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Start-up anxiety

October 25th, 2016 by Stephen Bourke

First the hard part — I take 75mg of Venlafaxine (Effexor) each day to manage my anxiety, and have been on one type of anti-depressant or another for most of my adult life. The diagnosis is generalised anxiety disorder, and it can be a pain in the backside.

There, it’s done.

After years of holding relatively senior roles at various blue-chips, it’s only now, as the co-founder of a health tech start-up, that I feel comfortable coming out. It sort of happened by accident — pitching to investors, I started to talk about my personal frustration with medication management (the problem our start-up is trying to solve), which invariably lead to talking about my condition.The first time was liberating, empowering even. Today, I don’t give it a second thought, thanks in part to the fact most investors see my condition as a plus. Due to Venlafaxine’s unforgiving 4-hour half-life, I can relate better than most to the challenges faced by 50% of the UK’s population who take a repeat prescription. That my co-founder also takes repeat medication (for asthma) means that our team is laser-focused on user experience. To coin a phrase, we manufacture, distribute, cook and eat our own dog food.

Out of nowhere, my condition, ostensibly a weakness, is now a company asset.

Of course, despite the personal drama my situation is far from unique. This Berkley study found that 49% of entrepreneurs have at least one life-time mental health condition. As a cohort, here is how we index against the wider population:


There is an emerging field of study into this phenomenon, but lets face it, giving up a secure, well-paid job to work for no money in your kitchen is hardly the most rational decision.

Curiously, parts of the media still like to position having a mental health condition as a prerequisite to start-up success. From Steve Job’s alleged Obsessive-Compulsive Personality Disorder to Bill Gates alleged Aspergers, you would be forgiven in thinking that these conditions were super-powers, not debilitating diseases.

HBO’s Silicon Valley has been accused of fetishising Aspergers, amongst other conditions. Its still bloody funny though.

For whatever reason, the start-up world feels more accepting of mental health issues, at least in comparison to places I used to work. The problem is most people don’t work in start-ups.

Corporate anxiety

I see a lot of senior executives who are desperately afraid people will know they have a problem. Stigma is still a very big issue

Dr Cosmo Hallstrom, Royal College of Psychiatrists

Despite best efforts, mental health is still taboo in most corporate environments, particularly at the top. From the fund manager struggling with depression to the lawyer battling bulimia, countless professionals live in fear of being outed — I know, because I was one of them.

Time to Change, Attitudes to Mental Illness 2014

Now, I should mention that I have seen some genuine, well-designed and properly funded corporate initiatives aimed at ending the stigma. But for all the positive noise, I’ve never worked anywhere that I’ve felt safe disclosing my condition. The logic goes something like this: Mental illness = risk, risk is undesirable, so therefore I need to hide my illness. This is a bit like driving with a flat tire — at speed you will eventually lose control and cause structural damage.

In the UK there are tens of thousands of people suffering in silence, afraid that their condition will impact their career prospects (after it has already taken so, so much). The trouble is, there is no equivalent of Ruby Wax or Stephen Fry in most sectors, no positive role model to normalise mental health. But they exist, and its time for them come out.

When Lloyds Bank CEO António Horta Osório took temporary leave for stress it felt like something big was happening — here was a banker, at the top of his game, admitting he needed help and being publicly supported by his Chairman. But in reality we have made little real progress. A recent study by BUPA found that, although three-quarters of business leaders believe they had encouraged managers to address and support employees’ mental health, only a third of staff agreed their organisations had effective support systems.

The only way we will end the stigma is if senior leaders with mental health issues actively share their experiences. No more hiding behind socially acceptable terms like exhaustion or personal reasons — its time for courage and transparency.

We need role models to emerge from our most admired companies and demonstrate that mental health is not barrier to corporate success…. you never know, it might even be an asset.

Further reading

Title image taken from Jessica Hagy's wonderful This is Indexed 

MOZ and Inbound co-founder Rand Fiskin’s account of his battle with depression.

Time to Change, a growing movement that exists to transform how we all think and act about mental health problems.

Richard Branson on ADHD / ADD and Dyslexia:



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