I’ve been building companies for 12 years. I’ve had periods where I couldn’t sleep, couldn’t stop working, couldn’t feel okay even when things were going well.

Founder mental health is a real issue. Here’s an honest conversation about it.

The Unique Stressors

Founders face particular psychological challenges:

Constant uncertainty: Revenue could drop. Key hire could quit. Competitor could emerge. The ground never feels stable.

Identity fusion: When your company is struggling, you feel like a failure as a person. The boundaries blur.

Responsibility weight: People depend on you—employees, customers, investors, family. The weight is constant.

Isolation: You can’t share everything with employees. You can’t share everything with investors. The loneliness is real.

The comparison trap: Other founders raising money, hitting milestones, getting press. You feel behind.

This combination is brutal. Don’t let anyone tell you it’s not.

What Doesn’t Work

Toxic positivity: “Stay positive!” doesn’t address underlying anxiety. You can be positive and struggling.

Hustle culture: Working more hours doesn’t solve psychological challenges. Often makes them worse.

Suppression: Pushing down feelings works until it doesn’t. Then it explodes.

Self-medication: The founder drinking problem is real. Don’t become a statistic.

Isolation: Not talking about it makes everything worse. Shame thrives in silence.

What Actually Helps

Therapy

Find a therapist who works with entrepreneurs. The context matters. Regular therapy has been the highest-ROI investment in my founder career.

Cost: $150-300/session, often covered partially by insurance. Worth it.

Peer support

Other founders understand in a way no one else does. Find a group—formal or informal—where you can be honest.

I have three founders I text when things are hard. They do the same with me. This alone has gotten me through bad periods.

Physical health basics

Sleep, exercise, nutrition. Boring advice because it works. When I skip these, everything gets harder.

Not heroic. Just necessary.

Boundaries

Your company will take everything you give it. You have to set limits. I don’t work Sundays. I don’t check Slack after 8pm. The company survives.

Professional management

Get an executive coach or mentor. Someone who can help you think through challenges without being your employee or investor.

Medication when appropriate

Some founders need it. No shame in brain chemistry. I’ve used medication during particularly difficult periods. It helped.

The Hard Conversations

With your co-founder

If you have a co-founder, talk about mental health directly. “How are you actually doing?” can reveal things that affect the whole company.

With your team

You don’t need to share everything, but admitting that things are hard normalizes it. “This is a challenging period” is honest and helps others feel okay being honest.

With your investors

Good investors understand founder wellbeing affects company outcomes. If you have the right investors, you can have real conversations.

With your family

The people closest to you see it anyway. Let them in. They want to support you but need to know how.

The Warning Signs

Watch for:

• Inability to disconnect from work
• Sleep problems that don’t resolve
• Using substances to manage stress
• Persistent hopelessness
• Isolation from friends and family
• Loss of enjoyment in things you used to like

Any of these are signals to take seriously.

Resources

Founder-specific:

• Startup Therapy (podcast)
• Founder peer groups
• Executive coaching

General mental health:

• Therapy (find someone who fits)
• Beyond Blue: 1300 22 4636 (Australia)
• Lifeline: 13 11 14 (Australia)

My Personal Practice

Weekly: Therapy session Daily: Exercise (non-negotiable) Monthly: Deep conversation with founder peer group Ongoing: Sleep prioritization, boundaries on work hours

Does this make building companies easy? No. Does it make it sustainable? Yes.

The Bottom Line

Your mental health is not separate from your startup. When you struggle, your company feels it. When you’re healthy, you make better decisions.

Invest in your psychology the way you invest in your product.

And if you’re struggling right now: You’re not alone. It’s not weakness. Get support.

The best founders I know take their mental health seriously. It’s part of being good at this.