The theme of this year’s World Mental Health Day on 10 October is “Mental Health is a universal human right.” Yet, even though most entrepreneurs have access to mental health services, and 72% of entrepreneurs report experiencing mental health challenges (versus 48% of the general population), far too few entrepreneurs seek help when mental health issues arise. 

We asked EO members about the mental health challenges entrepreneurs endure, and the obstacles, barriers or perceived taboos that can make it difficult to ask for help—especially for those over age 45.   

Even Tony Soprano was seeing a shrink 

“Mental health was taboo in Central Europe until not long ago. This has changed in my generation. I am 40 years old. Indeed, it’s still a taboo for people a bit older than me, sadly,” says Szymon Boniecki (EO Poland). “Entrepreneurs especially are known to deal with problems by themselves—not asking for help; often forgetting we are just humans.” 

“But remember,” Szymon adds: “Even Tony Soprano was seeing a shrink.” 

According to recent research by the Business Development Bank of Canada, reported by The Conversation, an increasing number of entrepreneurs are facing a mental health crisis, and age seems to play a key role in whether they seek help. While all entrepreneurs face similar pressures, those under age 45 are twice as likely to ask for mental health support vs. those over age 45. Why is that? 

“I’m 56. When I was growing up, there was a big stigma around mental health. Now the stigma is being reduced, which is incredibly helpful because we can acknowledge it, and we don’t have to hide it or be embarrassed,” said Paul Pahoresky (EO Cleveland). “When we have a physical health problem, like a broken bone, it’s no big deal to ask for help. We’re finally moving toward the same thinking about mental health.” 

Rodolfo Salazar (EO El Salvador) shared: “The age discrepancy in seeking help is striking but understandable. Molded by a culture of silence around mental health, older entrepreneurs find it challenging to break the barriers and voice their struggles. They’ve been conditioned to perceive vulnerability as a weakness, especially in the business world, making the pursuit of help a mountainous task.”  

“Conversely, the younger generation, growing in an era of openness and digital connectivity, are more willing to talk, share, and seek help—breaking the chains of stigma that held back their predecessors,” said Rodolfo. 

Stress from running a marathon at a sprint pace 

One reason that entrepreneurs experience mental health difficulties at a higher rate than non-entrepreneurs is that running a business creates a high-stress environment. It’s like a marathon run at a sprint pace, with motivation and intensity at their peak, while time and money are often scarce—conditions under which mental health can suffer. 

“As entrepreneurs, our stress levels are very high, but we can’t really show that to anybody because we have to be the fearless leaders of our family at home, and the fearless leaders of our companies at work,” said Paul. “And we can never really take extensive downtime to recuperate or regroup.” 

Rodolfo agreed. “I’ve grappled with immense pressures—the constant strive for success, financial uncertainties, and the sense of isolation,” he said. “The challenge was not just the external pressures, but the internal battle—acknowledging that I needed help and breaking through the cultural and systemic barriers to seek it.”

Seek help when you need it 

“You expect an MD to treat your physical body. That should be an expectation with your mind as well,” Szymon explained. “After hundreds of hours in psychotherapy, I would tell any entrepreneur to try it and see how it can help them. It has given me the best ROI on quality of life, to put it in business terms.” 

But seeking help can be tricky for entrepreneurs, who, by definition, have the creativity and determination to find solutions to problems others can’t solve. As a result, many entrepreneurs deny that they may be experiencing a mental health challenge.  

“When I finally reached out for help, my stress level was intense,” Paul shared. “The first step was acknowledging to myself and then to other people (including my EO Forum) that something wasn’t right, and that there has to be a better way. At my worst moment, I felt like I had nowhere to turn.” 

Lead with empathy 

Counselling proved extremely helpful for Paul. “I now realize that if you are transparent with people, it helps them understand why you’ve been so stressed. And in my case, helped one of my employees seek help for themselves,” he said. “It makes you more relatable when you make yourself more vulnerable. I grew up as a military brat; in that setting you can’t allow yourself to be vulnerable because one-third of people in your life move away every single year. That was one key thing I identified about myself—I had a tough time being vulnerable.” 

Szymon agrees: “It’s hard to make mental health a priority. Systemic and preventive initiatives seem years away even in most developed countries,” he said. “My company offers free mental health support for our 150 team members. It reduced stigma around the subject in our workplace.” 

Rodolfo is optimistic that entrepreneurs can help further destigmatize mental health challenges: “For you, the leaders shaping the future, it’s crucial to recognize that fostering mental well-being is integral to innovation and success. Encourage open dialogues, embrace vulnerability, and provide the support that fuels the human spirit behind every venture,” he said.  

Time to conquer the mental health age divide 

Entrepreneurs are wired to respond to challenges with curiosity and determination no matter what complex factors they must overcome. EO members are vanquishing the mental health age divide in a similar way. This is especially meaningful for entrepreneurs over age 45, who may still harbor fears or hesitation around acknowledging a mental health challenge and seeking help.  

Paul spoke to that: “If you can’t have the strength to do it for yourself, do it for the people you love and care about. It’s not easy. But anything in life worth fighting for isn’t,” Paul said. “I’ve done a lot of introspection, and finally realized: It’s okay to ask for help.” 

“Everybody has issues and problems they’re dealing with. Everybody! You’re not alone in facing your challenges,” Paul continued. “Sharing what you’re dealing with can relieve some of that pressure.”  

Rodolfo summed it up: “As entrepreneurs, let’s lead with empathy and make mental health a shared responsibility, building a future where every entrepreneur, regardless of age, feels supported in their journey.” 

For more insights and inspiration from today’s leading entrepreneurs, check out EO on Inc. and more articles from the EO blog.