Why Entrepreneurs Kill Themselves

First of all, a disclosure: I’m a therapist. I work with individuals and families. I meet with people in their homes and offices. Many of my clients from around the country are entrepreneurs. Many are high income earners. A few are on the post-exit side, financially comfortable but bored as hell. I’m also an entrepreneur. I consider my behavioral health agency a business with a product. I consider my patients as customers and treat them as such. I’m not sure which came first, entrepreneurship or being a therapist. Both have existed since I can remember (though not always tied together). When I hear about another entrepreneur’s suicide (referring to Austen Heinz), I cringe. I react as an entrepreneur and I react as a therapist who knows how to stop this. I also beat my head against the wall trying to figure out how to get those hurting to connect with those, like me, that can help. 

Entrepreneurs are a unique bunch. They (…we?) have large egos, low self-esteem (when no one is looking), we work stupid hours, are running from fear, elated when the needle moves slightly in our favor, we are hard to live with, have unrealistic expectations, are judgmental of others (more so of ourselves). There’s a ton of research that affirms this (borrowed from FeldThoughts):

Of the 242 entrepreneurs surveyed, 49% reported having a mental-health condition. Depression was the No. 1 reported condition among them and was present in 30% of all entrepreneurs, followed by ADHD (29%) and anxiety problems (27%). That’s a much higher percentage than the US population at large, where only about 7% identify as depressed.

What’s Helpful? Posting the National Suicide Prevention Hotline (1-800-273-8255) might make some bloggers or journalists feel like they are contributing to the solution. A few folks reading articles might actually call and some might find some solace. But for most entrepreneurs, it’s way more complicated. I’d also like to dispel another myth that most, if not only, tech entrepreneurs struggling with launching a product and desperately reaching to become the next unicorn, are the ones hurting. Not true. You do not need millions of dollars from a VC to have anxiety, depression, imposter syndrome, fears that at any moment it will all come crashing down and your ego will get sucked down with it. Pain comes from only a few places. The major one I’ve seen as a therapist for years is the gap between our expectations and our reality.  


What’s the Problem?


Therapists don’t advertise. They don’t connect to the outside world. When was the last time you read coverage of a therapist’s thoughts in Business Insider, Forbes or Inc.com? You don’t because we don’t think about communicating to the outside world. We hide in our comfy offices waiting for nice people with insurance (…or those few souls left that private pay) to trip over our profiles on antiquated therapist database websites. 

Therapists are not well-trained. We have minimum continuing education requirements, most of which are required to be on ethics (Don’t have sex with patients!). Even when we are trained to handle suicide intervention, only a handful of us are available 24/7 unless they work for behavioral health company that requires on-call responsibilities. I’ve been ‘on-call’ my entire professional life. At first it sucked. I felt tethered to my cell phone. But as I matured and as I started and ran my own agency, I understood that being available for those in pain is part of my business. It’s not only me being a good person, it’s a good business model and excellent customer service. 

No One Talks Prevention. Let’s get real. In the world of entrepreneurship, whether you are in tech, making widgets, or busting it out with an Etsy project, there are no systematic behavioral health solutions that cut across industries. Closest thing is Employee Assistance Plans (EAPs), but those are for large companies and tend to be low quality perks. There are a handful of VCs that provide informal emotional support to companies. There are some incubators that do the same. But overall, there is little formal or informal discussion about behavioral health prevention, intervention and resiliency. 




Yes, there are very real things we can do beyond just herding cattle towards the anemic volunteer force at the Suicide Prevention Hotline. 

1. StartUp: We need someone (maybe I’ll do it…) to start a biz which is the QuickBooks equivalent for mental health. Small/medium size business pays small monthly fee for ongoing support with behavioral health issues. Bizarre? I can think of a ton of services I first thought were stupid that soon became popular and financially successful. Either a platform or solution that cuts across industries, is inexpensive, super user friendly and deeply effective at preventing AND intervening with mental health and substance abuse problems. I imagine it being like a cool version of EAPs, but focused on startups and freelancers hoping to break through. 

2. Conferences: We need therapists to get invited to startup conferences and talk about how to reduce anxiety, depression and feeling like an imposter. Therapists also need to reach out to conference organizers and offer to speak. It’s great marketing for the therapist, it’s great value for participants and creates an opportunity for some cross-pollination between industries. 

3. Go to Therapy!: All entrepreneurs that have a history of depression, anxiety, substance use or other significant mental health issue should go and simply connect with a therapist while they are starting a business. Don’t give the bullshit line about not having the money. If you have enough money for an iPhone 6, you can find the money for a few sessions with a therapist.

4. Find a Qualified Therapist: Find a therapist with entrepreneurs and high achievement folks. You will know them when you first ask about their background. Their blogs will have entrepreneurial language. They will also be able to talk about depression, impostor syndrome, anxiety and money problems – all symptoms of the startup/growth world. Don’t count on finding this info on your basic therapist databases like Psychology Today or Good Therapy.

5. Kill Sacred Cows: You are not going to be a billionaire. Your startup will not change human history. Stop taking yourself so seriously and take a break. Learn to stop work at a certain time each day. Stop lying to yourself, families and friends that you are ‘killing it’ with amazing app or product. Get some sleep, eat some healthy food and get your ass moving for some exercise in the Sun (bright thing in sky from 6am-7pm). You get zero bonus points for how much you (and your family) have sacrificed. Chill out. 

Got your own experiences with entrepreneurship and how it affected your life or family? Email me and I’ll put together a ‘Part II’ of this post on entrepreneurship and behavioral health.