Ask HN: Is startup PTSD real and possible?

88 points by howtowin ↗ HN
To you individually, do you believe startup PTSD is real and possible?

Do you yourself - or someone you know and/or love - have it?

I ask this as a young person who has had both success and failure in tech entrepreneurship, with particular moments from the hardships causing severe negative emotional reactions and ultimately (at least temporarily) debilitating me from accomplishing things effectively, if at all.

I’d really like to treat this like any problem in my life: acknowledge it, understand it, take responsibility for it, and work to improve it, but struggle to find authoritative related resources.

P.S. I wrote this via my phone while sitting on my couch in silence on a Friday evening pondering this. My apologies for any spelling or grammar errors.

86 comments

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I had to shut down a company and lay off a dozen people, losing most of my savings and several years work. Friends have experienced much worse.

These might not compare to the worst horrors of war, but they rank among life's agonies with getting divorced, or losing a parent. They can cause something like PTSD. It can take months or years to be ready to try something big again, and some people never bounce back.

Most people who haven't experienced that kind of failure can't appreciate how much it hurts. So it's worth seeking out people who have gone through big failures to commiserate with. There are lots of them out there. Few will post details online, because it's sensitive stuff that involves other people. So you have to talk 1-on-1.

> They can cause something like PTSD.

I believe that OP was asking about actual PTSD, which is thing with a specific definition and diagnostic criteria.

Stress caused by trauma is by definition post-traumatic stress. It is commonly associated with war, car crashes or other violence but bear in mind that trauma is fairly subjective.
Yes, but to be a disorder it has to meet specific criteria.
Specific criteria set out by the DSM, the most recent version of which is essentially a checklist of symptoms for doctors to classify mental health on behalf of insurance companies for billing and labeling purposes. As a layperson, undiagnosed and untreated for any 'mental illness', and in my personal opinion, every new edition of this 'psychologists bible' demonstrates to me the entire point is quickly getting lost, and serves a different master than the wellbeing of patients. Its confirmation bias for my decision to go into technology rather than psychology, so take this with a grain of salt.
Not so. Traumatic events can cause an acute stress disorder that begins immediately after the event, while post-traumatic stress disorder by definition has a latency of at least six months.
All disorders are just labels trying to encompass the complexity of the entire human brain at every level. If you hear stories from people diagnosed with something and you're surprised by how much you relate to it, then you're surprised by how much you relate to it and can empathize on some level depending on how it impacted you and the person whose story you're comparing to. Or maybe you strongly relate but reject diagnosis for some reason. Maybe you feel you have a strong reason for this that isn't easy for others to understand, and maybe that's correct.
Eh, sorta? Clinicians take those "labels" seriously; they're more than a mere shorthand for the psychological experience(s) of an individual.
Some critics say psychological labels are invented, not discovered.

The medical model of the human brain is good for billing insurance companies and standardizing clinician behavior i suppose but not necessarily an objective reality.

Words ≠ reality...you don't say?
Laypeople word policing psychological terms on the internet is a weird rabbit hole if you buy the criticism the terms are arbitrary to begin with and don't really refer to reality.
What is reality?
That which is irreplaceable, I'd conjecture.
> don't really refer to reality

The terms refer to an abstracted and coarse version of reality. They don't have zero utility, even if the criticisms are fitting.

Guy tells an interesting story from his own experience and this dude wants to quibble about specific definitions and diagnostic criteria, this is the pedantry HN is famous for.
Going to have to disagree with you. There is a significant difference between going through something that really sucks, and being traumatized. Based on the information presented thus far, OP is going through the former.
>There is a significant difference between going through something that really sucks, and being traumatized. Based on the information presented thus far, OP is going through the former.

Yeah losing all your savings working on shit that didn't matter in the end while wasting years of your life isn't traumatizing at all. Glad you cleared that up for them.

At what point does it become traumatizing? After a person in that circumstance falls into one hellish layer of depression after another and decides to finally end it?

There is a specific set of objective diagnostic criteria for PTSD.

Nobody is saying that those experiences aren't traumatic or stressful. What we're saying is that Post Traumatic Stress Disorder is a specific thing with a specific definition, distinct from "the set of all people who have experienced trauma as the result of stress".

https://www.brainline.org/article/dsm-5-criteria-ptsd

>Nobody is saying that those experiences aren't traumatic ...

The person I was replying to was saying exactly that. The fact there's a specific diagnostic criteria wasn't relevant.

That said, you may find C-PTSD of interest:

https://www.ptsd.va.gov/professional/treat/essentials/comple...

I should have said it sounds like it could suck very much to the point of being traumatic, but not the level of trauma experienced by those who suffer from PTSD.
My apologies for coming off harsh, your prior comment struck a chord. I'll try to explain:

If you take even a cursory glance at C-PTSD, you'll see a lot of it has to do with the stress of being trapped in extreme circumstance, with highly deleterious or even catastrophic mental health effects resulting from that prolonged stress.

You wouldn't tell a POW or concentration camp survivor that their trauma was less than that of a combat veteran or shooting victim, would you? Of course not.

Consider failed startups can sometimes lead to homelessness, which is both very trapping and extremely stressful. Sometimes deadly.

Point being: if the trauma ultimately enlists the same physiological and emotional mechanisms in ripping apart the human mind, then attempting to become an arbiter of trauma severity is really besides the point, if not poor taste.

Personally, I've experienced events that satisfy Criterion A of the DSM-V PTSD diagnostic criteria. Think dealing with an enraged, manic family member with a loaded rifle. Being on the receiving end of domestic violence. Threats of sexual violence against loved ones. That level of bad.

While the effects of those events easily satisfied the remainder of diagnostic criteria at the time and lasted quite a while, they pale in comparison to the chronic effects of choosing to pursue a startup and what that did to my mental health.

Are you qualified to evaluate this persons anecdote from a diagnostic perspective?

I’m curious, since you’re a pedant about diagnostic criteria, I’m surprised that a qualified individual would make such a determination from a brief HN post.

You'll note I made no such determination for or against.
Those are entirely subjective and you can't tell someone what makes them traumatized
Not even the most orthodox clinician claims that PTSD is a binary thing. It's a label for a continuum of experiences, and you can diagnose it if it affects daily life enough to benefit from treatment.

The purpose of labeling disorders, whether it's PTSD, autism, or depression, is to be able to learn from related experiences. It's useful to talk about founders having post-traumatic stress because you can apply lessons learned from larger groups like soldiers and ER surgeons, both of which have large organizations studying their mental health, unlike startup founders.

Labels also cause problems. People reject labels because they feel they are so unique that no other human experience could possibly shed light upon their own. They may be right about some intellectual aspect of themselves, but people's emotional systems are pretty darn similar.

PTSD is a continuum and is not something that is clearly defined. The trouble that people get in is when they try to compare or apply hierarchy to trauma; eg: x > y where x, y are traumatic experiences. The whole activity seems rather pointless unless you're somehow trying to figure out what to treat first. That line of thought is fair when dealing with one individual with multiple traumas but when applied to a broader group it incentivizes downplaying and dehumanization. We used to do this a lot in the veteran community but I think folks have gravitated away from it.
Very real and have experienced it. There is a lot of privilege in running a startup, even a failed one, and few people who have gone through it. So finding help is hard because many people won't be sympathetic and nearly nobody will understand your trauma unless they have also run a startup.

There should be more startup mental health groups, or awareness, or something.

End of a startup can also end friendships and relationships and financial security and all of those things together can happen at the same time and honestly be very traumatic.

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Yes, absolutely. Any traumatic situation or event can cause PTSD. I don’t think it’s in doubt that some people find their startup experience to be traumatic in some way.
The categories were made for man, not man for the categories (as a wise man once said). If you can improve your lot without hurting someone else you should do it. The name of the problem doesn't matter if you have a solution available.
Any harrowing experience can cause PTSD. Usually time makes the feeling fade and understanding what specifically caused the stress during trying circumstances and avoiding or controlling those situations prevents them from occurring again.

I suggest you slow down and write cause, effect and solution for everything that seems to be circling repeatedly in your mind when your mind wanders. I also suggest taking a hike or few.

Healthy living, effective analysis, and time is a fix for most problems.

Fade yes. But it can be Shocking how something fairly minor will happen and instantly your back in the middle of your worst possible nightmare.
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Having recently been affected by the end of an Intent-based networking startup, I can tell you it is a very emotional thing. I feel like part of me has died and my belief in the industry’s future state shaken. I learned that many people I had trusted were complicit in the failure and that hurts as well. We had money but a complete lack of leadership. I saw people that I felt were true believers like me change overnight.

It was hard to accept the fact that your friends/coworkers will sell you out so quickly, and that no matter how bright the future looks, a stupid founder can ruin the whole thing in an instant.

I can only stress for the future: never get unquestionably-attached to a venture, colleagues, or a leadership pyramid. It's not a baby or a puppy, it's a configured paper organism commodity. True believers are also a BIG red flag: they lack perspective, assertive feedback, and creative debate.
Business without a net at the hemorrhaging edge is like war is like life. Been homeless, went bankrupt, and just idled a bit, for a while.

It's better to look at it as a game and an experiment. If someone gets too in-love with their "baby," emotionally or identity/ego, then they won't be able to pivot, chop it up, exit, or strangle it.

Take a break, get a job, go on a coke bender, sleep with 3 affiliates of VCs, become a Twitch DJ, vlog from India, sell windmills, have a kid, whatever it takes to get back to making a living or trying to make livings. It can be difficult to unfuck your shit after a big loss, do whatever physical or emotional labor is necessary to get back to an even keel. Psychological and/or pharmacological assistance could be needed for some people.

What a wonderful list of mind opening activities for the burnt out.

Time off helps and is difficult to take for the chronically obsessed.

Chose your obsessions carefully and learn how to let go.

All of that is fine except the have a kid part. Don't bring a person into the world with the thought that he/she will motivate you to unfuck your shit.
It is definitely real! Making big life changes for anything -- whether it be a startup, marriage, or new job -- can bring extreme highs and lows.

The most effective thing for me was confiding in supportive friends. I noticed I stopped thinking about it when I traveled far from the people/places that reminded me of it. Getting invested in new projects also helped.

Feel free to email me if you want to talk about it!

The aftermath of trauma is real. If you can tackle it on your own, great. If not, therapy can help teach you how to cope. Good luck!
Life is trauma. The more we take on the more punches we take. Let us not let our ambitions be weapons against ourselves. Leadership takes wisdom based on experience and learning.

The adrenals are the alarm, and the thyroid is the gas pedal. Trauma can offset both.

But yes, life and work is tough unless we have balance and willingness to grow from pain.

Keep breathing deep and take ashwagandha.

These times are more rough than most recent histories.

Sending love.

> Life is trauma.

Life is not trauma. As my cat says.

> ashwagandha

Can you elaborate?

It's an over the counter supplement that's purportedly anti-anxiety and sleep-promoting.
No.
Says the guy who raised 10s of millions of venture capital, used that to build himself up, pissed the company down the drain, and is now selling a fake story about his great successes. Yeah, startup PTSD doesn't apply to you because you don't care for anyone besides yourself. People like you are just making it worse.
"Most people who haven't experienced that kind of failure can't appreciate how much it hurts." - tld. Yeah, most people who are not in startups think you just got a bad quarter or launched an underwhelming project. They have no idea. Talking to other founders helps a lot though. You think you are alone, but then turns out your mind wasn't all that f--up at all, comparing to some others. Cheer up, you will eventually put it behind you, maybe.
Never heard that phrase, but your description sounds like burnout. You may have better luck researching it as such.
If you'd like to talk with other folks who've been there:

#PTSDChat on Twitter - Every Wed 9pm EDT since 2014

Disregarding the clinical definition of PTSD as I'm not qualified to diagnose, I will answer a slightly different question:

"Is _career trauma_ real and possible?"

Yes, absolutely.

I had an experience early in my career where I was working with a partner who was toxic, and over months and months I became more and more stressed out, and eventually I ended up having health problems. I finally had to end the partnership, and my health improved significantly -- but I was deeply burned out for a while, it took a long time to get all the way back to productivity.

So yeah, trauma in your work life is very real, it happens to many people, and it's difficult to recover from. But life does get better, and you can recover!

Definitely consider counseling if you aren't getting it already. A professional counselor can be a very big help to your mental health - and remember that in knowledge work our mental health is our vocational bread and butter, so it's worth investing in :)

How is someone else’s negative reaction to your business a “trauma”?
That's not what the post is claiming.
Trauma comes in many forms. Of course it is real and possible.
That depends if you mean PTSD in a clinical sense, or PTSD in the pop-culture-phrase sense. And also, you're asking a yes/no question, but it's probably better to ask "how likely is it". There are a lot of humans in existence, so a whole lot of really unlikely things are technically possible just by the laws of big numbers.

In the pop culture sense, PTSD is basically just residual stress/anxiety from some negative event that happened in the past. Burnout, or even generalized anxiety disorder with work-related triggers... these are all totally legitimate things that have a very negative toll on quality of life, and that people conversationally might refer to as PTSD, but from a clinical standpoint, they aren't the same.

PTSD has very particular clinical diagnostic criteria [1]. If you read carefully, they're perfectly understandable. But I want to make some key points: in a clinical sense, the trauma referred to in "post-traumatic stress disorder" is explicitly and exclusively "actual or threatened death, serious injury, or sexual violence". That's it, end of list. Among other things, a PTSD diagnosis requires some kind of repeating, severe negative episode(s) -- night terrors, dissociative reactions, panic attacks, that kind of thing. It has to last more than a month, and it has to cause significant disturbance in your life. PTSD is a disorder, but it is almost always a qualifier for a disability, because it is extremely common that PTSD precludes your ability to live a normal life. PTSD, in the clinical sense, is something I would find extremely, exceedingly rare in any kind of business situation, startup or otherwise.

To be clear, I don't want to be relativizing either PTSD or burnout or anxiety disorders. I don't want to be comparing anything; I've yet to see anything productive come out competitions about who has the worse health problems, mental or otherwise. There are plenty of other very real conditions that can and very likely do result from the stressful environment of a startup, and they can be very serious, even leading to suicide, and I really don't want to trivialize that. But I want to make one thing clear: from a clinical standpoint, PTSD is a distinct entity with concrete characteristics. I've personally been dealing with pretty severe mental health issues my entire life, and I've also had friends with diagnosed PTSD, and to be completely honest, even though I doubt you meant anything by it, conflating the two feels deeply disrespectful to all of us.

[1] https://www.ncbi.nlm.nih.gov/books/NBK207191/box/part1_ch3.b...

> extremely, exceedingly rare

One caveat to this: I'm considering workplace sexual assault and harassment as out of scope in my comment. That is itself a really important topic, but I don't think it was in the spirit of OP's question.

> conflating the two feels deeply disrespectful to all of us.

During my startup time, my co-founder joined me and a colleague at an event after he came back from the airport and might have even drunk something at the event. The way back while he was driving he was fairly upset (like he was all the time during work) We had a car crash, I was hospitalized for 2 or 3 days.

That said, to quote an actual psychologist, trauma is when there is something you cannot talk about.

Anyways, I'm not a Psychologist.

Yes.

"Daily Active users" from silicon valley made me cry for days and call and message former early stage co-workers.

The best way to work around it for me, is to accept it, work through it in my head; and if I can identify biases that I am scared of in current work, to at least call them out as things that I have good/bad experience with but encourage my team to work them to instead have a fresh point of view. Some of my spiders include cofounder trust issues; and seeing them can trigger hours of remembering why I am better off.

I have been working on a game solo for the last while. It can be extremely rewarding and extremely stressful. If you decide to go back to your startup role, it can pay off to take some time completely off (a day? A month? Longer?) and then go back to things very slowly and gradually in a low stress way, until it becomes enjoyable and feels manageable again. I wish I could say something more helpful than that
It is real. And it’s been debilitating for me as well. I’m working through the process too, holding on to the hope to rise back to a steady normal state of sorts. On my good days, journaling, mediating, exercising, good diet, and fresh air / outdoor time help.
I will say the year 2020 into 2021 has not been very good for behavioral health. But PTSD is like so old right now. The girls don't want that. They really go for the diagnosis that is currently found in a virtual parade being promoted on a website. romaticised. encouraged. Now start up PTSD? I think that it not really what you are talking about. Sounds like you like it is commonly found and many professions ups and downs problems mistakes failures and during the resilient or you're not. And I know that you said that it's like maybe possibly hindering your performance? Find a mentor in your industry. Southwest might be a little bit rattled from this you know the stress of it but it's not a disorder. I mean I'm not saying your experience doesn't qualify to be stressful but I am saying I'm sorry that you're going through it and you need to find a way like she said to grow through it. And I don't really think you're going to find a libertarian source on startup besides maybe like a startup that writes content about start ups.