All Leaders Have Anxiety. Here’s How the Best Ones Deal With It

On the HBO series Silicon Valley, startup CEO Richard Hendricks vomits a lot. He throws up in a trashcan after fielding an acquisition offer from a predatory competitor, and again when asked to deliver an inspirational speech before 50 hostile programmers.

After one such episode, Hendricks visits a health clinic. “It was just a garden-variety panic attack,” the doctor tells him. “Welcome to Silicon Valley. We see people like you all the time.”

It’s no surprise that anxiety is common among the entrepreneurially gifted, says Sarah Wilson, author of the book First, We Make the Beast Beautiful: A New Journey Through Anxiety. “It comes down to brain function: their ability to think beyond straight data and to hyper-connect,” Wilson says. People with high levels of anxiety “are able to think very broadly across multiple ideas all at once, which lends itself, obviously, to creating a business.”

Wilson, 44, is herself an entrepreneur, having recently closed her six-year-old wellness site, (Wilson says the 20-employee business was profitable but she left because the prospect of scaling turned her off.) Diagnosed with anxiety at age 12, she has struggled for decades with obsessive-compulsive disorder, bipolar disorder, and depression. At the same time, she forged an impressive career that included stints as the editor of the Australian edition of Cosmopolitan and host of MasterChef Australia.

The book was born from Wilson’s realization that anxiety wasn’t water dousing her fire but instead the kindling that fuels it. Rather than leave her cowering under a bed, her disorders propelled Wilson to act: boldly, sometimes even dangerously. She says it was the disorder that drove her to speak before audiences of thousands and take solitary overnight hikes through the woods. “It was all completely tolerable compared to the fretting and anxiety–the shit I make up in my head,” she says. “A lot of people with anxiety disorders extend themselves into what others would call stressful situations. They have to touch the flame.”

That is true, she says, for many entrepreneurs, who find inaction agonizing. An obsession with the future, which sufferers fear, also predisposes the anxious for startup life. Entrepreneurs “are constantly over-attending to things that might happen,” Wilson says. “They see what is ahead.”

But if anxiety can incite entrepreneurs, it can also complicate some core responsibilities of leadership. Wilson offers four suggestions for taming the beast.

1. Limit your choices.

Decisions are especially draining for anxious people, who can be paralyzed by choice. “If you overtax the decision-making part of your brain, you can trigger anxiety,” Wilson says. “And if you are anxious, you find it nigh impossible to make decisions.” The problem is compounded because trivial decisions may stress anxious people as much as weighty ones. 

Sinking “certainty anchors” throughout the day–always wearing the same style of suit, for example, or ordering the same lunch–“prevents you from wearing out that part of the brain so you don’t get decision fatigue,” Wilson says. For business decisions, she recommends asking staff to present you with a problem and three possible solutions. “Artificially narrow it as much as possible,” she says.

2. Don’t freak them out.

Wilson compares anxiety to walking through life with a bowl full of water, trying not to slosh it on yourself or the people you care about. Those people include employees, who may be shaken or demoralized at the sight of a fearful leader.

If you can’t communicate to the troops with at least a veneer of calm, let someone else do the honors. “Anxious entrepreneurs, if they are smart, will employ a CEO or someone else to handle it,” Wilson says. Even one-on-one communication can be difficult. “When your anxiety is super bad and you have descended into a spiral of cascading thoughts, sometimes you can’t even get a word out,” she adds. In those circumstances, she advises getting away for a day or so to refocus and regroup. Walking is a good remedy as well: “It calms the anxious part of the brain.” 

3. Rename it.

Anxiety is very similar to excitement, Wilson says. They both evoke the same biological response of arousal. Anxiety sufferers can choose to interpret that response any way they like. So if you are getting the shakes before a presentation, “you say, ‘I am probably anxious. But I’m going to choose to see this as excitement,'” she suggests. “If you simply say the words, ‘I am excited,’ then you will be.”

4. Have an exit strategy.

Wilson advises setting a trigger–for example, a specific level of financial security–that tells you when to sell or close down the business. Otherwise, she says, “your ideation is such that you can keep going and going until you find yourself in a dead end.”