Lying in bed one night in 2016, Andy Dunn, MBA ’07, starts howling at the moon. Then, in a manic spiral, he leaps up and bashes his head on a doorframe, punches a windowpane, which rips the skin off his knuckles, and strips off his clothes, convinced he is becoming the Incredible Hulk.
He is living with his future wife, Manuela Zoninsein, in a Greenwich Village apartment, and she has no idea what is happening. “Manuela is terrified by my baying,” he later writes in his memoir. She calls her mother, who arrives within minutes. There’s blood everywhere. When Zoninsein approaches Dunn to calm him, he doesn’t see the woman he loves. “I see her coming at me, an Ex Machina humanoid robot,” he writes. Then his mind shuts down. He can’t remember what happens next.
“It was one punch,” Zoninsein recalls. “There was a bruise on my cheekbone, under my eye. It didn’t really hurt—there was so much adrenaline. He kicked my mom. In her case it was, like, more shocking. Her future son-in-law had a total mental breakdown and kicks her.” The next thing Dunn remembers is being pinned down by police. He is strapped to a gurney and taken to the psychiatric ward at Bellevue Hospital in Manhattan, where he is treated for bipolar disorder.
At the time, Dunn had been flying high as co-founder and CEO of Bonobos, a digitally branded men’s pants start-up with $100 million in venture capital. When he was released from the hospital a week later, he was taken away in handcuffs by New York police and charged with felony and misdemeanor assault. The public image of a successful businessman living the American dream fell away and the challenges of Dunn’s mental illness were revealed, not just to those around him but, more importantly, to Dunn himself.
Dunn is one of an estimated three percent of U.S. adults—and, by one report, 11 percent of entrepreneurs—with bipolar disorder. He’s been diagnosed with bipolar disorder I, defined by the National Institutes of Health as including “manic episodes that last at least seven days or when manic symptoms are so severe that hospital care is needed.” Manic episodes—periods of extreme elation, energized behavior, and irritability—are the hallmark of the illness. They can also include symptoms of psychosis, such as hallucinations or delusions. Such episodes are often followed by long periods of debilitating depression.
Dunn uses two different metaphors to refer to his illness. Sometimes it’s a volcano sitting dormant in his brain. When the volcano erupts, it launches him into a manic phase, where his logical thinking dissolves into visions of grandeur; he believes he is the U.S. president, Batman, the Incredible Hulk, or, often, the messiah. Other times, his illness is a ghost lurking in the shadows, haunting him. “Thanks to my ghost, I came within an inch of losing the woman who is now my wife, the company, and everything I cared for in the world,” Dunn writes.
Now, almost a decade after his 2016 episode—and the $310 million sale of his company to Walmart—Dunn is once again an entrepreneur. But it’s different now, he says. He’s married and has a 4-year-old son. He’s written a best-selling book, Burn Rate: Launching a Startup and Losing My Mind, in which he shares his journey with bipolar disorder. His latest venture, a start-up called Pie, is a social app focused on bringing friends together in person, a concept that grew out of Dunn’s feelings of isolation during the pandemic. The work syncs with his efforts—through writing and public speaking—to promote greater discussion and action on mental health, particularly within the business world. “With Bonobos I was so insecure,” he says. “I felt like the company was everything, my reputation was everything. It felt like a matter of life and death. Now I still care so much, but I also come home every day to two people who I love.”
The first episode
Dunn was born in 1979 in the suburbs of Chicago and raised with his older sister, Monica. His dad was a teacher, and his mom led the ultrasound department at Good Samaritan Hospital in their hometown of Downers Grove. He was born with dimples like his mom, and a strong desire to win at everything, including Monopoly. Good at school, he became a mathlete and even skipped the third grade. He was “king of the nerds” in high school, he writes in his memoir, and was voted “most likely to be a millionaire” his senior year, which both flattered and surprised him.
“While I tried my hand at mowing lawns, I was more candy striper than side hustler,” he writes. “My dream was to be a doctor, not an entrepreneur.” It was while working as a candy striper at Good Samaritan that he first internalized what he now identifies as a misconception: that mental illness was something to be ashamed of. The candy stripers were told never to share the names of patients who were sent to the North Pavilion, the psychiatric ward, and to lie if necessary. “He’s headed up North” was code among the candy stripers for anyone acting atypically.
‘With Bonobos I was so insecure. I felt like the company was everything, my reputation was everything.’
He attended Northwestern University, which made his mother happy because it was close to home. While he characterizes himself as a late bloomer, he changed at Northwestern. He joined Sigma Chi, was a regular at parties, and assimilated to his fraternity’s study-hard, play-hard vibe. Then, as graduation neared, all that came to a halt.
“When I was 20, I was the messiah for about a week,” Dunn says in the opening of his 2023 TED Talk, with a big, broad smile. “And for those of you who haven’t had the privilege of being the messiah, I have to tell you something: It is awesome.” After a night of intense partying on New Year’s Eve 1999, he went 100 hours without eating or sleeping. At one point, he was “preaching his gospel” at the local Burger King. He was experiencing the euphoria of his first manic episode.
After several days, his family got him to the hospital where his mother still worked, and he was taken “up North” to the psychiatric ward, where he stayed for a week. Dunn’s best friend from Northwestern, Nick Ehrmann, remembers visiting him in the hospital: “He was in his first, like, real head-over-heels romantic relationship, in that state of euphoric love,” Ehrmann says. “When you blend that with a manic episode, it’s not good. He told us they were going to give birth to the second coming of Jesus. I thought, ‘Oh my gosh.’ ”
For several days, it remained unclear what was going on. Speculations included a bad drug trip or side effects of Accutane, an acne medication. Then, finally, a psychiatrist came to the family with answers. “The doctor told us he had bipolar disorder,” Dunn’s mother, Usha, says. “I was beside myself. I was very worried. He’d just gotten a job. He was still not finished at college.” But the psychiatrist threw them a life vest. He said that if Dunn didn’t have another manic episode in the next five years, perhaps he didn’t have the illness. Dunn and his family clung to that hope. In 2000 he graduated and started work, first as a consultant for Bain & Company in Chicago and El Salvador, then at a private equity firm. Five years after that first episode, still mania free, Dunn entered Stanford’s Graduate School of Business, where he decided to become an entrepreneur.
Two’s company
Dunn arrived at Stanford in 2005 and moved into Schwab, one of the Stanford GSB Residences, with Brian Spaly, MBA ’07. They’d met in Austin, Texas, over the summer and become friends. At first, Spaly led the charge—it was his dream to sell cool pants for men, and he’d already begun tinkering with the concept. After they settled in together, Dunn became the idea’s head cheerleader.
“I couldn’t find pants that fit, so I started making them myself,” Spaly recalls. “I had a girlfriend in Boston who loaned me her sewing machine, and I started taking apart my pants and putting them together better.” Eventually, he found a pattern maker in San Francisco to lay down the first design, and a cut-and-sew shop made the first 1,000 pairs. By the next year, pants had started piling up in their shared apartment. Spaly designed a more flattering curved waistline that better fit athletic builds like his and experimented with eye-catching colors and high-quality fabrics.
ROOM WITH A VIEW: At first, Spaly and Dunn ran Bonobos out of their shared apartment. (Photo: Kathy Willens/AP Photo)
“I started the business creating this really fun brand and selling out of the trunk of my car,” Spaly says. “In 2006 in America, a lot of men were still wearing these Dockers, an unflattering brand. It was almost a pathetic badge of honor for tech guys to wear khakis and a blue shirt. I thought, ‘That’s just so lame.’ ”
And sell they did. Spaly named his trousers Bonobos, after the peaceful, sexually promiscuous cousin of the chimpanzee, and recruited Dunn to take photos of him modeling the pants, which sold for up to $150. (In the years to come, pants would have names like the F. Scotts and Last Starfighters and sell for $100 to $350.)
During his final six weeks as a student, Spaly sold $16,000 worth of Bonobos pants. It seemed like every male Stanford MBA student was wearing a pair. Immediately after graduation, Dunn joined as CEO, and Spaly went to work for a private equity firm in Chicago while continuing on with Bonobos part-time. The co-founders, like their pants, seemed a perfect fit. Bonobos was one of the earliest menswear brands to be sold online-first, and the two had visions of creating a clothing company tailored for the digital age: Their customer base would be men who hated to shop.
The business picked up speed fast, garnering media attention with headlines like “By the Seat of Their Pants.” In September 2007, Dunn packed up 400 pairs of pants and moved the company to New York. Spaly joined him there on the weekends until, in spring 2008, he returned to Bonobos full-time as chief creative officer.
That’s how Dunn entered the fast-paced, risk-filled world of entrepreneurship. He began to struggle with mood changes that veered from euphoric periods of hyperfocused activity to weekends of near-catatonic depression, when he couldn’t get out of bed. It was a cycle that would continue throughout his years at Bonobos. Still, he kept the shame and fear of his earlier bipolar diagnosis hidden deep. When tensions began to simmer between him and Spaly, their friendship and their work relationship deteriorated. In 2009, Dunn asked Spaly to leave the company. Spaly moved on to another venture, running the Chicago-based personalized clothing service Trunk Club (later sold to Nordstrom).
“This was my best friend,” Spaly says. “He looked me in the face and said, ‘I don’t want to work with you anymore.’ I felt betrayed. Now I know he has this mental illness, which does explain some of the behavior. I’m proud of Andy for taking on this mental health advocacy role. At the same time, I was pretty burned by the whole process. It can be hard to be forgiving.” And yet today, the two are once again friends—“which we are both proud of,” Spaly says.
The year of the messy co-founder divorce, as they both refer to it, was the hardest year of Dunn’s life thus far. “Now that I was alone at the top, the blame-it-on-Spaly days were over,” Dunn writes. “I could never have imagined that it was going to get worse.” In the years that followed, Dunn experienced long periods of hypomania—in which he felt like the king of the world but understood that he wasn’t—followed by repeated and worsening periods of depression, a risky cycle that pushed him closer and closer to full-blown mania.
“The only way I could control the hypomania from turning manic was with alcohol,” Dunn says. His days were caffeine-fueled, and he spent his nights partying. He slept little and worked long, hard hours. The dormant volcano in his brain was getting ready to erupt. “Manic is standing on a street corner, naked, passing a bird and thinking you can talk to it,” Dunn says. “Hypomanic is having a wild amount of energy, decreased need for sleep, contagious optimism, and a unique sense of belief. What an entrepreneur calls having a good day.”
Creativity, risk tolerance, impulsivity, the ability to work long hours without sleep, high energy—these are often both the defining characteristics of an entrepreneur and the traits of someone with bipolar disorder, says Michael Freeman, formerly a clinical professor of psychiatry at UCSF, who has studied the link between mental illness and entrepreneurs for more than a decade. Often, as in Dunn’s case, the career can mask the symptoms of the condition.
‘Manic is standing on a street corner, naked, passing a bird and thinking you can talk to it. Hypomanic is having a wild amount of energy, decreased need for sleep, contagious optimism, and a unique sense of belief. What an entrepreneur calls having a good day.’
In 2019, Freeman and his team published the results of a survey they conducted of 242 entrepreneurs and 93 comparison participants on their mental health. Eleven percent of entrepreneurs reported having a bipolar disorder diagnosis, compared with 1 percent of the comparison group—a statistically significant difference. Entrepreneurs also reported higher rates of depression, ADHD, and substance abuse, and a significantly higher percentage of them had been diagnosed with at least one mental health condition over their lifetime: 49 percent compared with 32 percent of the other participants.
“Entrepreneurs are well known for their strengths and their superpowers—sociability, extroversion, comfort in a leadership role. They can be charismatic, very goal-focused, hardworking—but they also have vulnerabilities,” Freeman says. “It’s important to be aware of those.” Sleep sacrifice turns out to be a big problem. Entrepreneurs often see it as counter-intuitive that taking time out to sleep and reboot will lead to better work outcomes, he says. Looking back, Dunn says, both of his manic episodes had been preceded by a couple of sleepless nights.
Confrontations
The night after Dunn was taken to the hospital in 2016, Zoninsein moved out of their apartment and into her mom’s place. She visited Dunn twice that week in the hospital. When he saw the bruise on her face, he realized what he’d done and was overcome by deep shame, which lingers still.
That next week, as the police took Dunn’s mugshot and fingerprints, he began to imagine the story getting out in the press, ruining his reputation and thus bringing down the company and all its investors and employees with him. “As I saw my pictures show up on a computer, I envisioned Business Insider having a field day,” Dunn writes. “Paranoia set in. I asked if this would be public.”
“Dude,” the officer said. “You sell pants. You’re not the founder of Google.”
Still, he knew he had to tell the board what had happened. Two days later, he sat in his office at Bonobos’ headquarters and dialed in for the call. His sister sat at his side for support, in case he had another breakdown. “There are playbooks for almost everything in the startup world. But not for this,” he writes. His only plan was to rip off the Band-Aid and get his story out there fast.
After he did, there was a pause. Then Stanford lecturer Joel Peterson, one of Dunn’s teachers in the MBA program and the first investor in Bonobos, spoke up. “I know a few folks who have dealt with what you’re dealing with, Andy,” Dunn writes in his book, “including more than a couple of entrepreneurs. It’s entirely manageable. I have full faith in you to take care of yourself, and I have full confidence in you as our CEO.” (“I wanted him to feel safe, secure,” Peterson says, adding that his response was informed by a family member’s experience with mental illness.) That set the tone, and the board chose to support him. The story didn’t get out, and a little over a year later, the company wrapped up its sale to Walmart. Dunn stayed on as senior vice president of digital consumer brands.
Meanwhile, Dunn was struggling to save his relationship with Zoninsein. A week or two after he got out of jail, he met with her mother. “I thought it would be for the last time,” Dunn says. “She told me, ‘Andy, this is just like any chronic physical illness. If Manuela wants to stay with you, you have my blessing.’ And I started crying.”
A couple of weeks after the episode, the couple spent a night together at a hotel with his mom. A month or two later, they returned to their apartment. “I remember being nervous,” Zoninsein says. “Everyone in the family was on call. It was really day by day from there, with him taking his meds and me slowly building back confidence and trust in him.” Six months later, the assault charges were dropped. And on May 27, 2017, he and Zoninsein got married. “The day of the wedding I experienced a sense of peace unlike any feeling I had ever known,” Dunn writes.
Since 2016, Dunn has strictly adhered to a complex daily regimen of medications, twice-weekly therapy sessions, and sleep tracking, which he shares daily with his psychiatrist and family. His psychiatrist regularly monitors his mood and, when needed, adjusts his medications, which include mood stabilizers and antipsychotics.
Dunn left Walmart in January 2020. It took four years of intensive therapy before he could begin to write Burn Rate. Since its publication, he has lectured worldwide about the need for better treatment, acceptance, and understanding of mental illness, especially bipolar disorder. Using himself as a case study, he cautions about higher rates of certain conditions, including bipolar disorder, depression, and ADHD, among entrepreneurs.
Johns Hopkins psychologist Kay Redfield Jamison, whose books on bipolar disorder include her 1995 memoir, An Unquiet Mind, says she was struck by the intelligence and truth in Dunn’s account. “It is an illness that’s so complicated and so tied to the human condition, so biologically ingrained and has such an effect on families, that, well, it’s a difficult illness to put into words,” she says. Ev Williams, founder of Medium and co-founder of Twitter, found insight in the connection between Dunn’s experience and entrepreneurship, writing in his book blurb: “Burn Rate blows away the haze of American dream myths to reveal that, often, there’s a destructive mania that drives success in this country.”
Pie, Dunn’s newest start-up, continues to grow. A social app designed to help people make new friends, Pie has launched in Chicago, San Francisco, and Austin and has roughly 130,000 monthly active users. Dunn still lives the high-flying life of an entrepreneur—just now ever careful not to soar too close to the sun. He’s still a charismatic, gregarious, high-energy businessman. He still goes on ski weekends with his college buddies and thrives on social events. He still loves bringing his ideas to life. Both his wife and his sister now have their own start-ups, and he’s excited to help them. But here’s the thing. This time, he’s keeping one foot ready to step on the brakes. He enjoys his nights in with his family. He sleeps more and doesn’t drink alcohol, and he focuses on taking care of both his mind and body. At the first sign that he’s heading toward mania, he gets the go-ahead from his doctor to take a strong antipsychotic. He calls it “bringing down the hammer.”
“I’m much preferring this new journey,” Dunn says. “It’s nice to be more stable. My health comes first—otherwise I can’t be there for my son. Now I’m a husband and a parent first.”
There’s still a question that lingers, though. Can he be both stable and a successful entrepreneur? “Can I have my shit together and still do this?” As his new venture gains steam, he says, he’s beginning to feel like the answer is yes.
Tracie White is a senior writer at Stanford. Email her at traciew@stanford.edu.