As we have seen, there is a lot you can do in response to stress and trauma - both for yourself and your colleagues - before you even need to start thinking of seeking help from a mental health professional.

As a manager, you should start thinking of professional support for your staff when:

• You feel that your support is ineffective
• You cannot make the time to help someone
• There is aggression or abuse (physical or verbal)
• There are threats of self-harm
• You believe a situation is hopeless
• You feel that further discussions will affect professional relationships
• You are too close to the person concerned and need an objective perspective
• It is clear that there are more serious issues that need addressing.

You should start thinking of professional help for yourself when:

• Self-care strategies are either not working or you are unable to implement them
• Simply talking over your problems is doing nothing to relieve symptoms
• Your use of alcohol or other substances is interfering with your work and relationships
• You have been suffering consistently from acute stress symptoms for more than a month
• You feel like you want to give everything up.

Many organisations offer employees professional support and counselling through tailored Employee Assistance Programmes (EAPs). If you do not have access to such a programme through your organisation, but would like support from a mental health professional, it is possible to arrange counselling through CiC.

CiC have been providing psychological support to organisations and employees for over 19 years through a range of services that include EAPs, critical incident support and mediation. In order to access this service, a member of your HR team should call CiC on 44 (0)20 7937 6224.

Drug and alcohol treatment

If you have a severe addiction problem, no amount of therapy will be truly useful until that is first addressed. Therapy raises many uncomfortable feelings and repressed emotions; processing them constructively becomes almost impossible if they are then obliterated by addictive consumption.

There are, again, many different approaches to working with addiction, but most treatment programmes for addictive disorders are based on the so-called 12-Step model pioneered by Alcoholics Anonymous and now practised by a host of different organisations, including Narcotics Anonymous, Gamblers Anonymous, Overeaters Anonymous and Sex Addicts Anonymous. Treatment emphasises an admission of personal powerlessness over the substance or behaviour concerned, and combines social support (centred on regular meetings) with behavioural guidelines and the development of spiritual awareness.

The AA model promotes either total abstinence from the substance or behaviour (in the case of alcohol, drugs and gambling) or modification and integration (in the case of sex and eating).

For those uncomfortable with the 12-step approach, there are different treatment programmes that advocate cognitive behavioural techniques in order to moderate behaviour. While some people find they are able to cut back on their drinking and stick with it, many people with severe alcohol-related problems find that abstinence is the only effective solution.

Medication

Medication for depressive disorders continues to cause controversy in both medical and psychotherapeutic circles. While research has proved conclusively that anti-depressant drugs such as Prozac can be useful in some cases and even life-saving in others, it is now a widely held belief that they are being over-prescribed in almost epidemic proportions.

Critics of the widespread use of anti-depressants say that they have become a quick fix for anyone seeking relief from even the most minor emotional difficulties. Where more serious problems occur, they also say that anti-depressants can distract sufferers from actively and comprehensively working through their inner conflicts.

Having said that, medication has proved remarkably successful (in combination with good therapy) in the treatment of severe depression and Post Traumatic Stress Disorder.

As a rule of thumb, medication should be considered when emotional difficulties have begun to interfere systematically with the functioning of someone's life. Being too depressed to get out of bed, for instance, or thinking regularly of suicide, are two cases in point. Medication also works well in combination with therapy when someone is simply too closed off to be able to discuss their problems in any meaningful way.

If you think you might need medication, it is critically important that you first discuss it with a doctor, psychiatrist, or other mental health professional.