The Thing Nobody Tells You About Building Something in Hong Kong

By John Corbett | Psychologist | Hong Kong

There's a version of the entrepreneurial story that gets told a lot in Hong Kong.

The pitch deck. The Series A. The WeWork hot desk at midnight that becomes an office of thirty people. The hustle, the exits, the LinkedIn post about lessons learned. It's an appealing story. It's also, in my experience, missing about half of what's actually happening.

What doesn't make the LinkedIn post: the 3am anxiety that isn't about strategy, it's about survival. The performance you put on for your team while carrying something you can't name. The realisation, somewhere around year two, that you haven't had a conversation that wasn't about the business in longer than you can remember.

I work with entrepreneurs in Hong Kong. And what I see, consistently, is a group of people carrying an enormous psychological weight — often in silence, often alone — inside one of the most demanding business environments on the planet.

This article is for them.

The numbers nobody talks about at Demo Day

Let me start with some research, because entrepreneurs tend to respect data more than they respect feelings — and these numbers are worth sitting with.

Studies suggest that roughly three in four startup founders experience meaningful mental health challenges during the early stages of building a company. Depression among entrepreneurs runs at around four times the rate of the general population. Anxiety and chronic high stress affect more than half. Burnout hits approximately one in three.

And then there's loneliness. In one survey, entrepreneurs rated their loneliness levels at 7.6 out of 10. Nearly half report grappling with isolation. More than half say they spend significantly less time with friends than they did before starting the business; similar numbers report the same about partners and children.

Here in Hong Kong, the backdrop makes all of this harder. The AXA Mind Health Study found that almost half the city's entire workforce reported burnout in 2024 — more than double the previous year. Nearly eight in ten had experienced at least one work-related mental health issue. That's the environment your business exists inside. That's the water you're swimming in, even before you add the specific pressures of being the one who has to make payroll.

None of this is failure. It's the predictable consequence of what building something actually costs.

Why entrepreneurship is psychologically unlike anything else

I want to be careful here, because the suffering is real — but so are the rewards. Entrepreneurship can be one of the most meaningful things a person does with their working life. Purpose, autonomy, the chance to build something that didn't exist before: these are genuinely valuable. They're also, quite often, exactly what makes the difficult parts so difficult.

When your work is also your identity, the stakes of every setback are not professional. They're existential. A poor quarter for a salaried employee is a poor quarter. For a founder, it can register as: I am failing. What I am is failing.

Research into founder psychology has found that this fusion of self and work — where what you do and who you are become genuinely indistinguishable — is one of the most significant drivers of mental health difficulty in entrepreneurial populations. It's not just that the work is stressful. It's that the work is you, which means the stress has nowhere to land that isn't personal.

This is compounded by something specific to the founder role: the pressure to perform certainty you don't always feel. Teams need confidence. Investors need confidence. Customers need confidence. And so founders develop a particular skill — appearing steady on the outside while managing something far less steady on the inside. This performance, sustained over months and years, is exhausting in ways that don't always show up as fatigue. They show up as emotional flatness, irritability, a vague sense that something is wrong without being able to locate what.

The loneliness that comes with the territory

There's a particular quality to entrepreneurial loneliness that I want to name, because it's often misunderstood.

It isn't always about social contact. Many founders I work with have full lives externally — dinners, investors, events, a team around them every day. They can feel profoundly alone in the middle of all of it. What's missing is not people. What's missing is parity — someone at the same level, carrying the same weight, who doesn't need you to be okay.

Research on entrepreneurial loneliness describes it precisely this way: you can have a rich social life and still feel isolated at work, because there's nobody else operating at your level who you can speak to candidly. The people above you are investors — they have interests, not solidarity. The people beside you are employees — they need you to be steady. The people at home love you, but often can't fully understand the specifics of what you're navigating. And so the founder carries it.

In Hong Kong, this is intensified by cultural factors that are worth naming honestly. Vulnerability, in many of the professional networks here, is not safe. Admitting difficulty — to investors, to peers, to your team — carries real perceived risk. The result is a city full of people building things while managing the appearance of confidence, in environments where acknowledging the cost of that is not yet fully normal.

This isn't weakness. But it is, over time, genuinely costly.

What the grind actually costs

I see the downstream effects of sustained entrepreneurial stress in my practice, and I want to describe them plainly — not to alarm, but because understanding what's happening is usually the first step toward changing it.

Sleep is almost universally disrupted. Not always in obvious ways — many founders sleep the hours but lose the depth. The REM sleep that processes emotional experience and restores complex judgment is the first casualty of chronic stress. The result is a founder who is technically sleeping but not recovering, and who is making consequential decisions on a brain running at significantly reduced capacity.

Emotional regulation narrows. Under sustained pressure, the window of tolerance — the range of situations you can navigate without being flooded or shutting down — gets smaller. Things that wouldn't have bothered you in year one start landing heavily. Relationships become harder to sustain. Reactions feel outsized but difficult to control.

Physical health takes quiet hits. Chronic cortisol elevation affects immune function, cardiovascular health, gut health, and hormonal regulation. Founders in the grind phase often notice these effects but deprioritise them — there's always something more urgent. The body keeps its own account, though, and it tends to present the bill at inconvenient moments.

And beneath all of this, often unacknowledged: grief. The life that was foregone in pursuit of the business. The relationships that thinned. The version of yourself — more present, more rested, more available — that got deferred.

Entrepreneurs rarely name this as grief, but that's what it often is.

The story Hong Kong tells about this — and the cost of believing it

Hong Kong is a city that has, historically, worn its intensity as a point of pride. The work ethic here is real, the ambition is real, and the results — for many — have justified the cost. There is a narrative, still powerful, that difficulty is the proof of commitment. That the struggle is the credential.

I understand why this narrative exists. I also think it's responsible for a significant amount of unnecessary suffering.

Because what I see, in practice, is not founders who are thriving because they pushed through everything without support. What I see is founders who are more effective, more creative, more able to lead well — when they have somewhere honest to take what they're carrying. When the performance of certainty has a place to come off. When the cost of building is acknowledged, not just deferred.

The research supports this. Mental health challenges that go unaddressed don't simply plateau — they compound. Sleep disruption impairs decision-making, which creates more business problems, which increases stress, which disrupts sleep further. Loneliness that isn't addressed becomes chronic, with measurable effects on physical health, cognitive function, and the quality of relationships. What feels manageable at eighteen months becomes genuinely destabilising at three years.

The most resilient founders I've worked with aren't the ones who needed the least support. They're the ones who got honest about what they needed — and found somewhere to take it.

What actually helps

I want to be careful not to offer a wellness checklist here. If you're building something in Hong Kong, you don't need another to-do list. What I'll offer instead are three things I've seen make a real difference.

An honest relationship or two. Not therapy, necessarily — though that helps many people. Just one or two relationships in which you are not required to be okay. Where you can say I'm struggling with this without it costing you. For many founders, building even one relationship of this quality is the most significant change they make. The research on loneliness is clear: it's not the number of connections that matters. It's the depth of at least a few.

Taking the body seriously, not as performance. Sleep, movement, food — not because they'll make you more productive (though they will), but because a founder who is running on empty isn't just less effective. They're less themselves. The work you do, the decisions you make, the leader you are — all of these emerge from a physical system. Treating that system as an afterthought has real consequences that show up in the business, not just in the body.

Addressing the identity fusion directly. This is the deeper work, and it doesn't happen quickly. But the question worth sitting with — ideally with someone who can help you think it through properly — is: who are you when the business isn't in the room? What parts of yourself exist independently of what you're building? Entrepreneurs who have some answer to this question are significantly more resilient when things get hard. Because things always get hard.

One last thing

If you've read this far, I want to say something directly.

The fact that you're building something — in this city, in this environment, with the stakes that are involved — is genuinely difficult. Not difficult in a way that should make you proud of your suffering, but difficult in a way that deserves honest acknowledgment. The cost is real. The toll on your sleep, your relationships, your sense of self — these are not signs that you're doing it wrong. They're the predictable consequences of doing something hard.

What you do with that recognition is your choice. But the entrepreneurs I've seen navigate this most effectively are the ones who stopped waiting until things were critical to take it seriously. Who didn't treat the internal work as the thing you do after the business is stable — because for many founders, that moment never quite arrives.

The business needs you well. Not just functional — well.

And that, in my experience, is worth building toward just as deliberately as everything else.

John Corbett is a psychologist based in Hong Kong working with entrepreneurs, executives, and senior professionals on performance, psychological wellbeing, and recovery. He offers individual sessions and works with founding teams navigating the particular pressures of building in high-stakes environments.

To find out more or arrange a consultation, visit johncorbett.com