1. You must fake it. You cannot let anyone see you look like you are losing control. Ever. Once they see that… they will lose faith.
2. You need help. Ideally, 1, 2, or 3 others on the management team that can really help carry the load. So you don’t have to worry about 1, 2 or 3 key functional areas, at least not at an execution level. If you don’t have true help carrying the load — stop. Do almost nothing else. Recruit someone.
3. You need a break. In fact, lots of them. Some way. I ran 26 miles a week, and took long walks to think. Coffee is good too, if you take it away from the office. Something. Get breaks.
4. You need someone to confide in. At least one. One person you can really share the things with that make you …un-calm. One great advisor, whoever it is.
5. Once the business is real, self-sustaining — you need to take a real vacation. Not just a trip where you email 4 hours a day. A real vacation. Honestly, it may be 4-5 years until you can do this. But once you can, it will help a lot.
(1) Jason was answering a question specifically about CEOs. But this applies to all managers.
(2) A key element of immense work pressure for managers is the burden of making decisions. So think about limiting decision fatigue.
(3) “You cannot let anyone see you look like you are losing control” — see Tony Schwartz’ advice on how to resist emotional triggers.