This is not just for startup founders. As an employee of a startup you are going to go through major roller-coasters as well. Having very close friends to talk to, and that understand your problems (they might work on similar spaces as well), is crucial. Your parents, your family might not be much help on these cases, as they wont understand or be able to give you good advice.
I have 3 friends that are very close to me, and they know every detail of my life (and so do I of theirs), good or bad. When I do need advice, or they do, we can rely on each other to get some feedback on any thing. But I trust them and I know they will have my back, and they wont divulge my personal details.
People that don't form these type of friendships are missing out. It makes the roller-coaster so much easier, and especially when going through life changing moments (job changed, marriage, breakups, etc).
I might have to add though that I suspect the startup community is full of people that are partially inside the bi-polar spectrum. Sometimes it takes a bit of a mania to start something new or crazy, but that euphoric high is always followed by a depressing low. Adding the uncertain nature of the startups, the emotional rollacoster becomes even more crazy and magnified.
The arm-chair psychologist in me says the author might have had BPD symptoms, (borderline) during his childhood:
"I cried in private, hoping that my cries might just be loud enough for somebody to hear. I hit myself, to create physical pain that might distract from the emotional."
The OP resonated quite strongly with me, and I am neither a founder nor (currently) an employee of a startup.
IMO, the struggle that is described here is inherently universal. It's shared by anyone who has to maintain a facade of success while facing intense insecurity (often financial).
Likewise, the emotions described will ring very familiar to anyone who suffers or has suffered with depression - regardless of triggers.
> My personal bank account & business accounts both overdrawn, tens of thousands of dollars in debt to family members and my credit cards maxed out or closed. I've had no cash in my pocket and a dwindling supply of food in the cabinet.
On a smaller monetary scale, that is in fact me at this very moment. Last week I was de-facto homeless (living in a $10/day rental car). I don't want to wax poetic about my mental state at the time, but it bordered on the worst.
I was eventually able to swallow my pride and confided in some close friends and family that I was tapped out financially, physically drained and psychologically in quite a dark place.
Knowing, viscerally, that I have a support network that is in the know about my situation and willing to back me up was very powerful. If / when I move past this particular time in my life, I know that I most likely could not have done it without them.
I think I used to view that as a sign of weakness and dependence. Perhaps it is, but that's not really something that concerns me any more.
Arm-chair patient: Maybe. I've only seen a therapist as a kid, but as far as I know, through the rest of my adult life I haven't had any bipolar tendencies. But honestly I'm not that informed on BPD. So if I am somewhere on that spectrum, I'm not living pretty happily there.