The most successful people I meet are often the ones struggling most | Darren Lee

Sometimes the behaviours that helped us survive become so embedded that they mask our past traumas and adversity

• The modern mind is a column where experts discuss mental health issues they are seeing in their work

Some of the most successful people I meet as a psychiatrist are also some of the most dissatisfied with life. They don’t necessarily look unwell. They are executives, entrepreneurs, doctors, lawyers and high achievers. They run companies and families. They are the people others depend on when something goes wrong. Often, they are exceptionally good at coping. Until they aren’t.

Holly* came to see me after years of depressive symptoms and worsening substance use, both of which she had largely managed to conceal from family, friends and colleagues. Her GP recommended a residential treatment program. In her early 40s, she held an executive position in a demanding organisation. She was ambitious, respected and known for her extraordinary work ethic. She was also exhausted.

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