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Why The Stress Of Your Startup (And Those ‘Go Big Or Go Home’ Sayings) Can Kill You

Entrepreneurs carry an unthinkable load of stress on a daily basis. Are you aware of how it's showing up in your life? Believe it or not, it can kill you. Lioness Cofounder Natasha Zena shares how her recent bout with stress took her to the ER as well as why it's vital to know your body's default mode of dealing with it.

Every day I’m hustling. Go big or go home. Beast mode. And, our favorite here at Lioness: Rock the day! We entrepreneurs guzzle these motivation mantras about as much as we do caffeine. They are fun ways to psych up our psyches and trick our bodies into doing more. But, is more always good?

I’ve heard all about work/life balance and physical wellness and like most of you, I have my areas where I need improvement (hello waistline!). Last year, I started taking better care of myself in a way that I hadn’t since I became self-employed three years ago.  From shedding some pounds to observing Shabbat more consistently and throwing in some at-home yoga sessions and massages.

I was doing what some of the greatest minds in business recommend entrepreneurs do to maintain wellness and manage my stress. So, you can imagine my surprise when I went to my routine teeth cleaning and found out the exact opposite was happening. The dental assistant checked my blood pressure four times. Then I was passed to the dental hygienist who checked it an additional time.

Her: “Do you take blood pressure medication?”

Me: “Me? No.”

Her: “Your blood pressure is really high.”

Me: “What is it?”

Her: “178/118. You may want to see your physician.”

I was in and out of the emergency room over the next week — the second time I arrived by ambulance because I began to experience stroke-like symptoms. High blood pressure puts extra strain on your heart and blood vessels. Over time, the extra strain increases your risk of a heart attack or stroke. I was under a tremendous amount of stress in my professional and personal life, but because I was maintaining my wellness habits (yoga, meditation, stretching), I thought I was fine.

It wasn’t until the emergency room doctor asked me how I had been feeling lately, that it dawned on me that there were times when, indeed, I had not been feeling well. I had had random bouts of headaches, dizziness and there had been a few occasions where my cofounder Dawn noted that she thought my breathing sounded shallow. However, I did what I always do. I kept going. Beast mode, remember?

What Is Your Default Method To Cope With Stress?

Somewhere in my childhood, I developed a default method of dealing with stress. We all do. Some people overeat. Some drink. Others get angry. Exercise. There’s a number of ways any one of us may handle stress. Me? I keep it moving.  When I was 15 years old, my father passed away suddenly from diabetes. About six months or so later, when my mother and I were trying to adjust to life without him (my older siblings no longer lived in our house), I started getting a strange pain in my back and neck. Within a few weeks, I barely could turn my neck from right to left. I mentioned it to my friend one day in passing and, as usual, kept it moving.

The pain became so debilitating that my doctor began running tests. Meningitis? No. Maybe mono? No. Whatever it was, the symptoms worsened and new ones emerged. I was hospitalized. A battery of tests was done. They couldn’t find the cause of what was, by then, keeping me bedridden. There I was, a junior in high school whose classmates were thinking about prom while I couldn’t keep food down, could hardly open my inflamed eyes and needed my mother to bathe me. One day, I remember some specialists had come to my room to discuss my symptoms and my pediatrician, Dr. K, arrived. She stood at the foot of my bed and asked me if I had ever properly dealt with my father’s death. You can imagine I didn’t know how to answer that. How does one really deal with the unexpected death of a parent? See, she believed that my stress was being internalized and that, ultimately, my body had started to shut down.

Was she on to something? Was my default way to deal with stress to internalize it? After this last run-in at the emergency room, I went in search of understanding what effects stress can have on the body. I wanted to understand what I needed to look out for when under pressure and how I could best attack that stress before it set in and triggered my default. I scoured the Internet for information and I came across an article on Healthline by Ann Pietrangelo and Stephanie Watson on the effects of stress on your body. A few jumped out immediately from the page:

  1. Headaches. “Stress can trigger and intensify tension headaches.” In the weeks leading up to that fateful dentist appointment, I had been experiencing random flashes of pain in my head. Weird flickers of pain that I wouldn’t have categorized as a headache because many of them only lasted a few seconds.
  2. Rapid breathing. “When you’re stressed, the muscles that help you breathe tense up, which can leave you short of breath.” Dawn and I had driven to reSET, an accelerator in Hartford, and we were sitting outside in the car and I was thinking about some things I needed to do. “Take deep breaths, Natasha. You’re breathing really shallow,” Dawn said. Just like a couple other times she had mentioned it to me on different occasions, I wrote it off as nerves or walking too fast, because why else would I be breathing like that?
  3. High blood pressure. “Stress hormones tighten blood vessels which can raise your blood pressure.” Ding! Ding! Ding! Thanks to that life-saving dental visit, I became aware that my blood pressure had risen to dangerous levels. I had probably been walking around like that for weeks and had no idea, which is why hypertension is often referred to as the silent killer.

Getting Real About Stress Relief

I didn’t write this to have superficial conversations about entrepreneurship being stressful. We all know it is. I wrote this because I know there are other entrepreneurs walking around just like me. Other smart, sensible startup founders who are on the verge of or currently experiencing and tolerating stress and other stress-related health issues. At our last reSET startup accelerator weekend, mindfulness was on the agenda and it could not have been more timely for me. Chris Kernes, founder of on-demand mental healthcare application, Larkr, led us through a mindfulness exercise. One of the most poignant slides in her presentation was a list of entrepreneurs who had killed themselves over the last couple of years. People whom I’m sure exercised, had hobbies, a healthy lifestyle, did most of the things that we’re advised to do to manage stress.

Entrepreneurship is cast in such a sexy light, but the truth is it is fucking tough. If you don’t work, you don’t get paid. If someone is late to pay your invoice, you’re late to pay your bills.

You feel isolated. Not all of your friends understand. Not even the ones in leadership positions. They may oversee many people on an organizational flowchart, it doesn’t mean that they understand building a company. They cash their paychecks like everyone else and they don’t know firsthand the pressures of being the person who is responsible for finding the money on the other side of that paycheck. Entrepreneurship can be lonely. Scary. Unpredictable.

Why do we do it then? We believe in something — a cause, a calling, an idea. We believe that what we’re doing can change a community, enhance a life or affect the world. The highs of the good times bring us back from the lows. The catch 22 is that if we can’t get past the lows, well, we experience fewer highs.

When I was finally cleared to go home from the emergency room, I decided to take the next seven days off and I was not going to cheat at all. Not one email, article or conversation about work. I wasn’t going to lift a finger to clean or complete a project at home either. Giving myself permission to step away immediately brought tension release. I could literally feel my body decompressing. As I reduced my involvement at work and at home, my blood pressure reduced as well.  Over the next few days, the only thing I thought about was playing Candy Crush, getting a pedicure and binge-watching “Guy’s Grocery Games” on Hulu.

When I did return to work, I worked even lighter than I had before. In 2017, Dawn and I had committed to working smarter, not harder. So this time I cut my daily workload even more by approximately 10 percent. We’ve been having the working smarter conversations with mentor Shana Schlossberg, founder and CEO of Upward Hartford. Her candidness helped melt away lurking anxiety.

When I’m very excited about business opportunities, my body responds with the same symptoms as if I was under stress. My heart rate increases, my breath quickens. As Dawn has noted, “how can the body tell the difference?” It probably doesn’t. So as we hung out at Upward Hartford with Shana, she started talking about how uncomfortable entrepreneurship can make you and how it tests who you are and your boundaries and how it’s all so necessary in order to move forward. Just talking, being able to connect and share with somebody else who has been where Dawn and I was, brought me more relief than any 20-minutes on a yoga mat. You see, as entrepreneurs when we talk to our family and friends, they do their best to understand but they don’t know what it’s like.

And you end up getting feedback that sounds like this: “You’ll figure it out, you’re smart.” “You know what you should do…” “It’ll be fine.” None of it really helps. Neither do encounters with the “fake it ’til you make it” entrepreneur. We all know them. Everything is always fantastic. They may even try to tell you what you “should” be doing. However, they never have an authentic conversation about how freaking awful a week has been. At Lioness we always try to give female founders well-rounded conversations around entrepreneurship. It’s not all rainbows and butterflies. had a line on its site that stuck with me: “Shed the superman/superwoman urge.” I would never consider myself a person who is trying to be superwoman. If I look back at some of my behaviors, I definitely had times when I worked more often than I did other nonwork-related activities. It can be tricky for a person who lives for their work, but sometimes I have to check that I’m not overworking in order to avoid other pressing issues in my life that I may not want to deal with.  I’m understanding the value of completely stepping away from work, friends and, sometimes, family when I need to. 

We’re Inventors, Not Invincible

The other thing about the “fake it ’til you make it” facade is that it can keep you from seeking the help you may truly need. Statistics state about 30 percent of founders report dealing with depression. In comparison, about seven percent of the general population report suffering from depression. In recent years entrepreneurs have been coming forward about depression and other mental health battles. Over the last few years, the startup community has lost brilliant women.

Miss Jessie’s Cofounder Titi Branch hung herself in 2014. Twenty-two-year-old Karyn Washington, the founder of anti-colorism site For Brown Girls, took her own life in her car in 2014. Faigy Mayer, CEO and founder of Appton, an app development company, jumped off a popular rooftop bar in 2015.  And last year, Amy Bluel, founder of Project Semicolon, a mental health nonprofit organization, committed suicide.

While statistics show that men die by suicide 3.53 times more often than women, a 2016 article by The Guardian found that suicide amongst women is on the rise. As women, we have a natural tendency to take on extra work — whether it’s at home or at the office or at our places of worship or where our children may be concerned. Add those ingredients to the stresses of most startups failing and you potentially have a recipe for disaster.

When my father died I really needed some normalcy, or, I should say, I wanted to figure out what my new normal was going to be. My mother, who was still quite distraught over his death, couldn’t go long without bursting into tears. I remember being in the grocery store with her and my mother exploding into tears while handing the cashier money and sobbing, “My husband just died and I don’t know what I’m going to do.”

I was mortified because here was my mother bawling her eyes out at the register to this young, strange girl who had no idea what to say in return. I just wanted her to be strong. To be quiet. To not be so torn at the seams because it reminded me of this gaping hole in our lives. My mother couldn’t even get through a trip to the grocery store. How the hell were we going to get through life? I know now I was operating on my default which is to internalize it. Just push through, Natasha. My mother, which I didn’t understand at the time, was doing something far healthier. She was releasing all of that stress. She wasn’t internalizing all of that pain. I went back to school far sooner than I probably should have. I just wanted to get on with it. I could barely make it through an entire class. I always had to rush off to the bathroom to cry my eyes out and pull myself back together.

The things that bring us the most worry are often the things we have no control over. It can make you feel helpless, lost, even confused. Dawn and I acknowledge that there are some stresses we don’t share with each other as cofounders because you feel that voicing those concerns can make your business partner wonder if you’re not equipped to handle your role or that you’re close to crumbling. Which does what? Puts us back on that isolated entrepreneur island.

If we know that nine out of 10 startups fail, that means that the majority of founders are walking around with a sense of dread, fear of impending failure or unimaginable levels of stress. Let’s look out for each other. Instead of asking your fellow entrepreneur how things are going with their startup, maybe you might want to lead the conversation with: how are you doing? After all, we’re inventors, not invincible.

If you are someone you know is worried about their mental health, you can call the Substance Abuse and Mental Health Services Administration at 1-877-726-4727 to get general information on mental health and locate treatment services in your area.

About the author

Natasha Zena

Around age eight Natasha Zena was told it was a woman’s job to take care of the home and since then she has built a career out of telling women they can do whatever the hell they want to do. She is the co-founder of Lioness, the go-to news source for everything female entrepreneur. Natasha was recognized as an emerging leader in digital media by The Poynter Institute and the National Association of Black Journalists. She has mentored women entrepreneurs and moderated panels at a number of national accelerators, Startup Weekends and conferences such as The Lean Startup Conference, the Massachusetts Conference for Women, Women Empower Expo and Smart Cities Connect. Natasha is also the author of the popular whitepaper, "How To Close The Gender Gap In Startup Land By 2021." In her spare time, she writes short fiction and hangs out with her son, Shaun.


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