Not everybody is able to cope with the pressures of being a top executive.
The post-2008 economy has put considerable stress on the role of the chief executive officer (CEO) or the managing director of large organisations.
Paul Juljich was chairman of multi-million dollar organic food company listed on the New Zealand stock exchange.
"I thought I had the perfect life at 40," he says, "I built a grand mansion, had a Ferrari in the driveway, a 25-yard indoor pool, tennis courts. a personal trainer, and I travelled the world free as a bird," he recalls."
However, he says that due to stress and making poor lifestyle choices, he lost everything.
"Over a period of years, I worked very hard and focused on many issues," he says, "But one day I couldn't get out of bed. I was lying in foetal position in total darkness thinking I'm afraid of the world and don't want to talk to anyone."
He had mood swings, which was later diagnosed as bipolar disorder.
"When I was in a euphoric mood I thought I was invincible, signing contracts when I shouldn't be, stripping down to my underpants in a board room," he says.
"I had a complete mental breakdown and can't remember a lot of the embarrassing things that I did," he says, "Stress was controlling me, I wasn't controlling it."
He sought help with a psychiatrist and later booked himself into a clinic in the US.
While in the clinic he researched everything he could about stress.
"There has been stress since caveman days, there will always will be stress," he says.
Prior to the financial crash there was easy access to capital and executives were able to expand their business in a growing market.
But now they need a different set of skills and competencies to drive organisations in a period of significantly different economic conditions.
Some people do not have those skills, according to Toby Lapage-Norris of Boyden Executive Search.
"You need a different set of people to manage in a different environment," he says.
With 70 offices in 40 countries, he notes that the turnover of executives is higher than it has been for a while.
The main challenge is how to maintain shareholders and investor confidence when the market around you is putting you under considerable corporate stress.
"Some people have the capability but not necessarily the experience," explains Mr Lapage-Norris.
"There are opportunities to cut out the fat," he says, "But the real skill is how you then start growing through innovation."
Some organisations are seeing that their potential no longer lies in their domestic market and that growth now lies with the emergence of new economies.
That requires an executive team which can move into a global environment.
Questions are then asked as to whether or not the managing director has the right people at the helm.
"What is needed are chief executives who have the courage to do things they need to do, and also the humility to recognise they might not be the right people to do it," Mr Lapage-Norris insists.
There is a need to recognise that the business environment has become more complex and they might therefore need a different person in charge.
"Do they make that call before the shareholders and the institutions?" he asks.
"What is required is a balance, of a combination of skills, courage and humility, intellectual vigour and strategic capability," he says.
Mr Lapage-Norris now spends more time with organisations to understand what they really need, rather than just responding to what they want.
Understanding that business is not conducted the same around the world is a key requisite when choosing a new CEO or managing director.
"Relations need to be built and that is done differently in some cultures," he says.
"The key is to embrace diversity and very few do it well," he notes.
"We are looking for people with transferable skills, who can move from different geographies or technologies or markets so they can bring that experience to a particular company which is looking to change its technology or its geographical footprint," he says.
However, pressures which come with the office of a CEO or managing director have always been there - they are the ultimate decision maker and they have to display courage, confidence and commitment.
They also need a little humility according to Mr Lapage-Norris, when someone thinks: "This needs to be done and maybe I can do it while others have failed."
He says those are the people who display real leadership rather than just ego, and it is those men and women who actually have the ability to build organisations.
Business Daily is broadcast Monday to Friday on the BBC World Service. You can listen to this story here.