Chronic stress causes exaggerated levels of cortisol, and this is 'toxic' to the brain. This is particularly important in the context of ‘burnout’.
Content warning, trigger warning: This article contains mentions of suicidal thoughts and suicide.
One small crack does not mean that you are broken, it means that you were put to the test and you didn’t fall apart - Linda Poindexter
What would it be like to start a rock band without a lead singer or lead guitarist? That’s how a 40-year-old bootstrapped entrepreneur felt when his co-founders left the business, leaving him stranded. His mobile payments and e-commerce startup was facing financial stress and the founder, without any technology background, was the lone figure on the stage, facing a storm.
“You can’t run a band, if all you know is how to write passable lyrics,” says the founder who wants to remain anonymous, as he is still looking to raise funds.
The company made two stinging errors, by his own admission. “We delayed raising funds since we believed that we would be able to see the company through to a profitable path with our experience and network, and maintain our independence. This clearly was our first mistake,” says the founder who lives in a tier-II south Indian city.
He then somehow managed to get another co-founder, changed the business model from B2C (business to customer) to B2B (business to business), raised an angel round of around Rs 1 crore, hired a CTO (chief technology officer) and landed marquee clients. This was a period of elation which he now identifies as hypomania. Another two years were spent chasing scale by burning through the investments and bridging the gap in financial requirements from personal savings and via the friends and family route. “We had almost always believed that we had the so-called product market fit.”
But that was not to be. “You are almost always torn between client acquisition, product development and an overworked team. A new client in the B2B business, when one is having very limited resources, can eat into the development roadmap and push you into a maintenance mode.”
Soon enough, the product started to look shaky, the sales pipeline dried up and there was not enough cash flow to meet even daily expenses. “You start digging deeper into the rabbit hole of liquidation of personal assets and then over-utilise the friends and family channel. Being focused on daily existence, the long-term issues are never solved.”
By now, he was having severe anxiety and soon entered a phase of despair. “I was running straight down the path of depression.”
Neurotransmitters and depression
Biologically, like the circuits in your PC motherboard, there are several neuronal circuits in the brain which regulate mood, ability to experience pleasure, sleep, appetite, etc. The functioning of these circuits is altered in depression.
The neurons communicate with each other via small biochemical molecules called neurotransmitters. In the case of a person suffering from depression, the levels of certain groups of neurotransmitters called monoamines are lower than normal. The monoamines are serotonin, norepinephrine and dopamine. It is to restore the levels and functioning of these neurotransmitters that doctors prescribe medicines belonging to the class of antidepressants. Used in moderation, these drugs help to address severe cases of depression, says Dr Anju Mathew, a leading psychiatrist.
According to the World Health Organization (WHO), an estimated 264 million people suffer from depression globally, with many of them also suffering from symptoms of anxiety. A recent WHO-led study estimates that depression and anxiety disorders cost the global economy $1 trillion each year in productivity loss.
Read more: Mental Health Series Part 3: Is India Inc sensitive towards employees battling mental health issues?
Cortisol and burnout
There is a functional circuit extending from brain structures, namely the hypothalamus and pituitary gland, to an abdominal organ called the adrenal gland called in short as the HPA axis. Stimulation of the HPA axis produces a hormone called cortisol which enables us to deal with stressful situations - physical as well as psychological. But chronic stress causes exaggerated levels of cortisol and this is 'toxic' to the brain. This is particularly important in the context of ‘burnout’.
Exaggerated activity of a system of neurons called the sympathetic nervous system, results in palpitation and anxiety. Lower brain areas like the amygdala become hyperactive, exceeding the capacity of higher brain areas like the prefrontal cortex, to dampen the response. “This is akin to ‘emotion’ snatching the driving seat from ‘wisdom’,” says Dr Mathew.
Burnout is a syndrome resulting from chronic workplace stress that has not been successfully managed. According to the World Health Organisation (WHO), burnout is characterised by exhaustion, increased mental distance from one’s job and reduced professional efficacy.
Read more: Shot in the arm for workplace culture: psychological safety of teams and empathy when it comes to mental health are the new goals
Sadness isn’t depression
Psychiatrists have to assess whether the condition is sadness or depression. Sadness is a transient emotion due to a certain loss/failure. It’s normal. “A sad person is still able to enjoy a vacation or being with friends or gets pleasure out of watching a movie or taking a walk in the park. But a person in a state of depression feels sad, helpless, hopeless and worthless almost at all times,” says Dr Mathew. For genetically vulnerable people, stress acts like a second hit to cause depression.
If it’s a mild form of depression, it may be managed by psychotherapy and lifestyle changes. The person is encouraged to develop hobbies, find personal time and relax. Antidepressants are indicated in cases of moderate to severe depression. If depression is part of a bipolar disorder, they need mood stabilisers. Cognitive behaviour therapy, interpersonal therapy, and relaxation therapy like progressive muscle relaxation/deep abdominal breathing are some of the techniques used in the management of such patients.
Read more: Who needs a life coach, and what does positive psychology have to do with post Covid career growth?
Education system and emotional intelligence
Emotional intelligence and social intelligence are aspects that need better attention from society. Traditionally, we have given physical health more importance than mental or emotional health. For this to change, some tweaks have to be brought into the educational curriculum.
Says Puneet Manuja, co-founder of emotional wellness platform YourDOST, “Emotional intelligence sessions are important not just in colleges but even at the school level. Dinner-table conversations at home can be around one’s vulnerabilities too, not just wins. Children should be made to understand that it’s okay to fail. Parents have to tell the child that academics is only a part of life.”
The inability to cope with failure stems from incentivising winning at an early age. For example, some parents buy the child a bicycle if they score high marks and adopt punitive measures when they fail in an exam. This behavioural pattern can have repercussions for the child later on, as he/she wouldn’t know any coping mechanism when faced with an uphill struggle.
When YourDOST did a survey among 250 startup founders many admitted that they were nervous wrecks who felt a high level of anxiety on most days of the week. Many founders aren't able to share the hardships even with their family or friends because they don’t want to hear the 'I told you so’ story. Many of them have launched startups despite their immediate circles warning them against it. The journey is lonely.
Aparna Vishwanathan, founder of Bengaluru-based Zocio, an organisation that promotes social intelligence, says the key is to address the core issue lying beneath a mental scar, rather than merely trying to find a solution for it. “Emotional quotient (EQ) and social quotient (SQ) play a big role in how you manoeuvre through your emotions and relationships. If you don’t accept your feelings and emotions for what they stand for, it is difficult to build healthy relationships,” she says. This is especially important between co-founders, founders and the team, and the team and customers.
The best way to understand another person is by evaluating your own mechanisms and patterns. Once the other person is understood better, you can find peace and alignment within yourself. Wherever there’s a nonalignment, one sees an increase in cases of depression and anxiety.
“That’s why I say that emotional intelligence and social intelligence should be made a mandatory subject right from school. Only then children will learn to open up and be honest with their own emotions,” says the Zocio founder.
It's not the end of the world
Harshit Agarwal is a happy soul today and has learnt to be in control of his emotions. “At that time, I was feeling suicidal and needed help,” says Agarwal, whose story we had detailed in the first article of this series. Upekkha, the accelerator that he was part of, suggested that he seek help from YourDOST, the emotional wellness platform.
“I had given up hobbies like cycling and jogging, and I was asked to resume them. The counsellors heard me out for weeks, and I was relieved that there was someone to talk to on all matters that bothered me. I used to react in an impulsive manner, but the counselling helped me to gain patience. My mood and behaviour improved and that started to slowly reflect at work. I can say that the company now is showing a growth of 1.7-2x, year on year.”
Today Harshit understands the journey better. “Most issues eventually get fixed. It’s not the end of the world. I wasn’t a good manager and couldn’t figure out why things were going wrong. But today I empathise with my VCs. I have learnt to empathise with everyone around and look to build quality relationships.”
The other startup founder who wishes to be anonymous (quoted at the beginning of this article), says a simple tip that he came across from Shailendra Singh of Sequoia gave him some peace. That tip was ‘Take one day at a time’.
“That’s what I'm trying to do now. It’s important to not get overwhelmed by all this literature about hustling, boot camps and super success stories. Ashok Varma, Ilya Zhitomirskiy and Jody Sherman (founders who died by suicide) are examples that need to be studied probably even more than Steve Jobs, Larry Page, Elon Musk and Mark Zuckerberg,” he says. There is a need to differentiate between optimism, an infinite amount of optimism and hypomania. Even small successes need to be celebrated, but don’t willfully predict an overtly bright future, he says. “That’s a lesson I learned the hard way.”
Vivek Khandelwal of iZooto, who too was featured in the first article of this series, says adopting a nice daily routine has helped him to calm his nerves. This includes exercise, meditation and maintaining a journal. “Exercising has helped me a great deal in getting the anxious energy out of my system. The daily journal has helped me park aside my emotions and start the next day on a clean slate. Meditation, however, has been a true game-changer for me. I attended a 10-day vipassana course in 2018, and having experienced absolute calm, I truly understand the impact of meditation in one’s life.”
Also read: Meditation goes official as RBI stamps its approval and Healing Space | Why your meditation isn’t helping you cope
India's information technology body NASSCOM has adopted mentorship programs like product community and deep tech clubs where founders can discuss key business and mental wellness issues.
Is the new generation playing bolder?
A stronger generation – mentally astute – is making its way in. “I find that the teenagers of today are much more aware of the situation. They don’t shy away from discussing mental health concerns. As their share of voice in society goes up, things could change,” says YourDost’s Manuja.
Kris Gopalakrishnan, chairman of Axilor Ventures, agrees. Most of the current generation of founders are mentally very strong and are able to handle the pressures, he says. “I feel that the current generation has learned from the mistakes made by previous generations.”
When celebrities like Deepika Padukone openly talk about mental health challenges, it really makes a difference. The suicide of actor Sushant Singh Rajput also contributed to awareness about mental health. Such events have emboldened the new generation to have open discussions about the importance of seeking professional help at the right time.
Read more: Mental health series Part-1 | Sushant Singh Rajput’s death: Depression and role of COVID-19 in increasing psychological problems
With young founders keen on getting better industry support, national information technology (IT) body NASSCOM has adopted mentorship programs like product community and deep tech clubs where founders can discuss key business and mental wellness issues. According to NASSCOM, peer learning will be key, with companies sharing their best practices and experiences with each other. Employee wellness is becoming a business priority in all organisations, says the IT body.
"We firmly believe mental health issues are no different than any other health issue,” says Nirmit Parikh, founder and CEO of Apna, India’s fastest ever unicorn. “Mental health services such as counselling sessions within the organisation ensure that mental health issues are addressed properly. We are well aware of the importance of holistic wellness, as we continue to build young, strong teams,” says Parikh. Apna is a job platform for blue-collar workers that became a unicorn in September, after just 21 months of operations.
India added three unicorns every month in 2021 to nearly double the overall number of startups valued at over $1 billion to 51, as of end-August, according to a report published by Hurun India. Mobile Premier League (MPL) and Apna joined the unicorn club in September. At present, India is third in the list of countries with the most unicorns, trailing the US (396 unicorns) and China (277), but ahead of the UK (32) and Germany (18). The Hurun report said that as many as 11 co-founders in that list were under 30 years of age.
“Not until we are lost, do we begin to understand ourselves” – Henry David Thoreau
This is the third and final part of the series on Mental Health and the Indian tech startup ecosystem. The World Mental Health Day falls on October 10.Also read: Has the Indian startup ecosystem become a cauldron of mental health woes? and How a congratulatory echo-chamber has Indian startups pining for self-care - the first two articles in this series.