Inside the Mental Health Problems of UHNWIs

Inside the Mental Health Problems of UHNWIS

Author: Claudia M. Elsig, MD

It may be an old saying, but ‘money doesn’t buy health or happiness’ has a general truth, no matter how much you have. Enormous wealth comes with great responsibility and suffocating expectations. Being super-rich may be the dream of many of us, but extreme wealth poses many unique challenges and stressors.

Life as a billionaire isn’t as simple as enjoying a life of luxury with a team around you to do everything for you. Living in the ultra-rich lane is complex, and mental health is often the fall guy.

This blog takes a closer look at the mental health problems of UHNWIs.

Some facts about the world’s billionaires

Billionaires are a rare breed of individuals – the super-rich account for just one per cent of the population. According to Statista, nearly half of the world’s collected wealth belongs to the wealthiest one per cent.1

According to Forbes’ 37th Annual World’s Billionaires List:

  • 69 per cent of billionaires are self-made, and only 31 per cent are legacy.
  • The average age of the world’s billionaires is 65.
  • Plenty of youngsters have gotten super rich fast, including 15 people who are 30 years old or younger.
  • More billionaires hail from the United States than any other country, followed by China, India, Germany, and Russia.
  • The wealthiest people on the planet are still overwhelmingly male.2

The mindset of self-made billionaires

Since a high proportion of billionaires are self-made, it’s interesting to consider the mindset of this type of individual, especially when exploring the mental health issues that they appear to be susceptible to.  

A unique set of characteristics defines self-made billionaires. Hugely successful people are driven, have unrelenting ambition, and thirst for achievement that far surpasses the average person’s aspirations. These are people who yearn for greatness. An intensity drives their every action.

In the billionaire mindset, there is a relentless pursuit of goals and steadfast determination. Challenges are viewed as mountains to be conquered, and there is a willingness to make sacrifices. They are risk-takers and are not perturbed by failures, which they reframe as necessary for success. They are independent thinkers with a passion for learning.

But while hugely important for success, these characteristics aren’t confined to business; they spill into everyday life and relationships. Some can find a good balance in life by incorporating physical exercise and supportive practices, like meditation, mindfulness, and stress management techniques, to maintain mental well-being and ensure healthy relationships.

But achieving this balance isn’t easy. Routines must be constantly reset and recalibrated, and relationships must be worked on. When the pursuit of money and success is a priority, without such vigilance, burnout, addiction, depression, and other mental health problems can surface.

The effect of wealth on mental health

Many of the most prosperous lifestyles are accompanied by childhood trauma, addiction, and depressive states. Self-made wealth comes with immense pressure to stay rich and successful, while people who grow up wealthy and inherit fortunes can suffer from attachment disorders and not have any real goals and purpose in life.

Being sent away to an expensive and strict school, for example, can be incredibly traumatic for a child. Boarding School Syndrome is increasingly recognised. Read more about the childhood trauma of privilege in our blog on Boarding School Syndrome here.

As adults, there can be feelings of never having enough in both camps (inherited and self-made wealth). And for many, feelings of guilt, low self-worth, and isolation come hand in hand with the territory. Despite their wealth, many billionaires suffer from irritability, insomnia, paranoia, depression, anxiety, and panic attacks.

The personality traits of the super-rich

Very wealthy people share some personality traits. Not all, but many are likelier to exhibit self-promotion, emotional coldness, or a lack of empathy, dishonesty, and aggression. Dr Steve Loughman, a social psychologist at the University of Edinburgh, says of billionaires:

“These people are good at controlling their emotions, both positive and negative ones, and they tend to be less emotionally reactive to the world around them at high levels.”3

He also notes that billionaires are comfortable with conflict. “They can challenge other people without the need to be liked.”

The ultra-rich also tend to be extroverts, and there is a high level of narcissism in this socioeconomic grouping (read more on narcissistic personality disorder below). Elon Musk is a prime example. He is renowned for being a terrible employer with despotic conduct. He is consistent in one thing – abandoning rules and principles.

Destructive behaviours, narcissism, and the downside of risk-taking

In 2019, CNBC reported that one in five business leaders are psychopaths.4 “Many wildly celebrated character traits, such as courage and risk-taking, often coexist with psychopathic tendencies.”

Entrepreneurial types are risk-takers. They have to be. Great courage is required to venture into uncharted territories and explore opportunities others might shy away from. However, risk-taking as a personality trait poses challenges.

Thrill-seeking, ruthlessness, revenge, and a lack of guilt are common themes in the disruptive and egotistic personalities of risk-takers. These personality traits make them more open to losing their moral compass and to addiction. 

Addiction to power and money is notable, but there is a dark side, too. People of extreme wealth are significantly impacted by drug, alcohol, and sex addiction. Peer pressure in wealth circles can also play out, forcing people to engage in extravagant and unconventional behaviours.

Studies by psychologists specialising in UHNWIs have uncovered traits of narcissism, desire for control, self-centeredness, a lack of empathy, and competitiveness.

Sudden Wealth Syndrome

Not all billionaires are self-made. Some inherit wealth, which can create enormous challenges for an individual. Suddenly getting rich creates severe emotional and financial challenges.

Sudden wealth syndrome was a term first coined by Psychologist, Dr Stephen Goldbart after he discovered that some people struggle to adapt to their change in circumstances when they get rich overnight.5

Common themes include fear and paranoia, frivolous spending and destructive behaviours, changes in relationships, trust issues, isolation, and loneliness.

Learn more about the impact of sudden wealth on mental health here.

Pathological Money Hoarding Syndrome

The world’s super-rich have enough money to live lavish lifestyles AND solve all world problems. A staggering $12 trillion is held by the top 0.1% of households.6 So, what is stopping them?

Billionaires don’t hoard cash; most of their money is invested in financial and real assets, such as stocks, mutual funds, retirement accounts, and real estate. But billionaires wouldn’t be billionaires if they didn’t have a hoarding problem. Excessive wealth syndrome is a thing. It’s when a person has an excessive need to maintain and acquire more wealth. No amount of wealth feels like enough.

Research by Anthony Canale and Bradley Klontz of Kansas State University suggests that excessive wealth is a manifestation of hoarding disorder and that it can arise out of a basic instinct to survive.

“Hoarders can exhibit excessive saving behaviour, which is reinforced through feelings of pleasure associated with possessions and collecting. It has been suggested that several types of deficits are contributors to hoarding: information processing, beliefs about emotional attachment to possessions, emotional distress, and avoidance behaviours.”7

Drawing on past research, Canal and Klontz note that hoarders are more likely to have experienced traumatic life events. Traditionally, hoarding has been seen as a symptom of Obsessive Compulsive Disorder (OCD) or Obsessive Compulsive Personality Disorder (OCPD). Still, Canale and Klontz argue hoarding can be a condition in its own right without someone meeting the criteria of OCD or OCPD.

Treating the mental health problems of UHNWIs

At CALDA, we understand the unique challenges and mental health problems of UHNWIs. Our dedicated team of mental health specialists, psychotherapists, and complementary therapists treats one client at a time to ensure the utmost privacy and discretion.

We specialise in rehabilitation programs for mental health and the treatment of UHNWIs. We offer individual counselling, state-of-the-art psychiatry, precision medicine, and premium one-to-one support. Our private residencies are located in Switzerland on Zurich’s Gold Coast, overlooking Lake Zurich.

Please get in touch with us to find out how we can assist you with a treatment individually tailored to you. Our Medical Director, Dr. Claudia M. Elsig, will be happy to discuss our programs with you.


  1. Statista. Share of the global wealth held by the richest percent from 2010 to 2022. [Accessed online 14 Mar 2024].
  2. Peterson-Withorn, C. 4 Apr 2023. Forbes’ 37th Annual World’s Billionaires List: Facts And Figures 2023. Forbes. [Accessed online 14 Mar 2024].
  3. Hughes, A. 30 May 2023. How to think like a billionaire: The personality traits and morality of the ultra-rich. BBC Science Focus [Accessed online 13 Mar 2024]
  4. Chamorro-Premuzic, T. 1 in 5 business leaders may have psychopathic tendencies—here’s why, according to a psychology professor. CNBC Make It. [Accessed online 13 Mar 2024]
  5. Scorsch III, I G. 6 Jul 2012. Too Much, Too Soon: How to Avoid Sudden Wealth Syndrome. Huffpost Website. [Accessed online 14 Mar 2024].
  6. Davis, A. 15 Jul 2020. America’s billionaires have a hoarding problem. Fortune. [Accessed online 14 Mar 2024].
  7. Canales, A & Klontz, B. Dec 2013. Hoarding Disorder: It’s More Than Just an Obsession – Implications for Financial Therapists and Planners. Journal of Financial Therapy. 4. 43-63. 10.4148/1944-9771.1053.