Burnout at the top is not the same problem as burnout further down the organization, and most of the advice fails for a structural reason: it assumes you can reduce your load. A senior leader usually cannot. The work is not delegable in the way the advice assumes, the identity is fused with the role, and the people who could help are the same people whose confidence you are managing.
This page sets out what the data actually says, what to rule out before doing anything else, and - honestly - where psychedelic-assisted work fits and where it does not.
Is this actually common, or does it just feel that way?
It is common and it is getting worse. In DDI’s Global Leadership Forecast 2025 - 10,796 leaders across 2,014 organizations in more than 50 countries - 71% of leaders reported a significant increase in stress since stepping into their current role, up from 63% in 2022. Of those, 54% were concerned about burnout and 40% had considered stepping away from leadership entirely to protect their well-being.
Is it burnout, or is it depression?
This is the first question, not a detail. They overlap, and the difference changes what helps. Burnout is tied to a context; depression travels with you into contexts you used to enjoy. If low mood, loss of pleasure, sleep disruption or hopelessness run across your whole life rather than only your work, treat that as a signal to get it assessed properly - and soon. These are not symptoms to sit with while you wait to see whether the next quarter is easier.
Being told it is depression does not rule out anything that follows on this page. Depression is, in fact, the condition psilocybin-assisted therapy has been studied in most. What it does mean is that the decision belongs with someone qualified to make it with you, rather than to a website.
What should I rule out before anything psychological?
Comprehensive bloodwork rather than a single marker. Exhaustion in a high-performing adult can sit on top of thyroid or hormonal dysfunction, nutritional and micronutrient deficiency, metabolic dysregulation, inflammatory markers, or impaired organ function - and sleep disorders and medication side effects belong in the same first pass. A meaningful share of what presents as burnout has a physiological contributor that is straightforward to identify and treat once someone looks for it. Doing psychological work on top of an untreated physiological problem is expensive and slow.
Does time off fix it?
Rarely on its own. A holiday interrupts the load without changing what produced it. The common pattern is that recovery lasts roughly as long as the distance from the inbox.
Why it is structurally different at the top
You cannot reduce the load.
Standard burnout guidance assumes a manageable workload is available if boundaries are set. For a founder or CEO the load is largely non-negotiable, and the parts that could be delegated are often the parts only you can currently do.
The role and the self are fused.
For most employees the job is something they do. For a founder it is frequently who they are. That makes ordinary recovery advice - step back, get perspective - feel like an identity threat rather than a relief.
Nobody is checking.
Employees have managers who notice. Leaders have boards who want confidence, teams who need certainty, and families who have been told it is fine. Admitting burnout reads as a competence problem rather than a health one, so it goes unsaid, often for years.
Competence hides it.
This is the part that makes it durable. High performers keep performing. The results stay good for a long time after the person has stopped being all right, so nothing forces the issue.
What actually helps, in order
Burnout is common at this level, and it is becoming more so. LHH’s 2025 survey of 2,675 C-suite executives across ten countries found 56% reporting burnout, up from 52% the year before, with Gen X and millennial leaders the most affected.
It is also not a mood. The World Health Organization places it in ICD-11 not among illnesses, but among the factors that shape health - chronic workplace stress that has not been successfully managed, with three dimensions: exhaustion, mental distance from the work, and reduced professional efficacy. That placement is worth understanding rather than dismissing. It means there is no single test and no one appointment that resolves it, and it means the effects do not stay inside working hours.
What thins out first is usually the quality of thinking and attention. Then the range of what a person can feel. Then the relationships that would otherwise carry them, because the energy that maintains those is the same energy. Eventually the sense of what any of it is for. And in time, the body.
A person is not a set of separate systems that happen to share a body. Burnout is where that becomes impossible to ignore - and where treating one category at a time quietly stops working.
Monika Jakobson, Co-Founder, Health & Science Director
What follows is our contribution to that, and we make nothing from it. Burnout is multifaceted and it is not undone by one change or one prescription. But there is a great deal a person can do to support themselves - enough to free up the capacity to keep functioning day to day, and to deal with the deeper part later if that turns out to be necessary.
Steps 1 to 3 have nothing to do with us. We do not sell them, we do not profit from them, and they are worth doing whether or not you ever speak to us.
1. Rule out the physiological - and look at how you are living.
Comprehensive bloodwork rather than a single marker, and a sleep assessment. Then the parts no test will show you: what you actually eat, how much you move, whether you train or only intend to, and what you are using to regulate - alcohol, stimulants, intensity. None of this is glamorous and almost all of it is free. Do it first.
2. Get one relationship where the truth is allowed.
A therapist, a peer group with no commercial relationship to you, one friend outside the company. Not a mentor who also has equity. Isolation is not a side effect of leadership burnout; for many people it is the engine.
3. Change something structural, however small.
Recovery that depends on willpower against an unchanged environment does not hold. One real structural change beats a month of intentions.
4. Address what the pace has been covering.
For a subset of people, steps 1 to 3 improve things and it holds. For another subset, the exhaustion turns out to have been managing something older - unresolved loss, trauma, a life built to someone else’s specification. Standard executive coaching is not designed to reach that, and this is the point at which people start looking further afield.
5. Where psychedelic-assisted work fits.
It belongs to step 4, not step 1 - and it is the step where choosing badly does the most harm.
The evidence is narrower than the marketing. Clinical research on psilocybin-assisted therapy has studied depression; burnout itself has been measured in a small number of trials, all in frontline healthcare workers rather than executives, and in the one randomized trial to name burnout as an outcome the improvement did not survive correction for multiple comparisons, in twenty people. It has consistently been studied with structured psychological preparation and follow-up around it, never as a standalone experience. Anyone offering it as a shortcut past steps 1 to 3 is selling you something.
So if you look into this, do the diligence properly before you go anywhere. What separates one provider from another is not the setting or the substance - it is what surrounds it. Is there medical screening first, with someone qualified reviewing your bloodwork and your medications? Is there structured psychological preparation, done by people trained to do it? And what happens in the months afterward: is integration scheduled work with named people, or a word on a website? An experience without that architecture is a trip, not treatment - and it is the version most likely to leave someone worse than they arrived.
It is also not for everyone: a personal or family history of psychosis or bipolar disorder, significant cardiovascular disease, or current lithium treatment rule it out. See safety and screening and who this is not for.
If you stop reading at step 3, that is a good outcome.
Not everyone who reads this can take on a six-month program right now. Timing, circumstances and existing commitments decide that as often as anything clinical does. Steps 1 to 3 stand on their own. They cost almost nothing, and they are worth doing whether you ever speak to us or not.
None of that means the problem is small. Burnout does not resolve by being outlasted - the longer it runs, the more there is to undo. A 2024 meta-analysis covering 26,916 people found it associated with a 21% higher risk of cardiovascular disease; a prospective study following 8,838 employees found the highest-scoring group at 79% higher risk of going on to develop coronary heart disease. Steps 1 to 3 are not a light version of treatment. Done properly they take months, and they are worth starting now rather than after the next quarter.
When it is not burnout
If you are not sleeping, not coping, or having thoughts of harming yourself, that is not a burnout conversation and it is not a program decision. Speak to a doctor or a mental-health professional you can see soon. That is true regardless of what you conclude about us.
What we do
INLIBRIUM runs a six-month, medically supervised, psychedelic-assisted program for founders, executives and senior leaders. It begins with a psychiatric screening and a medical review - which is also where step 1 above gets done properly, as a full diagnostic panel rather than a referral - and it includes months of psychotherapy, health work and coaching around three private seven-day residentials in Jamaica.
We can only work with a small number of people each year. That is precisely why steps 1 to 3 are on this page in full, and free.
Hardi Põder, Co-Founder, CEO
Sources
LHH - Views From the C-Suite 2025 (2,675 C-suite executives, 10 countries)