A recent job satisfaction report published by Financial News showed that nearly a third of financial executives have suffered from stress or depression in the office, but very few of them felt able to inform their employer about the difficulties they were experiencing.

Stress and depression in the financial sector is not a new phenomenon. In the 19th century, one of the possible diagnoses a City worker could receive on admission to a lunatic asylum was ‘business anxiety’, according to contemporary reports. This long tradition of anxiety in the financial services has been exacerbated by an aggressive and competitive culture, now well established and showing few signs of becoming any less malign.

Status anxiety

This is a sector in which the worker is expected to be “strong” and resilient, and in which any sign of psychological unease or distress will be interpreted as weakness. Those working in the brash and show-off culture of the City feel a pressure to achieve status and wealth, in an environment in which differences in hierarchy tend to be associated with large disparities in income. It is a very competitive world that expects self-confidence and recompenses aggression.

This constant pressure generates status anxiety, which is a feeling of unremitting unhappiness, caused by the fear that one’s own status is being permanently threatened by the achievements of others.

Another factor compounding the anxiety of the City worker is the lack of a direct and predictable correlation between the effort invested in the job and the reward generated by it. A 25% extra effort may yield a proportional increase in reward, but it is equally likely to produce much less, or much more, or none at all.
As a result, the ever-present drive to work more is accompanied by a very unsettling feeling of uncertainty about the actual results of one’s toil.

Success is undefinable

Success, however we try to measure it, is a slippery concept. A patient of mine once told me that he thought he was a total failure. I initially thought he was referring to his personal life, because otherwise he was obviously a wealthy and successful man. But no, he was in fact referring to his perceived lack of wealth: “Me? Successful? You must be joking, doctor: every single friend of mine has
a private jet, but I still can’t afford one.”

Personal success is a bad goal to have in life, because nobody really knows what it actually is, or what it consists of. Since we don’t know what success is, it is therefore impossible to attain, so our repeated attempts to reach that nirvana will inevitably fail. Our status anxiety will increase our levels of nervous arousal and this in turn will make us feel anxious and unhappy. Our thirst for success will not be satiated; peace of mind will remain elusive.

Symptoms of anxiety

The main component of an anxiety disorder, which is what we call the type of anxiety that is more or less constant and quite disabling, is a feeling of impending doom. One dreads having to face the world in the morning. There is an excessive arousal of the nervous system, so one’s heart goes a little too fast and the digestive system is in overdrive. Sleep is often a problem and appetite is erratic.

Almost invariably, anxiety is accompanied by depression, a pervasive sadness that seems to infiltrate all and reach everywhere. A life lived with constant anxiety is impossible to enjoy, so it becomes very gloomy or, as Hamlet would put it, “stale, flat and unprofitable”.

Possible remedies

If one is suffering with such anxiety and depression, the first step is to acknowledge the problem. Working in the City, this may potentially be a difficult thing to do, given that there is arguably a higher level of stigma attached to mental health issues in the financial sector than in other occupations. It is therefore the responsibility of City employers to catch up with others in this area and provide support – or at least understanding – for those who find themselves struggling.

For the individual concerned, there are effective treatment options available. Standard remedies include antidepressant and anxiolytic pills, which will help a proportion of sufferers, at least to some extent. There are also different varieties of psychotherapy (talking therapies) that can be deployed, such as Cognitive Behavioural Therapy (CBT). ‘Mindfulness’, which is a type of meditation that emphasises the ‘present moment’, may also help control anxiety [see more on p32]. More recently, a novel physical treatment called repetitive Transcranial Magnetic Stimulation (rTMS), which has just lately become available at the London Psychiatry Centre, has proven effective in the treatment of depression and anxiety and, better still, it doesn’t involve pills.

It is in everyone’s interest to improve the mental health of the finance industry, and not a moment too soon – it’s time to reduce the levels of anxiety in the City.

Dr Rafael Euba is a consultant psychiatrist at the London Psychiatry Centre, 72 Harley Street, W1G 7HG; psychiatrycentre.co.uk