NEW DELHI: Soon after graduating from IIM Calcutta in 2013, Indrajit Pawar (name changed) turned down a crore-plus job offer to float a startup — a Flipkart lookalike — along with his girlfriend. The venture failed. A few months later, entangled in a web of debt and failure, Pawar slipped into depression.

His girlfriend coaxed him to seek help from Sunil Mittal, chief mentor at Cosmos Institute of Mental Health & Behavioural Sciences (CIMBS) in Delhi. Pawar has since recovered and the duo are now appearing for job interviews.

Around a year ago, Mittal says, work-related stress cases from startups were unheard of. In the past six months, though, over nine patients, all around 35 years, have been admitted to CIMBS for alcohol and substance abuse. These patients, belonging to startups and technology-led ecommerce companies, were brought in with work-related stress.

Doctors say more and more people leading startups or working in them are struggling with stress and depression. Milestone-linked investor targets, expansion plans and the struggle to get the right ‘product market fit’ often sap the life out of this community.

At least two to three people from start-ups and e-commerce companies are walking in to Fortis Healthcare in Delhi every fortnight. Though patients of depression and work-related stress are generally founders and senior employees of startups, the stress also seeps down to the lower levels, says Samir Parikh, director, Mental Health and Behavioral Sciences at the chain. “More than general physicians, these companies need psychologists,” he adds.

Unlike leading big divisions or subsidiaries of established firms, the buck stops with the founders, says Suchi Mukherjee, founder and CEO of LimeRoad, who helped set up the UK operations of eBay and was on the Skype board. “You are not working on a proven model. That feeling of running out of cash is rarely there in a big company,” she says. The stress is heightened when you are also a working mother, says Mukherjee, who made her peace with not seeing her children at night.

“It’s tough, but one needs to learn to be happy in this imbalance,” she says, recalling regular heated conversations with investors and team mates.

Stress is also beginning to catch them young. Tamaswati Ghosh, in charge of the incubation centre at IIT Madras says even though student entrepreneurs are initially energetic, stress levels go up as their ventures pick steam and they find it tough to juggle studies and the startup. So, from this year onwards, IIT Madras is letting serious student entrepreneurs take a semester off to be able to cope better.

Investors are also spotting signs of distress. Anil Joshi, partner, Unicorn India Ventures Advisors, got calls from a frantic start-up founder who missed filing declarations on overseas investments to the RBI on time and got penalised. “Many are first-generation entrepreneurs and do not understand compliance requirements like filing service tax on time. They get stressed when they fear investors may know.” Joshi also had to counsel a founder who couldn’t choose between taking his ailing mother to the hospital and an important investor meeting.

Recruitment firm HiRePro, which works extensively for e commerce startups, has now started holding serious preventive discussions with senior-level talent on what they may not find in a startup. “We’re gathering more data on candidates, their spouses and their additional responsibilities,” says Rishi Das, CEO.

Das says employees stayed put for 10 to 12 days at work at an e-commerce portal, preparing for their much-awaited bumper Diwali sale late last year, which caused a lot of stress among staff and families. Cofounder Anshuman Das points to frequent disagreements between co-founders and staff in e-commerce companies leading to increased and hushed-up senior-level exits.

While there are plenty of job seekers looking to ride the startup wave, most are unfit to deal with the ambiguous environment, says Ashish Kashyap, founder and CEO of ibibo Group. ibibo Group acquired bus ticketing platform redBus in 2013.

“It is definitely hundred times more fulfilling and fun to work in a startup and ecommerce company than a traditional set-up, but it can certainly take a toll on those who do not have the required energy and stamina,” he says.

Nakul Pasricha, who quit GE to join startup PharmaSecure as its COO, says that unlike a big company, stress in startups is compounded because of serious existential questions. “In a big company, the pressure could be because of managers or clients, and the onus of success or failure or a quarterly loss does not lie on you entirely.”

Family members of a startup founder have to be tough and the entrepreneur needs their buy-in, adds Sandeep Singh, cofounder and CEO, Freecultr. “If they are not with you, then it surely takes a toll.”