A survey of entrepreneurs found that 87.7% experience at least one mental health challenge in their daily lives. Anxiety was the most common, affecting 50.2%, followed by high stress (45.8%), financial worries (39.2%) and burnout (34.4%). Impostor syndrome affected 31.7%, and only 12.3% of the entrepreneurs surveyed reported no mental health challenges at all.
Peer-reviewed research comparing entrepreneurs with a matched group of non-entrepreneurs found that 72% of founderswere affected by mental health conditions, either personally or through their immediate family. Almost half reported one or more lifetime conditions and 32% reported two or more.
For small businesses, the consequences do not stop with the founder. When one person remains responsible for major financial, operational and staffing decisions, prolonged stress or burnout can become a vulnerability for the business itself.
Gugu Mjadu of Business Partners Limited says the findings reflect what South African business owners often describe in private. “SA’s entrepreneurs have built substantial companies, and many of them will tell you how hard it was. They talk about lying awake over payroll and putting their personal savings on the line. Those stories rarely make it into the public version of their success, and that silence leaves other founders believing they are the only ones struggling.”
Sleep is one of the first things to go. Insomnia and other sleep disorders affected 21.6% of the entrepreneurs surveyed, while 19.8% reported depression and 12.3% described feelings of hopelessness.
She continues, “Each year, Entrepreneur of the Year® competition entrants show how closely a founder’s personal and financial life can become tied to the business. While the entrepreneurial experiences vary, the stress remains consistent.” Mjadu recalls that one candidate sold her home to buy her first stock and packed products on her dining room table. Another started cutting hair in a single chair and now runs a national franchise. Others have described businesses that took years to become profitable or survived the loss of most of their revenue during Covid.
That pressure increases as a business grows and more people come to depend on it. “Founders think about those numbers constantly, particularly when they have signed personal surety or put their homes up as security for a business loan,” shares Mjadu. “It isn’t simply their own income they feel responsible for. There are employees, suppliers and families whose livelihoods may be connected to what happens next.”
The responsibility is also isolating. In many small businesses, the owner is the person employees and suppliers approach when something goes wrong, while having few people with whom they can share their own concerns. More than a quarter of entrepreneurs, 26.9%, reported loneliness or isolation, and the figure rose to 30.7% among those aged 34 and under. A quarter said they had no support system that allowed them to talk openly about mental health.
“The qualities that help entrepreneurs keep going through difficult periods, including focus, determination and a willingness to push through setbacks, can also make it difficult to recognise when the pressure has become too much,” notes Mjadu. “There isn’t always a co-founder, management team or board to share difficult decisions with.”
This is why she urges founders to build support around themselves as their businesses develop. “Peer networks make a real difference, because other business owners understand the pressures involved in a way that friends and family often can’t. A mentor who has faced the same decisions offers perspective. Building management capacity matters too, so that every operational problem doesn’t land on the founder’s desk.”
Support designed for business owners is not widely known. Only 18.5% of entrepreneurs said they were aware of mental health resources aimed specifically at business owners, while 56.4% said they were not.
Financial boundaries matter too. Separating personal and business finances and, where possible, paying the founder a regular salary creates greater clarity between the needs of the business and those of the individual behind it. Money worries weigh more heavily on women in business, with 44.1% of female entrepreneurs reporting financial worries compared with 37.1% of men.
According to Mjadu, founder wellbeing should be viewed as part of business sustainability rather than something separate from it. “When we assess entries for Entrepreneur of the Year®, we look at whether a business can sustain itself and continue creating jobs over time. The competition’s winners collectively employ hundreds of people. In one entry, a business owner calculated that the 15 people she employed were supporting 72 family members.
Yet, a company that depends entirely on one exhausted person is fragile. Decisions about cash flow, hiring and growth are difficult enough without one person carrying every problem alone.”
She believes the conversation around founder mental health needs to reflect that reality. “A business owner talking about anxiety, stress or exhaustion shouldn’t automatically be seen as someone who isn’t coping. Asking for support can be part of running a company responsibly, just as building a management team or keeping your finances in order is.”
Business owners are already worried about it. More of those surveyed said they were concerned about their mental health (58.6%) than their physical health (54.6%). The willingness to talk about it splits along gender lines, with 70.6% of women reporting a support system in place compared with 52.5% of men.
For entrepreneurs who recognise themselves in the statistics, Mjadu’s advice is not to wait until the pressure becomes unmanageable. “Speak to someone, whether that’s another business owner who understands the pressure, a mentor or, where needed, a mental health professional. The entrepreneurs who have come through some of the hardest periods often learnt that they didn’t have to carry everything on their own.”