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, an 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

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