Understanding Executives With Mental Health Disorders and Co-Occurring Addiction

Mental health disorders and addiction often go hand-in-hand, but their prevalence amongst executives may be particularly high due to the unique path co-occurrence takes for this population. Unfortunately, executives may also be especially likely to avoid treatment by hiding behind their success, keeping them from getting the help they need.

The story of stigma surrounding mental illness and addiction is well-known—those struggling are pushed toward the edges of society, where they suffer in isolation. And that story is sometimes true. Another cultural favorite is the romantic mythology of the afflicted artist whose writing, music, art are fuelled by illness and substances that drive them deeper into the emotional realm which then finds expression at the end of their pen, their fingers, their brush. Edvard Munch, an alcoholic and long suspected of suffering from bipolar disorder, once wrote, “Without anxiety and illness, I am a ship without a rudder … my sufferings are part of myself and my art. They are indistinguishable to me, and their destruction would destroy my art.” These stories imbue mental illness and addiction with an almost alchemistic quality, transmuting the ordinary flesh of man into a vessel for genius.

But there is another story, one not often told, about one who struggles with mental health disorders and addiction, and that is the story of the executive. In recent years, destigmatization efforts and rising public awareness have spurred journalists to cover the success stories of executives thriving in spite or even because of their mental illnesses. Headlines like Genius in Madness? 72% of Entrepreneurs Affected by Mental Health Conditions and articles attributing Richard Branson’s illustrious career to his ADHD do indeed chip away at the false notion that mental illness is antithetical to business acumen. However, they also threaten to create a new and damaging version of the tortured artist myth, valorizing psychological suffering or, perhaps more accurately, ignoring that suffering to recast damaging symptomatology as virtue.

It is not that the symptoms of some mental illnesses cannot be strengths. They can, they often are, and it would do us a great disservice to ignore the multifaceted nature of psychiatric disorders. But the diagnostic criteria of mental illnesses all share one thing in common: they cause distress and loss of normal function. And many executives cope with that distress by turning to drugs or alcohol, resulting in co-occurring disorders that push you deeper into danger.

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The Prevalence of Co-Occurrence

Mental illness and addiction go hand in hand for people from all walks of life. According to the Centre for Mental Health and Addiction, “at least 20% of people with a mental illness have a co-occurring substance abuse problem” and “more than 15% of people with a substance abuse problem have a co-occurring mental illness.” Depending on the specific type of mental illness in question, those rates can be significantly higher; the Epidemiologic Catchment Area Survey found that 47% of people with schizophrenia and 61% of people with bipolar disorder also have a substance abuse disorder. The exact reasons for these high rates of co-occurrence are not fully understood, but the medical establishment recognizes that substance abuse often arises as a form of self-medication.

The Path to Co-Occurrence For Executives

Although there are no studies yet specifically focused on the prevalence of executives with mental illness and co-occurring addiction, clinicians believe that executives as a group may be particularly prone to psychological distress and self-medication for both lifestyle and personality reasons. At the most basic level, a busy work schedule with poor work-life balance can leave little room for basic self-care activities such as exercise, good nutrition, forging meaningful personal relationships, and simply relaxing, which in turn can compound pre-existing emotional distress and leave you vulnerable to substance abuse. Taking a pill, having a drink, snorting a line is fast and easy, much more so than carving out meaningful space for self-care.

But there is also a more deeply-rooted and less easily solved reason for the high rate of co-occurrence: you are used to being in control. Rather than turn to outside sources of help, such as psychiatrists, therapists, or even family and friends, you believe you can manage your own emotional and behavioral turbulence. After all, it’s what you do best. “Many executives and professionals spend their entire work lives devoted to managing: managing work, managing resources, managing people, managing information, even managing thoughts, feelings, and behaviors,” write O’Connell and Bevvino in their book, Managing Your Recovery from Addiction: A Guide for Executives, Senior Managers, and Other Professionals. And so you believe you can control your mental illness—and when you find your drug of choice, you believe you can control your drug use, too. And for a while, perhaps you can.

Hiding Suffering Behind Success

One of the reasons executives with mental health disorders and co-occurring addiction often enter treatment quite late in the game is that you are often more successful than most in denying your own struggle. When your work is the central focus in your life, it is easy to measure your own stability and even your self-worth by your professional success—if you’re getting it done at work, things must be okay. Shortcomings and conflicts in your personal life (which may be stretched thin to begin with) can be easily explained away and your high professional standing taken as proof that you are fine, even thriving. “It is a well-known fact that with most executives and professionals, job performance is usually the last area of life to be affected by the deleterious impact of [mental illness and] addiction,” write O’Connell and Bevvino. “This continued feeling of ‘power’ in the workplace reinforced our denial.”

Just as importantly, those around you may be more likely to stay in denial themselves. With your tailored suit, your Italian leather shoes, your professional accolades, your educational pedigree, you do not look like someone with mental illness or addiction either to yourself or the outside world. Even when things begin to crack, your colleagues and your loved ones may have a vested interest in keeping your struggle hidden, both for their own protection and your own. Your secretary makes excuses for your absences, your wife tells herself you’re just stressed out, your peers cover for you at the big meeting when you’re coming down, when you’re in the midst of depression, when you’re high. Others depend on the illusion of your stability, emotionally, financially, organizationally. And you do too, for your self-worth, your identity, your economic security, and your sense of place in the world.

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Getting the Help You Need

Staying afloat professionally when you’re struggling with mental illness and addiction is a tricky game and, eventually, you lose. Self-medication may temporarily satiate you, but it never resolves the underlying condition you are trying to ease, and soon your substance use pairs with your mental illness to create deeper suffering for both you and those around you. The longer you keep yourself from getting the help you need to recover, the further you fall into emotional and behavioral danger and the harder it will be to come back. In the end, your intelligence, your work ethic, your professional success cannot protect you from phenomena that are larger than yourself.

But you are not alone. Although you are used to self-sufficiency and self-reliance, recovering from mental illness and addiction requires the support of a community of expert clinicians and compassionate peers who can guide you toward healing with compassion and dignity.

Residential addiction treatment programs catering to executives and other high-level professionals provide an ideal setting in which to begin your recovery process. With experience treating co-occurring mental health disorders addiction in executives, these programs understand the unique barriers to treatment executives face and the special needs you may have during your time in treatment. By designing individual treatment plans to meet your personal and professional needs via empirically-based therapies and tailored structuring, executive recovery programs offer the very best in psychiatric and addiction medicine in a way that is meaningful to you. In the company of like-minded peers and expert clinicians, you can break through the isolation and secrecy that so often surround mental illness and addiction to find camaraderie, community, and solace as you replace damaging patterns with healthy coping skills.

There is never any shame in admitting you need help. Just as you seek out the most talented colleagues to help your business flourish, so too can you seek out the most comprehensive treatment programs to nurture yourself and set yourself up for the best chance of success. In recovery, you can open the door to new possibilities both personally and professionally, gain real control of your life, and find expression for your most authentic self.

Bridges to Recovery offers comprehensive treatment for those struggling with mental health disorders as well as co-occurring substance abuse disorders. Contact us to learn more about our innovative program and how we can help you or your loved one start on the journey toward a more stable, fulfilling life.

Image Source: Unsplash user Matthew Henry