Many highly successful individuals, including executives, entrepreneurs, and professionals, often face significant mental health challenges despite outward appearances of achievement and resilience, according to Dr. Darren Lee, a psychiatrist and acting medical superintendent at South Pacific Private, a mental health treatment center.
Dr. Lee highlights that while these individuals may seem to manage life effectively, their accomplishments can mask deeper issues such as depression, substance use, and emotional exhaustion. He presents the case of a woman, referred to as Holly, in her early 40s who sought help after years of depressive symptoms and increasing reliance on alcohol. Holly held a demanding executive role and was known for her strong work ethic and ambition, yet she was struggling privately with fatigue, insomnia, sadness, and numbness.
Despite her distress, Holly found work to be the environment where she still felt energized, often working 12-hour days and using busy schedules as a way to avoid confronting difficult emotions. According to Dr. Lee, Holly’s story is reflective of a broader pattern where characteristics like ambition, perfectionism, and relentless productivity serve as coping mechanisms rather than purely positive traits.
Early life experiences can play a role in this dynamic. In therapy, Holly’s childhood emerged as a period marked by unpredictability, which fostered intense self-reliance and a drive for success linked to self-esteem. For some, the pressure to continually achieve can become intertwined with emotional survival. Without the structure of constant goals and deadlines, unresolved feelings such as sadness and worthlessness may surface, creating discomfort that can perpetuate the cycle of overwork or other maladaptive behaviors like substance use.
Dr. Lee explains that society often rewards the behaviors that contribute to these struggles, such as working late hours or taking on additional projects, making it difficult to identify when ambition turns into a harmful need. He emphasizes that ambition itself is not inherently problematic—rather, it’s when achievement becomes a necessity for self-worth that risks arise.
Treatment for individuals like Holly involves addressing both the symptoms, such as depression and substance use, and the underlying factors driving relentless productivity. Therapy may explore questions related to resting without guilt, failing without self-judgment, and valuing oneself beyond accomplishments. For Holly, developing the ability to sit with her emotions and creating space away from constant achievement helped her rebuild a sense of identity separate from her professional success.
Dr. Lee concludes that many adaptive behaviors formed to cope with adversity can become deeply ingrained and obscure underlying trauma. The therapeutic challenge is not necessarily to eliminate these behaviors but to understand their origins and regain a more balanced sense of self beyond them.