The hugely-pressured nature of the legal profession, combined with the personality characteristics of those attracted to the law mean a high number of lawyers are prone to psychological problems such as depression. Sarah Dryburgh reports

As a psychotherapist with a practice within easy reach of the City of London, it is hardly a surprise that I receive a lot of enquiries from lawyers. What I do find slightly shocking is that lawyers make up one of the largest single occupational groups among my clients, despite the fact that there are better represented occupational groups in the area.

Although they have specific individual problems like any other group, I began to realise that there were common factors which make lawyers prone to psychological problems, particularly depression. The first thing I noticed was how difficult it is for lawyers to find the time to attend sessions. Some can only manage appointments on Saturday. Others arrive by taxi at 9pm – having left the office early – and in some cases return to work after the session. The rhythm of work in law firms seems to be relentless, even by the standards of other professional organisations. Law firms are required to offer a very high level of service and responsiveness in a very competitive environment, putting the needs of the client first at all times. Naturally, these pressures are transmitted to the individual lawyers. Another characteristic of the work is its stop-start nature – periods of frantic activity alternate with lulls between projects. For many this creates an emotional rollercoaster which is hard to handle. It is particularly difficult for anyone with a tendency to manic depression, as the highs and lows of the condition are mimicked by the highs and lows of the workload.

As might be expected, this unusual environment calls for an unusual type of person. It is a given that someone entering the world of City law is highly intelligent, well educated and extremely hard working. Behind these objective characteristics, however, there is often a very particular psychological type. The rather cruel paradox is that the very characteristics that enable this personality type to enter a large firm and perform well, are the characteristics that create problems.

The amount of effort and dedication required to qualify into the profession – and then to practise at a high level within it – means that City lawyers tend to have an unusually high level of drive. This drive can come from a variety of different sources: the need to compete and win, the desire for the income and status which success brings, or perhaps just a very strong intellectual fascination with the work. There is another source of drive, however, and it is this which often creates a problem. Many people who reach success are driven, paradoxically, by a feeling that they are not successful or not good enough in some way. They have come out on top in a highly competitive world throughout school, university and employment, but still feel as if they are frauds or failures.

Another related trait which can make for both professional success and personal unease is a tendency to feel overly-responsible. Not only do such people feel responsible for their own work, but they have an automatic response to feel responsible for anything that goes on around them. If a matter is not going well, whether it is because of the inherent limitations of the situation, someone else's failure or just simple bad luck, they will feel personally accountable – and even guilty. It is easy to see how such a person would be valued in a professional practice, and how difficult they would find life personally.

People of this personality type have a very strong need for approval, but at the same time find praise difficult to accept. They hold themselves to impossibly high standards: when it comes to their own performance, the glass isn't 95% full, it is 5% empty.

The final paradox is that people in this bracket are often unable to 'downshift'. The personnel director of a large City law firm told me that although quite a few of her lawyers left the firm and moved out of London in search of greater quality of life, many of them soon returned. They had found the quality of life, but not the quality of work. The work they were doing simply did not offer the intellectual stimulation they needed.

Stress, lack of control and the feeling of never being quite good enough add up to a powerful recipe for depression. Depression reduces the quality of your work and not unusually leads to drug or alcohol abuse. A depressed person is a difficult colleague – aggressive, uncommunicative and generally very difficult to be around.

So what can we do? The practice of law can hardly be reorganised. Neither can we completely change the personalities of lawyers. One of the crucial questions I always seek to address with my clients is: do we try to make changes in the way we think and react, or do we look for ways of living more easily with the way we are? In this case we need to recognise the inherent conflicts and compromises and work more effectively within them.

So, if you find yourself caught in this double bind, what can you do? Firstly, be less hard on yourself. It is a fundamental tenet of psychotherapy that if we can understand and observe the way we think, we have a chance of changing our behaviour. So try to observe what is going on. What are you saying to yourself? Can you identify any specific events or situations that trigger feelings of depression and hopelessness?

As a lawyer you are probably very good at building and arguing the case against yourself. Try making the opposite case – if only as an intellectual exercise. Remind yourself of your achievements. Look for things that you have done well. Set yourself more realistic goals and standards. Recognise that sometimes things will not go perfectly, for reasons which you cannot control. All this may be easier said than done, and you will certainly benefit from the support of others. Cherish friends and personal relationships, but be prepared to look for professional help as well – in addition to specific skills, a psychotherapist offers objectivity and has no agenda other than helping you out. I'd also recommend exercising whenever you can, and avoiding drugs and alcohol. These have a depressant effect and will leave you feeling worse than you did before.

Finally, some advice for managers. First of all, recognise how lucky you are to have this sort of person working for you. Think of how many managers have to deal with staff who are lazy and constantly looking to cut corners or avoid responsibility. You don't need to worry about any of that. Your staff are hugely conscientious and hard working, and will drive themselves to the limit. In fact, they could be driving themselves beyond the limit to the point where they damage themselves. That is what you need to prevent. Don't be too controlling, except where necessary in the technical aspects of the job. Make an effort to recognise achievement or good work – a little praise or recognition goes a long way. Most of all, avoid at all costs sounding like a nagging or critical parent – these people are quite capable of supplying that function themselves.

Sara Dryburgh is a psychotherapist based in London.