If I’m A CEO And Have An Anxiety Attack, What Should I Do?

I recently received a long email from a CEO, who I don’t know, about an anxiety attack he had. At the end, was a pertinent question that I don’t think I’ve ever addressed before.

“What is my responsibility to openly communicate this important matter to the Board? And how do I balance what I feel is a need for material disclosure with a desire for privacy around my personal health information?”

I wrote the following in response.


First of all, thanks for being brave enough to write.

Next, and most importantly, make sure you are getting professional help. If you don’t have a psychiatrist or a psychologist, I strongly encourage it. In moments of crisis, I’ve found this kind of a relationship to be critical. I’ve figured out so many things about myself in this kind of a setting, especially when I’m having a personal crisis.

Re: what to do in terms of disclosure, start with (a) what you want the outcome to be and (b) what you know about the people involved. If you have a trusted personal relationship with one of your investors, consider talking openly about it. But recognize that once you start talking about it, you will likely be viewed differently by that investor, especially if they aren’t comfortable with anxiety themselves.

If you don’t yet know what you want the outcome to be, find a non-investor who is a trusted advisor to talk to. One of the biggest challenges is exactly what you identify – balancing your work on your own mental health with your responsibilty to the company, your partners, and your investors. If you feel like this is manageable, even when you struggle under real anxiety, that’s one path. If you are afraid it’s not manageable, that’s another.

Facing your biggest fears about this (e.g. “they kick me out of the company”, “they don’t have any respect for me”, “they aren’t supportive”, “they don’t believe I can do it”) is important as by simply asking yourself the question you’ll often get guided toward what you should do.

My wife also has been an incredible supporter and help for me. I don’t know if you’ve read our book Startup Life but we have a section on this and how we’ve dealt with it. But don’t put all the burden on her – it’s a huge burden for a spouse, especially when combined with the pressure of family and work.

As a short term tactic, if you haven’t tried meditation, I suggest it. I discovered it last year and found Headspace.com to be super helpful. It has two 30 day segments (up to 20 minutes / day) on anxiety and stress.

Finally, breathe. Sleep, Rest, Take care of yourself. It’ll give you a base to work on everything else.

  • jamesoliverjr

    Meditation is the only thing that helps me manage, avoid, and eliminate anxiety. Last year I ran out of cash, the business was dying, and it was one of the most difficult times in my life.

    Support from friends and family was great, but meditation, above all else, helped me keep my sanity and not go down the dark, depression rabbit hole. I still do it regularly and it makes all the difference for me.

    I wish this guy all the best.

  • Rob Ryan

    Started meditating 7-ish months ago – it’s done wonders for stress and
    balance. It’s like an island I can paddle to everyday when I need it. I
    found one that works really great after years of trying. Happy to
    share more personally about it if you’re located in Boulder, over a coffee.
    Also, there are some really great nutritional supplements and ways to
    exercise that counteract stress and anxiety. Good luck!

  • Kristin R Darga

    An important topic, Brad. I focus on exactly this with the CEOs and high level teams in my client circle. Surrounding ourselves with the correct support team, coaches, therapists, network is key to being able to cope with the ride of being a CEO, entrepreneur.

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  • TimMofMN

    We all struggle with BALANCE….when I was early in my career and full
    of aspirations of becoming the CEO, I was hit with an aha moment. A
    good friend of mine recently became GM of a large division of our
    company. This required a moving his family and a dramatic change in
    life style. Fast forward 6-months and I met with this shell of an
    individual who had displaced personal relationship and sacrificed his
    health – question to self…..is this what it takes to succeed in this
    Goliath organization….NOPE, don’t want that, now what! Everything I
    ‘thought’ was important just evaporated. TIME OUT and left work to
    contemplate what was now important to me. Boiled it down to these 5 key
    elements: Spiritual – Physical – Family – Friends – Career. Now
    picture yourself juggling all to maintain balance in your life. Not
    surprising we suffer from anxiety. Now consider the first four as glass
    balls and the fifth (career) as rubber. We spend 80% or more of our
    stomach acid on our careers, something we know we can bounce back from,
    until something happens to the other four (i.e. a failed marriage, loss,
    health issues, etc.). Many times we are not able to bounce back from
    these.

    Take time to reflect on all of these and ensure you are
    meeting the needs of the four – you will find significantly more
    fulfillment in your career. And remember, you can’t have it all;
    however, if you have good relationships, health and are contributing to
    society, what else do you need.

    Here’s to BALANCE!

  • Simone Brunozzi

    Brad,
    assuming that the issue is health-related, and that the CEO risks of being thrown out of the company, there is ONE person he/she should talk to for sure: a lawyer. Know your rights, and know what’s the best way to disclose your health issue without giving the board any advantage.

  • Thanks for posting your response to this CEOs question.

    It’s the CEO’s role to grow the company and make it successful. Is the CEO performing well? If not, is it because of the anxiety or is it also because of other factors? If the anxiety is untreated then why not have it treated by medical professionals and then give it some time?

    Life can be messy and challenging. Who doesn’t get stressed out and have some level of anxiety? And especially founders or CEOs of startup companies.

    Maybe the CEO can get professional help and this could quickly become a non issue.

    If the CEO is really struggling with serious anxiety then maybe it’s not the best time in their life to be a CEO. Discloser to the board could make sense as the CEO might want to step down gracefully and give the board time to find an ideal replacement.

  • Ben Horowitz credits his wife for being a source of incredible emotional support (his book, The Hard Thing About Hard Things, is great). And so I’ve often wondered how it is for these really young, single guys who don’t have that.

    Trying to date and also run a company — that’s pretty tough. A few founders I’ve talked with (all guys) have said it’s basically impossible to build a relationship. There’s just no time, and no emotional bandwidth.

    I think anxiety starts like a paper-cut. We all get that from time to time. Under certain conditions, it can turn into something much more serious and potentially harmful — even life-threatening.

    But with early attention and care, it needn’t be so.

    So the challenge is to recognize anxiety and attend to it from the outset, rather than suppress or ignore it until it gets really big and scary.

    Also – not sure if it’s cool to post this or if it’s too self-promoty? – I’m leading a workshop at HustleCon next month called: “Be a Badass Without Losing Your Sh*t: Meditation for Founders”

    We’ll be talking about this stuff, and learning specific tactics you can use in real life.

    • I strongly agree with Ben. My wife Amy has been an incredible base of support for me, especially when I’m extremely anxious or depressed. We ended up writing a book about this – Startup Life: Surviving and Thriving in a Relationship with an Entrepreneur. I strongly encourage it. Also – thanks on the note about your workshop on meditation – definitely not to self-promoty!

      • Oh good! I’m definitely going to check out our book — really looking forward to reading more about your story and experience.

      • Hey Brad, I read your & Amy’s book! So much I loved about it — thanks for putting so much thought & heart & insight into it.

        Have a feeling I’ll be referencing it for a while 🙂

  • DR.J.K. LAHAREY

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