My feeling on this is that if you get to that tier in the technical world, you should probably have realized what you were getting into long before you get there. Now as to whether that ultimately leads to depression or burnout, I think that's going to depend on the individual. There should have been enough early warning to prepare yourself to avoid it (although it is likely many do not).

I would say that the thing that mortifies me the most, and it is an issue that continues year after year after year, is dealing with all the new newbies learning the same lessons over and over again. Things like how to troubleshoot, make code changes without causing side-effects, or at least knowing where and how to look for side effects, etc. Each new wave of newbies goes through the same learning process while the old-timers end up having to deal with the fallout. Now that's depressing.