I recently read a study done by a clinical professor and entrepreneur by the name of Dr. Michael Freeman. He surveyed 242 entrepreneurs about their mental health. Of the 242 entrepreneurs he surveyed, 49% reported having a mental-health condition.

Surprisingly, depression was the highest-reported condition, being present in 30% of all entrepreneurs. ADHD (29%) and anxiety (27%) followed just behind.

That’s a dramatically higher percentage than the US population as a whole, where only about 7% identify as depressed.

Make no mistake about it, being an entrepreneur is not what it seems and you may even be surprised to know that many of the most successful entrepreneurs suffer from depression and anxiety disorders.

Here’s what other entrepreneurs have to say about their experiences with burnout and depression.

1. Elon Musk - Tesla, SpaceX

“Running a start-up is like chewing glass and staring into the abyss. After a while, you stop staring, but the glass chewing never ends.”

– Eating Glass and Starting Up [2015]

2. Tim Ferriss - NYT best-selling author, angel investor

“The fact of the matter is this: if you’re driven, an entrepreneur, a type-A personality, or a hundred other things, mood swings are part of your genetic hardwiring. It’s a blessing and a curse.”

– Some Practical Thoughts on Suicide [2015]brainpickings

3. James Altucher - bestselling author

“In mid-2002 I was so depressed I simply ran out of ideas.

Depression scorches the earth of your brain.

I would sit in it at 3 in the morning in the dark. Lord of my crumbling kingdom. Every day I went a little more broke and there was nothing I could do about it. Going broke is very scary.

I would drink to help me sleep. Then I would refuse to wake up. Then the fear would repeat until I fell asleep again.

I pretended to smile at my children. I pretended to smile at my wife.

People say when you pretend to smile it often triggers happiness because you fool your brain into thinking you are happy.

I can tell you: my brain was not fooled. If anything, fake-smiling made me more depressed.”

– The Magic Of Idea Math [2015]

4. Marc Andreessen - Netscape, A16Z

“First and foremost, a start-up puts you on an emotional rollercoaster unlike anything you have ever experienced. You flip rapidly from day-to-day – one where you are euphorically convinced you are going to own the world, to a day in which doom seems only weeks away and you feel completely ruined, and back again. Over and over and over. And I’m talking about what happens to stable entrepreneurs. There is so much uncertainty and so much risk around practically everything you are doing. The level of stress that you’re under generally will magnify things incredible highs and unbelievable lows at whiplash speed and huge magnitude. Sound like fun?” (source)

5. Rand Fishkin - Moz founder

“Depressed Rand is weird. Don’t get me wrong, regular Rand is weird, too. But depressed Rand magnifies the bad 10X and minimizes the good. He refuses to even acknowledge good news and, because he’s a pretty smart guy, he can usually argue for why that good news is actually just temporary and will turn to shit any minute. The weird part is, I think depressed Rand is actually a very authentic version of myself. When I felt depressed, I upheld TAGFEE – particularly the values of transparency and authenticity – as the reasons why I could and should be such a raging, all-consuming, negative naysayer.”

– A Long, Ugly Year of Depression That’s Finally Fading [2014]

6. Aaron Swartz, Reddit co-founder

“Surely there have been times when you’ve been sad. Perhaps a loved one has abandoned you or a plan has gone horribly awry. Your face falls. Perhaps you cry. You feel worthless. You wonder whether it’s worth going on. Everything you think about seems bleak — the things you’ve done, the things you hope to do, the people around you. You want to lie in bed and keep the lights off. Depressed mood is like that, only it doesn’t come for any reason and it doesn’t go for any either. Go outside and get some fresh air or cuddle with a loved one and you don’t feel any better, only more upset at being unable to feel the joy that everyone else seems to feel. Everything gets colored by the sadness.”

– Sick [2007]

(Aaron tragically committed suicide in 2013.)

7. Christina Wallace - Founding Director of BridgeUp

“When my startup, Quincy, was on the brink I fell into a funk. I don’t know if it was a true, clinical case of depression. I didn’t see a professional during that period so I have no way to know. What I do know is that I crawled into bed and didn’t leave for three weeks. I didn’t talk to anyone. I didn’t leave my bed, except to answer the door when the occasional Seamless delivery arrived. I watched all seven seasons of The West Wing top to bottom and I sobbed.

I mourned the end of my company. I also mourned the death of the grandmother who raised me, which had occurred just three weeks prior. And — if we’re being totally honest here — I was mourning the end of my relationship with my co-founder and friend (though happily that turned out to be only temporary).

But the end of my company wasn’t the first time I’d felt this way. There were so many moments throughout the nearly two years that we built Quincy where I cried myself to sleep. I had friends to talk with — fellow founders to commiserate with, grad school friends who took me to dinner and were kind enough to pick up the check, and exes who were still friendly enough to take a call and talk me off a proverbial ledge.”

 Let’s Get Real About Startups And Mental Health [2015]

8. Sam Altman - Y-Combinator

“If you ask a founder how her startup is going, the answer is almost always some version of “Great!”

There is a huge amount of pressure as a founder to never show weakness and to be the cheerleader in all internal and external situations. The world can be falling down around you—and most of the time when you’re running a company, it is—and you have to be the strong, confident, and optimistic. Failing is terrifying, and so is looking stupid.

Founders end up with a lot of weight on their shoulders—their employees and their families, their customers, their investors, etc. Founders usually feel a responsibility to make everyone happy, even though interests are often opposed. And it’s lonely in a way that’s difficult to explain, even with a cofounder (one of the things that works about organizations like Y Combinator is that you have a peer group you can lean on for support).

So a lot of founders end up pretty depressed at one point or another, and they generally don’t talk to anyone about it. Often companies don’t survive these dark times.”

– Founder Depression [2014]

9. Ben Horowitz - Loudcloud, A16Z

“I have seen CEOs try to cope with the stress by drinking heavily, checking out, and even quitting. In each case, the CEO has a marvellous rationalization why it was OK for him to punk out or quit, but none them will every be great CEOs. Great CEOs face the pain. They deal with the sleepless nights, the cold sweat, and what my friend the great Alfred Chuang (legendary founder and CEO of BEA Systems) calls “the torture.” Whenever I meet a successful CEO, I ask them how they did it. Mediocre CEOs point to their brilliant strategic moves or their intuitive business sense or a variety of other self-congratulatory explanations. The great CEOs tend to be remarkably consistent in their answers. They all say: “I didn’t quit.”

What’s The Most Difficult CEO Skill? Managing Your Own Psychology [2011]

10. Brad Feld - Foundry Group

“It’s not a topic the start-up community understands well. After all, this is the very culture that turned the chestnut “pick yourself up by your bootstraps” into a much-celebrated verb. Admitting you struggle with depression is like admitting you can’t reach your bootstraps. It’s assumed that successful people can just “shake it off.”

But that’s not how it works […] depression carries a stigma. Most of the success stories we hear involve an entrepreneur who pushes himself beyond his physical and emotional limits. He’s unbalanced–but in a good way.

My own experience has made me realize that this imbalance is no way to live the start-up life, and, in fact, it’s detrimental to this kind of work. The only way I survive the dark periods is by constantly renewing myself and my perspective. Starting over is part of the process of starting up. That’s something those in the entrepreneurial community should understand better than anyone else.”

– Entrepreneurial Life Shouldn’t Be This Way–Should It? [2013]

There is no doubt, being an entrepreneur is a very stressful career path. Whether or not people with mental health challenges are more likely to become entrepreneurs or not, there’s still a majority who deal with it.

As an entrepreneur, times get tough, it’s part of the game. We need to realize that the “dark times” do not need to be spent alone, or pushed under the rug of shame.

If I can attest to anything, it’s that during this “darkness” is when we need to reach out for help, we need to keep moving, keep talking, just keep swimming. The loneliness and solitude of pride and shame will only keep compounding, resulting in a deeper slope to climb out of.

Know one thing… If you’re going through tough times as a founder or entrepreneur, know that you’re not alone – and that there are others out there just like you who are eager to listen and help.

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