Mental Health Is Essential to Your Business Strategy

Monisha Edwards was running her own successful branding agency when the unthinkable happened: her father was wounded and she became his caregiver. The stress of the new role surfaced underlying anxiety and depression. Her creativity tanked and she struggled to get out of bed.

Depression is a leading cause of disability, according to the WHO. The organization also reported that the global prevalence of depression and anxiety increased by 25% during the first year of the pandemic. Entrepreneurs like Monisha are not immune—even if they normally thrive in the high stakes conditions of starting a business solo.

Studies show, in fact, that entrepreneurs often report higher levels of certain mental health symptoms versus the general population. Among this group, isolation, lack of resources, and the pressure to adopt hustle culture can pile up.

Three experts who work at the intersection of mental health and entrepreneurship spoke to us about the causes and impacts of mental health struggles on founders—as well as their optimism for the future.

Overworking as a coping mechanism

Chivon John is the Global Wellness Lead at Shopify and runs her own business on the side. She bristles at the expression “When you do what you love, you’ll never work a day in your life.”

In her experience, the opposite is often true. “If anything, the more passionate and dedicated you are, the more mindful of burnout you have to be because you’re not necessarily going to put up those guardrails,” she says.

In her work, business coach and mental health advocate Nora Rahamian has witnessed the same with her clients. She helps entrepreneurs mitigate stress and burnout by helping them to approach their businesses creatively while avoiding the pressure to adopt hustle culture. “Hustle culture can be a response to that stress,” she says, “because if I just hustle, hustle, hustle, I feel like I have power.”

This was true for Stacey Moss. The founder of Moss Botanicals watched her home and business burn to the ground in a California wildfire. “Right after the fire, I was in go mode,” she says. “The grief didn’t come for six months.” In crisis, entrepreneurs react in the way they know how: working harder.

Hustle culture, which has permeated stories from startup leaders, still has a pull on business owners. “There’s this feeling that you can’t pause or take your foot off the gas, essentially. You’re supposed to be constantly in this motion,” says Chivon. “There’s no one telling you to take that break.”

The pressure to keep up has affected some groups more than others. One study found that the workload among entrepreneurial women amounted to three full-time jobs, while their pay only reflected 50% of one job. Although the balance is steadily improving, the brunt of “informal care” still falls to women.

While the pandemic has certainly highlighted some of these challenges, it hasn’t been the only factor impacting mental health rates in certain groups. “There are so many intersectional layers,” Chivon says. This includes, “Racialized people being more impacted by COVID, the political uprisings, the increase in racist acts and hate crimes.”

Why burnout shouldn’t be ignored

Sherry Walling, PhD, a clinical psychologist who works with entrepreneurs, cautions that burnout is a lot more serious than it sounds. “Burnout is essentially a repetitive stress injury, where we’re using the same neurological circuitry over and over and over,” she says. “It’s brain damage. We can see it visibly on an FMRI, in someone who has high levels of burnout.”

For founders with growing teams, the effects can be inadvertently contagious. “If you see your boss online at all hours, not taking a vacation, it sends the message, ‘Oh, should I not be taking a break?’” says Chivon. “Leaders set that tone.”

But often, stigma pressures those same leaders to hide vulnerability or avoid asking for help. “When you’re leading a company, if people perceive you as someone who is unwell, they’re less likely to trust you, they’re less likely to buy into your leadership,” says Sherry. “If you are unwell, there’s this perceived vulnerability around the business.”

With depression showing up as one of the leading causes of disability, it’s therefore a leading case of absence from work, too. As a result, Sherry recommends that founders invest in team wellness at the outset.

“The minute your business is big enough to support a gym membership or a membership to BetterHelp, those are really good investments in keeping your workforce productive, healthy, focused, and creative,” she says.

Barriers to access among founders

Pre-COVID, seeing a therapist usually meant booking an appointment, driving or taking public transportation to the therapist’s office, having the appointment, and then returning home. “Two hours out of the day for most entrepreneurs is pretty challenging,” Sherry says. Lacking a vehicle or reliable access to public transit makes this even more difficult.

Virtual improvements forced by lockdown have accelerated in the past few years, eliminating many schedule and travel barriers. But other challenges still exist. “Many entrepreneurs just get the ‘hit by the truck insurance’ and don’t have good mental health coverage,” says Sherry. She also points to patient-provider fit. “There is a unique psychology that dictates the relationship entrepreneurs have with their business, that a lot of clinicians maybe aren’t as familiar with.”

While the demand for specialized services and resources for underrepresented demographics is helping to drive change, stigma is still deeply rooted in some communities. “In the Black community, we despise mental health stuff,” says Monisha. “We don’t really believe in going to see a therapist because that’s rich people’s stuff. And taking medication? Oh, that means you’re crazy.”

Nora experienced the same. “The first time I went to therapy, my mom was like, ‘Don’t tell anybody,’” she says. “And she’s a therapist.”

That stigma can also lead to certain elements of mental health being pathologized unnecessarily, says Sherry. “Sometimes those things are actually really, really helpful for entrepreneurs,” she says, referring to high rates of conditions like ADHD among entrepreneurs. “The ability to bounce back and forth between lots of things very fast is super useful when you’re starting a startup. This sort of type of brain does really well with entrepreneurship.”

Conversation inspires action

The silver lining to these increasing challenges—collective isolation, the piling demands of caregiving, and job insecurity among them—is that at long last, people are finally ready to talk about them openly. This, in turn, makes it possible to take action.

“This moment has really brought to the forefront how much our wellness and well-being shows up at work,” Chivon says. “All of the things that were behind closed doors are now at the forefront.”

Mental health was a contributing factor to The Great Resignation—a phenomenon that saw job exodus reach a 20-year high at the outset of the pandemic. One study found that participants cited flexibility in hours, working too many hours, or experiencing challenges with caregiving as contributing factors to leaving careers.

There’s this feeling that you can’t pause or take your foot off the gas, essentially. You’re supposed to be constantly in this motion. There’s no one telling you to take that break.

Chivon John

Simultaneously, hustle culture faced backlash, seeing millennials leaving corporate jobs in droves. Some chose entrepreneurship as an alternative to traditional work, resulting in an uptick in business formation during the pandemic. Others followed the FIRE movement, seeking financial independence on their own terms. “This level of uncertainty has highlighted that we crave agency,” says Chivon.

Caring for your business and yourself in equal measure

There’s no need to buy into the conventional way of running a business, Nora says. “Overnight success” is an unrealistic picture of entrepreneurship, and one that leads many to burnout and fail.

Monisha realized that the hard way. She eventually addressed her mental health issues, taking a path of prioritizing wellness. While making candles as an activity that calmed her, she saw an opportunity for her next business. She’s back in the entrepreneur game with her business Scent & Fire—but this time maintaining good mental health is right up there with her business goals.

When facing the daunting systemic? and societal challenges that contribute to high stress or anxiety, Nora says to focus on the things you can control. “We’ve been indoctrinated into thinking that success is scaling, and you don’t have to do that,” she says. “You can choose what success looks like for your business.”

Nora asks her clients to use one of their biggest assets—creativity—to design not only products or marketing campaigns, but also to define the relationship they have with their businesses. And the research supports this approach. One study found that entrepreneurs driven by intrinsic values demonstrated better mental health wellness than those motivated by extrinsic values like money.

We’ve been indoctrinated into thinking that success is scaling, and you don’t have to do that. You can choose what success looks like for your business.

Nora Rahimian

In addition to designing a business model and working style that fits your lifestyle, Sherry suggests proactively prioritizing different facets of wellness—like finding community, prioritizing basic needs like sleep, and working out your brain—to stave off mental health struggles. “The best strategy to offset burnout is neurological diversification,” says Sherry, suggesting activities like doing yoga, working with your hands, or solving puzzles as examples. “You have to stop staring at the screen.”

And remember, it’s preventative medicine. “Self care should not be a recovery strategy of supporting you when you’re burnt out,” says Chivon. “It’s part of the day to day—it’s not something to pick yourself back up when you’re at your lowest.”

Looking ahead

There were signs a year into the pandemic that the tides were already starting to turn.

A report comparing entrepreneurship wellness and founder outlook between November 2020 and May 2021 found a significant increase in optimism, with 70% reporting feeling “under control” by the end of the study. “I think that the ethos is changing,” Sherry says. “Access is changing significantly. I feel really hopeful about some of these barriers going away.”

A crucial step to maintaining this positive trend is reshaping the narrative around what ”good entrepreneurship” looks like. “A lot of the pressure that I see entrepreneurs feeling is the expectation to do it perfectly,” says Nora. Taking a realistic view of business ownership as a society and surfacing stories of struggle help normalize the conversations of mental health in this community.

For Monisha, leaning into the things she could control—her own environment and work life—helped her make space for wellness. Prioritizing her mental health isn’t a distraction from her other priorities—it has the opposite effect, giving her the foundation to show up for her business, her staff, and herself.

“In a time where we have very limited things that we can control,” says Chivon. “We’re seeing that what we can control is how we take care of ourselves.”