London is synonymous with high-pressure work environments. In financial centres like the City and Canary Wharf, stressed professionals walk at break-neck speed as they attempt to balance an impossible schedule with the demands of everyday life.

For some the pressure comes with the job and is manageable. But others have more complex demons at work beneath the surface, ready to feed on the strain.

According to psychologists like Nightingale Hospital’s Dr Bijal Chheda-Varma, working in London can have a massive impact on an individual’s mental health.

This has led to a growing demand for the Marylebone facility’s services, leading to the opening of a new outpatient therapy service after demand increased 20% from 2014 to 2015.

Nightingale has also noticed a rise in the numbers of busy, high-performing workers who require treatment for conditions like depression and anxiety.

“It’s quite a significant problem,” Bijal said, “especially in London where the stress levels build and people are worried about work.

“It can make it a lot worse. Some are not able to get out of bed and function. It can get to the point where it’s so severe that you lose your sense of self.”

The psychologist also warned of the impact the perceived stigma of having a mental health condition might cause.

Bijal said negative reactions were usually the result of people not understanding an affliction rather than anyone trying to cause any harm to those affected.

“I think the biggest issue in terms of society’s attitude towards mental health issues is that you can’t necessarily see them,” Bijal said.

“People don’t know when a person has them. It makes them very difficult to understand if you haven’t suffered from them before.

“I think the biggest part of what the stigma is about is that people want to tell others what they are suffering with but they are afraid people won’t understand them.

“We have got plenty of work to do but I think it is getting better.

“The awareness of the condition that has been raised has helped, particularly with people like Stephen Fry being so open about his experiences.”

Her advice for anyone unsure of what to do is to speak to their GPs, take advantage of NHS and private services and be open with friends and family.

“You should talk to the people closest to you,” she said, “whether that means your partner, parents, brother or friend. Speak up. Don’t fight it alone.”

Dr Bijal Chheda-Varma, psychologist at Nightingale Hospital

Case study: An anonymous London worker with depression

How would you describe yourself before you became depressed?

"At school I did exceptionally well and was a straight A student. After joining a leading law firm, I continued to deliver results and hence was entrusted with a lot of high profile cases. I had a beautiful girlfriend, lots of friends and a penthouse apartment – on the surface, everything was great."

What about after you became depressed? What were your symptoms?

"I felt like a shadow, a husk of myself.

"I had lots of feelings of pain, sadness and suicidal feelings. One of the weirdest symptoms was psychomotor retardation – my brain slowed down and I went from being able to read long complex contracts to being unable to read the cooking instructions on the side of a fish finger packet."

What was your trigger for depression?

"I had a large, complex and high value caseload and I did not manage the stress effectively.

"The final straw which broke the camel’s back was a row with a senior colleague who started bullying me over social class.

"I was not from the stereotypical City boy background. I was simply not equipped emotionally to deal with this in the stressed out state I was in and I hit a brick wall."

To what extent was stigma an issue?

"Stigma was a huge issue. The people knew in the firm where I was working but I managed to get a job at a different firm and hid it from the people there."

Do you know of any other people suffering similar symptoms as you did?

"Yes I do. They tend not to be open but once you’ve had the experience yourself you tend to be able to spot others who have had similar experiences."

Do you have any tips for dealing with depression?

"The importance of regular aerobic physical exercise in reducing office stress is not widely understood in the City.

"Pro-actively taking charge of your own mental health is your own responsibility and the long term benefits to quality of life are truly remarkable."

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