Seems like a complex issue, but at least as far as your mental health goes: reach out to your doc, get connected with a therapist. I've been in a very similar

Seems like a complex issue, but at least as far as your mental health goes: reach out to your doc, get connected with a therapist. I've been in a very similar situation as a first time founder for over half a decade, and getting professional help to deal with anxiety, burnout and depression was super helpful. I was spending days staring at the screen phasing out, couldn't get out of bed, crying, deriving no pleasure from anything, and all that jazz. This lasted over a year before it got bad enough I had to reach out for help. I was going to either quit and/or accidentally take the company down with me. No pills involved to fix it in my case, just a lot of techniques and practices prescribed by the therapist that help you keep your sanity over the long term. You can get over it within a couple of months if you are diligent about staying on top of the process. I suspect that almost every high performer who pushes hard in their career will eventually get to this point, it's normal, you need to learn how to deal with the level of anxiety that these positions can induce. Just like most super successful people have coaches, I think most super successful people have therapists keeping them afloat.