Is Mental Illness Among CEOs a Trait or an Outcome?

By Oren Frank, CEO & Co-Founder at Talkspace

In 2013, Reddit cofounder Aaron Swartz took his life at the tragic age of 27.  Just months later, well-known tech entrepreneur Jody Sherman (47), founder of the online marketplace Ecomom, shot himself to death. Sherman’s company had just been forced to close its doors—without a cent left of the multi-millions the 28-person company had raised. In a world where the vast majority of startups fail, Swartz and Sherman’s stories aren’t just isolated tragedies. The number of similar stories seems to be growing steadily.

As the Co-Founder and CEO of Talkspace, an online therapy startup, I care deeply about mental health and technology. But I also went through various painful, depressive episodes during the early stages of the company, almost shutting it down at different points as I navigated the anxiety-inducing process of “trading money for time to make mistakes” that is part of almost every startup’s history. It is time we all address the psychological toll of entrepreneurship and leadership.

Many founding CEOs are young. Some go straight from playing video games in their dorm rooms to managing millions in investments and large teams. The work isn’t easy, and the stress of founding a company tends to put people in survival mode—working around the clock, coasting on a near-constant adrenaline rush, all just to keep afloat. It’s a life of fight or flight.

Of the 242 entrepreneurs surveyed, 49% reported struggling with a mental health condition. Depression ranked as the #1 reported condition, and was present in 30% of participants.

Younger CEOs sometimes take pride in their extreme environments, unaware of the fact that self-neglect doesn’t contribute to success. The reality is that things like lack of sleep, poor diet, and untreated chronic stress, all exacerbate existing mental health issues. In a recent study, psychologist and psychology professor Michael Freeman researched mental health conditions among entrepreneurs. Of the 242 entrepreneurs surveyed, 49% reported struggling with a mental health condition. Depression ranked as the #1 reported condition, and was present in 30% of participants. (Compare that to the U.S. population in general, where only 7% report themselves as depressed). Whether mental illness encourages ambition and creativity among entrepreneurs, or is the byproduct of burnout, mental health challenges among business leaders are far more common than we might think.

The combination of survival anxiety and ego, which many business leaders actually cultivate, can be quite dangerous. According to other recent research, the personality traits that make entrepreneurs so charismatic, ambitious, and creative also makes them more vulnerable to depression, anxiety, and suicidal thinking.

The downfall of Theranos CEO Elizabeth Holmes can be used as an extreme example of the culture of entrepreneurship in America, particularly in tech, and the mental health implications of being an entrepreneur. When Holmes raised $750 million dollars from VCs, she was pitching Theranos as a cutting-edge technology that would enable clinicians to get a full blood picture from just a few drops of blood, in real time. Almost automatically, Holmes made it onto the cover of Fortune magazine in June 2014, and thereafter was featured in The New York Times, The New Yorker, and beyond.

According to other recent research, the personality traits that make entrepreneurs so charismatic, ambitious, and creative also makes them more vulnerable to depression, anxiety, and suicidal thinking.

A year later, however, The Wall Street Journal re-examined Holmes and Theranos in an article reporting that the company wasn’t using any of its own machines. The product was a marketing fabrication. Holmes may provide an insight into what psychologist and professor John Gartner explores in his book The Hypomanic Edge: The Link Between (a Little) Craziness and (a Lot of) Success in America, which argues that “hypomania” may be a condition shared among entrepreneurs that may bring them success—but also psychological challenges that are the dark underbelly of obsession.

Even in more mature companies, after founding CEOs have survived the stress and practical challenges of fundraising, gathering a team, and growing a company from the ground up, survival challenges persist and often create a breeding ground for depression and/or severe anxiety. In order to write The Secrets of CEOs, author Steve Tappin interviewed 150 global CEOs about business, leadership skills, and their daily lifestyles—including their harshest realities. “There should be a health warning,” Tappin explained to CNN.com recently, reporting on his research. Tappin and his colleague, a trained neuroscientist, even performed neurological tests on the book’s CEO subjects. The results? Most CEOs worked too many hours, consistently felt stressed, and suffered from severe fatigue.

Whether entrepreneurs are attracted to leadership positions because of their personality, or are forced to deal with the mental health consequences of what it takes to be successful, it’s clear that many founders and CEOs are suffering. We need to provide a more accurate reflection of what the reality of leadership is like: leadership is hard work that requires immense sacrifice, but that doesn’t make CEOs heroes to celebrate or Gods to worship. This first mode of thinking perpetuates the pressures put on CEOs to be superhuman, and conceal their vulnerabilities and challenges behind closed doors.

It’s important, and difficult, but if we all work collectively to change the way we talk about and with CEOs, we can be part of the solution.

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