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The scream munch


CEOs need to manage their own mental health in times of crisis

Published 7 April 2022 in Management • 13 min read

Senior executives are under constant pressure, that’s not news. But two years of turmoil caused by the pandemic have pushed stress levels to breaking point. Here we examine the evidence and suggest ways to tackle the problem. 


The pressure on CEOs can have a significant impact on their mental health and wellbeing, according to global research. One paper on CEO health and corporate governance, for example, examined the mental health of CEOs in Sweden compared to that of the general population over a 15-year period. It found that in normal times, CEOs generally have better-than-average mental health – a point which is not surprising, according to Frederik Anseel, Professor of Management and Senior Deputy Dean (Research & Enterprise) at UNSW Business School. 

Researchers “found that there is a level of self-selection on the part of CEOs, as well as selection by boards …  you need to prove that you have resilience and that you’re tough before you are placed in these sorts of positions,” he said. “People who have struggled with mental health problems may sometimes refrain from applying for the real top-level jobs because they know the pressure is huge. And board members will look out for some signals that would indicate that somebody is not really fit for this type of role.”  

However, the study found that six per cent of CEOs sought medical consultation for anxiety and tension while three per cent sought medical assistance for depression. This was lower than in the average population but still quite substantial, according to Anseel. 

He highlighted another study, CEO Stress, Aging, and Death, which examined CEO mortality rates in the US and the impact of corporate crises on personal health and organizational performance. The study found that if a company went through a crisis which caused its share price to fall by 30% or more, CEO mortality rates increased and the aging process accelerated. “Through a very clever analysis they were able to show that the mortality rates of CEOs increase if the company goes through a serious crisis, while the CEO would on average age a year-and-a-half during that period,” he explained. 

The same researchers also used an AI algorithm to analyze pictures of the CEOs before and after serious crises: they looked 18 months older directly following the issue.  

“So, if we extrapolate those findings and apply them to what happened with COVID-19,” explains Anseel, “we remember what happened to the stock market and the V curve, right? If you’re the CEO of a company and your stock drops 20, 30, 40% and you’re responsible, the pressure and the stress are huge.” 

hand omming out of the water
Many CEOs have found it hard to keep their heads above water during the pandemic

CEOs, mental health and managing through COVID-19 

COVID-19 has challenged CEOs around the world in ways that were previously unthought of prior to 2020. CEOs were simply unprepared for the new levels of VUCA (volatility, uncertainty, complexity and ambiguity) brought on by the pandemic, and the safe reassurance of carefully planned business strategies could not be relied on in such conditions. And with COVID-19 still causing significant levels of disruption, uncertainty and geopolitical unrest, CEOs are not out of woods yet. 

“The mental health and wellbeing of CEOs is, I think, a bigger risk now than it’s ever been,” said Marina Go, former Head of Hearst Australia and now a board director of multiple local and international companies including 7-Eleven, Transurban, EnergyAustralia, and Adore Beauty. “2021 was a much tougher year than 2020 – and that was difficult enough. I have noticed more fatigue than we have seen previously among leaders of organizations,” she said. 

In the rush to look to minimize health risks to employees, Go said many CEOs forgot about the importance of self-care. “What I think happened with CEOs is they haven’t considered themselves. I liken it to the airlines when they say in the case of emergency, put on your own oxygen masks first before looking after others. And what we’ve seen with CEOs is in many cases they have not put the mask on themselves.” 

As a result, many CEOs were tired by the end of 2021 – so much so that boards had to actually direct them to take a break and look after themselves. “We got to the Christmas break last year, and some leaders were looking like they were about to break. This wasn’t an issue I had observed before, and it was more of a mental health issue than anything. We were increasingly concerned about this and it became a conversation around the table for some of the boards I sit on,” said Go. 

Merete Wedell-Wedellsborg, Adjunct Professor in Leadership at the Institute for Management Development (IMD), observes one thing that almost all CEOs have in common: they radiate energy, because they are driven to succeed. “They want to make a difference to their business and in the world. But during the pandemic, I have had hundreds of conversations with top leaders, and at some point in our conversation, so many of these highly charged leaders confessed they have had days where they felt really, really tired. Not just tired, but tired-to-the-bone: drained; exhausted, and barely able to go on,” she said. 

In every crisis people go through different phases, said Wedell-Wedellsborg: emergency, regression and recovery. When a trauma first becomes evident, what happens in the first phrase (emergency) is that energy rises and performance goes up. “That’s where we find our unknown reserves. And we saw it very clearly with most CEOs. They really stepped up. But then came a second phase. It’s called a regression phase, and it is a really tough phase for teams and leaders. It feels a bit like hitting a wall.” 

She recalls how many CEOs said performance and energy levels suddenly dropped and they had more conflicts. “Many of us felt more tired, bored or frustrated. And for some of my CEO clients that phase came as a bit of a surprise for them. They were really looking forward to a new year and a new beginning. And they didn’t understand why they felt so tired,” said Wedell-Wedellsborg, who is also a clinical psychologist and executive advisor with more than 20 years’ experience in working with CEOs and executive teams 

The third phase (recovery) is about seeing the light at the end of the tunnel: “you start to focus on the important growth questions: what is our future going to look like? What deep changes have come from the crises – personally and professionally?” Going through recovery has been very ambivalent for many CEOs, according to Wedell-Wedellsborg.  

Anseel also said the stress on CEOs has been significant from the outset of the pandemic, from the initial shock of stock markets around the world tanking (and subsequent impact on organizational share prices), through to the need to help and support employees through everything that has followed over the past two years. 

“It has been stressful for everyone in leadership positions, but the buck stops with the CEO, right?” said Anseel, who specializes in organizational psychology and works with executives around the world to improve leadership performance. 

Marina Go
“I liken it to the airlines when they say in the case of emergency, put on your own oxygen masks first before looking after others. And what we’ve seen with CEOs is in many cases they have not put the mask on themselves.”
- Marina Go, former head of Hearst Australia

Is a more resilient breed of CEO required? 

The kind of pressure many CEOs have been under over the past two years requires skills that may not have been necessary in the past. The first skill is the ability to manage uncertainty, their own and that of others, according to Anseel. If multiple influential stakeholders (think investors and boards of directors) are nervous, CEOs require the ability to help address the cause of their anxiety and tweak their communication towards those different audiences. This requires a very high level of emotional intelligence and, Anseel said, this “will be incredibly important to the future”. 

Another key skill for CEOs in the future relates to leading hybrid organizations. Anseel recalled a recent discussion he had with the CEO of a bank, who said: “Everything you’ve learned about leading in an analogue world and the old physical environment – if you think you can simply transpose what you’ve learned to the digital world, that will fail, that is impossible.” 

Anseel gave the example of managing mental health and wellbeing for a virtual workforce and said CEOs could no longer walk the floor to talk with employees and get a feel for their mental and emotional state. “Some CEOs have become very adept at virtual communications and have even learned how to make TikTok clips with quick, snappy, inspiring communications,” said Anseel. 

A related third skill required on the part of CEOs is a new openness and willingness to address mental health and wellbeing – both for themselves and within organizations. “They can create a safe environment for the rest of the company to show we are all struggling, and it is OK to struggle,” said Anseel. 

From a psychological point of view, Wedell-Wedellsborg has also noticed CEOs are expanding their capacity to be more adaptive, relational and vulnerable – and less prone to technical fixes when something is hard. “I have seen more mature and self-reflective leaders become the CEO over the past six months,” she said. “They try to surround themselves with talented people who can balance seemingly paradoxical leadership behaviors.”  

These CEOs also seek more feedback from their boards, HR, peers, employees, consultants and advisors. “They are not afraid to ask for help. They take ownership for their team’s behaviors, and they invest in building trust among team members focusing on maturing the team,” said Wedell-Wedellsborg.  

Instead of being driven by their ego, many CEOs are focused on what they can achieve together with others. Wedell-Wedellsborg recalled the example of a CEO she visited 10 years ago whose office was the smartest, most expensive and heavily decorated in all the company’s buildings. “Now I see CEOs who focus on their employees’ offices before their own, or CEOs in a much more conservative office,” she said. 

5 ways CEOs can take care of their mental health and wellbeing 

Merete Wedell-Wedellsborg offers practical steps for CEOs to improve their mental health and wellbeing: 

One way to improve your mental health is to show what you are going through. No one wants to be led by a “robot” CEO. You need to have deeper one-to-one conversations where you dare to share and ask questions. Not only: are you OK? But are you really OK? Sharing your own stories or even a “I had a terrible day” can go a long way toward normalising the conversation, showing employees that no-one is alone in struggling with these feelings.

The best performing leaders I see right now spend their time thinking and talking about what’s going to happen in a year from now. And they are super realistic about it. They don’t think of it as just going back to work and adopting old habits. They try to create new meaning and ask questions such as, what was the point of this crisis? What will we do if this happens again? What did we learn? How can we move faster next time? They look for a realistic sense of optimism and what should change. 

One of the best ways to help improve your mental health is to be generous towards others and give back. This has been proven repeatedly in research, and during the pandemic. I have seen many CEOs who invested heavily in society, climate or helping children.

A large global retailer I work for requested a psychological pandemic survival kit training for management, to help address the acute emotional needs, pressure and unforeseen stress in their organizations. Such kits are not a new concept, and the approach is used in NATO units and in large high security organizations where severe accidents can occur and where management need to be able to handle significant psychological reactions.

Allow yourself to focus on at least one daily activity that gives you pure joy and energy and remember to allow others space for theirs. Sometimes those sanctuaries are the first we give up under pressure. We consider them a luxury. Just when we need it the most, we stop doing it. Is it running, gardening, playing with your (pandemic) puppy or making homemade granola? I find that this question truly energizes CEOs and often they need to be reminded of this.

Implications from a Board perspective 

The events of the past two years have also caused board directors a fair share of anxiety, and as the organizational overseers, board directors have taken a stronger hands-on approach with CEOs through the pandemic. “For boards, it’s about best practice governance and good risk management,” says Go. “Boards are expected to proactively mitigate risk, and that’s what we need to do. If we get to the point where we’re code red with a CEO, and that’s because of something that we could have managed, then that’s our problem. And you should never get to that point. It’s avoidable.” 

Go is seeing the emergence of new KPIs in CEOs’ balanced scorecard reports as well as other metrics that are being monitored and measured at board level. 

“Physical safety has been a KPI for a very long time, but now the mental health and wellbeing of staff is featuring more prominently. Sexual harassment is creeping up into the reporting around safety too. Those kind of KPIs are the clearest way to tell an organization about what matters to the board,” she said. 

She recalls one of her clients (a board chairman) who said to his management team: “every decision we make we should evaluate through these three criteria: (1) are we doing the right thing for society? (2) are we keeping everyone safe? and (3) are we strengthening our business?” 

It is natural that board directors will want to take a more hands-on approach during a crisis, but there is a fine line in striking the right balance at the right time and “moving closer without meddling or interfering”, said Wedell-Wedellsborg.  


The mental health and wellbeing of CEOs is, I think, a bigger risk now than it’s ever been
- Marina Go, former head of Hearst Australia

CEOs have often been hired by executive search firms in the past, however, Anseel said companies needed to think more about how they developed their own leaders. “From a governance perspective, I think a lot of boards will start thinking about how they build a real, high-potential base of people internally who can be nurtured, mentored and developed – right up to the level of the CEO.”  

“This means more than having the right professional background and the right experiences. It incorporates questions around helping them in terms of mental health, wellbeing, giving them the right skills, what they eat, what exercise they do, and their sleep hygiene. Many top CEOs have personal coaches for health, diet and sleep – and these are often recommended or at least supported by the board.” 

Johnson & Johnson, for example, launched a “Premier Executive Leadership” program for its top executives in 2016. The program includes a tailored, proprietary two-and-a-half day health evaluation (with tests including bone density scans, abdominal ultrasounds and a pharmaco-genetics review) as well as comprehensive mental and emotional analyses of participants, who are supported by a team of exercise physiologists and registered dietitians. The nine-month programme was so successful that Johnson & Johnson made it available to external companies in 2017. 

Anseel also suggested boards needed to be more accommodating and open to CEO candidates who may have struggled with mental health problems in the past. “We need to be more open and supportive, recognizing that those people have had their problems in the past, but they have a better understanding of how to overcome these, too,” he said.

What CEOs can do to improve mental health in times of crisis 

In the wake of the pandemic, CEOs across all industries need to take a step back, reassess and take better care of themselves, according to Go. “If I refer back to that earlier flight scenario and the need to put your oxygen mask on first, you’re no good to anyone if you’re not breathing, right? That’s the advice boards are giving our CEOs: make sure you’re taking care of yourself,” she said. 

“That means you have to actually lead by example. If we want our people to be taking regular breaks to be more effective, turn the technology off. And if they’re working from home, that means that people potentially have access to the CEO 24/7. There needs to be a clear line for turning off. Of course, there might be urgent things you might have to respond as a CEO, but it is important to manage the expectations of your people. We’ve had to encourage our CEOs to set very clear boundaries for their staff.” 

It is also important for CEOs to ensure that they take breaks from work when required, and Go said some boards she sits on have told CEOs to take a couple of weeks off. “I’ve noticed that boards have become more directive towards a CEO in telling them to take a break, which is the complete opposite to conversations a decade ago when CEOs were expected to be always on. If anything positive comes out of this, I would hope it’s a realistic understanding of just how far you can push a person before they break. And if they are the best person to lead your company and they do break, then that puts the company in jeopardy – and your job as a board is to make sure that you don’t reach that point.” 


Merete Wedell-Wedellsborg

Merete Wedell-Wedellsborg

Adjunct Professor in Leadership at IMD

Dr. Merete Wedell-Wedellsborg is a clinical psychologist who specializes in organizational psychology. As an executive advisor, she has more than two decades of experience developing executive teams and leaders, and she runs her own business psychology practice with industry-leading clients in Europe and the US in the financial, pharmaceutical, consumer products and defense sectors, as well as family offices. Merete is the author of the book Battle Mind: How to Navigate in Chaos and Perform Under Pressure.


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