Stories of heavy boozing, drug-taking, long days and short fuses in the City are legion, and recently there have been reports of a surge in referrals to psychiatric practices as City workers struggle with stress, anxiety and depression.

If anyone is qualified to sift myth from reality, it is 49-year-old Dr Neil Brener. Most weeks he works for a day at the Rood Lane Medical Group practice in the City, half a day at Canary Wharf in Docklands, two-and-a-half days at the Priory Hospital in North London, where he is medical director, and a day in Harley Street. He is arguably the City’s leading consultant psychiatrist.

“I see everyone from chief executives to cleaners and postroom workers,” he says. “Mental illness is no respecter of status.”

The proportion of men and women whom Dr Brener sees is roughly equal, and most are aged below 45. A “disproportionate number” work in the IT sector.

What could account for this last fact? “They may be particularly susceptible to stress because of their strict deadlines,” says Dr Brener. “There are millions of pounds riding on them getting things right, and they are perhaps more isolated, more focused on machines and find relationships with people difficult.”

In discussing the “psychopathology” of the City, says Dr Brener, it is useful to look at particular disorders. “Quite often you see cases related to some kind of anxiety disorder, such as panic attacks,” he says. “There are all sorts of triggers – an excessive intake of drugs or alcohol, a failed relationship.

“Bereavement is a very common trigger – I see that much more in the City than anywhere else. You see people who have been doing well, then they lose a family member and the whole thing begins to emotionally unravel for them.”

Part of the problem, suggests Dr Brener, is that while the City provides a structured environment for professional development, it does not accommodate emotion well. “There is a failure to recognise the fact that people are not machines,” he says, adding that City workers are often their own worst enemies: such is the stigma of mental illness that they often try to convince themselves that they are suffering from a physical rather than a mental problem, or self-medicate.

“The City is about being cool, calm, calculating and knowing what you’re doing,” he says. “Anything that stops feelings from getting in the way is used – though you never see crack or heroin, because on those you become so disorganised that there’s no chance you could hold down a City job.

“I see very severe alcohol problems, though. There is plenty of cocaine if you want to use it, and all sorts of other problems. Workaholism. Sex addiction is more common than you would imagine. Compulsive overeating. I’m waiting to see my first true BlackBerry addiction. And then there is gambling.”

A recent report suggested that gambling addiction has more than doubled in the UK since 2001, and that those most susceptible are men aged between 25 and 34. Dr Brener says that the problem is accentuated in the City, where traders are arguably paid to gamble with other people’s money, and where winning performances are rewarded with large amounts of cash. He has coined the term “bonus anxiety disorder” to describe the way in which psychological health is affected.

“There’s a great deal of tension around bonus time,” he says. “The size of what you get tells you whether your stock is rising or falling, and people often struggle. My advice to anyone finding it difficult is to seek help. Do not die of shame and guilt – talk about it.”

He suggests that a good starting point is to discuss problems with a friend, or with someone from personnel. Human resources departments, he says, are waking up to the idea that it is more humane (and cheaper) to help people to recover than to replace them.

Does he feel that the City is an unsafe place to work? “Well, I only see one side of it. And the City is not just a place, it is a state of mind much bigger than the Square Mile – an attitude that can extend from the West End into Canary Wharf.”

And would he encourage his children to work there? “Only if they knew what they were letting themselves in for,” he replies. “The City can be a very secure and structured place to work, where you are paid huge sums of money. But people then take out large mortgages on their salaries and bonuses, and it can become a gilded cage.”