Entrepreneur Mental Health: 7 Challenges of Business Ownership & How to Overcome Them

Mental health for business owners is directly tied to business success. Yet we entrepreneurs go through the wringer with our emotions. It’s a rollercoaster.

One morning something is going well and you’re on an emotional high. You think:
“Frig yeah! This is why I do this!!!”

But that afternoon, something tanks, and you’re circling the drain, emotionally. You think:
“That’s it. Nothing I try ever works out. I’m burning this shit down.”

Many of the people I have worked with come to me asking what’s wrong with them.

They’re confused about why, as strong, capable, competent entrepreneurs and leaders, who have ridden every kind of wave imaginable, they suddenly can’t cope like they used to.

In my work I have identified 7 factors unique to the experience of entrepreneurship that impact mental health for business owners and make our lives and work so much more stressful than that of the general population.

Isolation affects mental health for business owners

Isolation is first on the list of challenges that affect mental health for business owners. It’s the issue most women business owners I know and work with talk about.

Social isolation is a major risk factor for suicide. Evidence links perceived loneliness and social isolation with depression, poor sleep quality, impaired executive function and cognitive decline. It’s easy to see why this is a challenge to business owners and to their businesses.

Nearly 70 percent of first-time CEOs who experience loneliness report that the feelings negatively affect their performance.

Entrepreneurs are isolated because there are simply fewer business owners around–and even fewer women business owners. It’s much easier to find someone with a difficult work situation or micro-managing boss with whom to commiserate. It’s harder for us to find someone who gets us.

It’s also lonely “at the top.” Stuff comes up for leaders about the people they lead: clients, employees, contractors. etc.. It’s not appropriate and in fact harmful to the relationship to expose these people to the stuff that comes up for us about their behaviour—but stuff does come up! We do a lot of emotional labour to manage all this, yet there are few places to be transparent about this work.

Most people are risk-averse, but we business owners embrace risk and are frequently taking leaps into the unknown. We mitigate our risks with contingency plans.

What we need is someone who can say to us, “Yes, of course it’s scary. I know you have what it takes to do this and I’m here to cheer you on.” rather than “How could you give up the security of a regular paycheck and a pension?”

Sometimes we’re just too busy or too pooped to socialize—outside of networking where you have to be always on.

Another isolating factor is the desire for impression management. It’s hard to trust that disclosing your vulnerability when you’re having a bad day won’t deter people from doing business with you. In addition, it’s hard to find the right place where you can really let your hair down with people who get you—fellow entrepreneurs.

But what if someone does figure out you’re “not OK?” Entrepreneurs are leaders and public figures who can’t be seen to have problems, so we may believe we have to hide them. As a result, we can experience shame when we are exposed in a way that’s not consistent with the carefully curated representation we’ve been working to convey—of course with the best of intentions, to enable potential clients to trust us.

Lack of access to support is another factor that plays a role in isolation, but it’s so important that I address it separately below.

Systems of oppression aka “hustle culture”

Much of the stress we experience as women–but discount–comes from systems of oppression that exert invisible but deeply felt and harmful pressures upon us and affect mental health for business owners. We absorb many “truths” from these systems without even knowing where they came from, so they affect our mindset.

One example is hustle culture. Hustle culture is a way of thinking, leading to behaviours, that focus intensely on productivity, ambition, and success regardless of the cost.

As business owners, we work hard. We may work smart as well, nevertheless it all comes down to us and there are times when we work more than 8 hours a day–or even times when we push ourselves to work more than is good for us our our businesses even when we don’t have to, because we are caught in the hustle trance.

We experience a great deal of stress with the pressure to get clients and make money.

This pressure may be real or imagined, but let’s get serious, viscerally, business success can feel like life or death.

Institutional expressions of oppressive systems put barriers in the way of our business success.

The degree to which these systems block us depends on how many of our personal characteristics are different from that of the dominant identity: middle-class, university-educated, thin, able-bodied, cisgender, heterosexual, white, Western, Christian (or “secular” but actually Christian) and male. It also depends on how these differences come together. (Here is a great exercise to explore if you’ve never thought about privilege and intersectionality before.)

In essence, living under capitalism is traumatizing. White supremacy is the root and all other systems of oppression are connected to it: racism in all its forms (anti-Black, anti-Semitism, Islamophobia, anti-Asian etc.)  as well as fat hatred, able-ism, ageism, misogyny, misogynoir, heteronormativity, transphobia and homophobia to name only a few.

The constant onslaught of so-called micro-aggressions elicits a stress response in our mind and body that is depleting and affects mental health for business owners.

What may be more visible is toxic productivity and the extractive focus on production at all and every cost. These are consequences of living under capitalism, and ideas that are drawn directly from the Calvinism of the Mayflower colonizers.

Our time is at a premium because of the breadth of responsibility we carry and the pressure to produce. As a result we often don’t meet our basic needs, such as eating, drinking and going to the bathroom.

I’m serious! How many times have you said to yourself, “Just one more email.” “Just one more phone call.” before grabbing something to eat?

When it’s a juggling act to get your basic needs met, time for true self-care through activities that soothe, discharge and nourish the nervous system and restore balance often get pushed to the side.

How VUCA affects mental health for business owners

VUCA is an acronym originating from leadership theories that was coined 1987 to refer to the conditions experienced by leaders:  volatility, uncertainty, complexity and ambiguity experienced by leaders.

VUCA, along with constant adversity, challenges, decision-making, problem-solving, always facing new and ever-changing conditions, and wearing all the hats (CEO, bookkeeper, PR, marketing, admin, customer service, etc.) takes its toll. It results in cognitive fatigue and depletion of physical and emotional resources.

The most recent and extreme example of VUCA in the lives of entrepreneurs has been COVID.

It was sudden, the data and directives were constantly changing, the path and its impact were unpredictable, there were many forces at play, and it was hard to get a read on things.

But we women entrepreneurs face VUCA every day and it has a negative effect on mental health for business owners.


Barriers to professional support are a challenge to mental health for business owners

Entrepreneurial poverty is a thing.

There have been some months in my business that I wasn’t able to pay myself a salary without leaving some bills unpaid.

Most of us are not Galen Weston, Jeff Bezos or Richard Branson. We may earn a sufficient living, but we don’t always net what we want to and cash flow can be tough. Finding after-tax cash to cover therapy isn’t easy.

Furthermore, there is a dearth of practitioners. Demand for mental health support has always outweighed the supply. It’s even harder to find someone who gets both mental health and entrepreneurship.

Stigma is also a barrier.

In 2022, The Hustle reported that 84% of business owners surveyed say stigma exists around mental health challenges within the business community.

In addition, there is a common belief that if we “break down” or need support that there is something wrong with us. We live in a culture that valorizes going it alone. There is a cultural stigma attached to mental health challenges that doesn’t apply to physical health challenges.

Can you imagine telling someone who is drowning that it’s just in their lungs and to get over it? But people with anxiety and depression receive (implicit or explicit) messages like “just get over it” or “pull your socks up and get going” on the daily.

Business owners with mental health struggles are told unhelpful things as well, such as “You’re lucky you’re the boss.” or “Just work less, then, if you’re so stressed.” or “If it’s bumming you out so much, why don’t you just get a job?”

Other kinds of professional support are also important to our mental health. DIYing everything is stressful and exhausting and affects mental health for business owners.

Yet without sufficient cash flow, we can’t access the business support (like VAs, graphic designers, coaches, bookkeepers, website security experts, etc.) that would alleviate so much stress.

Linking self-worth to success

This is a common human foible. We connect our sense of self-worth with our role and then when the role shifts, or we lose it, we don’t know who we are anymore, and haven’t got stories to tell ourselves about our success that help us feel good about ourselves.

It’s even more the case that entrepreneurs—especially values-driven entrepreneurs—identify closely with their business, so successes and failures toss them around. This is another challenge to mental health for business owners.

Self-kindness and business

One of the (many) problems with the concepts of self-worth and self-esteem is that they are comparative and depend on performance.

Researcher Kristin Neff has determined that, in order to be able to see ourselves positively, people buttress their sense of self as worthy by locating themselves in relation to others who are below, or less than, they are.

Self-worth or self-esteem depends on both performance (success allows you to tell yourself good tings about yourself) and comparison, in order to be able to feel good in comparison.

It’s human. We all do this.

But what happens we we don’t have good things to tell ourselves about ourselves? What happens when we perceive ourselves as being in the “one down” position?

The inner critic uses all this as fuel for its fire and we feel really bad.

Self-kindness and self-compassion serve mental health for business owners much better.

At its simplest level, when things aren’t going our way, this involves saying to ourselves something like, “I’m having a hard time. And no wonder. What I’m trying to do is [insert emotion here: hard… scary… distressing].”

Read more here about self-esteem and self-kindness.

When we are kinder in the way we talk to ourselves, we can divorce our self-worth from business success and failure and escape from some degree of the emotional volatility that accompanies entrepreneurship.

Ironically research has shown that people who are kind to themselves—especially when they are struggling—perform better on all sorts of measures.

Mindset and business

One of the great gifts of mindfulness is the understanding that we are not our thoughts, emotions and behaviours.

But it’s a human tendency to believe our thoughts and take them for true.

Eastern concepts of anatomy consider that we have 6 sense doors: eye, ear, nose, tongue, body (or touch) and mind.

We would never think sense data (smell, taste, hearing, touch and sight) determines our reality.

For example, we would never confuse ourself with the bite of pizza in our mouth.

You’d never take a bite of pizza and, based on the sensory data from your taste buds, think, “I’m pizza.”

It’s strange that we don’t think sense data determines what’s real, but we confuse ourselves with our thoughts all the time.

We think, “I’m a failure.” and believe it to be true. Making a mistake does not define you as a failure.


We can’t believe everything we think.

Making a mistake does not define you as a failure.


Predisposition to mental health challenges

Research conducted both in the US and Canada has documented the mental health challenges experienced by entrepreneurs.

We entrepreneurs are also more likely come from a pool of people in the general population who are predisposed to mental health challenges.

In his research, Michael A Freeman, a psychiatrist and psychologist, found that “people who are on the energetic, motivated, and creative side are both more likely to be entrepreneurial and more likely to have strong emotional states.”  Those states may include depression, despair, hopelessness, loss of motivation, and suicidal thinking.

The secret seventh factor

Truth bomb: these 6 factors all potentiate one another.

That fact is often lost on us.

We think, “What is the matter with me? I can handle anything. I’ve been rolling with the punches for years. Why am I losing my shit now when all that happened is my software crashed?”

The truth is that the effects of chronic stress accumulate, and each new stressor exacerbates poor mental health for business owners. Things combine in such a way that, like mixing drugs and alcohol, each element has its own impact and furthermore makes the impact of the others more powerful.

“Oh, c’mon,” you might be saying. These 7 factors aren’t unique to business owners. And you’d be right to say that.

However it’s important to note that while non-entrepreneurs experience many of these, they don’t come together for them in the day-to-day in the same way that they do for entrepreneurs.

These are our working conditions. These are the things we face every day.

Is it any surprise we “break down?”

There’s nothing wrong with you

We are conditioned to think that if we “break down” something is going wrong.

I invite you to consider that, if you “break down,” something might be going right.

What’s wrong is we’re taught that stress, burnout, depression and anxiety are exceptions, not the rule.

By implication, if we experience them, we have somehow failed.

But that thinking is flawed.

We have to recognize that, as entrepreneurs, mental health risks are inherent in entrepreneurship, and, like all other risks we face in business, we have to control for them.

This way of thinking is key not only for our own sanity, but also to de-stigmatize mental health struggles and open the way for ourselves and others to access support.

We also must recognize that, no matter how much we anticipate and plan, no matter how many mitigation strategies we put in place, sometimes the challenges will overcome us.

“Failure,” too, is inherent in entrepreneurship. Failure itself isn’t truly failure, but failing to learn from it is certainly a missed opportunity.

This is where support comes in.

When it all gets to be too much: emergency preparedness

Part of your business planning should include emergency preparedness. And while “breaking down” might not be exactly an emergency, the analogy holds when we think of contingency plans.

To make it through, emotionally, when the shit hits the fan, and to thrive afterwards, the supports need to be in place.
Trying to find and put in place the appropriate supports in the midst of a crisis is near-impossible, and your mental health will suffer in ways that can be avoided.

Having ongoing support in place so all you have to do is book an appointment—or better yet, just show up at your regularly scheduled appointment that’s already on the books—goes a long way toward helping you weather the storm with your sanity intact.

If you’re curious about what that support might look like, you can learn more about working with me here.

About the author 

Shulamit Berlevtov  -  Shulamit (she/her) is the Entrepreneurs' Therapist. She is working passionately to mitigate the entrepreneurial mental health crisis through keynote speaking and educational workshops and by supporting women entrepreneurs 1:1 to care for their mental and emotional wellbeing and their money psychology in an era of relentless stressors that can make you want to lose your crap on the daily.

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