The answer to the question posed in the headline may seem an obvious one. OF COURSE there is a connection between being nuts and mounting a startup. Many so-called “normals” look at what it takes to start a tech company and conclude no normal person would. That leaves the rest of us to do it.

The truth is that many entrepreneurs do not have their own pages in the DSM-5, bible of psychiatric diagnosis. But many do and this is about them. And it’s not funny.

The same headline was used for a recent story on KQED’s “The California Report” that told about the findings of two researchers who are examining the connection between mental health and the startup mind.

Psychiatrist Michael Freeman of UC-San Francisco and psychologist Sheri Johnson of Cal-Berkeley conducted an online survey of 240 entrepreneurs. According to a story in the Washington Post:

Forty-nine percent of entrepreneurs surveyed reported at least one mental health condition. Nearly a third reported having two or more mental health issues, such as ADHD, bipolar disorder, depression, anxiety or substance use conditions. And half of the entrepreneurs who reported no mental-health conditions identified themselves as coming from families with a history of mental illness.

In short, there is a significant connection between entrepreneurism and mental health conditions. This may seem counterintuitive, but bipolar disorder, Asperger’s Syndrome, ADHD, depression or substance use can have a beneficial side, too.

“When someone truly has manic-depressive illness and they’re very disabled by it, they’re in and out of the hospital, if you look at their relatives, their siblings, their parents and their children, they are all high-achievers,” Freeman told the Post. “And that’s been demonstrated over and over again.”

ADHD individuals are known for creativity. independence and quick decision making. Depression is associated with with empathy and creativity. Asperger’s is linked with laser-like focus. For all of the challenges these conditions create there are also benefits.

But let’s not romanticize.

Who in their right mind would choose to be an entrepreneur?

“Who in their right mind would choose to be an entrepreneur? The barriers to success are virtually unlimited and most startups fail as a result,” Freeman asks in an excellent report describing his findings.

“Entrepreneurs have lower initial earnings, lower earnings growth, lower long-term earnings, greater work stress, and more psychosomatic health problems than employees. Why would anyone voluntarily accept the longer work hours, fewer weekends and holidays, more responsibility, chronic uncertainty, greater personal risk and struggle, and greater investment of emotional and physical resources required to be an entrepreneur instead of the security and long-term rewards of having a career?”

“By conventional standards choosing to be an entrepreneur is an exercise in bad judgment,” Freeman concludes.

Even if mental conditions can help build companies, what is their impact on personal and family life? Does treatment dull the advantage? With its small sample size and limited scope, the researchers’ work leaves more questions than answers.

For now, what it teaches us only confirms what many already recognized: You don’t have to be crazy to become an entrepreneur, but it may not hurt, either.

photo credit: Cayusa via photopin cc