How a CPA beat burnout after strokes, years of depression
After suffering two strokes in four days, the author battled mental health issues before he learned to recognize, address, and prevent chronic stress.
Do you feel tired most of the time and question why you became an accountant? Do you not care as much as you used to? Do you keep telling yourself: “I just have to power through for a little longer until I catch up.”? Are your neck and shoulders constantly tight? Are you eating much more or much less?
Any of this sound familiar? If so, you may be suffering from chronic stress. Left untreated, it can lead to emotional, physical, and mental exhaustion, aka burnout, which can lead to depression and a host of physical issues. I should know. Eleven years ago, the stress of my job led to two strokes in four days and years of struggles with depression.
Tri-Merit Specialty Tax Professionals, the firm I co-founded in 2007, grew incredibly fast during its first decade. It was an exhilarating ride, and I was burning the candle at both ends, trying to be the managing partner running the firm and the chief rainmaker bringing in the business. It got to be way too much, but I kept trying to power through until I had a stroke Feb. 6, 2014, and then a second stroke four days later. I was 51.
Physically, I recovered pretty quickly, but not mentally. For the next five years I suffered from post-traumatic stress disorder, panic attacks, depression, and feelings of hopelessness. In 2019, I finally got the help I needed and began to make the necessary changes to my work and personal life.
WHY ARE CPAs SO PRONE TO BURNOUT?
Nearly half of U.S. workers (44%) reported feeling burned out at work, according to a 2024 report from the Society for Human Resource Management. Compare that to a 2024 study by the University of Georgia and accounting software company FloQast that found nearly all (99%) accountants experience exhaustion, feelings of inefficiency, and alienation from their jobs at some point in their careers — the very dimensions that define burnout.
And the phenomenon isn’t limited to the United States.
A 2023 study by the AICPA, CIMA, and PwC found that 51% of team leaders in accounting and finance in Central and Eastern Europe felt symptoms of professional burnout. And more than half (55%) of accountants surveyed in 2022 by The Institute of Chartered Accountants in England and Wales were suffering from stress and burnout, compared with 41% of employees in other sectors.
A combination of professional demands and personal traits can make matters worse.
Accounting work requires a meticulous, detail-oriented eye, the ability to frequently adapt to changing standards and protocols, and the discipline to constantly meet deadlines. Combine that with a penchant for sticking with a problem until it is fixed, a willingness to work harder and longer to catch up, and a fierce sense of control, and you have conditions that can lead to mental health problems.
To protect everybody’s mental health, leadership must be intentional about cultivating and supporting a culture that keeps stress from creeping up.
HOW EMPLOYERS CAN HELP WITH MENTAL HEALTH
The numbness, slurred speech, and mental confusion that I suffered during the strokes went away quickly, and I didn’t stay long in the hospital — one day the first time and four days the second time. After each stay, I promptly returned to work.
Mentally, I wasn’t OK, though, and in 2015 I decided to start regular therapy. Four years of trying to make sense of my ongoing mental health struggles followed.
In 2017, I reluctantly stepped away from my role as managing partner at Tri-Merit and handed over the reins to Andy Lane, the firm’s co-founder. I didn’t want to give up control of the business, but I realized I was a passionate entrepreneur who loved starting businesses but wasn’t good at running them. Meeting KPIs, processes, and procedures bored me. Andy had been waiting in the wings to manage the firm, and he turned out to be very good at it.
During the next two years, I helped start a craft beer bar in Chicago, which distracted me from having suicidal thoughts. I set up the bar’s finances, got the business going, and then turned it over to a managing partner. I supported Tri-Merit’s business development team and continued to talk about my mental health struggles off and on. In 2019, I finally got back to my old self.
I tend to obsess about details, try to control everything, and strive to keep everything in life in perfect balance. But that’s not how life or business works. My therapist finally helped me realize that I couldn’t control everything in my life. She helped me get control of my spiraling, suicidal thoughts. But even now, I have to check myself regularly.
As I travel to promote the firm and educate other practitioners about tax credits and incentives, I also share ideas on how our profession is evolving. We can build rewarding practices without routinely working 80-hour weeks, billing strictly by the hour, or accepting every engagement that comes our way.
At Tri-Merit, we offer unlimited PTO or vacation days, we promote taking mental health days, and we use value-based pricing.
Make mental health resources readily available
As I go around the country evangelizing about mental health awareness, I tell practitioners and firms that one of the best things they can do is make mental health resources readily available at their organization and to remove the stigma around accessing them. This could include an employee-assistance program, access to counseling services, or allowing employees to take “mental health” days without fear of judgment or loss of vacation days.
Every year our firm’s CPA Career Satisfaction Survey finds that CPAs who work at firms in which mental health resources are readily available (without stigma) are more than twice as likely to feel “highly satisfied” in their careers than CPAs who work at firms in which those resources are not readily available.
You should also make holistic well-being part of your firm’s DNA. For instance, according to a Thomson Reuters report, firms such as Kearney & Company employ “mental health ambassadors” who receive training to help remove the stigma of discussing mental health in the workplace. This strategy also increases the firm’s ability to provide support and direct staff to additional resources.
Make sure everyone on your team knows that it’s OK to ask for help if they need it, and ensure that they know where and how to obtain those resources.
Allow leaders to show vulnerability
As a firm leader, one of the best ways you can encourage adoption of mental health resources is to show that you can be vulnerable and to share personal stories about how you’ve dealt with your own anxiety, insecurity, and mental health challenges. In my experience, employee satisfaction levels — and retention — go way up when team members see that firm leaders can be vulnerable and that there’s no shame in asking for help.
If an employee feels they are not getting the support they need or is reluctant to ask for an occasional mental health day for self-care, then remind them to tap into their network. The accounting profession is a supportive community. Anytime something comes up and you feel yourself falter, remember someone is always a phone call, text message, or email away and can support you in your time of need.
6 WAYS TO REDUCE STRESS AT WORK AND AT HOME
Here are six ways that I’ve found to be very effective for reducing stress in your life:
- Improve time management. Start taking control of your calendar rather than always reacting ASAP to client phone calls, emails, and unrealistic demands. Carve out quality “focus time” to get your high-value client work done. Don’t try to tackle everything on your to-do list. Instead, identify the top three priorities for the day and laser focus on them. Let everything else go until you’ve tackled the top three priorities.
- Disconnect at the end of the day. As Brian Kush, CPA, once told me on my podcast: Bookmark your work at the end of the day. Create an “instead plan,” which means to intentionally plan activities that have nothing to do with work to keep from being sucked into work during time off. Perform mental and physical shutdown practices. Set your priorities for the day ahead. Our firm’s aforementioned career satisfaction study found that CPAs who work at firms in which there are clear boundaries between work and personal time are more than twice as likely to feel “highly satisfied” in their careers than those who work at firms in which the lines are blurred between work and personal time — or who feel like they’re always on call.
- Take frequent breaks. Research shows that humans can focus fully for only four to five hours a day. Your brain needs rest during the day, so take frequent breaks and let your brain clear.
- Improve self–care. Don’t sit at your desk all day long, and don’t eat meals at your desk. Eat right. Get plenty of exercise and rest. Meditate. Go for walks during work hours and leave the phone behind.
- Help others on your team. As my friend John Garret, former Big Four auditor, podcaster, and author of What’s Your And?, likes to say, it takes only 40 seconds a day of real personal interaction with somebody on your team to make them feel valued and appreciated. Also, if you’re a manager, stop modeling unhealthy work habits such as:
- Not setting and observing boundaries between work and personal time.
- Sending texts, emails, and Teams messages at all hours. If you’re working flexible hours, schedule emails and set yourself reminders to send texts and messages during regular hours.
- Setting unrealistic expectations.
- Celebrate hobbies and passions outside of work. Add personal hobbies and passions to each team member’s bio page on your website. Make sure everyone at the firm knows when a colleague has finished a half-marathon, won a prize at a photography show, or taken a leadership role in a local civic organization. Our firm’s career satisfaction survey confirms that accountants who work at firms in which their colleagues know about their passions and interests outside the office have a career satisfaction level of 3.6 on a scale of 4.0 compared with accountants working at firms in which few details of their personal life are known or shared (2.6 on a scale of 4.0).
5 TACTICS TO REDUCE COLLECTIVE STRESS IN THE FIRM
Here are five tactics that I’ve found very effective for helping accounting firms of all sizes to reduce teamwide stress:
- Prune your client list. Have the courage to get rid of the clients who are chronically late payers, unprofitable, abusive to staff, or constantly complaining.
- Ditch the time sheets and stop selling hours. Change your billing strategy to focus on deliverables and client outcomes. Our CPA Career Satisfaction Survey found that three in five accountants (60%) who were not required to track their time were “highly satisfied in their careers” vs. less than half (48%) of CPAs who were required to track and report their time.
- Automate as much as possible and delegate tasks that aren’t your immediate responsibility or that don’t require the highest and best use of your time.
- Stop trying to do everything. Develop strategic relationships with people — inside and outside your firm — who have expertise that you don’t have.
- Bring a mental health coach into the firm. You can start by hiring a licensed therapist to come on-site for office hours once or twice a week, say four hours per day. You can also contact the National Board for Health and Wellness Coaching or the International Coaching Federation, which set standards and provide credentials. Finally, you can also set up an account for your firm at online therapy resources such as BetterHelp
TRACKING ASSETS AND LIABILITIES
A bonus tactic for both yourself and your organization is to track self-care activities vs. mental health liabilities (see the table, “Mental Health Balance Sheet,” below).
Here’s how it works. At the bottom of the Self Care Assets table, add up your Self Care Assets (such as exercise or hobbies). Next, go to the Mental Health Liabilities table and add up your Total Liabilities (such as weekend phone calls or stressful clients). When you have both lists, tally up the numbers to determine net retained energy: (ASSETS) — (LIABILITIES) = NET RETAINED ENERGY.
If you or someone on your team has negative Net Retained Energy, then they may be at risk of burnout and mental health challenges. Don’t let this go ignored.
When it comes to mental health, ensure that everyone at your organization knows it’s OK to ask for help. It’s one of the best ways I know to recruit, train, and retain the best talent in our profession.
About the author
Randy Crabtree, CPA, co-founder and partner of Schaumburg, Ill.-based Tri-Merit Specialty Tax Professionals, is an author, lecturer, and host of The Unique CPA podcast. You may contact him for his Mental Health Awareness presentation or to receive a complimentary copy of the Burnout Balance Sheet workbook.To comment on this article or to suggest an idea for another article, contact Jeff Drew at Jeff.Drew@aicpa-cima.com.
LEARNING RESOURCE
Owning Your Leadership: Building Extraordinary Relationships Beginning With Self
Gain a deeper understanding of the leadership and relationship skills you’ll need to be an effective leader from any position — it starts with managing self.
CPE SELF-STUDY
For more information or to make a purchase, go to aicpa-cima.com/cpe-learning or call 888-777-7077.
MEMBER RESOURCES
Articles
“Managing Teams, Managing Time: The Importance of Setting Expectations,” JofA, Sept. 22, 2025
“How to Stop Work From Consuming Your Life,” JofA, Jan. 1, 2025
“Taxed at Work? 4 Keys to Staying Healthy, Happy, and Productive,” JofA, July 8, 2024
Podcast episodes
“Leading With Authenticity and Vulnerability,” Transforming: Tales of Business Evolution, AICPA and CIMA PCPS, May 30, 2025
“Working 9 to 9: One Expert’s Experience With Severe Burnout,” JofA, April 4, 2024
Websites
Find articles, podcasts, webcasts, and presentations designed to help practitioners tend to their state of mind and to assist firms in supporting their employees.
