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The CEO Suicides: The Rise of Financial Post-Traumatic Stress Disorder

The financial crisis didn't just cripple. It killed.

Ed Note: This story originally ran in the April 2009 issue of Best Life.

In the early morning hours of January 5, Steven Good, age 52, husband, father of three sons, and head of one of the nation's largest real-estate auction firms, took his red Jaguar for a spin. The car was warm and well insulated from the cold air outside. This was suburban Chicago, after all, the first week of 2009, and the temperature was in the teens. Good paid attention to his route that morning. He couldn't use the home-to-office autopilot he normally would on any other workday morning, because this wasn't going to be just any other morning. Instead of heading south from his home in Highland Park to his office in Chicago, he headed west into Kane County. When he reached his destination, the Max McGraw Wildlife Refuge near Elgin, the parking lot was deserted. Peaceful. He put the car in park and shut it off.

The next stretch of time is a mystery. Perhaps he waited for the first ghost of winter light to come up, taking time to consider the ramifications of his plan. Perhaps he didn't wait at all, knowing that hesitation might deter him. But at some point on that wintry morning, this hypersuccessful, well-respected real-estate broker, attorney, author, and family man hauled a rifle over to the driver's seat, cocked it, positioned it in the only effective way you can in a car, and shot himself. A maintenance worker discovered his body at 8:20 a.m. that day.

Why did Good do it? No one knows. He left no note. What we do know: The real-estate market nationwide has been a soul crusher. And while we hear bad news every day on all things financial, a new trend has emerged that is almost impossible to believe: Some of the wealthiest men in the world, successful in everything they've ever done, are choosing to take their own lives.

The same week Good shot himself, billionaire Adolf Merckle, number 94 on the Forbes list of wealthiest people, committed suicide by stepping in front of a train. On December 23, 2008, financier Rene-Thierry Magon de la Villehuchet took some sleeping pills and slashed his wrists with a box cutter at his desk in New York. He had reportedly lost more than $1 billion of his investors' money—and millions of his family's—to Bernard Madoff's Ponzi scheme. Wall Streeters were abuzz about two other recent suicides: one a 27-year-old stockbroker with two children, the other a 50-year-old hedge-fund manager and father.

This downturn, or recession, or depression—or whatever historians will call it when it's over—hasn't just crippled, it has killed. It has given us a new phenomenon that can be called financial post-traumatic stress disorder, and the condition is indeed that serious. "It's a good term because it accurately describes the aftermath of a first-time catastrophic experience," says psychologist Leslie Mayer, PhD, a senior fellow at the Wharton School of Business and the founder of the Mayer Leadership Group, an executive-coaching firm. "Financial loss can trigger feelings of self-loathing, profound shame, shattered dreams, and worthlessness. In the case of successful, highly driven businesspeople, this is magnified by the fact that the trauma ties not only to a core fear, but also to a core piece of their identity. Tough and smart in business does not necessarily apply to managing one's own emotions. It might even be argued that the same quality that created success—a sharp focus on winning—is the quality that interferes most with adapting to failure."

"The trauma is very real," says certified financial planner Thomas C. Scott, CEO of Scott Wealth Management in Orange County, California. "I've seen my clients lose money, and my own pension has been cut in half. You spend 20 years on a path of achievement and you have a sense of accomplishment. That becomes a part of you. To see it evaporate in the blink of an eye is shocking. There's a sense of betrayal, like everything you've been working on your whole life has been a joke."

How much have you lost? How much value has evaporated from your home, your retirement accounts, your children's college funds? Everyone has lost something. But how well equipped are you, emotionally, for managing that loss? Successful men aren't used to losing. Not like this. And when you're one of the more successful men—one of the guys programmed to win—an eviscerating loss is the equivalent of an ego amputation with no anesthesia. Some really believe there is no better answer than the business end of a gun, a few pills and a box cutter, or a punctual train. In their minds, like George Bailey in It's a Wonderful Life, they're worth more dead than alive. What's left for the rest of us who aren't so tragic with our coping methods?

This: A new way to approach not just stress, but also the deep, dark anxiety that comes with major losses in both cash and career.

When a Type-A takes a big hit

J.R. is a lot like you: Smart, driven, serious. Nothing was more important to him than success in his career. He worked hard and nailed that sweet gig: CEO of a manufacturing corporation in San Diego. Even then, chronic success remained the goal. "I couldn't let down my board or my staff," he says. "I couldn't let down my family. I just couldn't fail."

Yet that's exactly what it felt like to the 54-year-old father of three when he was removed from his post several years ago.

"So much of my self-worth was tied to my position," he recalls. "I plunged into depression. It was as if I had a weight tied to my feet and it was pulling me under. I contemplated suicide."

Even after J.R. secured a new position as the president of a company he had always dreamed of leading, his depression didn't lift. He was irritable, and his negative mood ate away at his relationships at work and at home. His wife pleaded for weeks before he agreed to see a psychiatrist at the Executive Mental Health Program at the University of California at San Diego Medical Center, which caters exclusively to professionals in key corporate roles.

"Due to long hours and excessive stress, a corner-suite executive is more vulnerable to anxiety, sleep disorders, weight change, substance abuse, depression. . .you name it," says Mounir Soliman, MD, clinical service chief of the UCSD department of psychiatry and the director of the program. "For one, an executive has more responsibility and more to lose. Two: He believes he's immune. And three: He's too busy or too frightened to seek help."

Although the stigma surrounding mental illness is lifting, many men still believe that depression or anxiety signifies weakness, says Dr. Soliman. "Our goal is to be preventive and proactive—in a highly confidential setting—and to help executives develop a safety net of behaviors that will empower them to deal with stress before it turns into chronic anxiety or depression."

The economic downturn has been a boon for Dr. Soliman and the four-year-old center. The clinic is part of a nationwide trend toward providing custom-designed health assessments and treatments for stressed-out execs who don't have the time (or inclination) to take better care of their mental and physical health. Many of the clinics offered at places such as the Mayo Clinic, the Duke Center for Living, the Cleveland Clinic, and Canyon Ranch deliver a host of medical services, including advanced blood work, vascular and full-body scans, stress-management courses, and executive coaching. But the Executive Mental Health Program at UCSD is unique in that in addition to these health assessments, they focus on proactive psychological wellness.

There's clearly a need for such a facility. High-profile suicides aside, last year's Vistage CEO Confidence Index, a survey of almost 2,400 top executives, found that 50 percent of executives reported feeling more stress in 2008 than they did in the previous year. The financial crisis has also caused a surge in mental-health cases, according to the American Psychiatric Association, and calls to the National Suicide Prevention Hotline went from 412,768 in 2007 to 540,041 in 2008. The phrase "suicide methods" recently hit a multiyear high on Google Trends, which tracks how often words or phrases have been searched on Google. Any sudden catastrophic failure or humiliation through foreclosure or economic loss can leave people feeling desperate, profoundly depressed, and unable to see a way out, according to Robert Simon, MD, a member of the APA's Workgroup on Suicidal Behaviors. While the current economic turmoil is certainly a factor, a lot of stress-related disorders simply come with the high-pressure territory of The Big Job.

A new way to take back control

Like someone suffering from depression, the Executive Mental Health Program hides in plain sight in a nondescript professional park in the San Diego suburb of La Jolla. It's nestled between a Mexican restaurant called El Torito Grill and, believe it or not, the Rock Bottom Brewery. Clients enter through one door and leave through a separate, anonymous exit to ensure confidentiality.

During the first visit, a client meets with a team of integrative physicians, therapists, and nutritionists in one room to expedite the comprehensive assessment process and avoid duplication of information. Execs seem to appreciate the efficiency of the all-at-once approach and the boardroom setting, says Dr. Soliman, as it appeals to the CEO mentality of "let's get it done." After the meeting and assessment interviews are complete, a personalized holistic program is crafted, combining Western medicine with nontraditional approaches. This means you might find yourself in appointments with acupuncturists, massage therapists, and healers as well as Harvard-trained internists, psychiatrists, and psychotherapists. Depending upon the results of your assessment, you may be screened for hormonal imbalances and vitamin deficiencies. If you need pharmaceutical help, doctors will prescribe antidepressant and antianxiety drugs, but never without exploring natural treatments that target the root of the problem, such as talk therapy, nutritional approaches, energy medicine modalities such as Reiki, and meditation practice to build up your chi. The center can also arrange executive coaching to develop conflict-management skills and rehearse better ways of interacting with subordinates.

"We look at the whole person and say 'Let's find out what is making you feel this way,' because it may be a number of components," says Roya Kohani, MD, a board-certified internist trained in integrative medicine at the center and an associate professor of medicine at UCSD School of Medicine. A molecular biologist by training, Dr. Kohani earned her medical degree at Harvard, and then spent eight years working with integrative-medicine guru Andrew Weil, MD. "Depression and anxiety are only symptoms of other problems," she says. "Our purpose is to identify imbalances that are piling up, both physical and lifestyle imbalances, and then empower your body's innate healing capabilities." A typical individualized program at the center lasts five days over the course of five weeks, with a 90-minute one-on-one session once a week, plus phone follow-ups and additional workshops. For out-of-town patients, the initial program is completed over five full days.

Interest in such an integrative approach to stress-based health issues versus strict psychopharmacology is a growing movement that is being fueled by both the financial crisis and advances in neuroscience that are revealing why type-A personalities are more sensitive to stress, says psychiatrist Gabriela Cora, founder of the Executive Health and Wealth Institute, a similar program in Miami. "The current health-care paradigm doesn't address the real issues of stress," she says. Antianxiety pills are just a temporary fix. "The root of the problem is usually a misalignment of the personal and organizational life. That's what keeps you up at night. And that requires prioritization, organizational planning, a repositioning of everything that people are doing in their lives."

Another useful weapon: Look at new research to figure out why these misalignments set us up for so much heavy anxiety in the first place.

Understanding the new science of stress

You've probably heard along the way that there is good stress (the kind that motivates you) and bad stress (the kind that paralyzes you). The trick is to know the difference. "The CEO type tends to be very good at using stress productively to excel and achieve," says Dr. Soliman, "but there's a point at which stress overwhelms and becomes destructive. It's a fine line." Dr. Soliman says that by being aware of how and why your brain processes fear, you may be able to manage stress before it crosses that fine line and becomes an illness.

"We need to reframe how we look at anxiety. It's not something to run away from, but something that can be used as productive energy," says Robert Rosen, PhD, author of Just Enough Anxiety: The Hidden Driver of Business Success. Rosen has interviewed and consulted with hundreds of top CEOs in the past 20 years. He cites an unchallenged scientific truth: "Fear is the body's way of preparing for action."

But why is it that some men consume this fear as fuel while others are simply consumed? New research offers some clues. According to the latest brain science, highly successful type-A executives are at an increased risk for stress-induced health problems, especially when their status or control is threatened. Last year, cognition researchers at the National Institute of Mental Health identified, for the first time, parts of the brain that are activated when a person moves up or down in the pecking order.

In the study, 72 participants played an interactive computer game in which they competed for money and social status; while they played, their brains were monitored using functional MRI scanners. When a player performed worse than an "inferior" and risked losing status, the brain circuitry that is known to process intense emotional pain and frustration showed high activity. "People who like being in the top position had the highest activation, suggesting that it hurt them a lot more to lose," says Caroline Zink, PhD, a research fellow at NIMH. "This kind of response in the emotional-pain circuitry may mean a greater risk for stress in high achievers."

Man confronts modern-day threats—financial ruin, job termination—with a fear response that is more appropriate for living in the Pleistocene epoch. In other words, when HR requests an unexpected appointment for tomorrow morning, your body reacts as if a large, hungry animal is sniffing around your cave door.

For all those nebulous fears waking you up in the middle of the night (neurologically, we evolved to be sensitive to fear at night because that's when bad things happened to our ancestors), you can thank your amygdala. Stemming from the Greek word for almond, this pair of nut-shaped structures resides on each side of your brain. The amygdala is a vault for your emotional memory and a central station for triggering physiological responses to fear (neuro docs call it the brain's Department of Homeland Security). It evolved to help animals survive in hostile environments, explains New York University neuroscientist Joseph LeDoux, PhD, a pioneer of amygdala research and the author of The Emotional Brain.

The amygdala reacts with the speed of a trip wire to a perceived threat, whether it's the sudden bark of an angry dog or your emaciated 401(k) statement landing in your mailbox. This complex structure and its neural connections at the center of the limbic brain commandeer every part of your gray matter to deal with a crisis. One of those areas is the hypothalamus, which secretes hormones that activate the body's emergency-response substance, which triggers the fight-or-flight reaction. This activates the nervous system: Blood rushes to the large muscles of the limbs to prepare for flight, pupils dilate, and heart rate and respiration accelerate. Neurotransmitters such as dopamine flood the brain to rivet your attention on the source of the fear. "The things that make rats and people afraid are very different," says LeDoux, "but the way the brain deals with danger appears to be similar."

While sharp-toothed stress dissipates when the dog reaches the end of its chain, fear of losing a company or the security of a job creates chronic worry, triggering chemical changes in the brain and affecting the entire body: the heart, the immune system, the gastrointestinal tract, and your sleep patterns. Surges in the stress hormones adrenaline and cortisol can affect reasoning and cognition and paralyze the mind's critical abilities. Short-term memory, creativity, and planning functions evaporate from the stressed human brain. With their primal fear response turned on indefinitely, some men reach for a fifth of bourbon or sink into chronic anxiety or depression. About 50 percent of mental problems are anxiety disorders, and many of those are related to the brain's fear system, says LeDoux.

As Dr. Soliman says—and instructs at the Executive Mental Health Program—understanding how this process works is the first defense against it. Still, as a success-oriented male, an even more important weapon is understanding this: Admitting that you are negatively affected by stress is not a failure. Nor is asking for help.

Pursue results. . .like you always do

The now-familiar pock! sound echoes across the court as a well-struck tennis ball lands inside the line. This one is a winner, but not all of J.R.'s shots are, nor does he win every game, every set, every match. Tennis has become one of his many antidepressants. The hunger for victory is still there, of course, but now he has a realistic appreciation of defeat when it happens. Our stressed and depressed CEO learned how to rewire his approach to life after six months of therapy at the Executive Mental Health Program. His treatment began with a prescription for a literal antidepressant medication. It was a crucial first step. "It allowed me to clear my head of obsessive thoughts so I could understand where I was making bad judgments," he says

Dr. Kohani also prescribed nutritional supplements and DHEA, a precursor to the male hormone testosterone, because she found that J.R. suffered from low testosterone levels. (How would any man know this is a problem unless he finally asks a doctor for help?) And he credits daily meditation with helping him become more conscious of himself and his relationships with his wife and teenage kids.

J.R. has also reassessed his career motivation and regularly leaves the office in the early evening. The tennis, the meditation, and the family time are all new additions to his schedule. And guess what? He's still successful. Yet he is no longer a candidate for taking a tragic detour through a wildlife preserve on his way to work. "Don't allow your self-worth to be tied completely to your job," advises J.R. "If I learned anything from this experience, it's that I'm not perfect and neither is anyone else. I don't try to control the world anymore."

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Jeff Csatari
Jeff Csatari, a contributing writer for Eat This, Not That!, is responsible for editing Galvanized Media books and magazines and for advising journalism students through the Zinczenko New Media Center at Moravian University in Bethlehem, PA. Read more
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