Managing Stress as a Founder or Manager

It helps to use precise terms. Stress is the response to demands. It is normal and short-term stress can be useful. Problems start when demands stay high for a long time and recovery does not happen.

The World Health Organization's ICD-11 describes burnout as a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It has three dimensions:

• feelings of energy depletion or exhaustion;
• increased mental distance from one's job, or feelings of negativism or cynicism related to it;
• reduced professional efficacy.

The WHO is explicit that burnout is classified as an occupational phenomenon and is not classified as a medical condition. It also specifies that the term applies to the work context only.

NIOSH explains where burnout comes from using a demands and resources lens. It describes burnout developing in people who repeatedly experience mismatched demand-resource scenarios together with poor coping and emotion management. Resources can be tangible, such as good tools and enough staff, or intangible, such as support from others and a sense of self-efficacy. NIOSH also notes a downward spiral: when you lose resources, it becomes easier to lose more.

The concept is not without critics. A critical review of the burnout literature argues that no valid diagnosis for burnout exists despite nearly 50 years of research, and that it overlaps substantially with depression. The practical takeaway for a founder or manager is useful either way: if you recognize the pattern in yourself, do not settle for a label. Take it seriously and, if it persists, have it assessed by a professional.

Because the slide is gradual, it helps to watch for specific changes rather than wait to feel "burned out."

NIOSH's module adds descriptions from people who experienced it, including "fatigue, fatigue, and more fatigue," and workers who are typically kind and committed simply losing their passion and going through the motions. It also notes that burnout may impair decision-making abilities, which is the core asset of anyone who leads.

A simple monthly check works well. Rate yourself from 1 to 5 on energy, engagement and effectiveness. Write one sentence on what is driving each score. A downward trend across two or three months is a signal to act, regardless of how busy the quarter is.

Stress management interventions are well studied. Three meta-analyses give a consistent picture.

• Workplace programs in general. A meta-analysis of 36 experimental studies covering 55 interventions found an overall effect size of 0.526, a significant medium to large effect. Cognitive-behavioral programs consistently produced larger effects than other types, while relaxation programs were the most commonly used.
• High-demand professions. A meta-analysis of 83 stress management interventions for nurses, a group with one of the most demanding jobs, found a combined medium effect. Person-directed interventions showed larger short-term effects, and they worked better on current stress than on longer-term strain such as burnout.
• Leaders specifically. A meta-analysis of 25 studies of leader-targeted stress management found significant effects on mental health and, after excluding influential cases, on work- and leadership-related outcomes, concluding that these programs can be an effective approach for promoting occupational health.

The main lesson is that structured methods work better than willpower. A short, well-designed program, ideally with cognitive-behavioral content, is a better investment than an app downloaded and abandoned.

Esade summarizes research on entrepreneurs' recovery into three categories: respite, reappraisal and regimen. They make a useful frame for a personal plan.

Respite: interrupt the work.

• Schedule real time off and protect at least one evening a week from work entirely.
• Use breaks during the day for movement or time outdoors, not more messages.
• Keep relationships outside the company active. They are a resource, not a distraction.

Reappraisal: change how you read the stressor.

• Write worries down. A founder quoted by Endeavor described the value of writing anxieties down, looking them in the eye, and asking whether they are as big as the mind is telling him.
• Separate what you control from what you do not. Put effort into the first list.
• Consider structured help such as cognitive-behavioral coaching or therapy, which aligns with the strongest evidence above.

Regimen: build the baseline.

• Protect sleep, exercise regularly and eat reasonably. These are the inputs that let you absorb stress.
• Keep a fixed weekly review: what drained you, what restored you, what to change.

Esade also notes a "recovery paradox": the more entrepreneurs need recovery from work stress, the more they struggle to get it. That is why the plan should be scheduled in advance, when you are well, rather than invented in the middle of a crisis.

Coping skills help, but they treat the effect. A chapter on stress management interventions from the University of Manchester classifies them by level, individual or organizational, and by focus: a primary focus on altering the causes of stress, or a secondary or tertiary focus on reducing stress itself. Founders and managers are unusual in that they have the power to change the causes.

Use the demands and resources lens from NIOSH to find the biggest levers.

For your team, the same levers apply, and they spread. A manager who models a sustainable pace, makes priorities explicit and removes low-value work reduces strain for everyone below them. That is the organizational, primary-focus intervention the research describes, and it is the one only a leader can make.

Some signs mean it is time to get professional help rather than adjust a routine: persistent low mood, loss of interest in things you used to enjoy, sleep problems that do not improve, reliance on alcohol or other substances to cope, or panic attacks. The founder who wrote the Endeavor piece describes anxiety and panic attacks after selling her company, and years of therapy and reflection to recover. Her account is a reminder that capable people need help too.

If you ever have thoughts of harming yourself, contact local emergency services or a crisis line immediately.

For leaders, getting help also sets an example. When a founder or manager says openly that they use a coach or therapist, it lowers the cost for everyone else to do the same.