Trouble at the Top

While C-suite leaders may have reached the pinnacle of their careers, they also are shouldering immense mental and emotional pressure. With 50% of executives reporting high stress and an alarming rise in burnout, we asked mental health experts and career coaches for advice on how to support leaders at the top.

Just because you’ve made it to the C-suite doesn’t mean you’ve made it. On paper, a CEO or leader’s role might be the pinnacle of their career, but mentally, executives often struggle. They are under enormous pressure from shareholders and boards, they are responsible for the livelihood of their workforce, they are often buoyed by the tides of the economy, and their work-life balance often suffers greatly in this world of 24-7 business decisions. In fact, 50% of top executives experience significant stress levels, and 1 in 5 rank that stress as high or extreme, according to Harvard Business Review. 

In a world where executives are often called upon to champion their workers’ mental health, their own is neglected. “In 2023, a record number of CEOs left their positions,” writes Julian Haynes II in Forbes, “with a sobering statistic revealing that 19 CEOs tragically passed away while in office. The relentless demands of the C-suite are breeding exhaustion and stress, with 75% of C-suite executives seriously considering quitting their jobs for better well-being support, according to a Deloitte and Worplace Intelligence survey” Haynes goes on to point out that CEOs are working an average of 62.5 hours per week, a number that isn’t likely to decline.

So how do we help our leaders today and in the future? We reached out to Georgetown alumni working in the mental health field and as career coaches to offer some words of wisdom to our not-always fearless leaders.

Rewrite Your Story: Prerika Agarwal (MBA’13), Founder, Inspiration Careers, Podcast Host, Design Your Career

Prerika Agarwal says she always felt out of place growing up. Having come to the United States from India at the age of three, she sought validation through academics and saw great successes on paper—she quickly became a star student. She was able to ride on those accomplishments, including earning her MBA, and thought that she was on her way to corporate career success and a happy life. But a failed engagement left her contemplating her decisions and her purpose. 

“I embarked on a journey of self-discovery, challenging the ingrained mentality of overworking for success,” says Agarwal, “I shifted my mindset to feeling an abundance of time and to recognizing that success is not measured just by external accomplishments but from holistic fulfillment from many areas of your life.”

Today as the podcast host of Careers by Design and a consulting executive, Agarwal finds herself in the position of the coaches she leaned on in difficult times. Her goal is to help professionals, from mid-career to executive, find both a successful career and a healthy mind. “As a coach, I work with high-achieving professionals who, on paper, have everything they worked for,” she says, “but inside, they’re exhausted, disconnected, and wondering if this pace is sustainable.”

Here, Agarwal, a motivational speaker, coach, and advocate for personal growth, shares a few insights that she offers her clients.

Boundaries are a leadership skill:  Leaders who struggle to set boundaries burn out faster and create the same toxic culture for their teams. If you answer emails at 10 p.m., your team will too. Decide when you’re off, communicate it, and hold that line. Telling your team to prioritize well-being means nothing if you don’t. 

Don’t wait for time to reset—build it in. Leaders need to schedule micro-breaks, when they step away from their desks, and create true mental pauses. You wouldn’t run a marathon without water stops, so why are you treating work that way? Step away for 10 minutes, go outside, grab coffee, breathe. Small resets keep you from hitting a wall.

Bring joy back into work—it changes everything. High performers don’t just need a paycheck—they need purpose. The executives who reconnect with what excites them about their work show up better for their teams and themselves. When was the last time you laughed at work? Find moments of connection—whether it’s celebrating wins, mentoring, or doing the parts of your job that excite you. If everything feels like a grind, it’s time to recalibrate.

Have a Safe Space to Talk: Whether it’s coaching, therapy, or a trusted peer, find a space where you can be real about stress. You need it just as much as your team does.

Change the Conversation: The leaders who thrive won’t just manage stress—they’ll change how leadership works. The CEOs of the future will be measured not just on performance, but on how well they lead their people—including themselves, which brings us to one last important point: The best leaders aren’t the ones who run themselves into the ground—they’re the ones who set the tone for a sustainable, high-impact career.

The Leadership Rollercoaster: Anita Hossain Choudhry (B’07), Founder, The Grand

Anita Hossain Choudhry’s goal in launching The Grand was to make the world feel a little less lonely. Isolation, she knows from experience, is detrimental to anyone in any position, but can feel most intense at the top where leaders are faced with a constant stream of high-stakes decisions, unexpected challenges, and a persistent undercurrent of uncertainty. Through all of that, they are expected to lead, remain calm and objective, and guide others on their own career paths. 

“We saw how transformative this group coaching model is because it helps people feel less lonely in their journeys as they were supported by a group of peers who really get it,” Hossain Choudhry told Forbes in 2021, just two years after launching her company. The phrase “it’s lonely at the top” is often repeated, but what does it actually mean?

A friend once asked Hossain Choudhry what had surprised her most about being a founder—especially given her background in venture capital and executive coaching. Her response? “I knew there would be high highs and low lows. I just didn’t realize how quickly they’d cycle. You can feel on top of the world one moment, and 15 minutes later, a dreaded email can make you question everything.”

Managing the emotional rollercoaster of leadership isn’t just about resilience—it’s about being intentional in navigating the ups and downs. The Grand’s model revolves around group coaching and community, helping members find confidantes who are navigating similar transitions, from starting companies, being promoted to manager, or becoming a new parent returning to work and more. The future they envision is one where no one has to walk through work or life alone and can understand their strengths to become the best version of themselves. Here are three key strategies that have helped Hossain Choudhry and the leaders in The Grand’s community stay grounded.

Find a Peer Group: One of the most powerful ways to combat isolation is to connect with peers who truly understand the journey. A dedicated peer group provides a space to exhale, gain fresh perspectives, and remember that no leader is alone in their struggles. My founder peer group is invaluable—especially when I was fundraising while pregnant with my second baby. Their support helped me build self-trust in a season of intense uncertainty. I also learned a crucial lesson: Sometimes, the fear of failure creates the conditions for failure. Having peers who challenge that mindset can make all the difference.

Adopt a Reflective Practice: Research shows that 70% of learning comes from reflecting on experiences. Yet, in the fast-paced world of entrepreneurship, leaders rarely carve out time to pause and process. Building a reflective practice is essential. Whether through journaling, guided frameworks like The Grand Retro – an assessment of wellbeing across eight different dimensions—or simply taking a beat after key moments, intentional reflection helps leaders extract lessons and course-correct in real time.

Use Vulnerability as a Superpower: It’s tempting for leaders to put up walls—to protect their teams, their investors, and even themselves. But real strength comes from vulnerability. This doesn’t mean oversharing, but rather setting the tone for open, honest conversations about stress, burnout, and well-being. At The Grand, this has become a core part of our human-first culture, helping leaders build deeper trust within their teams and communities. One simple but powerful tool The Grand uses is Red, Yellow, Green Check-ins: Red – Physically present but mentally elsewhere. Yellow – Engaged but with something lingering on the mind. Green – Fully present and focused. This practice allows teams to acknowledge their emotional state without judgment and fosters a culture of understanding and support.

The Quest for Peace of Mind: Korin Torrence (EMBA’18), Founder, Torrence Strategies, Podcast Host, The Soulful Circuit Podcast

As the Founder of Torrence Strategies, a consulting firm specializing in AI and digital strategy for the public and private sectors, and host of The Soulful Circuit Podcast, a series that delves into the connections between technology, spirituality, wellness and personal growth, Korin Torrence has worked with organizations tackling pressing issues like mental health. One of the most impactful projects she has helped cultivate is URaWARRIOR, a mental health app dedicated to ensuring individuals never feel alone. Through strategy and change management consulting, the app team analyzed mental health struggles across higher education, nonprofits, corporate organizations, and healthcare. “The findings were clear—suicide rates and mental health challenges are rising, fueled by social media pressures, increasing isolation, and heavier workloads with fewer resources,” says Torrence. “Without accessible, stigma-free solutions, these issues will only escalate, making it critical for organizations to prioritize mental well-being at every level.” 

This is tough for any leader, but women often feel these pressures acutely. Sixty-nine percent of C-suite leaders report significant work-related stress, and over half face burnout (Forbes, 2023). Women are disproportionately affected—69% of mental health-related leaves in 2023 were taken by women, with Millennial women accounting for one-third (Deloitte, 2023).

As a woman of color in leadership, these challenges are even more pronounced. Women of color hold only 5% of senior executive roles in the United States. (McKinsey, 2023). “All of this means we’re often the only one in the room, navigating bias, higher performance expectations, and a lack of representation,” she says.

Here Torrence, a leader herself, discusses the particular challenges facing women leaders—and what we can do about them in the quest for peace of mind.

Seek Balance, Not Blending: Women leaders often adopt work-life blending, in other words, work infiltrates their home life and vice versa—and this is a far cry from work-life balance. Working moms and executives often juggle the demands of leadership with the responsibilities of their families, leaving them feeling like there’s never enough time for either. The weight of this dual responsibility (often felt by women in households, though it can be true for men, too) creates a persistent feeling of guilt and unrealistic expectations. The result? Exhaustion. So throw away the idea of blending your worlds together and truly look for balance. It helps to turn the computer off at a certain hour each day, avoid checking emails and messages until a certain time each morning, and have plans in place for urgent matters that need your attention.

Identify the Barriers and Help Break Them: Long hours and the pressure to over perform have only intensified, with over 50% of women reporting higher stress than the previous year (McKinsey, 2023). Yet only 25% of women feel comfortable discussing their mental health at work (Deloitte, 2023). And for many women of color, the “Only” experience—being one of the few in leadership—can feel isolating and mentally exhausting, requiring an additional level of resilience just to navigate professional spaces. But here’s the good part: Executives have pressure, but they also have power. Addressing representation gaps is critical,  fostering a culture where female executives—and everyone who works for them—where female leaders and workers can thrive rather than constantly prove themselves.

Can’t Change Your Life? Change the Culture. As leaders, we can be the key to an organization’s acknowledgement and normalization of mental health challenges for executives—and everyone who works for them. Creating workplace flexibility—through remote work options and autonomy—allows executives to balance professional and personal responsibilities more effectively. Investing in digital mental wellness tools, like URaWARRIOR, provides stigma-free and proactive mental health support, ensuring that executives don’t have to suffer in silence.

Make Sure Women are in the Conversation: As a woman of color, a leader, and a mom actively juggling both worlds, I know firsthand that the mental health conversation must include executive women, especially those balancing multiple roles and breaking barriers in business. Prioritizing our well-being isn’t a luxury—it’s a necessity for sustainable leadership, thriving businesses, healthier families, and the future of the workplace. As women leaders, we have a duty to create a culture that helps everyone in our organization thrive—and hopefully our male counterparts can look around the table, notice if we are absent or alone, and bring us into the conversations at the highest level.

Wealth Health: Sheila Walsh, CFP® (MBA’08), Walsh Wealth and Wellness

C-Suite execs are used to managing an organization’s cash flow and financial statements. They forecast, they visualize the future they want to build, they know big expenses need to be planned, and they build in a margin of error. They know to keep spending low and revenue high and manage liabilities. But do they apply these same principles in their personal life? Not always, says Sheila Walsh, a CERTIFIED FINANCIAL PLANNER™ professional and owner of Walsh Wealth and Wellness. When your job is to be the face of an organization and manage all of its financial ups and downs, it can feel like more work to look at your personal finances and make smart decisions for your future and future generations. Walsh works with clients to help them identify skills and strategies they use in their everyday lives and roles that can then be used in managing personal finances. “Our physical, mental, emotional, and financial health are intertwined,” says Walsh. “While many of us prioritize eating healthy and going to the gym as part of our self-care, our financial wellness is often overlooked.” 

Here are Walsh’s top tips for executives and their personal balance sheet: 

What Does Your Future Look Like? C-suite execs visualize the future of their companies and brainstorm big ideas. Do they similarly take time to visualize their future? This can be especially helpful when individuals are feeling anxious about their money, overwhelmed, have been ignoring their personal finances, etc., because it helps lower the barriers to actually taking the steps needed to address their personal finances. You need clarity on your money goals and what it will take to achieve them. Then you need a plan to get there, and commitment to check on the plan routinely so you can adjust as needed.

Exercise Your Values: I take a values-based approach to financial wellness. Trusts, wills, medical proxies are often put off as something ‘I’ll get done in the future.’ Yet if you have core values of family, health, independence and you haven’t created or updated important documents, you might have a misalignment.

Plan a Financial Get Away: Book yourself a Financial Wellness Meeting every month. Protect this time on your calendar. Use it for anything related to your personal finances—from getting your credit report to researching prices for a desired purchase, to locating your password to finally update your beneficiaries on your retirement plans. If you have a partner that you share finances with, consider a money date. I have one CMO client that has a money retreat 2x a year with her husband where they go somewhere (outside their home), talk money, and then do something fun together.

This story was originally featured in the Georgetown Business Spring 2025 Magazine. Download the Georgetown Business Audio app to listen to the stories and other bonus content.