When it comes to mental health, entrepreneurs have dangerous jobs.
In a survey, 72% of founders reported being concerned about their mental health. Entrepreneurs also experience high rates of depression (30%) and substance use conditions (12%). These alarming statistics are exacerbated by subtle warning signs that make it difficult to seek help.
In my experience as a psychologist for entrepreneurs, the type of depression that plagues high performers is also the hardest to spot. Called “high-functioning depression” or “walking around depression,” it comes with subtle symptoms that some entrepreneurs dismiss as fatigue or stress.
The same instincts and determination that drive corporate leaders to take risks convince them to act like everyone is good, even when they suffer. Here are some warning signs.
What is high functioning depression
Part of the criteria for a diagnosis of major depressive disorder is functional impairment, meaning you may have difficulty completing basic tasks, such as getting to work on time or brushing your teeth, and many domains of life suffer greatly. This is not the case for everyone, however. Those with high-functioning depression usually don’t see major changes in these areas.
Although not a formal diagnosis, high-functioning depression is a handy phrase for those living under the weight of depression with less obvious outward signs.
While others opposed to the term high-functioning depressionin my experience this reflects the knee-jerk reaction of high-performers to emotional stress: just keep going.
Warning signs of high-functioning depression
Entrepreneurs can accumulate enthusiasm and compulsive optimism like anyone else, leading them to start businesses with low success rates (and high perceived risk of failure) rather than looking for a more stable job. Most entrepreneurs I’ve worked with don’t experience functional impairment until their depression is severe, instead pushing through the hard stuff.
A sign of high-functioning depression is a decrease in happiness, as if the amount has been lowered in your life. You won’t feel like yourself because you won’t get as much pleasure from your favorite activities. And, while you are able to perform tasks, you feel like a zombie while doing them, moving on autopilot from one thing to the next.
Common signs of high-functioning depression include:
- has an appetite, but does not enjoy food
- who is peripherally interested in intimacy, but sex is not as pleasurable as it used to be
- stick to hobbies or exercise routines, but not as often or with vigor
- feeling less rested, despite the same sleep pattern
- difficulty making decisions, even simple ones, such as what to make for dinner
- spending time with friends and family, but feeling disconnected
- take care of the ups and downs of running your business, but the wins are not so sweet
Goal-oriented people often wait to have these emotional needs met. Do you find yourself creating arbitrary benchmarks for when you can get better? I just need to get through this day, this quarter, this year. I was fine after I made a few key hires. This annual report is the real source of my stress. Your health is not just another goal.
Seeing through the haze (and getting help)
The stereotypes surrounding depression are exaggerated. We expect people with depression to eat too much or not enough. They sleep too much or too little. They have irrational outbursts, or they feel nothing. But depression can also feel like a gray area in your emotional life.
If you are concerned that the low points are becoming more frequent, it may help to keep a journal. Rate how you feel at the end of each day using a scale of one to 10, and note any significant emotional experiences. If you have scores lower than five most of the time—somewhere in two or three weeks—consider therapy.
A long moving depression can be dangerous for traders because it acts like a leak in a dam. It is difficult to detect due to the constant movement of the water, but it is catastrophic when additional pressure is applied. When entrepreneurs experience a significant mental health crisis, the onset may seem rapid to the outside observer. However, in most cases the disturbance develops for months or years before a crisis. Treating high-functioning depression can save lives.
In many cases, high functioning depression can be reversed with a combination of psychotherapy, personal assessment, and practices such as sleep, ACTING, connectivity, and amenities. SOMETIMES DRUGS helpful route too.
May is Mental Health Awareness Month, a time to remember that prevention is better than intervention. It’s easier to engage in structured, reflective dialogue before things go south. The outward signs of high-functioning depression can be subtle, but a trained mental health practitioner can spot them.
Entrepreneurs justify speaking or leadership coaches as business expenses, prioritizing output over health. They stopped promoting mental health care as a business priority. It’s time to change that mindset.