Most entrepreneurs expect to experience a rollercoaster of intense ups and downs when building a business. But recent statistics suggest an alarming mental health care crisis looming within startup culture. Studies show that, compared to the general population, founders are twice as likely to suffer from depression, psychiatric hospitalization, and suicidal thoughts. We explored the topic of entrepreneurship and depression with Andrew Dubowec, VP of Strategy and Corporate Development at League, Inc. whose professional and personal experience makes him uniquely poised to discuss the link between entrepreneurs and depression. In an open dialogue with Shikhar Ghosh, he shares insights on how to help protect your mental health or help a colleague who’s struggling.
4 Ways to Help Yourself or a Colleague Who Is Struggling with Depression
Be Aware & Empathetic
Resist the Temptation To Define Yourself by Work
Reframe Your Narrative
Consider Sharing Your Story
Entrepreneurs and Depression
Some entrepreneurs don’t want to admit that they’re struggling. Few would willingly risk damaging their startup’s—or their own—reputation. And many fear that admitting any mental health challenges could potentially jeopardize funding. At the same time, simply self-recognizing the signs of depression presents some challenges. Most entrepreneurs consistently perform at high levels and face intense, prolonged pressures. This can make it difficult to differentiate between ongoing stress and an imminent clinical mental health issue, like major depression, as Dubowec learned.
While completing an MBA at HBS, Dubowec competed in the Rock Accelerator Program and conceived of a startup idea, “openmind.” The product—an online network would enable physicians, case managers, and counselors to coordinate patient care. His idea won an award and recognition as one of the “most promising startup ideas from Harvard.”
Now at League, Inc., a leading enterprise OS that is revolutionizing employee healthcare, insurance, and benefits, he continues trying to improve the health care system. Between graduating from HBS and joining League, Dubowec went through a 12-month battle with major depression which completely upended his life.
Resist the Temptation To Define Yourself by Work
For many founders, the line between startup and self is blurred. But deriving your sense of self-worth and identity from work can foster a climate for depression. After completing his MBA at HBS, Dubowec joined Thalmic Labs (now North), an early-stage, rapidly-growing startup that produced wearable technology. The VC-backed startup had just raised $120+ million from investors and was under pressure to scale. In his early twenties after graduate school, life experience had not prepared Dubowec for the relentless pace they needed to maintain.
Excited to have joined the team so soon after graduation, he threw himself into the role. “I wanted to be attached to my day job because I wanted to work with passion,” he recalls, but he quickly grew “too attached to my day job.” A high-achiever who had always held himself to high standards, he felt unprecedented pressure to meet or surpass targets. That self-imposed pressure, combined with the isolation of working remotely and a biological predisposition to depression, set the stage for a mental health crisis which he discusses in more detail here.
I was far too attached to my day job. I wanted to be attached to my day job because I wanted to work with passion. But you have to have something more. Your job should be one part of your existence, but not the whole thing.
Notice If You’re Taking Failure or Rejection Personally
When he joined the Waterloo-based Thamlic Labs as VP, he worked remotely from Boston. Managing his team from afar and lacking daily contact with colleagues proved unexpectedly challenging. The pressure to meet VC’s expectations made any mistake feel catastrophic. He described any failure as “my fault because of my shortcomings.” At the same time, as a young entrepreneur, his identity felt inextricable from work.
When he missed some sales targets, he began “confronting failure in a way that was very personal.” He conflated any failure at work with his identity and self-worth. Following popular tropes, such as “being self-critical can make you a stronger founder,” intensified his self-induced pressure and exacerbated feelings of failure. He advises other entrepreneurs caught in this cycle, “Even if you are failing, it’s okay. It’s okay for it not to be a good fit. It’s not a judgment on you personally.”
If you feel like you’re failing in a particular role or you don’t fit, resist the urge to interpret that as a judgment on you personally. It just is.
Cultivate Your Life Outside of Work
One of the biggest steps entrepreneurs can take to protect themselves from depression, Dubowec advises, is to separate your identity from your job. Make time for other things in your life that you find fulfilling. For instance, after recovering from depression, Dubowec prioritizes time with his wife, playing golf, and mentoring others in the tech startup community.
He credits yoga with helping him through his recovery period. The experience with depression taught him, “Nothing is more important than your health. Whether it’s mental or physical health, nothing is more important than that. That’s the only thing you can hold on to.”
Reframe Your Narrative
For many entrepreneurs, depression can twist circumstances and cause insidious self-doubt. Working away from his team, Dubowec had convinced himself that he was deeply introverted, didn’t have friends, and had lost his edge.
Recognize Your Internal Monologue
Looking back, he reflects, “It was not anything the company did wrong. It was an internal belief I had that you can’t show that kind of weakness. You can’t raise your hand and say, I’m struggling.” As he sought help and worked through his depression, he realized that he wanted to redefine himself. Taking steps like reframing your narrative and inner monologue can help entrepreneurs battle against depression.
I had an internal belief that you can’t show weakness. You can’t raise your hand and say, “I’m struggling.”
Consider Changing Your Environment
He wanted to spend time with people that didn’t know him. He shares, “It felt like an opportunity to go and find what was next.” For Dubowec to evolve, he needed to change his surroundings. “That’s not a judgment that the current scenery I was in was bad,” he notes. But change “allows you to discover things about yourself that you can’t when you’re in your current place.” He elaborates,
When you go through a form of crisis, you can have a lot of negative emotions and attachment to the things you associate with that point in time. You have to remove yourself from that environment. Go somewhere new so those negative attachments are left behind and you can start fresh effectively.
Broaden Your Perspective
It’s natural to associate a mental health challenge with your industry or place of employment. Instead, Dubowec encourages entrepreneurs to step back and examine their experience with depression within a larger context. After taking the time to rest and heal, the process of searching for another job helped him reframe his narrative. He shares, “It pulled me from thinking about a six month or a 12 month or 18 months story, and it made me think about a 29-year story.” Taken in the context of a 29-year old life, Dubowec’s year of struggle with a major depressive episode “looked like a blip on the radar screen or a part of an evolution.”
It’s essential for entrepreneurs recovering from depression to place the episode within the larger context. Instead of thinking about how to spin a 6-month, 12-month, or 18-month story defined by mental illness and recovery, try to see the incident as part of a larger context.
Be Patient with Yourself
Rebuilding the damage depression wreaks on self-image, especially for entrepreneurs who are accustomed to being high-achievers, takes time. Dubowec recalls, that, after being invited to interview at a consulting firm, “I literally broke down in tears because I was so shocked that they would even interview me.” But reconnecting with others and forging new connections is priceless. “Having people confirm, ‘Hey, you’re really interesting. You’re really talented,” helped him reconstruct his narrative. “Even when I got rejected,” he humbly recalls, “which was frankly, most of the time . . . came a certain validation and a changing of the narrative.”
I started to frame a perspective. A point in time when things aren’t going right—whether it’s professionally or personally—doesn’t define the whole story. It isn’t who you are.
Be Aware & Empathetic
Often, entrepreneurs are so immersed in their work they are oblivious a colleague is struggling with mental health issues. “The reality is people are so busy that they don’t really notice what’s happening around them,” Dubowec admits. Interactions with any colleague are small in the context of your entire week, so “to actually pick up on something requires you to be aware.”
Whether it’s real or perceived, there’s an underlying belief that mental health conditions and issues are weaknesses. Noticing that someone on your team is struggling and reaching out with compassion can help.
Paying attention allows you to show empathy. Commenting to someone that you’ve noticed a change—without placing any judgment on the change—can be a good way to approach a discussion and encourage someone to open up. Little things, like truly listening to the person or including them in a small activity and show that you’re genuinely concerned. “Asking people to go for a walk, taking them out for a coffee, checking in through text or a phone call, can make a huge difference when someone’s going through a hard time.”
It can be very helpful to have someone ask you, “How are you doing? Do you feel different? Is there anything I can do to help?”
Resist the Urge to Solve the Problem
While listening can be extremely helpful, he cautions people to resist the urge to propose a solution and to remain empathetic and observant even if people don’t want to have the conversation. “You have to let the person get to the point that they’re ready to get help.”
One of the biggest challenges in helping someone with a mental health condition like depression is that, at the time, they believe a skewed version of reality is rational. Dubowec recalls that it’s easy to “misinterpret facts to reach an alternative conclusion.” He elaborates, “If you say, ‘I’m stupid,’ and people say to you, ‘you’re not stupid and here are the five ways in which you’re not stupid.’ You’re in a mindset where you will not accept those comments as facts because you’ve come to a belief that’s so different.” Instead of trying to counter the person’s skewed version of reality, recommends that you simply listen and express empathy. If the skewed perceptions persist or deepen, encourage or direct the person to seek professional help “but don’t prescribe help. I think those are nuanced, but they’re different,” he clarifies.
It’s important to remember that there’s only so much you can do to help a colleague. Dubowec emphasizes that any person struggling with depression—or any mental health issue—has to want to receive help. “You have to do the work yourself. You have to get there on your own.”
At the end of the day, it comes down to patience, support, empathy. And, when the time is right, encouraging people to seek help.
Consider Sharing Your Story at the Right Time
Deciding to share if you struggle with mental health challenges is a personal choice. If you want to share your experience, Dubowec acknowledges that it’s important to decide whom you will tell and when you will share the news.
Weighing the Benefits of Sharing Against Potential Risks
Candidly sharing an experience with mental health struggles can be cathartic. “There’s a healing element to be able to put what you went through into the open,” he believes, because it allows you to find meaning in the experience.
But should you present the information that you have a history of depression when interviewing for a job, especially if that history caused performance issues at your last company? For many founders, he acknowledges, divulging an experience with depression presents tangible career risks.
Dubowec didn’t raise the issue during the interview process or broadcast his experience to the entire company. He chose to divulge his history with one of the company’s co-founders on his first day. He shares “the act gave me the confidence that if I ever needed to raise my hand, I could raise it.” He adds, “I actually never raised my hand. I’ve been there for almost four years. But just having that card, built a lot of confidence.”
He advises, “You should try to raise that or explore raising it in a way that makes sense” depending on your needs. For some people, telling HR might make more sense than talking with a hiring manager. “Instead of declaring what challenge you have, you could also think about it through the lens of, “how do I learn more about how the company thinks about its policies, like time off.”
Ultimately, he believes, “the risk is worth the downside of having to live in fear in an environment where you can’t be healthy. Because the reality is, for many people, these issues are life and death. It needs to be thought of that way.”
Timing a Decision To Disclose
Dubowec decided to inform his colleagues at North about his experience with depression after he decided to leave the company. When he first divulged how intensely he struggled, he feared his former colleagues would react negatively. Instead, they reacted with compassion. Some shared their own stories.
The most powerful part of the experience is that you can start a dialogue that people aren’t typically having.
Sharing his experience with depression with colleagues and other entrepreneurs, he hopes, will encourage others to ask for help. As more entrepreneurs candidly discuss their experiences with depression, it will weaken the stigma surrounding mental health issues at startups. The positive reactions Dubowec received after sharing his story convinced him that startups could effectively take the lead in launching a dialogue about mental health and the workplace. “We’re privileged in this community to work at some of the best companies in the world, with some of the best leaders in the world.”
National Suicide Prevention Lifeline: 1-800-273-8255. The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals.
Anxiety and Depression Association of America (ADAA) works to improve the quality of life of those affected by anxiety and depression-related disorders. The nonprofit provides education, resources, and support for people to find treatment.
The National Alliance on Mental Health, provides “advocacy, education, support, and public awareness so that all individuals and families affected by mental illness can build better lives.” One in five adults (47.6 million people) in the U.S. suffers from mental illness annually. NAMH measures how common mental illness is, to understand its physical, social and financial impact. They provide access to support, raise public awareness, de-stigmatize, and advocate for better mental health care.
“The Right Resources Can Help You Manage Depression” provides a Comprehensive List of Depression Resources.
Kip, a San Francisco-based startup launched by Erin Frey offers a hybrid of in-person therapy and software services to entrepreneurs and startup employees. The app, which is accessible 24/7, allows busy founders to be active collaborators in addressing mental health issues on their schedules. It also promises to be more effective than traditional therapy as it leverages user data to help therapists develop personalized treatment plans and lets users track their progress.
In “Investors and entrepreneurs need to address the mental health crisis in startups,” Jake Chapman, a managing partner at Alpha Bridge Partners, cites studies documenting the link between the entrepreneurs, depression and other mental health issues. He makes an impassioned plea to investors: “Addressing the ongoing mental health catastrophe in entrepreneurship is a moral imperative, and for wise investors, it should be a function of doing business.” He stresses, “it is extremely likely you or someone you know is suffering right now and could use support” and their challenges are “largely addressable through individual action” such as de-stigmatizing the need for help.
In a study of entrepreneurs undertaken by Stanford and the UC system, researchers demonstrate an underlying relationship between entrepreneurship and neuropsychological and behavioral differences associated with certain mental health conditions. Founders are twice as likely to suffer from depression, 3X more likely to abuse substances; 6X more likely to have ADHD; and 10X more likely to be diagnosed with bipolar disorder. 72% of entrepreneurs reported mental health concerns at some point in their careers. 49%—reported having one or more lifelong mental health conditions. Their findings could impact business education, executive coaching, and human resource management as “understanding the strengths and vulnerabilities associated with personal and familial mental health histories may contribute to improved entrepreneurial outcomes, and to the development of protective resources for entrepreneurs.”
“Why Is Entrepreneurship Bad For Our Mental Health?” offers a Q&A with entrepreneur, coach, consultant, and author, Louise Nicolson. Her latest book, The Entrepreneurial Myth, examines why entrepreneurs suffer more from poor mental health more than the general population. She challenges business owners, educators, and policymakers to reconsider toxic tropes about the “entrepreneurial mindset.”
In “7 Strategies Every Entrepreneur Should Employ To Optimize Their Mental Health,” therapist and executive coach, Megan Bruneau, provides tangible ways that entrepreneurs can safeguard their mental health, such as “notice where expectations are ruining your life,” connecting with others, and seeking help from a professional. In her podcast, The Failure Factor, she interviews entrepreneurs about how they coped with challenges and failures and ultimately thrived.
Kip blog provides inspirational stories and mental health care tips. In 2017, Kip launched the Investor Pledge for Mental Health to raise awareness about how the pressure from investors contributes to mental health deterioration among founders and how they can effectively help founders build company cultures that promote mental health. By taking the pledge, investors weaken the stigma attached to mental health problems and signal that it’s acceptable for founders to seek help.