The workplace can be an unforgiving environment for those suffering from depression, writes Salamander Davoudi.

Alison Cowan was on a fast-track career path in a large London marketing agency when, at the age of 27, she had a breakdown relating to clinical depression.

Her employers asked her to tell colleagues she had a virus. They expressed disappointment in her and said they would not have employed her if they had known she suffered from the illness.

Cowan took some time off and returned to work - only to be treated like an office junior. The company eventually asked her to leave, offering her a small pay-off.

"My line managers made me feel like they were being generous to me but they were actually being very abusive," she says. A couple of years later she bumped into some former colleagues, who looked shocked to see her. They had been told she had HIV.

In spite of legislation in Europe and the US on discrimination at work and a growing public awareness of mental health issues, the workplace can be an unforgiving environment for those suffering from depression. The condition still carries a stigma that makes few willing to admit to it publicly. Yet according to Mind, the UK mental health charity, nearly three in 10 employees will have a mental health problem in any year, mostly anxiety and depressive disorders.

Statistics such as this have come to the fore in the Republic recently too with the launch of the HSE's "Your Mental Health" campaign, aimed at raising awareness of mental health and wellbeing. Research conducted by the HSE found that 85 per cent of Irish adults believe that anybody can experience a mental health problem.

For many employees with depression, particularly those at a senior level, silence often seems the only option - a point that was reinforced last week when Lord Dennis Stevenson, a senior City of London executive who is chairman of HBOS and former chairman of Pearson, the owner of the Financial Times, admitted he has suffered from depression for years, describing it as "hell on earth".

"Depression is a major clinical problem and something like one in five people suffer from it. One in three people get close to the edge," says a partner in a top City firm who has suffered from the illness. "Ten years ago there was a terrible stigma attached but slowly it is getting better."

Today Cowan has a senior job in the city and, partly as a result of her personal experience, has become vice-chairwoman of Mind. "A job that I had been proud of had turned into something oppressive and negative and about telling lies. Now I know my rights."

Clinical depression is characterised by a malfunction in the limbic system, the brain area associated with emotion and motivation. It can occur just once, several times or can be a lifelong disorder. The cause is partly genetic but depression may be brought on by hormonal changes, drug abuse or excessive drinking. Many doctors believe one of the common triggers is stress.

"The classic sufferer is the highly ambitious executive who wants to be seen to be doing well, constantly pushes himself and never takes time off. Ultimately he goes too far," says a former investment banker. "These people are the best employees because they work the hardest and they want to do well. I can spot the personality type within four seconds. It is a stupid company that holds depression against its employees. I think it is closely related to creativity."

The high-risk, macho ethos of the financial sector is often cited as part of the problem. "It's more common in the public sector to receive help but in the world of high finance you have to roll with the punches. You can't afford to reveal any weaknesses," says a corporate financier.

So how should companies respond when they find that an employee is in difficulty? Many offer "employee assistance" programmes, usually in the form of confidential helplines and counselling. Some banks, such as Société Générale, even go so far as paying for therapy. UBS, the investment bank, runs stress management seminars, offers corporate counselling and has an in-house "care team".

"There are processes in place in most city firms," says a former human resources director of a large City of London bank. "They are always confidential so we would receive a bill stating how many individuals were taking part but not their identity."

But in spite of such policies, many employees with depression say they would never consider confiding in their colleagues, let alone seek help from their employer, for fear of being written off.

"Most people don't use these help schemes. Many executives have privately said to me that they wouldn't even go to their doctor for fear of future references that would jeopardise their career," says Andrew McNeilis, a managing director at Talent2, a UK executive coaching firm.

This can make it hard for those at the top to assess the extent of the problem. "People don't generally admit to it," says the chief executive of a second-tier investment bank.

"We have had some people take a sabbatical and disappear. We do offer some paid leave but they usually decide it's the wrong environment for them to work in. It is perceived as a weakness. I don't see a lot of it."

One partner at a UK law firm says: "A lot of people get invalided out of the legal profession following a breakdown, or total inability to cope. Most don't come back. Ultimately you become a cost to the business. It comes down to economics. If you are a superstar and are worth more to the employer stabilised, then they may bring you back into the fold."

Lord Stevenson has called on companies to raise awareness and create a "culture of humanity" where managers are not afraid to show their emotions. Some employees say they would like their employers to offer more flexible working arrangements, provide quiet rooms and allow people to work from home more often. Correcting the stigma towards depression cannot be done overnight, say sufferers, in spite of the willingness of human resources departments to show they are progressive and tolerant.

"The City [ of London] will tolerate many peccadilloes, including alcoholism," says McNeilis. "It will pay for rehabilitation at the Priory for a narcotic habit. It will even turn a blind eye to sexual deviancy. However, the one thing no one ever wants to discuss with their line manager is depression."