I recently lost a friend to suicide.
When I got the word, I was shocked. My friend was a charismatic executive who had led major organizations and inspired people wherever he worked. Only months before his death he spoke with enthusiasm about his family and new projects around the world. While long ago he’d confided that he’d struggled with lifelong anxiety, nothing in that conversation hinted at how heavy his internal world had become. Nothing outwardly suggested collapse. Yet behind achievement lived a private weight I will never fully understand.
My friend is not the only top leader I know who died by suicide or who succumbed to health issues from a high-stress existence. I keep asking myself, “When leaders are responsible for so much, where do they turn when it all seems too heavy?”
Leadership is widely associated with influence, visibility and accomplishment. In reality, it also creates exposure to pressure, scrutiny and isolation. Senior leaders make decisions that shape livelihoods, reputations and financial futures. They manage uncertainty while being expected to project certainty. They absorb criticism privately and deliver reassurance publicly. Many hesitate to reveal doubt because they fear it will erode confidence in their leadership.
The higher the role, the fewer people you can speak honestly to. Decisions affect livelihoods. Failures feel personal. Vulnerability feels dangerous. Leaders at the top can feel isolated and lonely even when surrounded by their teams and families. And when position or status becomes identity, the pressure becomes intensely personal.
Research shows the experience of leadership stress is common rather than exceptional. In the Harvard Business Review article, “CEOs Often Feel Lonely. Here’s How They Can Cope,” authors Alaric Bourgoin, Sarah L. Wright, Jean-François Harvey and Saouré Kouamé describe findings of their study of more than 100 CEOs. They found loneliness stems from responsibility and decision authority rather than social isolation. One executive explained, “You have to find new solutions to keep moving, and you’re all alone in this, because you’re the one who has to make the decision.” Twenty-five percent reported frequent loneliness and over half described significant episodic loneliness, yet many minimized it because they felt pressure to appear composed.
The emotional cost matters far beyond the individual leader. The World Health Organization reports that depression and anxiety lead to roughly 12 billion lost working days each year and nearly $1 trillion in global economic losses. Leadership well-being influences culture, productivity and stability throughout organizations. Even when the most senior people struggle silently, the effects are there in subtle (or not so subtle) ways, which cascade downward through teams and performance.
Executives also face elevated clinical risk. Research from the Journal of Occupational Health Psychology cited in a McLean Hospital article shows about 26% of executives report symptoms consistent with depression, higher than the general workforce. In the McLean article, psychiatrist Amy Gagliardi observes that many high-performing professionals avoid seeking help because they associate vulnerability with weakness. Concerns about confidentiality, reputation and perceived competence often delay intervention until stress becomes severe.
This silence is reinforced by organizational expectations. Leaders are encouraged to support employees’ well-being yet rarely receive structured emotional support themselves. The World Health Organization’s “Mental health at work: policy brief” indicates that when managers demonstrate empathy and openness, 84% of employees report strong psychological safety. Culture flows from leadership behavior, which means leaders must be able to practice the same openness they are asked to encourage in others.
The HBR research emphasizes that leaders perform better when they cultivate support networks, seek feedback and share challenges rather than carrying them alone. Peer groups and trusted advisers provide perspective and emotional grounding. Reflection and self-care improve judgment under pressure. These practices strengthen leadership capacity because complex decisions require mental clarity and clarity depends on emotional stability.
My friend’s death left grief and unanswered questions, but it also clarified responsibility. Organizations frequently invest in strategy, governance and risk management while overlooking the psychological sustainability of the people guiding those systems. A culture that quietly rewards exhaustion and isolation increases danger for individuals and organizations alike.
Senior leaders should feel permission to pursue therapy, coaching, peer counseling and honest conversation without reputational cost. Boards and stakeholders can reinforce this by treating mental health as a component of governance rather than a personal matter. Colleagues can normalize discussion about stress and decision burden. These actions strengthen leadership effectiveness and organizational resilience simultaneously.
Leadership requires judgment, accountability and continuous adaptation. Human capacity for those tasks depends on support, recovery and trust. When leaders have safe spaces to speak openly, they make clearer decisions and create healthier cultures.
I think often about my friend and how capable he was of guiding others while quietly carrying his own weight. Eventually, that weight was too much. His loss reminds me that responsibility runs in both directions. Organizations have to make support visible and safe, and leaders have to step toward it before the pressure becomes silence. Reaching out should be understood as part of leadership, not a failure of it.
My hope, shaped by loss, is that more leaders will seek help early and that workplaces will make that choice easier to make.
