because as an entrepreneur, every day, something goes wrong.

It’s said that startups go through near-death moments, where, basically, because of a situation, product or funding, founders feel like they’re nearing the end of the startup. So, the belief is that the startup that survives these near-death moments would go on to become successful. Even saying that “startup founders face mental health issues” sounds like such a negative, something that would be said to denigrate them, instead of a crease to be ironed or a problem to be solved.

It’s said that the startup world is like a battlefield, where glory or ignominy awaits. Maybe, startups know no mercy. The notion may be either to achieve glory or die.

It’s an environment where startup founders are constantly on edge, juggling various aspects of their business, with sleep deprivation adding to the damage and facing criticism and doubt from their backers and the fifth estate. Most of these founders work round the clock, keeping one eye on the product or service, one on revenue and one on investments.

A startup founder is both a janitor and a CEO, handling every aspect of the business. Investors are said to be essential for the growth of startups and they demand hockey-stick growth. The pressure to scale may be immense, often pushing founders to their limits. For many first-generation entrepreneurs from salaried backgrounds and who don’t have generational wealth, this journey is far from the faint-hearted. The sacrifice seems to go beyond sleepless nights and they willingly trade their health for a shot at success.

There’s one example of Cafe Coffee Day founder VG Siddhartha, who tragically took his own life. This may have forced the startup ecosystem to acknowledge the hidden struggles of entrepreneurs. Even today, whether we like it or not, mental health is still, kind of, considered a joke, with therapy seen as an option only when someone is “sick”.

So, the stress in the startup ecosystem could lead to a range of mental health problems, like high stress, anxiety, burnout and depression. Yet, only a small percentage actually consult psychologists or coaches, with even fewer turning to their investors for support.

Every year, October 10th is celebrated as Mental Health Day. It’s an international day for global mental health education, awareness and advocacy against social stigma. Will the culture of silence around mental health issues in startups change? Can founders need to prioritize their well-being, just as they prioritize their business?

Seeking professional support, creating support networks within the entrepreneurial community and fostering an empathetic work environment could be essential for these startup founders. Maybe, creating a professional schedule with time to breathe and fostering a working environment of empathy could humanize an ecosystem that is said to be quite cutthroat.

Could startup founders focus on exercise, getting a good amount of sleep, spending time with loved ones and scheduling time away from screens to better their headspace? Can professional success in a startup and personal well-being complement each other?

And there’s a worry that transparency could affect the chances of startup founders to secure additional funding. 90% of these investors surveyed report they don’t discuss stress with their investors. Could investors be a great support network for these founders?

What’s interesting is that despite having their mental health affected, close to 95% of entrepreneurs would do it again: that the sacrifice was well worth the effort.

Could acknowledging vulnerability help founders pave the way for a healthier and more sustainable startup ecosystem? If the joy of founding a company is grounded in the vision of long-term growth, will good mental health be a non-negotiable aspect of the journey? Can the stigma be dismantled to protect these entrepreneurs from the devastating impact of mental health issues?

Will the same resilience show the way?

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