The Executive Mental Health Crisis: What Are We Going To Do About It?

The corner office has never been lonelier, or more dangerous to mental health.

While organisations invest billions in leadership development, executive mental health has reached crisis levels. This isn't anecdotal. The data from global research institutions and consultancies paints a concerning picture of the psychological toll of senior leadership.

The Scale of the Problem

Deloitte's Executive Wellbeing Survey, conducted in partnership with Workplace Intelligence (2022), surveyed 2,100 employees and C-level executives across four countries: the United States, United Kingdom, Canada, and Australia. 

The findings are stark: nearly 70% of C-suite leaders are seriously considering leaving their roles for a job that better supports their wellbeing. More than three-quarters (76%) reported the pandemic had negatively affected their wellbeing. And critically, a significant proportion reported their work was taking a measurable toll on their physical health. Stress-related conditions including cardiovascular issues, chronic pain, and sleep disorders are becoming normalised aspects of executive life.

The McKinsey Health Institute's (2023) global survey of more than 30,000 employees across 30 countries confirmed that senior leaders and managers are not protected from burnout by virtue of their power or autonomy. Approximately one in five employees globally reported experiencing burnout symptoms. Those in more demanding roles consistently report higher rates. 

The survey found that workplace demands, rather than individual resilience deficits, are the primary driver of burnout. Toxic workplace behaviour was the single strongest predictor of burnout symptoms across all 30 countries surveyed, accounting for more than 60% of the total variance, a finding with profound implications for how organisations develop and support their leaders.

The DDI Global Leadership Forecast (2023), which surveyed nearly 14,000 leaders across more than 1,500 organisations, found that signs of burnout among leaders increased 60% since 2020. Only 40% of leaders rated their organisation as having high-quality leaders, and just 12% of organisations reported a strong leadership bench, thought to be in part because high-potential leaders are burning out before they can step into senior roles.

The Performance Paradox

The very traits that propel individuals into leadership roles, high achievement orientation, perfectionism, GRIT, and the capacity to suppress emotional responses under pressure, become liabilities once executives arrive in those roles. We often recruit leaders into senior executive positions because of their admirable ability to exceed performance expectations, then wonder why things fall apart over time.

Anonymous harassment and bullying complaints. Failed promotions and burnout. Boardroom dysfunction. Redundancy. High-stakes conflicts, peer rivalries, final warnings, team mutiny. I see this every day. This is what happens to dysregulated elite executives when we expect them to excel without adequate leadership, or well-being support.

PwC's Global Workforce Hopes and Fears Survey 2023, drawing on nearly 54,000 respondents across 46 countries, found that more than one in five workers reported their workload was frequently unmanageable, a figure likely to be higher among those in leadership roles managing both their own pressures and those of their teams. Their 2024 survey of 56,000 workers across 50 countries confirmed the pattern: 45% reported increased workloads in the past 12 months, and 62% said they had experienced more workplace change than in the prior year.

Research (Tehan et al, 2012) also demonstrates that major life stressors such as grief, divorce, serious illness, when unprocessed in leaders, do not stay compartmentalised. The suppression of stress and grief, initially adaptive for maintaining performance, eventually undermines the cognitive and emotional capacities required for effective leadership.

What the research surfaces repeatedly is what might be called a satisfaction-exhaustion paradox: leaders can simultaneously report high job satisfaction and high burnout. Many have normalised dysfunction, losing the ability to distinguish between sustainable high performance and unsustainable overextension.

The Neuroscience of Executive Burnout

Neuroscience has made significant contributions to understanding how chronic executive stress literally rewires the brain. The foundational work of Amy Arnsten at Yale University, published in Nature Reviews Neuroscience in 2009 and extensively built upon since, demonstrates that even mild acute uncontrollable stress can cause a rapid and dramatic loss of prefrontal cognitive abilities, and that more prolonged stress exposure causes architectural changes in prefrontal dendrites. A subsequent 2021 review by Woo and colleagues in ASN Neuro confirmed that chronic exposure to uncontrollable stress causes measurable loss of spines and dendrites in the prefrontal cortex.

The prefrontal cortex is responsible for precisely the capacities most critical for leadership: strategic thinking, emotional regulation, perspective-taking, and sound decision-making. Under chronic stress, high levels of catecholamine and cortisol release shift the brain from reflective, prefrontal-regulated functioning to a more reactive, reflexive state. This is advantageous in acute danger, but deeply problematic when leading organisations, managing people, and making decisions that affect thousands of lives.

At the same time, the amygdala's threat-detection system becomes hyperactive. Leaders operating under sustained stress are, neurologically, not the same leaders their organisations recruited.

The HeartMath Institute, whose research programme began in 1991, has developed an extensive body of work on psychophysiological coherence including the alignment between heart rate variability, emotional state, and cognitive function. Their research, including a landmark 1995 study published in the American Journal of Cardiology, demonstrates that chronic stress creates measurably disrupted coherence patterns that impair decision-making and cognitive performance. Their work further shows that the heart's electromagnetic field extends beyond the body and can be registered by others nearby. This suggests these disrupted states create ripple effects throughout teams and organisations.

The Organisational Cost

The financial implications are substantial. Stewart et al.'s 2003 research published in the Journal of the American Medical Association calculated that depression costs US employers $44 billion annually in lost productivity. More recent estimates are significantly higher: Greenberg et al. (2010) estimated employer costs at $43 billion, and

Gallup's 2022 research estimated that missed work alone from poor mental health costs the US economy $47.6 billion annually, with total productivity losses far exceeding this.

Gallup's State of the Global Workplace 2023 report found that low engagement and poor wellbeing among leaders costs the global economy $8.8 trillion annually, 9% of global GDP. Their longitudinal data demonstrates that manager engagement drives approximately 70% of the variance in team engagement levels, making leader wellbeing a critical organisational risk factor, not a personal one.

The World Health Organization's classification of burnout as an 'occupational phenomenon' in the ICD-11, announced on May 28, 2019, provided important formal recognition. Their definition identified three dimensions: energy depletion or exhaustion; increased mental distance from one's job, or feelings of cynicism; and reduced professional efficacy. The cost is significant. 

The WHO estimates depression and anxiety alone cost the global economy $1 trillion annually in lost productivity, with 12 billion working days lost each year. For leaders, where the consequences of impaired functioning cascade across entire organisations, the stakes are disproportionately high.

The neuroscience cited above makes this concrete in a way that should alarm every board. Leaders operating under chronic stress are functioning with measurably impaired prefrontal cortex function, the same region governing the strategic thinking, risk assessment, and relational judgment on which their organisations depend. We are running major institutions on cognitively compromised leadership and calling it high performance.

The Help-Seeking Gap

Despite these alarming patterns, support-seeking remains rare. The DDI Global Leadership Forecast 2023 found signs of burnout increasing 60% since 2020, and yet the cultural infrastructure that would enable leaders to seek help has not kept pace.

Wang et al.'s research, published across major peer-reviewed studies including the 2004 Health Services Research paper and the 2007 WHO World Mental Health Survey Initiative spanning 76,012 respondents across 15 countries, found that people wait a median of 8–11 years from first symptoms of a mental health condition to seeking treatment. For depression specifically, studies consistently cite delays of 6–8 years. What happens to an organisation's decision-making, culture, and people when its most senior leaders wait this long?

This is the point at which I most often see my elite executive clients: the end of the line. They have either to resign, or to completely transform to save their role, their relationships, and often themselves.

The Path Forward

The research is unequivocal: executive mental health is in crisis, and traditional leadership development approaches are insufficient. 

Organisations cannot develop leaders who are neurologically compromised by chronic stress. You cannot teach emotional intelligence to someone whose prefrontal cortex is under sustained cortisol suppression. You cannot resolve executive crises through values workshops, or competency frameworks.

Stressed executives need calm nervous systems to begin the journey back to emotional, mental, and relational health, the foundation upon which sustained high-performance leadership is built.

It is time we stop ticking leadership development boxes, and focus on bringing back the human beings that live inside every executive home to themselves. There is a great deal on the line for all of us if we don't.

About the Author

Caryn Cridland is a business psychologist, lawyer, and mediator who transforms Fortune 500 executives' career-defining crises into conscious leadership breakthroughs through her proprietary Executive Evolution System.™ With two decades specializing in high-stakes workplace conflicts and leadership development, four degrees in psychology and law, she helps "brilliant exceeders" evolve from intellectual dominance to conscious leadership.

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Key Research Sources

Arnsten, A.F.T. (2009). Stress signalling pathways that impair prefrontal cortex structure and function. Nature Reviews Neuroscience, 10(6), 410–422.

DDI. (2023). Global Leadership Forecast 2023. Development Dimensions International.

Deloitte & Workplace Intelligence. (2022). Workplace well-being: C-suite and employee wellbeing survey. Deloitte Insights. Published June 22, 2022.

Gallup. (2022). The economic cost of poor employee mental health. Gallup Workplace.

Gallup. (2023). State of the Global Workplace 2023 Report. Gallup Press.

HeartMath Institute. (1995). The effects of emotions on short-term power spectrum analysis of heart rate variability. American Journal of Cardiology, 76(14), 1089–1093.

McKinsey Health Institute. (2023). Reframing employee health: Moving beyond burnout to holistic health. McKinsey & Company. Published November 2, 2023.

PwC. (2023). Global Workforce Hopes and Fears Survey 2023. PricewaterhouseCoopers. Published June 20, 2023.

PwC. (2024). Global Workforce Hopes and Fears Survey 2024. PricewaterhouseCoopers. Published June 25, 2024.

Stewart, W.F., et al. (2003). Cost of lost productive work time among US workers with depression. JAMA, 289(23), 3135–3144.

Tehan, M., & Thompson, N. (2012–2013). Loss and grief in the workplace: The challenge of leadership. Omega: Journal of Death and Dying, 66(3), 265–280.

Wang, P.S., et al. (2004). Delays in initial treatment contact after first onset of a mental disorder. Health Services Research, 39(2), 393–415.

Wang, P.S., et al. (2007). Use of mental health services for anxiety, mood, and substance disorders in 17 countries. The Lancet, 370(9590), 841–850.

World Health Organization. (2019). Burn-out an 'occupational phenomenon': International Classification of Diseases. WHO. Published May 28, 2019.

World Health Organization. (2022). Mental health at work. WHO Fact Sheet.

Woo, E., et al. (2021). Chronic stress weakens connectivity in the prefrontal cortex: Architectural and molecular changes. ASN Neuro, 13.