A Note on Mental Health

Close-up view of gentle ripples on the surface of deep blue water, with soft light reflections creating a serene and calming pattern.

Starting and leading a startup is one of the most exciting paths you can take, but also one of the most challenging ones. It’s often described as a rollercoaster, with intense highs and lows, even within the same day. This can take a heavy toll on your mental health, a subject that is still quite “taboo” in founder circles.

Many founders, especially those backed by venture capital, worry that admitting to struggles will shake investor confidence or team morale. But the opposite is true: Vulnerability and openness about this will build deeper trust, stronger relationships and the support networks you need to thrive, not just survive.

About 72% of entrepreneurs report experiencing mental health challenges during their startup journey (Michael Freeman, 2015). Biotech CEOs in particular face higher burnout risks due to the intense regulatory hurdles, long timelines, and scientific uncertainties (BIO data).

Mental health challenges are never a sign of weakness, or a sign that there is something wrong with you. They are just a natural response to extreme stress and pressure. The key is to plan ahead, recognize your limits, and give yourself permission to prioritize your well-being.

So what can you do in advance to prepare yourself for this journey? Here’s some ideas:

Self-Reflection about your Stress Signals and Patterns

Start with some self-reflection about your stress patterns in the past, and the current situation. We suggest to take some time and journal about topics such as these:

What is currently causing me the most stress, tension or anxiety? What do I notice in my body, even now as I am writing about this?
When was the last time I felt truly overwhelmed? What triggered it, and how did I respond?
What physical or emotional signs show up in my body when I am stressed? What do I notice?
What are the early signs I’m reaching my limit emotionally or physically?

You can also create a “Stress Traffic Light” system, where you write down or draw what you notice when your body is relaxed (“green light”), when you’re experiencing manageable stress levels (“orange light”), and how your body reacts to heavy stress (“red light”). This list can help you recognize in which state you currently are. It can be a good idea to print it out and schedule regular check-in time points with yourself during the day to consciously notice your current stress levels, and journal about them.

Alternatively, you can also journal about your internal “battery system” – how do you notice you’re entering your “low battery” state, or experience critical battery levels? What do you notice then? How does it express itself?

Define Your Personal Resilience Tools

Now let’s reflect about what to do when you notice low battery levels or high stress. This is very individual, as each person has their own way to react to stress and has built their own strategies to deal with stressful situations. It’s a good idea to journal about questions like these:

What has helped me bounce back from a tough day or setback in the past?
What feels restorative or relaxing for my body? What is filling my batteries?
How do I notice that my body is calming down?
What does “rest” mean for me, and how does it look specifically? What do I need to be able to feel truly rested?

It can be nice to build a “Self-Care Menu” of things that help you charge your battery and make you feel relaxed again. This is very individual to you and what you love doing, what works well for you. This list ideally includes activities of all sizes:

XS (very short and immediate actions – such as a 10-minute walk, cuddling your dog, drawing something or a sending a message to a loved one)
S (immediate actions such as a longer walk or workout, taking the time to read a book or listen to a podcast, playing an instrument, calling a loved one)
M (something that needs a little planning – like an evening with friends, a fun weekend trip or event to go to, or starting a new hobby)
L (longer actions – such as a holiday, longer trip with your loved ones, new creative endeavor or adventure to go on)

Having this list ready makes it very easy to pick something in the very moment you need it. Make sure you’re regularly sprinkling in such activities, especially in very intense and stressful times – XS activities should even be possible during those times!

Build Your Support System

The best founders don’t build in isolation – ideally, you’re surrounded by a support system that is there for you through the easy and the tough times. This support system can contain several layers:

A person with a prosthetic arm is sitting at a table using a laptop. The person is smiling and appears to be engaged in their work. A plant and a notebook are also on the table.

Your Inner Circle (Loved Ones): The people closest to you will likely be your most immediate “support layer”, and will be witnessing much of your journey with you. It’s a good idea to discuss beforehand how they would want to be involved in your journey, and share expectations, boundaries and when you might need extra support. It can be really helpful to schedule regular check-ins (some couples even do quarterly retreats!) to discuss how things are going and finding the right balance between sharing and relying on them, or overburden them or isolate yourself. They will likely be your strongest supporters, so it’s a good idea to communicate a lot and frequently about how things are going for both sides.

A person in a wheelchair moves independently up a ramp toward the entrance of a building, demonstrating accessibility for individuals with mobility impairments.

A Coach/Therapist: Before starting an intense journey like this, it’s a good idea to find a good coach or therapist that can support you. Finding the right person for this is a bit like dating – it may take some time to find them, but is worth it in the end. Think about the education/background, experience, personality and viewpoints you’d want the person to have – do you need a person to listen and support, or would you want to be challenged and confronted? Ideally, you’d meet several coaches and therapist, and pick the one that works best for you.

A stick figure sits at a desk using a computer. Another stick figure stands beside them, pointing at the screen as if explaining or discussing something. The background is plain and uncluttered.

Advisors and Mentors: It’s a good idea to rely on advisors and mentors that are super experienced in this. They very likely have navigated the stormy waters already and are no strangers to the most stressful of all times. Make a conscious choice on who you believe can help you navigate this best, and build a rapport based on honesty, trust and vulnerability – their real-life advice can really put things into perspective and support you heavily when times get difficult.

A person sitting cross-legged in a relaxed meditation pose with their hands resting on their knees, eyes closed, and a calm expression, drawn in a simple black line art style.

Fellow Founders / Founders Community: One of the best resources is to have a network of fellow founders or a founders community. Most likely they have already been where you are, and can offer you really valuable and hands-on advice on how to navigate it. You can find those networks or communities in your city, or through organizations like BIO or other organizations that support startups. Forums or therapeutic area-specific organizations are also a great way to connect to your community!

Build Your Self Care Framework

Now that you have your foundation in place, you can also incorporate it into your everyday routines, with practices such as these:

Schedule reflection sessions during the day: Schedule 10-minute self-reflection sessions to assess your stress levels, energy, and emotional state into your work week. Use tools like journaling, your traffic light system or apps to identify triggers
Take time for rest and restorative activities: Leverage your self care menu to consciously include restorative activities in your work week
Frequently check in with your support system: Find the right frequency to check in with your support system, and keep them in the loop on your wellbeing or needs you might have for them
Set Boundaries: Block off non-negotiable time for rest, exercise, or family. For example, no emails after 9 PM or a 30-minute daily walk. Allow your team to do the same, and make sure to respect their set boundaries. Try to delegate tasks where possible
Create an open company culture: Encourage an open company culture, speaking about stress levels and emotional experiences. Have plans in place in case you or your employees need to take a leave for mental health. Have benefits in place that support your employees with this.

Prioritizing your mental health is one of the most important things you can do as a founder and lays the foundation for your success, especially in the long-term. Remember that stress is absolutely normal on this journey and communicating about it is super important. You’re not alone in this journey, and being open and vulnerable about it will help you create trust and will be beneficial to finding the best path forward!

← TECH STACK

PLAYBOOK HOME

FUNDING LANDSCAPE →