This is the first in a three-part series by Morra Aarons-Mele about how high-achieving executives manage their anxiety and depression.

The state of our mental health has a profound impact on how we work and manage others.

Poor mental health is the No. 1 reason people miss work. A 2021 Mind Share Partners report found that 76% of U.S. workers reported at least one symptom of a mental health condition like anxiety or depression, and 84% of respondents reported at least one workplace factor that had a negative impact on their mental health.

Research shows high achievers struggle more with their mental health. And yet few prominent executives are willing to speak publicly about their personal struggles. They believe exposing their anxiety will make them seem weak. They worry that opening up about their personal mental health challenges will tank their company’s stock price. They think—correctly, based on my experience—that people consider anxiety and strong leadership incompatible.

When our leaders don’t share how they feel, it sends a clear message to the world: It’s not okay to talk about mental health in a personal way. Successful people typically hide how they feel. But this is changing, and more leaders are sharing their personal experiences with mental illness. Storytelling can heal and helps reduce the stigma of mental illness.

Diane Patrick has held many prestigious positions throughout her career: For 25 years she worked at the law firm Ropes & Gray, including as co-managing partner of the firm’s Boston office. She began her legal career at O’Melveny & Myers in Los Angeles, helped launch the New York City office, and then joined the general counsel’s office at Harvard University as university counsel.

Later in her tenure at Harvard, Patrick was asked to serve as the director and associate vice president of human resources. Beyond her successful law career, Patrick also has a very public private life, as the wife of Deval Patrick, former two-term Masschuetts governor, assistant attorney general in the U.S. Department of Justice, and potential future presidential candidate.

In 2007, early into her first term serving as first lady of Massachusetts, Patrick, then 55, was hospitalized to be treated for clinical depression and exhaustion. It was a big news story at the time, and her husband asked his lieutenant governor to assume some additional responsibilities so he’d have time to spend with his family.

Looking back, Patrick says that being a public figure, facing constant scrutiny and racism, left her feeling “like a carrot peeler was just peeling all of the outer protection that I had built. One night I said, ‘I can’t do this. I don’t even want to walk outside.’” She took a monthlong leave from her law firm and public life. “Fortunately, I had the foundation to know that I could get through this, but I just needed the time and the help.” Ever since, she has been open about her mental health challenges.

“I’m happy to talk [about it] because I think this is the sort of thing that should be much more broadly discussed. But it’s hard because for so long, people have seen it as a flaw in a person’s character, ability, talent, or intelligence.”

Patrick describes herself as an overachiever. She went to college at 16, and she says she’d get upset if she didn’t get all A’s.

“I have always had this driving need to please, whether it’s to be nice or to be the best lawyer or the best student or the best Scrabble player,” Patrick says. “I think that part of that drive was part of my sickness because I needed everybody to like me and approve of me, and that was really debilitating.”

As a child growing up in a Black family, Patrick says they never talked about issues like depression. “You just didn’t talk about how you were feeling emotionally. If you had some issues, it was just, ‘Pull up your big girl pants and move on’ or ‘Don’t be weak.’”

Statistics tell us that even today, 25% of Black people seek mental health treatment when needed, compared to 40% of white people. Historical inequities, distrust of the medical system, lack of access, and cultural norms mean many Black communities have passed a fear and mistrust in the idea of getting treatment for mental illness through the generations.

Patrick says she worked really hard to mask her anxiety as she rose through the ranks at the law firms, but it came at a cost. And for a long time she didn’t tell many people about her struggle. Her friend from law school perfectly summarized how she felt when she told him about her struggle with anxiety. “I remember him saying to me, ‘You’re like a duck. You’re calm on the water but your feet are flapping constantly underneath,’ and I thought, ‘Wow, how does he know that?’”

When Diane became associate vice president of HR at Harvard, she found herself micromanaging her 60 staff members because she was so anxious that she might “let down” the university.

“I had a major anxiety attack, and I actually thought, ‘I don’t know what to do.’ I felt just like I was going out of control, and there was nothing that necessarily triggered it except that I was working incredibly hard, doing 60 people’s work that I shouldn’t be doing. I talked to my husband and he said, ‘You need to talk to somebody.’”

That’s when Patrick first started seeing a psychiatrist, whom she still sees to this day. They helped her understand that she had an illness and there was treatment for it. Patrick realized she no longer had to suffer in silence.

“I’m still a perfectionist, but I’m less anxious about it,” Patrick admits. “I just have more confidence in myself. I am less afraid of failure.”

Getting treatment for her anxiety didn’t impact her ambition and drive, she says. But it changed her anxiety around that ambition. “When I talk to people about this, I say, ‘Look, it doesn’t have to be this hard.’”

Patrick thinks it’s crucial for executives and leaders at big companies to talk about their own experiences with anxiety and depression as a way of encouraging others to get the support they need.

“It’s important to us that we all take care of each other, especially now when so many people are suffering.”

Morra Aarons-Mele is the author of The Anxious Achiever: Turn Your Biggest Fears Into Your Leadership Superpower.