Why Business Owners Should Care About Mental Health

What does mental health have to do with entrepreneurship?

Entrepreneurship and mental health are intimately connected.

Owning and running a business can be like riding an emotional rollercoaster, and that’s hard on your mental and emotional well-being.

(Content advisory: this article makes reference to specific emotional and mental health challenges so please take your capacity into consideration as you read this.)

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One month things are going well. Clients are happy. Contractors are turning their work in on time. Your stress is low and you’re feeling good. You do your weekly review and think: 

“Ahh, yes. This is why I’m in business for myself.”

But the next month, a project tanks, you lose a client, your revenue drops, a contractor quits and your emotions are circling the drain. It’s a Friday afternoon and you’re looking at yet another weekend of work. You think:

“This is too hard. I’m burning this business down.”

As humans, the state of our mental health—our emotional, psychological and social well-being—affects our ability to cope with everyday interactions and activities.

This is no less the case for entrepreneurs. Our business success depends on our mental and emotional skill, intelligence and stability, and on our skill in handling the instability, stress and threat that comes with entrepreneurship.

Yet for business owners, the relentless stressors and the constant emotional ups and downs erode mental and emotional well-being.

Many reports and studies of entrepreneurs’ mental health recognize the pivotal role mental health plays in an entrepreneur’s capacity to succeed in business. 

In 2019 the Canadian Mental Health Association (CMHA) called for the integration of mental health education and supports into business programs.

It’s clear that mental health challenges are inherent in entrepreneurship.

Mental health challenges are inherent in entrepreneurship

One source of threat to our mental health as entrepreneurs is the conditions of work.

I invite you to consider this list of experiences:

  • Sleep deprivation (either because you can’t sleep from worry or you work late into the night)
  • Food deprivation: scarfing meals or not eating at all
  • No down time, no leisure activities
  • No movement (sitting cramped at the computer all day)
  • Not even taking time to go to the bathroom…

We may not experience these all the time, but we’ve all had days like this… sometimes weeks… months… or maybe even years. 

This is the life of an entrepreneur, right?

We all recognize that this lifestyle is demanding and can really suck at times.

Yet despite these demands, there are strong, powerful, competent business owners who come to me thinking there is something wrong with them because some “little thing” has done them in.

It’s common to gloss over the excessive behaviours in business that make us unhealthy.

After all, “that’s what it takes to succeed!”

So in the name of success, or out of fear of failure, we actively co-sign driven, self-abusive behaviour.

But wait a minute…


Let’s take these out of the entrepreneurial context for a second.


Sleep deprivation…hunger… enclosure in a windowless room for hours on end… prohibited from meeting bodily needs… restricted physical activity… lack of contact with other humans…

What does that sound like to you?

In my workshops and presentations, audience members say this sounds like jail, prison, torture, etc.

And while that might be overstating the case, these are the kinds of tactics used by police and military all over the world to break people down.

So is it any surprise we break down when these are our conditions of work?

In addition to our actual day-to-day working conditions, there are also other factors of mental health risk inherent in the experience of entrepreneurship.

Risk factors for entrepreneur mental health

Research in the field of entrepreneurship and mental health shows that entrepreneurs experience unique stressors. 

In that same 2019 publication, the CMHA reported that the unique stressors experienced by entrepreneurs include risk-taking, income uncertainty, high work demands and the need to make frequent, consequential decisions.

In Nov 2022, the Business Development Bank of Canada (BDC) published a report that states the main sources of stress for entrepreneurs are cash flow, recession, work/life balance and fear of loss/failure.

As if we didn’t know this for ourselves, research into neuroplasticity confirms that negative events and stressors can lead to mental health struggles

In my work and research I’ve identified a set of mental health risk factors for entrepreneurs: isolation; hustle culture and systems of oppression; volatility, uncertainty, complexity and ambiguity; barriers to accessing support; and linking self-worth to success. You can read about these in detail here

 These factors are not unique to entrepreneurs, but they affect us in ways that are different from the general population.

Furthermore, unlike employees, we experience them in combination, and often more than 2 at a time. In addition, their impact is multiplied, in that they potentiate one another.

Many former employees start businesses because of, or to address, mental health challenges. In 2002, a US-American survey of 2,000 US Americans found that than 25% resigned from their jobs because of their mental health .The trend of leaving employment to start a business or self-employment has been on the rise since 2009.

Flexibility is one of the main reasons cited by my clients, colleagues and self-employed friends for choosing self-employment-–and research supports that this flexibility is exactly why folks with mental health and other challenges choose self-employment. 

In 2021, a phenomenon called The Great Resignation was identified. The Great Resignation is a wave of employees voluntarily resigning from their jobs in the wake of the COVID-19 pandemic.  

People, especially women and folks of the global majority, were resigning in part because they realized how much better their mental health was when they were working from home–even in the midst of the pandemic.

Of course not everyone who leaves their job becomes self-employed, but statistics from the UK showed a 32%  increase in new businesses in 2020 and as of July 2022, more US Americans were self-employed in 2022 than have been since 2008. In Canada, 2,000,000 new businesses were started during the COVID pandemic. 

So we can conclude that many entrepreneurs who resigned their jobs and started new businesses did so as a strategy to improve their mental health because of pre-existing mental health conditions, or working conditions that were detrimental to their mental health.

Entrepreneurs experience mental health problems more than non-entrepreneurs

Content advisory: this section mentions specific emotional and mental health challenges, so please take your capacity into consideration as you read.

Ironically, business ownership as a mental health strategy can be a double-edged sword. In reaction to the mental health effects of toxic work environments, racism, sexual harassment, and other oppressions at work, people create their own work. And yet, working for yourself has its own inherent mental health challenges.

There is abundant academic research on the connection between entrepreneurship and mental health. 

A widely-cited 2015 survey conducted by Michael A. Freeman, a psychiatrist and psychologist in the US, found that entrepreneurs have a higher prevalence of mental health challenges than the general population. 

He also found that entrepreneurs were 30 per cent more likely to experience depression than members of the general population, and that 49% of the entrepreneurs surveyed reported having a mental health condition, with depression and anxiety being two of the top three. 

Freeman’s work also showed that entrepreneurs are more likely to come from a pool of people in the general population who are predisposed to mental health challenges: “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”.

Furthermore, other research in 2014 demonstrated that entrepreneurship is negatively correlated with mental health challenges.

More recently, a Canadian study released in August 2021 reported that more than half of women entrepreneurs surveyed struggled with mental health issues.

Can you name a well-known entrepreneur who’s had a mental health problem?

Have you had challenges with your mood, emotions or mental health, or know someone who has?

Have you experienced anxiety and/or depression? Do you know someone who has?

In any given year, one Canadian out of every five experiences a mental illness or addiction problem. By the time Canadians reach 40 years of age, 1 in 2 have—or have had—a mental illness.

I’ve experienced both anxiety and depression, and my depression has been quite severe at times, including suicidal thoughts and a plan. 

Some people consider depression among entrepreneurs an epidemic. Entrepreneurs are at greater risk for suicidal thoughts and suicides among entrepreneurs are not uncommon.

Mental health challenges are common in the general population and even more so among entrepreneurs.

When you stop to think about it, it makes sense that business owners are at much greater risk, given the conditions of entrepreneurship under which we run ourselves ragged and all the factors inherent in entrepreneurship that threaten our mental health.

If you find yourself breaking down, there’s nothing wrong with you.



Entrepreneurs need mental health and therapeutic support


The stress symptoms the body gives us are a warning.

The mind, body and spirit need time to rest and digest, and to repair.

So, if you “break down” after being run into the ground, there’s nothing wrong with you.

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.

What’s needed is care, mental and emotional care. 

As an entrepreneur, your brain and your mind are your greatest assets. If they are not functioning well, your ability to run your business is hampered.


Therapy is good for entrepreneurs for the same reason therapy is good for anyone: research has shown over and over again that psychotherapy is effective. It mitigates and can heal the impact of negative, stressful and traumatic events.

In light of the rates of depression experienced by entrepreneurs and business owners, it’s important to note that psychotherapy is as effective as medication in treating depression and is more effective than medication in preventing relapse. 

Studies consistently show that emotional interventions work just as well or even better than medication to treat various mental health conditions, including anxiety and depression.

Even though therapy helps you feel better, it doesn’t stop there. It’s not enough to simply feel better. 

Feeling better enables your CEO-self to come back online. This is called cortical facilitation.

We now know from neuroscience that life experiences affect our brains. This is called neuroplasticity. 

As we all know, negative events and stressors can lead to mental health struggles. 

Stress also impairs your ability to calm yourself and think straight. This is called flipping your lid (formally known as cortical inhibition).

But the flip side of neuroplasticity also means experiences–including therapy–can help modify brain structure and function into a healthier state.

Studies have found that as people get better at controlling their emotions, the brain’s prefrontal cortex (aka the CEO-self) changes.

In other words, your CEO-self becomes stronger.

Your CEO-self is the part of the brain that supports creative problem-solving, taking in and synthesizing new information, focus, decision-making, and collaboration, among other things.

When you flip your lid, cortical function is inhibited. Your CEO-self goes offline.

When it’s offline, all we have to go on is emotion and habit, and these don’t always serve us, as I’m sure you’ve experienced.

Ongoing therapeutic support provides you with opportunities for emotional regulation and co-regulation (IOW cortical facilitation) so your CEO-self can come back online.

Better cortical functioning leads to better decision making, greater insight and more ease, a more profitable business and more satisfied customers.

With your CEO-self back online, you can do the things you need to do to run your business.

You can engage all your executive functioning skills you need to run a successful business.

You can take in and synthesize information, make decisions, focus, prioritize and engage in problem-solving and other creative business endeavors.

You won’t flip your lid and blow up your business when the shit hits the fan.

Beyond the brain changes that result from therapy, it’s also a learning process. 

Therapy works long-term because of the skills it gives people. 

We entrepreneurs are constantly facing challenges, the unknown, and failure. 

But without formal commitment and support for debriefing on these challenges and failures, we miss the learning.

If we don’t learn from our experiences, we can’t have the flexibility and creativity we need for our business to thrive. 

Through therapy, you can learn about yourself as an entrepreneur and as a leader, and can continue using these insights as you face new challenges–of which there is never a shortage in business.

Support makes you stronger.

Support makes you a better leader.

Support makes you a better business owner.

Therapy works, and it works in a way that makes you a better leader for your business,

The trick is to recognize that mental health risks are INHERENT in entrepreneurship, and to control for them, just as you would for any other risk in business.

There are many ways to do this. Bringing mental health conversations to the table with your biz bestie, your coach, your mastermind group and as appropriate in other conversational settings like networking is just one way.

The best way to protect your mental health as an entrepreneur is to have a plan in place

A business plan helps you prepare for and mitigate risk, and plan for and sustain healthy growth.

Just like every other risk in business, you can mitigate the risks to your mental health as an entrepreneur by having a plan.

Your business plan includes financial, marketing and cash flow plans. It should also include a mental health plan for the owner.

And if your business experience of plans being what it takes to make your goals come to fruition is not enough to persuade you, neuroscience also shows that writing down your goals increases your chances of achieving them. Having a formal, recorded strategy for achieving those goals makes it even more likely you’ll be able to accomplish them.

In the same way that the best way  like you want to grow your profitability with a plan, you can also nourish your mental health and expand your resilience skills with a plan.

Plans like these allow you to thrive.

Make your plan. Mitigate your risk. Cultivate healthy growth.

My goal as the entrepreneurs’ therapist is to help you keep your CEO-self online as you ride the emotional rollercoaster of running a business, so you don’t flip your lid and blow up your business when the shit hits the fan.

And while it may seem like you “should” be able to keep your CEO-self online on your own, it’s much harder than people think. 

There are so many barriers and stressors in the way.

You may think that asking for help makes you weak. The truth is that strong women are even stronger with support.

Support leads to emotional regulation. 

When emotions are regulated, that leads to better decision making, greater insight and more ease. 

When we are resourced (have better decision making, greater insight and more ease) that leads to more profitable businesses that are emotionally easier to run, and results in more satisfied customers.

This is where I come in. I function as an auxiliary cortex, providing both emotional support and deep knowledge so that, ultimately, your cortical function is facilitated and you are empowered to face and address your challenges as an entrepreneur and bounce back from stress better and faster.


Don’t blow up your business when the crap hits the fan. 

Get support for what affects your mental and emotional wellbeing and create a plan to care for it.

Book a free call to learn about working with me here.

(If you want to review a bibliography for the references cited in this article, click 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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