One morning, John, a 44-year-old software designer, wakes up and realises he no longer has to go to work. For several years, he has toiled 60-70 hour weeks at his Silicon Valley start-up. Now his company has gone public and John is worth over pounds 3m.

His dreams have come true, yet, after an initial spending spree, his life seems empty. What now? he asks himself. He doesn't want to start a new company, but he no longer needs to work at the old. His friends, jealous, are unsympathetic. Instead of enjoying his new wealth, John is isolated and plagued by anxiety.

Like other unfortunate multi-millionaires, John is afflicted with what psychotherapist Stephen Goldbart has identified as "Sudden Wealth Syndrome". Symptoms include overspending, dreaming about money, sleep disorders, guilt, marital breakdown and drug abuse.

In the San Francisco area, the Internet gold rush is creating 64 new (dollar) millionaires every week. Add to this the billions in inheritance being doled out to baby boomers, and you have a critical mass of former middle-income Americans who are suddenly stinking rich.

Most of us imagine our problems would be solved by an injection of cash, yet the nouveau riche just can't cope. In fact so many are traumatised that Stephen Goldbart and colleague Joan DiFuria have recently founded the Money, Meaning & Choices Institute in California, where victims of "Sudden Wealth Syndrome" are queuing up for treatment.

Goldbart's patients are worth between pounds 3m and pounds 36m and range from their mid-twenties to late forties. Like John, most did not grow up in wealthy families, and don't have a history of dealing and living with money. "All of a sudden, they have more money than their parents ever had and far more than their friends. Getting money sends a shockwave. It is like going to a country you've heard about and is supposed to be fantastic. Once you're there, you find you don't know the language or what to do with your time," says Goldbart.

The first reaction, of course, is often to spend, spend, spend. In San Francisco, an Internet "dot-com" millionaire reportedly offered pounds 11m for a house plus pounds 650,000 for the furnishings. Others have reportedly sent estate agents up to houses not even on the market, to ask the owners to name their price.

There are waiting lists for pounds 10,000 Hermes bags, and sales of luxury cars are booming. If the "dot-com" millionaires don't buy, then they build - vast new houses with marble swimming pools dubbed "McMansions". "They overspend," says Goldbart, "but once their shopping spree is over, what are they going to do, buy yet another car? Spending is not an endpoint in itself; when they are past that high, an identity crisis sets in."

Newly wealthy people fail to realise that suddenly coming into money means a change of life and identity. "These folks have more choices yet do not know what to do with them. They may also feel guilty about having so much. If you are from the middle classes then wealth separates you from your peers and you can get lonely", says Goldbart.

Sylvia, who is 40 and recently inherited a substantial sum of money, came to see Goldbart because she was worried about how her friends would react. "I'm excited about my inheritance but afraid to show it, because it might turn off my friends. I fear they might think I'm just a spoiled `poor little rich girl'. I'm also worried how this money will affect my husband", she says.

Many newly wealthy people discover old friends are quickly replaced by new "friends" who pester them for donations to help fund an artistic endeavour, new business, or help a relative in trouble.

Millionaires, poor things, may also have to deal with hostility. "There is a lot of animosity towards those with money. It's even worse in Britain where there is less sense of social mobility", says Goldbart. At the institute, he treat patients in three stages: "First you must recognise you have a problem, second regain control over that problem, and thirdly rebalance your life."

Silicon Valley workers put in long hours; many start at 6am and leave at 7pm. "To be happy, you need a balance between self, relationship, work and community. We point out that dedicating yourself primarily to work is not healthy", says Goldbart, who encourages "dot-com" millionaires to get involved in philanthropy.

Goldbart finds it easier than most to be sympathetic towards the problems of the rich. His own wife recently inherited a lot of money, and although he won't reveal what he charges for psychotherapy, his clients are millionaires. But wouldn't his energies be better directed towards helping the have- nots? Isn't his practice just another indulgence for angst-ridden rich people?

Goldbart counters that he is encouraging his patients to give more money to charity. "As well as helping them recover, we are showing them how they can return some of their wealth back to the community".

Sudden Wealth Syndrome does bring one other benefit to the community. It provides some solace to those of us who have struggled for years from that other popular malaise: No Wealth Syndrome.

Help - I've Hit the Jackpot

IS "SUDDEN wealth syndrome" getting you down? Here are a few pointers to help you handle your millions:

Do:

Become a philanthropist. Think of all those charity balls! (And of course the pleasure you'll gain from helping others)

Travel. Why not? Sometimes you really can run away from your problems

Keep your day job. You'd only be bored at home, lounging by the pool. And anyway, we need you to make the tea

Stay in touch with friends and family (although, if you never really liked them, you could find new ones at Tramp)

Leave all your money to cats

Don't

Tell us exactly how much you're worth (including share portfolios and overseas investments). It's boring. And we'll hate you

Buy a jacuzzi for every bedroom - it's so nouveau riche, darling

Waste your money on gold-digging dates (unless it's the only way you can pull, in which case, needs must)

Spend, spend, spend. You don't need to tip the pizza delivery boy with a Merc

Whinge to the papers about how money has ruined your life.

Do you really expect sympathy?