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Startup CEO burnout is caused by sustained physical neglect, loss of perspective, and carrying stress alone. The founders who avoid it do three things consistently: they protect 7-8 hours of sleep as a non-negotiable performance input, they maintain at least one perspective anchor outside the company - whether relationships, exercise, or volunteering and they build a small group of fellow founders they can be honest with. Everything else compounds from there.

A hard-won guide to staying mentally healthy while building a startup.

I founded Stitcher in 2006, one of the first podcast platforms and ran it for eight years until we sold in 2014. We raised through Series B with investors like Benchmark and NEA. From the outside it looked like a typical startup success story.

The reality was brutal in ways nobody talks about. We were within a month of running out of cash three times. We had to lay off almost half our team at one point. We were never growing fast enough and there were a million other punches in the face, as YC calls them.

In the beginning I didn't actively prioritize myself enough and it really hurt me. By the end of year two I was physically and mentally exhausted. I was taking stimulants, working 90-plus hour weeks and drinking when I got home to numb the pain. I had zero balance. Stitcher felt like the center of the world and every failure felt deeply personal.

That second year I committed to making changes. I spent the next six years testing and implementing things to improve my mental state. Since leaving Stitcher I've been an EIR at a venture firm, invested in and advised startups, ran the early stage Startup BD team at AWS and now coach founders full time. I've spoken with thousands of founders about this challenge.

What I'm sharing here are the things that helped me most. None are magic bullets. But I hope sharing my personal experience motivates you to prioritize yourself a bit more.

What Startup CEO Burnout Actually Looks Like

Besides luck, what are we striving for as founders? Early on it's this: the ability to fail, recover quickly, iterate and fail again almost constantly, while inspiring others to follow you, for a long period of extreme uncertainty.

That's the ugly truth about finding product-market fit and early growth. At Stitcher, our first product was an iTunes plugin to help organize podcasts on your desktop. The first version was so bad that after launching we had exactly zero retained users. We had to pay people to try it just to understand why it was so terrible.

A lot of what makes a good startup founder is hard, painful, unnatural and exhausting. You end up feeling like crap a lot of the time. The key to the mental game is prioritizing yourself, specifically activities that help you feel less like crap. That's what allows you to do more of the failing and recovering, and to do it better, more objectively and more authentically for longer without burning out.

I bucket these activities into three categories. Maintaining perspective. Wellness foundations. Trusting yourself.

Maintaining Perspective

These activities help you stay objective, be happier, calmer and more empathetic. They make you a better leader and they are the most underrated part of avoiding founder burnout.

Make founder friends and talk to them regularly.

This probably helped me the most. One of the most difficult things about being a founder is that you generally have to stay positive for everyone around you and you can't really talk openly about what you're dealing with. You end up carrying a lot inside. It's incredibly lonely.

I created a CEO support group with four or five founders. I invited two friends, they each invited a friend and the group evolved over time. We met monthly for two hours, rotating between offices. The format was simple. The host got to complain first, unless someone had something urgent.

Deep friendships developed in our group. The two friends I brought together, one is now a VC and invested in the other's second company. Take advantage of founder communities. Get each other's numbers, self-organize and create these support systems. The loneliness of the founder role is real and this is the most direct solution to it.

Meditate.

There's research showing meditation reduces stress, positively affects emotions and mental wellbeing and increases clarity. Try box breathing, which is used by Navy SEALs: breathe in through your nose for four counts, hold for four, exhale for four, hold for four. Repeat. It's simple but effective. I started because I couldn't stay present and within weeks it was making a measurable difference.

Volunteer and help people with bigger problems.

I know what you're thinking. I have so much on my plate and this guy wants me to volunteer? When I was running Stitcher I didn't have a family or much of a life. This was about the only other thing I did most weeks.

I started volunteering as a mentor for underserved kids about a year into Stitcher. I mentored Damante for four years, spending time with him every Sunday. It feels genuinely good to give back. Scientists call it giver's glow. When you're giving you get additional dopamine and endorphins.

As a leader it's your job to lead by example. I brought Damante to our office sometimes and our team would light up around him. Instead of looking like a bad example it energized everyone and inspired other team members to give back too.

Read books about people with bigger problems.

I started reading long biographies of great leaders in history, partly to help me put away my phone and transition to sleep. A surprise benefit was perspective. When you're reading about Harriet Tubman or Abraham Lincoln and what they went through and what was on the line for them, your revenue missing targets doesn't feel as catastrophic.

Keep a gratitude list.

Quick and easy. Write down things you're grateful for regularly. Studies show it improves your mood and your ability to handle adversity. Set a reminder three or four times a week and write down three things. It can be simple like "I have a place to sleep" or more specific. The point is to look up from the grind for a few minutes.

Wellness Foundations

My lack of self-care in the early Stitcher years was probably extreme but the single biggest difference maker to my state of mind was taking care of myself physically. Fixing my sleep, eating healthy, not consuming bad things and exercising. There are so many studies on the effects of each on cognition and performance that it's simply fact at this point. Startup CEO burnout is almost always accelerated by physical neglect.

Sleep is the game changer.

For the first year and a half of Stitcher I averaged four to five hours of sleep a night and would occasionally sleep twelve hours thinking I was caught up. That doesn't work.

Here's what crystallized it for me. We had to raise our Series A in 2008. I had pitched 90 VCs and 89 had passed. I was at the one-yard line with one potential investor when they asked me to meet with their EIR. It was a terrible sleep week. I was working non-stop and powering through on caffeine.

In that meeting I literally couldn't do simple math. The guy must have thought I was a complete moron. We didn't get the term sheet. It was a huge wake-up call. How can I make the complex decisions necessary to run a startup if I can't even get through a basic meeting?

Contrast that to the Benchmark round, after I had started prioritizing these things. I slept 7.5 hours the night before the partner meeting and went for a run. We didn't have nearly as much user growth as in 2008 and we were six weeks away from running out of cash. But being in the right mental state was a big part of why that meeting went well.

Sleep practices that helped me:

Same wake time every day including weekends. Your body is on a clock and consistency helps it more than anything else.

No screens within an hour of bedtime. TV, phone, everything off. Screens trick your brain into thinking it's daytime and prevent your mind from winding down.

No alcohol. It reduces sleep quality even when it helps you fall asleep faster.

Leave your phone outside your bedroom. I started leaving mine in the kitchen at 8pm and not looking at it until 8 the next morning.

Get help if you need it.

This is the most serious thing I'll discuss. Research by UC's Michael Freeman found that entrepreneurs have much higher prevalence of mental health conditions and are more vulnerable to depression and substance abuse. This is made harder by the fact that founders have to be cheerleaders for their companies.

If you're depressed or experiencing suicidal thoughts, please get professional help immediately. I never experienced depression or suicidality but I did mask stress with Xanax and alcohol at night. Putting aside the health risks, it impaired the most important things I needed as a leader: judgment, mood, energy and clarity.

When I eventually fixed my evening routine everything improved within two months. If you're masking the pain with substances and need professional help, get it. There's no shame. More startup founders are opening up about mental health. Don't wait until it becomes a crisis.

Exercise.

We all know exercise helps. I exercised regularly throughout Stitcher and it was one of the only healthy things I did in the beginning. One tip: if you're highly competitive and going hard in your workouts but feeling fatigued in general, tone it down. I found that if I pushed over 70% intensity the tiredness afterward would outweigh the benefit. Exercise should add energy to your week, not drain it.

Trusting Yourself

As a founder one of your most important jobs is making decisions. Early on that can be genuinely hard and the difficulty is often underestimated in conversations about startup CEO coaching and leadership development.

Write it down.

Use a simple pros and cons approach. It's remarkable how much writing forces clarity of thought. It helps you clarify the decision for yourself and articulate it to others. You'll likely make unpopular decisions and this process helps you feel more grounded when you do.

It also helped me with self-awareness. I realized that any decision involving people and feelings was hard for me. I'm sensitive and feel people's pain more deeply than most. Decisions like firing someone or scrapping something people had been working on, I wasn't weighing those correctly. Being aware of it and writing it down helped me see what was actually happening rather than just feeling stuck.

What Changes When You Start Prioritizing Yourself

The founders I work with who make the biggest performance jumps are almost never the ones who found a better strategy or hired a better team. They're the ones who fixed their physical and mental operating system first.

When you sleep well, exercise consistently and have people you can be honest with, you make faster decisions. You recover from setbacks more quickly. You show up more calmly in board meetings. You stop personalizing every piece of bad news. The company moves better because you move better.

Founder burnout is not inevitable. It's the result of specific habits and choices that compound over time. The same compounding works in the other direction.

The Bottom Line

You are the most important asset in your company. Not the product, not the team, not the runway. You.

Start with sleep. Add one perspective practice. Find two or three founders you can be honest with. Write things down when decisions feel stuck.

None of this is complicated. All of it is hard to actually do consistently. The founders who do it consistently are the ones who last long enough to build something.

‍

If you want to talk through how you're operating as a CEO and what's getting in the way, book a call at startupceo.coach.

I founded Stitcher in 2006, one of the first podcast platforms and ran it for eight years until we sold in 2014. We raised through Series B with investors like Benchmark and NEA. From the outside it looked like a typical startup success story.

The reality was brutal in ways nobody talks about. We were within a month of running out of cash three times. We had to lay off almost half our team at one point. We were never growing fast enough and there were a million other punches in the face, as YC calls them.

In the beginning I didn't actively prioritize myself enough and it really hurt me. By the end of year two I was physically and mentally exhausted. I was taking stimulants, working 90-plus hour weeks and drinking when I got home to numb the pain. I had zero balance. Stitcher felt like the center of the world and every failure felt deeply personal.

That second year I committed to making changes. I spent the next six years testing and implementing things to improve my mental state. Since leaving Stitcher I've been an EIR at a venture firm, invested in and advised startups, ran the early stage Startup BD team at AWS and now coach founders full time. I've spoken with thousands of founders about this challenge.

What I'm sharing here are the things that helped me most. None are magic bullets. But I hope sharing my personal experience motivates you to prioritize yourself a bit more.

What Startup CEO Burnout Actually Looks Like

Besides luck, what are we striving for as founders? Early on it's this: the ability to fail, recover quickly, iterate and fail again almost constantly, while inspiring others to follow you, for a long period of extreme uncertainty.

That's the ugly truth about finding product-market fit and early growth. At Stitcher, our first product was an iTunes plugin to help organize podcasts on your desktop. The first version was so bad that after launching we had exactly zero retained users. We had to pay people to try it just to understand why it was so terrible.

A lot of what makes a good startup founder is hard, painful, unnatural and exhausting. You end up feeling like crap a lot of the time. The key to the mental game is prioritizing yourself, specifically activities that help you feel less like crap. That's what allows you to do more of the failing and recovering, and to do it better, more objectively and more authentically for longer without burning out.

I bucket these activities into three categories. Maintaining perspective. Wellness foundations. Trusting yourself.

Maintaining Perspective

These activities help you stay objective, be happier, calmer and more empathetic. They make you a better leader and they are the most underrated part of avoiding founder burnout.

Make founder friends and talk to them regularly.

This probably helped me the most. One of the most difficult things about being a founder is that you generally have to stay positive for everyone around you and you can't really talk openly about what you're dealing with. You end up carrying a lot inside. It's incredibly lonely.

I created a CEO support group with four or five founders. I invited two friends, they each invited a friend and the group evolved over time. We met monthly for two hours, rotating between offices. The format was simple. The host got to complain first, unless someone had something urgent.

Deep friendships developed in our group. The two friends I brought together, one is now a VC and invested in the other's second company. Take advantage of founder communities. Get each other's numbers, self-organize and create these support systems. The loneliness of the founder role is real and this is the most direct solution to it.

Meditate.

There's research showing meditation reduces stress, positively affects emotions and mental wellbeing and increases clarity. Try box breathing, which is used by Navy SEALs: breathe in through your nose for four counts, hold for four, exhale for four, hold for four. Repeat. It's simple but effective. I started because I couldn't stay present and within weeks it was making a measurable difference.

Volunteer and help people with bigger problems.

I know what you're thinking. I have so much on my plate and this guy wants me to volunteer? When I was running Stitcher I didn't have a family or much of a life. This was about the only other thing I did most weeks.

I started volunteering as a mentor for underserved kids about a year into Stitcher. I mentored Damante for four years, spending time with him every Sunday. It feels genuinely good to give back. Scientists call it giver's glow. When you're giving you get additional dopamine and endorphins.

As a leader it's your job to lead by example. I brought Damante to our office sometimes and our team would light up around him. Instead of looking like a bad example it energized everyone and inspired other team members to give back too.

Read books about people with bigger problems.

I started reading long biographies of great leaders in history, partly to help me put away my phone and transition to sleep. A surprise benefit was perspective. When you're reading about Harriet Tubman or Abraham Lincoln and what they went through and what was on the line for them, your revenue missing targets doesn't feel as catastrophic.

Keep a gratitude list.

Quick and easy. Write down things you're grateful for regularly. Studies show it improves your mood and your ability to handle adversity. Set a reminder three or four times a week and write down three things. It can be simple like "I have a place to sleep" or more specific. The point is to look up from the grind for a few minutes.

Wellness Foundations

My lack of self-care in the early Stitcher years was probably extreme but the single biggest difference maker to my state of mind was taking care of myself physically. Fixing my sleep, eating healthy, not consuming bad things and exercising. There are so many studies on the effects of each on cognition and performance that it's simply fact at this point. Startup CEO burnout is almost always accelerated by physical neglect.

Sleep is the game changer.

For the first year and a half of Stitcher I averaged four to five hours of sleep a night and would occasionally sleep twelve hours thinking I was caught up. That doesn't work.

Here's what crystallized it for me. We had to raise our Series A in 2008. I had pitched 90 VCs and 89 had passed. I was at the one-yard line with one potential investor when they asked me to meet with their EIR. It was a terrible sleep week. I was working non-stop and powering through on caffeine.

In that meeting I literally couldn't do simple math. The guy must have thought I was a complete moron. We didn't get the term sheet. It was a huge wake-up call. How can I make the complex decisions necessary to run a startup if I can't even get through a basic meeting?

Contrast that to the Benchmark round, after I had started prioritizing these things. I slept 7.5 hours the night before the partner meeting and went for a run. We didn't have nearly as much user growth as in 2008 and we were six weeks away from running out of cash. But being in the right mental state was a big part of why that meeting went well.

Sleep practices that helped me:

Same wake time every day including weekends. Your body is on a clock and consistency helps it more than anything else.

No screens within an hour of bedtime. TV, phone, everything off. Screens trick your brain into thinking it's daytime and prevent your mind from winding down.

No alcohol. It reduces sleep quality even when it helps you fall asleep faster.

Leave your phone outside your bedroom. I started leaving mine in the kitchen at 8pm and not looking at it until 8 the next morning.

Get help if you need it.

This is the most serious thing I'll discuss. Research by UC's Michael Freeman found that entrepreneurs have much higher prevalence of mental health conditions and are more vulnerable to depression and substance abuse. This is made harder by the fact that founders have to be cheerleaders for their companies.

If you're depressed or experiencing suicidal thoughts, please get professional help immediately. I never experienced depression or suicidality but I did mask stress with Xanax and alcohol at night. Putting aside the health risks, it impaired the most important things I needed as a leader: judgment, mood, energy and clarity.

When I eventually fixed my evening routine everything improved within two months. If you're masking the pain with substances and need professional help, get it. There's no shame. More startup founders are opening up about mental health. Don't wait until it becomes a crisis.

Exercise.

We all know exercise helps. I exercised regularly throughout Stitcher and it was one of the only healthy things I did in the beginning. One tip: if you're highly competitive and going hard in your workouts but feeling fatigued in general, tone it down. I found that if I pushed over 70% intensity the tiredness afterward would outweigh the benefit. Exercise should add energy to your week, not drain it.

Trusting Yourself

As a founder one of your most important jobs is making decisions. Early on that can be genuinely hard and the difficulty is often underestimated in conversations about startup CEO coaching and leadership development.

Write it down.

Use a simple pros and cons approach. It's remarkable how much writing forces clarity of thought. It helps you clarify the decision for yourself and articulate it to others. You'll likely make unpopular decisions and this process helps you feel more grounded when you do.

It also helped me with self-awareness. I realized that any decision involving people and feelings was hard for me. I'm sensitive and feel people's pain more deeply than most. Decisions like firing someone or scrapping something people had been working on, I wasn't weighing those correctly. Being aware of it and writing it down helped me see what was actually happening rather than just feeling stuck.

What Changes When You Start Prioritizing Yourself

The founders I work with who make the biggest performance jumps are almost never the ones who found a better strategy or hired a better team. They're the ones who fixed their physical and mental operating system first.

When you sleep well, exercise consistently and have people you can be honest with, you make faster decisions. You recover from setbacks more quickly. You show up more calmly in board meetings. You stop personalizing every piece of bad news. The company moves better because you move better.

Founder burnout is not inevitable. It's the result of specific habits and choices that compound over time. The same compounding works in the other direction.

The Bottom Line

You are the most important asset in your company. Not the product, not the team, not the runway. You.

Start with sleep. Add one perspective practice. Find two or three founders you can be honest with. Write things down when decisions feel stuck.

None of this is complicated. All of it is hard to actually do consistently. The founders who do it consistently are the ones who last long enough to build something.

‍

If you want to talk through how you're operating as a CEO and what's getting in the way, book a call at startupceo.coach.