It’s easy to romanticize being an entrepreneur. You become the captain of your fate. You answer to no one but yourself. Really, when we were kids, how many times did we pretend to be the boss of some huge company? How we beamed at the earnings we made from selling lemonade or from our own garage sale?

But there’s a dark side to running a business, and one that is often overlooked by the industry: mental healthcare.

The constant pressure of making sure the business stays afloat, the added burden of knowing you are responsible for the livelihood of your workers, and the increasing isolation caused by always trying to chase profits-all these will exact a high price on the business owner’s health.

The UK’s Federation of Small Businesses (FSB) ran an internal survey of the most common issues that forced owners to seek help. In that study, 17% of the respondents were struggling with mental issues. Another 6% were dealing with cancer which, in all likelihood, is caused by stress.

Everymind, formerly The Hunter Institute of Mental Health, has claimed that small and mid-sized business (SMB) owners are more likely to suffer from mental health issues compared to the general population. In the survey, more than 8 in 10 of the total 442 respondents revealed that they usually bring their work home, leaving no place to spend quality time with their family. Also, they are not getting enough sleep because of the problems at work. Finally, unpaid bills are common causes of stress and anxiety.

Risks Associated with Being A SMB Owner

The problem is that the odds are stacked against the budding entrepreneur. A survey by the Small Business Association (SBA) revealed that 3 in 10 of SMBs fold during the first couple of years. Meanwhile, half of the businesses fail within the first five years. Based on the group’s estimates, only a quarter of the businesses will survive through 15 years.

The pressure of keeping the business running exposes the entrepreneur to some risks, including:

Depression – Unpaid bills, the guilt of not spending enough time with the family, the lack of sleep, and the lack of variation in their routines may drive the business owner to depression. The chance of depression indirectly proportional to how the business is doing. However, because they don’t have any experience with the condition, they ignore the symptoms until it’s too late.

Self-esteem problems – Almost all entrepreneurs equate their self-worth to the success or failure of their businesses. The problem with this mindset, however, is that the system is not very compassionate to SMBs. As the statistics bear out, only 25% of the businesses survive for more than a decade. Those are grim realities that will tell you that hard work and good idea alone are not enough for you to sustain the business.

Anxiety – When you already signed the post-dated check and no money is coming in despite the scheduled withdrawal date, it’s enough for anyone to develop anxiety. How about needing to close that deal, the results of which will spell the survival or death of your business? Owners are always under a pressure cooker. If they don’t seek help to manage their stress, this could progress to clinical anxiety.

Addiction – The connection between stress and substance abuse is well-chronicled. But there is no research that scientifically proves the link between chronic stress and alcohol or drug abuse. However, clinical studies, as well as charting the patterns, showed a correlation between stress and the risk of substance dependence.

Obstacles to Seeking Treatment

The stress and responsibilities will constantly nag at the business owner that it’s almost impossible to function normally. They overlook their families, they ignore their friends, they constantly delay that much-needed vacation and skip family gatherings.

The question, however, is if the problem is so pervasive, why aren’t business owners seeking help for their mental health issues? Wouldn’t it be easier to provide healthcare, such as coverage for Tricare rehab?

There are a number of factors why they overlook mental healthcare:

They ignore the warning signs – Depression, anxieties, and addiction typically manifest themselves through several symptoms. They link mental health with weakness – Entrepreneurship is not for everybody. It takes an enormous amount of courage to gamble your hard-earned money for an idea. Unfortunately, this Alpha personality also prevents them from seeking help. They think they can solve their problems through sheer strength of will. They are in denial about the true state of the business – One reason why they become so isolated is that they can’t tell their personnel that the business is struggling. They think that they are protecting the staff from the bad news. But they are only worsening their mental state.

Watch Out for These Red Flags:

Stress can be a killer but business owners can still do something about their situation before they spiral out of control. The trick is to spot the early warning signs of a mental health issue.

They always feel tired and fatigued They are unable to concentrate too long on a single task They are often distracted even when they are outside of work They become irritable and angry even at the slightest triggers They turn to alcohol or drugs in response to stressful situations They find it harder and harder to decide even on simple issues They lash out at their families They alienate themselves and even skip their own company events They have trouble sleeping

Unfortunately, the stigma associated with mental health issues still exists. Apparently, they have more problems about being branded as “crazy” rather than seeking professional help to properly ensure their mental health. If the pressure and stress prove too much, there’s no harm in trying to defuse the situation. The alternative is to become a walking time bomb that will only result in more damaging consequences for the business.