Mental health risks among startup entrepreneurs

Recently I had a few coffee and video chats with some of my startup entrepreneur friends. I found myself inadvertently performing a small study (n = 6), as I started the conversations in a way that most people in the startup/venture ecosystem aren't accustomed to. Like most conversations, we began with “how are you doing?” Every single person replied with answers focused on their company, not themselves, like: “I’m great – we’re raising our series A,”  or “I’m fantastic – we signed a large customer last month.” 

This demonstrates one of the common mental health risks associated with being a startup founder. It’s the “I am my company” syndrome. Founders blur the line between themselves and their companies in such a way that they lose any sense of self. This may not seem like a problem when business is going well, but it can have devastating effects on a founder’s mental health when things go sideways. And with 90% of startups failing, things are always going sideways.

So, I followed up my question with: “That’s great, but, how are you doing? How is your mental health? Are you ok?” 

Three of the six seemed truly stunned. One slipped back into the “method acting” mode of being a brand cheerleader and answering with more company success metrics. But four people seemed genuinely relieved that I had not only asked the question, but that I wanted to provide a safe space for them to answer it.

ENTREPRENEUR MENTAL HEALTH STATS:

• 49% report having one or more lifetime mental health condition, as compared to 18.9% in the general population
• 30% have clinical depression as compared to 7% in the general population
• 29% have ADHD as compared to 8.1% in the general population
• 11% have bipolar depression as compared to 1% in the general population

SELF-SELECTION:

There are many reasons that entrepreneurs are at such high risk for mental health issues. Self-selection is one factor. Most startup founders have a similar personality type: extremely high-energy, passionate, extroverts with a low need for sleep, vivid imaginations, and a strong drive for achievement. When you consider of the type of person it takes to convince a group of investors and future employees to hold their hand and jump off, it makes sense that a startup entrepreneur is a risk-taker with a persuasive personality and dogged determination.

However, this DNA can make the entrepreneur susceptible to feelings of isolation, as they begin to lose the ability to relate to people who are not engulfed in the startup word. The all-encompassing nature of running a startup makes it hard to be “present” in any other aspect of one’s life. One startup founder told me that the moment he realized that his company had taken over his life was when he began to view the time he spent with his family as getting in the way of his work. 

DANGEROUS INDUSTRY NARRATIVES

Entrepreneurs are constantly exposed to unrealistic success stories about startups that are “crushing it” with super-charged funding rounds, quick exits, and other unrealistic achievements. Entrepreneurship is almost becoming synonymous with celebrity. And a founder is expected to constantly exude confidence and boast an exaggerated list of successes such as fundraising, growth, and revenue achievement. Under the gaze of Silicon Valley, entrepreneurs tirelessly project a persona of charisma and evangelism despite silent fears stemming from risks and setbacks. 

Similarly, entrepreneurs have to channel this same energy to motivate their own team. Recruiting talent on low budgets is a challenge. I recently asked a former startup founder client of mine if he could delegate some of the fundraising work that was consuming his weekends to other team members. He answered that as much as he would love to, there simply wasn’t anyone else on the team who had the experience to do it. 

Additionally, most startups recruit talent at low salaries that are offset by incentive stock opportunities. The work is endless and the pay is poor. Founders are worried about losing good talent. They encourage people to have work-life balance, but this often means that crucial projects like investor deliverables, sales materials, and other time-sensitive work rolls onto their plate. Startup founders, themselves, typically draw salaries that are 70% below their previous role and work an average of 64 hours per week (as compared to the 44 hour average among all U.S. workers). 

WHY NOT SEEK HELP?

The fear of repercussion is very real for entrepreneurs playing in the venture-funded, startup space. Most investors state that at least 1/3 of the winning formula for a startup worthy of investment is the founding team. Entrepreneurs are applauded for being machines with relentless drive. If we’re truly honest about how the system works, investors make their living off of the efforts of founders – and they sometimes have unrealistic expectations that can cause significant mental anguish.

When entrepreneurs constantly hear investors talk about the importance of a strong founding team, it’s no surprise that the last thing they want to do is admit that they are struggling with mental health issues like anxiety or depression. There is always a fundraise in the works, a plan for a future acquisition, and a dream for an IPO. Therefore, most founders don’t want to put their company at risk by sending a message that they are anything short of a superhero.

Additionally, there is a tremendous amount of peer pressure in the startup ecosystem. Founders seek out other founders because they speak the same language and face the same unimaginable risks and uncertainties. But these relationships often stop short of being a safe space that fosters vulnerability and support, because founders measure their success by comparing their company to other startups. One founder/CEO told me that he had to stop having weekly coffee with a friend whose startup was taking off, because he began feeling dangerously hopeless, trapped, and depressed after their dates. 

HOW DO WE FIX THIS?

It is inspiring to see the great strides we’ve made as a society to reduce the stigma associated with mental health. From celebrities to politicians, we’re seeing people come forward with a message that mental health issues can effect anyone, and asking for help is okay.

But supporting the group of people who carry the uniquely stressful weight of running a venture-backed startup is a responsibility that must be shared among all stakeholders. 

1.  Incubators / Accelerators: Incorporating mental health self-care into the curriculum for early stage startup founders is the most proactive way to arm entrepreneurs with tools and resources as they embark on their startup journey.
2. Investors: With investors touting the importance of investing in the “team” and not the product, we need more of them to incorporate models to promote mental health support for their startups. Regular check-ins to simply ask how a founder is feeling and asking how they can help can are simple actions that provide immeasurable value. Providing a stipend for mentors, coaches, and therapists for their founders is a small investment that can literally change lives. And simply being a good human who genuinely cares about the people they invest in goes a long way.
3. Employees: Everyone works hard at a startup. But taking a moment to ask your founder or CEO how they are doing mentally makes a huge difference for someone who’s cup is almost empty. Even the cheerleader needs a pep talk, sometimes. Just knowing that your team appreciates you and sees you as a vulnerable human being who is struggling like everyone else can significantly decrease the sense of loneliness and isolation most founders experience.
4. Entrepreneurs: Entrepreneurs should educate themselves on the signs and symptoms of mental health disease. There is a difference between feeling stressed intermittently and unknowingly living with generalized anxiety disorder or depression. Don’t dismiss your thoughts and feelings as being par for the course of startup life. Seek help from a professional and let the people you trust know that you are struggling.