There’s nothing new to the fact that entrepreneurship is an attractive career path for millions of Americans –– 27 million in 2015. And with entrepreneurship majors and minors popping up in colleges and universities around the country, we may very well see the that number continue to increase.

The attraction of entrepreneurship to people –– young and old –– makes perfect sense. After all, at its core, entrepreneurship embodies the human desire to find meaning, purpose, and make a difference for both themselves and for others.

But there is an elephant in the room that we need to address: mental health and entrepreneurship.

Much of the culture of entrepreneurship is about putting your nose to the grind and focusing on nothing but your company until it becomes a success. And that kind of pressure can have very real, very detrimental impacts on entrepreneurs and their lives outside of their startups.

So what can entrepreneurs do to help themselves? And what do they need to know about the cross-section of mental health and entrepreneurship?

I spoke with Emily Griffiths, a therapist who specializes in working with entrepreneurs, to gain some insight into the challenges that entrepreneurs face.

What is your experience with mental health and entrepreneurs?

When I decided to start my own practice, I was very excited. However, this excitement was quickly replaced by anxiety and despair. I had no clients! I had a tremendous amount of existential angst.

Because I am a perpetual student of the mind (and had a lot of time on my hands), I decided to research the psychological side effects of entrepreneurship. I couldn’t believe what I found. Entrepreneurs were struggling with anxiety, depression, traumatized nervous systems, substance abuse, divorce recovery-all of the issues I had been trained to treat.

And here I am in Austin, Texas-THE place for startups and entrepreneurship. I decided to put together a talk and reach out to places like Capital Factory. My practice then began to fill up.

I became very interested in the idea of meta-entrepreneurship. I can’t do what I do without my clients, and hopefully my clients are better at what they do because of the work we do in therapy. Philosophically, entrepreneurship interests me on so many levels. I find it to be a pursuit for meaning, responsibility, free-will, identity. It interests me on a sociopolitical level as well as it is the crossroads of service and enterprise.

How common do you think these kinds of stressors and these instances of depression and anxiety are in the startup sector?

I think they are very common.

Do you think there is an awareness about that before people start out?

I would presume that people do have an idea that entrepreneurship will be stressful. But it’s like anything else in life, you don’t know how stressful things can get until you’re in the midst of it.

Before they seek therapy, how do they try to deal with it?

I think everyone is different in how they manage their internal world. If how you’re handling things doesn’t sit right with you, therapy could be a great way to uncover historical antecedents for problems, and then find more beneficial ways of coping with stress, anxiety, and despair. I believe people decide to change when the risk to stay the same is greater than the risk it takes to change. Therapy is a whole-brained activity which encourages left and right brain integration. By expressing feelings and thoughts, our brains become more developed.

How can young entrepreneurs spot warning signs early on and know when to seek help?

I would say look at your psychological health like you look at your physical health. If you have a sore and you ignore it, it can fester until it becomes infected. Our psychological health is the same.

Especially in certain communities, whether it’s geographical or cultural, there’s a gap there.

Absolutely. In many cultures-including American culture-it can be stigmatizing to address one’s mental health. There’s a lot there around gender identity, too. Many men are taught that self-worth is net-worth, and that certainly comes through in entrepreneurship. I work with a lot of men, and many of them have been taught not to express their feelings or to show emotion. Society is largely to blame for that. Men are taught not to feel, and women are taught not to speak. This is something we can change.

Do you think people are having these conversations about depression and anxiety in entrepreneurship?

I think conversations about mental health are becoming more prevalent in general. However, I’m not sure if a public discussion is necessary. It’s ok to be private about such matters. However, if it helps an entrepreneur to speak out, then go for it! I’ll support that all day long. What I think is most important is that there be an awareness that some very difficult feelings might come up in this process, and that our entrepreneurs know that there are a lot of resources out there to support them.

Why do you think people are drawn to the idea of becoming entrepreneurs?

There have been a lot of young people before me and after me that wanted to do something different with their lives. I always knew that I wanted a thinking life. And I think a lot of entrepreneurs always knew that they wanted to do something different, too.

Identity gives us self-purpose and meaning. The more complicated the world becomes, the more important it is to have identity. The identity of entrepreneur gives one pride.

Do you think that entrepreneurs in particular can be susceptible to feelings of anxiety and despair?

There is tremendous pressure in entrepreneurship. The financial pressure alone is overwhelming to many-securing funding from investors, the intense pressure to grow for employees. Of course an entrepreneur is going to feel anxious with that much responsibility. There are so many choices to consistently make.

How do you think the practice can be reframed more positively for entrepreneurs?

I think it’s really important that entrepreneurs have a good, solid support system around them. Who do you call when things are going well? Not well? Completely awful?

How do you think entrepreneurs can be better about practicing self-care?

Face struggles. Instead of deflecting or ignoring a situation, just step into it. You don’t have to jump in head first, but simply face what it is that is troubling you.

And then there are the obvious self-care strategies: exercise, good nutrition, developing your relationships, fun hobbies that make you feel good.

What do you think the most common stressor is for young entrepreneurs?

I understand that many young entrepreneurs can struggle with imposter syndrome and uncertainty about the future. Uncertainty causes anxiety and chronic worry. But, we can’t ever be certain what the future will bring. Mindfulness is a great tool for dealing with uncertainty and rumination. I often teach mindfulness to entrepreneurs. It’s a very simple and effective way for coping with anxiety.

As far as imposter syndrome…well, we could do another blog post alone on that one! Ambitious people often suffer from imposter syndrome. Entrepreneurs are extremely ambitious. When you are ambitious, you put pressure on yourself to achieve. When you do achieve what you have been working towards, it may be difficult to internalize the accomplishment. There can be a sense of, “I”m a fraud.”

Do you think that sense of uncertainty or being a fraud is amplified if they don’t perceive their startup to be an immediate success?

Yes, exactly. There are so many unknowns. It’s important that an entrepreneur develop his or her “know-how,” which is an ability to know how to deal with any situation that comes up. When you’re starting a business you don’t have a clear path to success. Success itself is often a personally defined and very elusive entity. However, I have yet to hear of a really great success story without at least one or a series of stressors and setbacks.

Entrepreneurs tend to work harder and harder when they are worried about not succeeding.

Overworking yourself can be a way of distracting yourself from what’s really going on…over-functioning to function as I like to call it. There is something to be said of having a persistent work ethic and striving to complete your goals. I admire this tremendously. However, when it gets in the way of managing your mental health, then it’s time to slow down, not speed up.

When you go into panic mode and can’t mediate stress, then you can’t focus and reflect on the things that you really need to do. If entrepreneurial success is your end goal, taking care of your needs and paying attention to overwhelming or unfamiliar feelings will be a part of achieving that.

I like to say that entrepreneurs are a lot like athletes. Any athlete will tell you that interval training and rest are important aspects of competition. I think the same goes for entrepreneurship. Our nervous systems simply aren’t designed to go-go-go all of the time.

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So take care of yourself and pay attention to your body. And don’t compare yourself and your needs to those of other people. To be healthy and successful, you have to find out what works well for you.

Do you have a story about your experience starting a company that you want to share or advice about how you got through a stressful time? Let us know in the comments!

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