The Carey Nieuwhof Leadership Podcast

Episode CNLP 755 | 29 Stress Points in 14 Months and My Health Wake-Up Call: Inside My Hardest Year in Leadership in 20 Years

Host: Carey Nieuwhof, Art of Leadership Network
Guest Host/Interviewer: Sean Morgan
Date: September 18, 2025

Episode Overview

In this unusually personal episode, Carey Nieuwhof opens up about what he describes as the hardest year in his two decades of leadership. The conversation, originally intended for Sean Morgan’s "Leaders in Living Rooms" podcast, is a candid deep-dive into the 29 external stress points Carey encountered within a fourteen-month stretch. He reveals the impact of relentless external pressure on leadership, his significant health scare, and the profound insights—both personal and professional—that have emerged from this difficult season.

Key Discussion Points & Insights

1. Defining External vs Internal Stressors

• Carey distinguishes between internal stressors (burnout, overwork, internal conflict) and external ones (events outside of a leader’s control—illness, family death, environmental disasters).
• The episode is framed by the surprisingly high number Carey counted: 29 major external stress events in just 14 months, including family deaths, parental illness, property loss, and a personal health crisis.

"Twenty years ago when I burned out, almost 20 years ago, it was all internal stuff—stress, overwork, all within my control. But starting in February of 2024, there was a series of events...29 when I wrote them down."
— Carey Nieuwhof (03:11)

2. The Health Crisis & Early Warning Signs

• Carey details the story of turning 60 expecting a year of optimal health, only to be hospitalized with a rare blood disorder: idiopathic hemolytic anemia.
• Worn down and confused by symptoms (fatigue, weakness, shortness of breath), Carey paints a vivid picture of being blindsided, the impact on his daily life and leadership, and how health tracking tech (Oura ring) flagged changes before his diagnosis.

"A month after my 60th birthday, I'm in the hospital overnight for the first time since I was a child... The diagnosis that they're still working on is warm idiopathic hemolytic anemia..."
— Carey (09:45)

• The severity shocked him and doctors: "If you go 10 points lower [in hemoglobin], it's welcome to your heart attack or stroke." (15:29)

3. The Prednisone Rollercoaster

• Hospital doctors put Carey on extremely high doses (90mg) of prednisone, with side effects ranging from insomnia and manic energy to depressive crashes and mood swings.
• The experience gave him empathy for people struggling with mental instability and unpredictable moods, reminding leaders of the powerful intersection between brain chemistry and behavior.

"I felt insane for certain points of time... who I am at 11am is different from who I am at 11:18... It's like the White House changes every 20 minutes."
— Carey (18:27; 32:44)

• The side effects also highlighted the importance of food and exercise for mood regulation, and how medical crises can unexpectedly shape outlook and empathy.

4. The Cascade of External Stressors

• Inspired by Craig Groeschel’s book Winning the War in Your Mind, Carey started journaling his own external stressors over 14 months:
  • Death of father-in-law & leading the funeral
  • Both parents diagnosed with significant illnesses (dementia, heart failure)
  • Moving parents and selling family properties (including family conflict)
  • Massive property loss from an ice storm ("70% of trees in our yard gone")
  • Personal health, work pressures, technology failures, partnership transitions

"As I'm reading Craig's book, I start to journal. Well, how many external stressors have I had?...It was 29. And it blew me away."
— Carey (23:13)

• He describes the effect as relentless punches, comparing it to "being in the boxing ring...and eventually I got knocked down, and then I got back up, and then I got hit again and again." (25:48)

5. Leadership Lessons: Capacity, Margin, and Grieving

• Carey recounts how reaching his threshold forced him to re-examine assumptions about his resilience, capacity, and how much external pressure even the strongest leader can process.

"I thought I was invincible. But at 29, I was really at the breaking point. By April of this year, I was in tears, on the regular with just simple things, and I’m like, what is going on?"
— Carey (08:26)

• Emphasizes the need for:
  • Awareness: Tracking both internal and external stressors.
  • Margin: Building intentional space into calendar and life for grieving, processing, and rest.
  • Boundary-setting: Learning to say no, deflecting non-essential requests, and letting go of unnecessary burdens.

"If you've got 10 external stressors on your list, you probably need to book that weekend away, or you need to slam the laptop at 4, not at 6, or you need to build more margin, more sleep, more rest, more processing into your life."
— Carey (37:46)

6. The Danger of Accumulated, Unprocessed Loss

• Carey and Sean explore how leaders often move from crisis to crisis, with little time to process or grieve. Sean references a key distinction between short-term compartmentalization (which is necessary) and long-term emotional repression (which is dangerous).

"Ministry is a series of ungrieved losses."
— Carey (37:46)

• Without sufficient margin for emotional processing, leaders risk burnout, emotional volatility, and impaired decision-making.

7. Reflection on Expectations and Family Roles

• Carey describes the challenge of being “in control” in professional life but powerless in family crises.
• Acknowledges the personal tendency to carry expectations and try to fix family dynamics, but asks: “Why does someone else’s drama have to be my drama?” (39:14)

8. Contribution vs. Consumption—Rethinking Retirement

• Carey questions typical Western concepts of retirement as endless consumption, positing that real joy comes from contribution at every stage of life.

"I do enjoy consuming in moderation. It’s in contribution... I think God designed us to create, He designed us to contribute. That is a greater joy than lying on a beach forever."
— Carey (70:46)

• The shape of contribution and leadership must evolve with seasons, but the heart remains to serve and invest in others (referencing John Eldredge and Arthur Brooks on the “King” and “Sage” stages).

9. The Power of Relationships and Community Support

• Carey reflects on how the outpouring of prayer, care, and love during his illness moved and surprised him, highlighting the importance of cultivating close friendships and support networks.

Notable Quotes & Moments

• "You can only take so many hits. Doesn't matter how strong you are." (49:16, Carey)
• "Resilience is the ability to get up one more time than you're knocked down." (29:14, Carey)
• "You want to carry on your shoulders what should be on the shoulders of others—and leaders who survive 40 years plus in leadership do that really well." (55:20, Sean)
• "The creativity always happens in the margins." (62:27, Carey)
• "The thing you think is going to get you there actually pushes that stuff away the harder you achieve." (77:26, Carey, reflecting on Thoreau)

Memorable & Vulnerable Moments

• Carey sitting in hospital, reflecting on whether this was a replay of his earlier burnout:

  "I realized, because I know what it is to have the internal storm...this time it was very much alive on the inside." (29:17)

• Carey’s honest account of mood swings on prednisone:

  "I could have been the road rage guy that ends up in some viral video when I'm driving to town...this is not me." (32:44)

• Sean’s emotional honesty about needing an 'emotions wheel' to help process his feelings and become a more peaceful, less repressed leader. (53:33)

Practical Takeaways for Leaders

• Track your stressors. List not just what you manage inside but the weight coming from outside. Be honest about your current load.
• Build margin before you need margin. Creativity, rest, and resilience are birthed in the white space of your schedule, not in ceaseless busyness.
• Process losses before they accumulate. Regularly make room for honest grieving, not just after a blow, but as a normal rhythm.
• Rediscover boundaries. Learn to say no, especially as your responsibilities—and consequences of overextension—increase.
• Reframe retirement and succession. Prepare to contribute, not just consume, in every season.
• Value your inner circle. Intentionally nurture a few sustaining friendships and invest in community.
• Empathize and adjust as a leader. True capacity is always limited; adapt rhythms, expectations, and work styles accordingly, especially after health or life transitions.

Timestamps for Key Segments

• Carey introduces “29 external stressors” (03:11–05:50)
• Health wake-up call details (09:45–18:53)
• The impact of prednisone & mood (18:27; 32:44)
• Counting and describing external stressors (23:12–27:07)
• Reflection on margin, grieving, and emotional health (37:46–59:15)
• Reimagining purpose, contribution, and retirement (70:46–76:53)
• Walter Thoreau quote on seeking meaning (77:26)
• Final thoughts on relationships and gratitude (81:07–83:16)

Episode Tone & Style

Carey’s tone is candid, vulnerable, and practical—equal parts storytelling, confession, and coaching. He expects to help leaders feel seen in their struggles while equipping them with fresh language and tools for endurance. Sean brings warmth, empathy, and peer perspective, making space for deep reflection and challenge.

This rich, transparent dialogue is a must-listen for any leader navigating seasons of relentless external pressure, seeking permission to slow down, grieve, and build a life marked by authentic contribution and sustainable impact.