Let’s Be Frank About Entrepreneur Mental Health

Let's Be Frank About Entrepreneur Mental Health

Table of Contents

By Zuzana Hegerova

A few years back I’d have little other than second-hand accounts to contribute to any discussion about the topic of entrepreneur mental health. Over the recent years, much of my work has been focused on helping African changemakers and entrepreneurs polish their ideas and better understand the skills and resources they require to realise their ambitions and to make the world a better place for all.

I am immensely inspired by the innovation and creativity that these visionaries manifest on a daily basis and by their fearless commitment to invest whatever it takes to the building of a more socially and environmentally sustainable world. I also regularly find myself utterly stunned by the stories of their struggles, sacrifices and perseverance.

So whether I am busy helping them analyse their results to date, build complex models to forecast their paths to commercial success or unpick the weaknesses in their investment readiness, I am always somehow in the midst of an informal research project observing the workings of the entrepreneurial mind.

Through an unexpected serendipity of my professional background, connections, exposure to the global startup support universe and my personal fascination with the human psychology, I have also become a parent to a startup baby – Headroom Online Mental Health. Not my first, but slap-bang just before the pandemic hit and with all the trials, tribulations and the unavoidable burnout as a result. I’ve thus become fascinated with the topic of entrepreneur mental health and psycho-social well-being and compelled to uncover more.

The Entrepreneurial Mindset – Glamour or Downfall?

The entrepreneurial mindset approaches risk with confidence. Often against what healthy logic may dictate. It means accepting that the paycheck that can take care of you, your family and any unforeseen troubles may not come for a long while, while you are trying to convince others to buy your product or service.

I dare to say that it is impossible to assess such a wide-ranging risk even remotely accurately, particularly when we carry more responsibility than just ourselves. Moreover, and as 2020 demostrated, black swan events on top of that are not exactly the easiest to pivot around.

Entrepreneurs think fast, take action, commit to the grind and do things that most people won’t. But they are also slow to admit that they need help when things stop going well.

Being An Entrepreneur Is Negatively Correlated With Mental Health

There is no doubt that mental health can be a challenge as an entrepreneur. Today we have ample research to support that – despite its glamorization – entrepreneurship is negatively correlated with mental health.

72% of entrepreneurs are directly or indirectly affected by mental health issues compared to just 48% of non entrepreneurs. That’s according to a study by the National Institute of Mental Health. 49% of entrepreneurs deal with mental health issues directly while only 32% of others experienced them. Similarly, 23% of entrepreneurs have family members who face these issues compared to just 16% of others with family members who face these same types of issues.

Here are a few reasons why:

The 7 Biggest Psychological Hurdles Of Entrepreneurship

1. Stress and lack of self-care

The life of an entrepreneur is stressful. Yes we are motivated, inspired and energised by all the big and daring ideas we work so hard to turn into reality every day. And soon we get trapped in an “always on / always working”  mentality, giving up opportunities for fun and connection and thinking about work even when we’re not actually working.

We justify our sacrifice as temporary, soon to be reversed by the immense success that awaits us in the next x months when virtually every assumption we are basing our most optimistic views on actually materialises.

We become a fast-moving train, sleep-deprived, over-caffeinated, fed on technology and financially constrained – with little emphasis on self-care and adaptive coping strategies such as down-time, exercise, human connection and fun. Many of us live with a predisposition to addiction, vulnerable to developing unhealthy relationships or other numbing tendencies.

2. Doubt. And so much uncertainty.

We’re all different in how much uncertainty we can tolerate in life. Our questioning of “what-ifs” and preparing for worst-case scenarios about what tomorrow may bring can be emotionally draining and trap us in a downward spiral of endless worry. As humans, we like to create an illusion of certainty to manage our anxiety around our ultimate powerlessness.

The ability to envision our future entrenched in a foreseeable financial security is an anxiety-avoidance tool less accessible to those working for themselves. Thus we navigate higher levels of uncertainty, anxiety, and responsibility for what’s truthfully out of our control.

3. Social isolation

Particularly in the early stages of a startup and oftentimes working alone for protracted periods of time, entrepreneurship can be incredibly socially isolating – a textbook precursor to depression. Additionally, the interactions entrepreneurs engage in most often are networking or sales-focused, based on a quid-pro-quo rather than on a vulnerability necessary for authentic connection.

We also stand to experience isolation when we feel unsupported or not understood in taking a nontraditional path. When we’re surrounded by the “9am-5pm” crowd or have loved ones telling us to admit defeat and get a “real job,” further loneliness, frustration and/or shame may not be far from nestling in our minds. Without a corporate bonus scheme, budget for team buildings, rewards for reaching simple goals, and the odd client freebie, keeping ourselves and our teams upbeat and motivated is no small task.

4. Shame and stigma perpetuated through “impression management”

Impression management is a conscious or subconscious process in which we attempt to influence the perceptions of other people about us and our fledgling business by regulating and controlling information we share with others.

Many entrepreneurs believe that, in order to be considered competent by stakeholders, we need to be perceived as infallible, as “having it all together” and to show no weakness. A stark contrast to the stigmatized stereotypes of a person with compromised mental health. This perpetuates disconnection and discourages self-care and help-seeking behaviors.

When so much of our attention and energy is placed on controlling how we are perceived, there is little room for us to develop our true selves. Yes, exactly those true selves which the success of our status-quo-shattering entrepreneurial endevours depends on. There’s evidence to suggest that impression management prevents the development of a ‘sense of self’ and contributes to insecurity and identity confusion.

5. Barriers to appropriate mental health support – access, stigma and cost

Online mental health resources are plentiful these days and come in a myriad of shapes, forms and sizes – self-help articles, mediation and mindfulness apps etc. We are self-learners by nature and most of us would have consumed a fair share of the vanilla advice already. But they may not even touch sides for someone going through one of the most challenging phases of life with multi-layered psychosocial dynamics that few ever experience.

Many entrepreneurs tend to rely on just a very basic (or no) medical aid plan, without the premium coverage that funds professional mental health support. Unaware or in denial of just how important their mental well-being is as a fundamental building block for their business success, many bootstrapping entrepreneurs don’t factor such need into their budgets.

6. Predisposition to mental health challenges

The typical accompanying lifestyle notwithstanding, there is scientific evidence that entrepreneurial types have a higher prevalence of mental health challenges than comparison populations.

The qualities that make a great entrepreneur – independence, risk-taking, multi-tasking, creativity, empathy, flexibility, resilience, humor and crisis-management skills – are often rooted in the same  life experiences as our trauma, anxiety, alienation, abandonment, perfectionism, ADHD, shame and discomfort with the status quo.

Fortunately, through self-awareness, psycho-social support, and emotional intelligence we can learn how to both leverage our mental programming for personal success and how to support ourselves through areas that inhibit our growth.

7. Identity and self-worth fused with the business

Many of us lose ourselves in building our businesses. “I don’t know who I am if I’m not the owner / founder / business person” a client anxiously admits, more often than ever now, amidst the business closures and slow-downs caused by the Covid-19 pandemic.

We become detached from our own needs, disconnected from friends and loved ones, and sacrifice other sources of meaning such as relationships, present parenting, travel and play. The looming existential void and self-worth tied to our business success is a manifestation of perfectionism that causes immense anxiety and an emotional roller coaster.

Let’s Be Frank About Entrepreneur Mental Health

Whether you’re an entrepreneur or one of their inner circle living the grind with them –  I encourage you to reflect on which of the above points resonate with you. In future articles, I’ll be offering suggestions for how to mitigate these barriers to psychological well-being, and I’ll share wisdom from interviews with entrepreneurs who’ve been open about their mental health journeys.

To unpack your personal challenges and the best way forward in confidential session with a professional, talk to us here. Above all, know that you are not alone, you are not broken and you are more resilient than you know.

If you are an organisation supporting entrepreneurship in any shape, type or form – I invite you to light up meaningful conversations within your areas of influence on this topic.
How much of your success as an organisation may be more dependent on your beneficiaries’ ongoing well-being than on the aspects you directly control? What do you do to understand the psychosocial hurdles your beneficiaries are facing? How do your programs and activities support the real humans behind the ventures? We’d love to hear from you.

Entrepreneur Mental Health Talks

Our talks are proudly supported by the following exceptional entrepreneurship support organisations and intermediaries who recognise that the entrepreneurship ecosystem’s ability to drive large scale economic and societal impact in Africa must be measured by its ability to develop both the businesses and the funders who make them work:

SA Innovation Summit 
Southern Africa Innovation Support Programme 
Southern Africa Startup Awards 
Research Institute for Innovation and Sustainability
Women’s Entrepreneurship Access Centre


Headroom is South Africa’s first independent online platform enabling fast, affordable and discreet access to a wide range of licensed professionals, for anyone seeking mental, emotional or social support.

Anyone with an internet connection can book, pay and consult with a suitable professional from the comfort of their device and receive confidential support via secure live video sessions.

Headroom lists licensed and experienced psychologists, social workers and counsellors, who provide their services at varying times and costs, suitable to any budget:

Headroom lowers the barriers of ACCESS, STIGMA and COST and harnesses global standard healthcare technology to make it possible for anyone to reach out to licensed therapists. Conveniently, privately and confidentially.

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