Over the past two years, Thankyou Group co-founder Justine Flynn learnt a lot from an experience she describes as "the undoing".
"I had to learn it the hard way of literally being bedridden, literally being in a place where all of my titles were stripped away," Flynn says.
The 32-year-old co-founded social enterprise Thankyou with her husband Daniel Flynn and their friend Jarryd Burns more than 10 years ago. The company, which started selling bottled water and expanded into bathroom products such as handwash and baby goods, donates its profits to projects aimed at alleviating extreme poverty.
It has raised $6.2 million for charitable causes and built a cult following that led it to launch into the major supermarkets - a significant coup for such a young company. Last year it donated $700,000 to projects.
However, by the end of 2017, Flynn says three doctors had advised her to remove herself from the business for at least three months, including having someone to help care for her young son during this time.
She had experienced months of not feeling herself, coupled with a creeping sense of stress and anxiety, and it was interfering with her day-to-day work in the business. Doctors said her adrenal glands were over-producing cortisol and her only option to restore her physical health was to step out of entrepreneurial life to recover.
The decision to step away was one Flynn says she would have been unlikely to have made without the advice of medical professionals.
"We always put Thankyou first," she says.
Flynn says a range of factors led to her health situation, including previously having had glandular fever. She says she had not taken enough time during maternity leave "to actually let my body heal and restore properly".
"As a founder, when I was pregnant with Jed, I was listening to so many other entrepreneurs out there that were like, 'Yeah I was back in the office after a few weeks - I had the baby under the table at six weeks old.' I heard all these stories. And I'm a high achiever as much as they are and I'm thinking, 'I can do this,' " she says.
Now back working in the Thankyou business, Flynn reflects that, while conversations about founder burnout and balance are now present in mainstream media, there weren't many examples at the time of Australian entrepreneurs openly discussing their health.
"I'm hearing more and more stories that so many people are on the edge or gone over. It can seem a very isolating time and that you're on your own. We have to change this pace - have to change to the idea that it's actually OK to rest and say no more," she says.
"You can't drink from an empty cup."
Having gradually returned to the business, Flynn says she now has a different approach to operating, which includes prioritising rest and saying no.
"I think that it got me to a place where it was understanding who I am, just as me and not with everything I do. I think, as entrepreneurs, we get so used to a pace which is based on, I guess, achievement."
Action key on founder health
Conversations about founder welfare have been front of mind in Australia over the past two years, with the federal government backing small business mental health policies.
In June, the World Health Organisation recognised burnout as an occupational phenomenon that can affect staff's performance at work and can result in physical and mental exhaustion.
Despite these trends, doctors focusing on the impacts of burnout say start-up culture can still make it difficult for founders to take action about their health, even if they know they should.
Dr Amy Imms created The Burnout Project, a platform for Australians to learn more about the phenomenon. She wanted to talk more about the issue after seeing patients present in her office with signs of exhaustion.
"One of the things I've really noticed is it's not the people who have low resilience that get burnt out," she says. "People that are skilled and driven - they can put up with it for decades."
Imms believes patients, particularly staff and founders of start-ups, can leave it way too late before they seek help for the mental or physical impacts of overwork or over-committing. Often it is not necessary to step away completely from one's business, though there are plans that can be put in place to manage the stress, she says.
Other founders agree Australia still has work to do to encourage founders to find balance in their work and take time out when it's needed.
"There's a lot of narrative around hustle culture. Oftentimes, it's attributed to these venture-backed companies who are pushed to grow, but most small businesses don't need to be playing in that sandpit," says entrepreneur and founder of innovation consulting firm Collective Campus, Steve Glaveski.
"You need to be healthy, both emotionally and physically, and more founders are starting to say things like that."
Flynn says it's important to support colleagues and founders taking leave and resting.
"When you're constantly on the go and going so fast, it takes a lot of courage to say: 'Hey, I'm going to switch all of this off and find a new space for a while.' "
If you are experiencing personal difficulties, please contact on Lifeline 13 11 14 or beyondblue on 1300 224 636.