Doc Martin GP

Doc Martin GP Dr Martin Brunet | GP and GP Trainer near Guildford UK | Videos on mental health topics

11/04/2026

If you have health anxiety then this is SO important to understand! We know that what we think can make us anxious, but it is just as likely that how anxious we feel at any given time will affect how we think! When we feel anxious our brain will recognise the feeling of threat and look for the source of danger, and so will be more likely to misinterpret innocuous symptoms as dangerous, raising our threat level further in an ever ascending cycle until we are really panicking!

So, if you catch yourself in this cycle, worrying about a symptom, seeking reassurance, looking at the internet for answers and feeling increasingly alarmed, remind yourself that your brain can’t be trusted to make the right decisions when it is feeling threatened like this. Instead of focusing on the content of what you are worrying about (the cause of your symptoms), change your focus to regulating your nervous system first. This might involve slowing your breathing, grounding techniques, physical activity or distraction. What is important is that it should help bring you down from the flight/fright response that was triggered by the symptom and the health worry. Once you are back in the green zone and the warning lights have quietened down, then you can start to carefully re-look at the symptoms that were worrying you (if they are still there, they may have even disappeared!) and decide if you need to act on them or not. I’m not saying this bit is easy, but it is a lot easier to do once we are calm than when we are panicking! 😊👍

I don’t think there is enough out there to help people with health anxiety! Maybe I need to write a book on it? Let me know what you think! I’d love to hear your views on anything to do with health anxiety! 😊👍

03/04/2026

Supporting someone else who is struggling with their mental health can be challenging. Carer burnout is a very real issue and it is so easy to make basic mistakes - like telling an anxious person that they have nothing to worry about or trying to help with their OCD using scientific logic.

We need to learn about what they are dealing with in order to avoid these mistakes, but not learn so much that we try to fix them, since that rarely ends well and we usually end up pushing our ideas on them when they are not ready, and when they are probably not the best ideas anyway!

We can help in other ways though - a very powerful tool is coregulation, where we help someone to regulate their nervous system by keeping our own calm so that they can come in tune with us. And setting boundaries is sometimes so important, not only to avoid carer burnout but also to help provide structure and consistency for the person we are supporting.

There are certainly more tips than just four so I feel that this one might need a sequel - what would be your tip for other people to learn from? 😊🤔👍

28/03/2026

So should RSD be a medical diagnosis? It isn’t recognised as such at the moment, and maybe it would help give it more prominence among doctors if it were to become a formal diagnosis? Certainly at the moment it’s not much talked about in GP circles.

And yet it seems to be more of a symptom (or a cluster of symptoms) than a medical condition. Often it occurs as part of ADHD, which is why has been talking about it on his excellent and published his new book on the topic (‘Why does everybody hate me?’ - I haven’t read it yet but it is my next audiobook to listen to and I think it will be great - do check it out). It is certainly important, and people who experience an RSD reaction really relate to the description of an unbearable, almost instantaneous and overwhelming physical and emotional reaction to rejection. But does it need to be a diagnosis? Labels are complicated and so I think we should only make a new diagnostic label if we are sure it will be helpful; and the problem with any diagnosis is that you need a clinician to make one. I can genuinely envisage long waits for people who know they are affected by RSD to ‘get their diagnosis’ of RSD, being left in limbo in the meantime. At the moment you don’t need a doctor, you can just learn about RSD, see how much you relate to it and then learn about what might help. I wonder if that isn’t a bit simpler? I’m ready to be persuaded, though, so I would love to hear your thoughts! 😊👍

14/03/2026

There’s a right-wing narrative that people with mental health problems are flakey, take time off because they don’t want to work and are ruining our country by living on benefits. When you hear this narrative, and hear how GPs are being pressured by their manipulative patients to sign them off work, just remember that the journalist has only chosen to interview GPs who might support this narrative, and that when I said I had a different view, they didn’t want to know.

12/03/2026

If our solution to the mental health crisis is to police fit notes and make it harder to be away from work when you are unwell then we will only make things worse. Of course there is always the chance that someone, somewhere is ‘milking the system’ but the vast majority of people I sign off work with their mental health don’t want to be off work and they don’t want to be unwell. As a GP I am here to listen to them, to support them and to believe them!

Instead of berating GPs for being soft on our patients, or blaming patients for being unwell, we need to improve the support to help people who are unwell, making it much more specific for the person and not one size fits all, improving trauma services, having neurodiverse awareness therapy, coaching, better support and access for people with ADHD and more - then we really could make a difference to people, and reduce the cost of welfare in the process!

In fairness to the BBC article there is some mention of this in the second half and there are some good initiatives mentioned, but it is government response that will matter here.

07/03/2026

If you needed to, could you vacuum only half a room and then have a rest? Be honest! 😊😂

Many of us are very task oriented, we don’t like to waste time and resting makes us feel guilty. These are all understandable, but when you are recovering from burnout, or another significant illness, then you may need to rethink and learn all about the value of rest!

28/02/2026

If you are stressed, anxious or emotionally distressed, should you try to stimulate your vagus nerve?? Well, yes, and no! I can see why people suggest it (and there is loads of advice about it on social media!) since the vagus nerve calms our nervous system, it slows the heart rate, calms our gut function and get our body ready to rest. People suggest massaging your neck where the nerve is located, cold water or buying an expensive vagus nerve stimulator, among other things.

There are two problems with trying to directly stimulate the nerve. The first is that it’s hard to do it in a sustained way. Massaging the vagus nerve is actually a medical intervention intended to slow the heart rate in certain heart rhythm problems, and so I have performed it in multiple patients - I can tell you that getting any meaningful slowing of the heart rate is very difficult, you have to rub quite vigorously (which can actually be dangerous), it’s not very pleasant and the effects are brief. Which is why companies will sell you a stimulator for a more prolonged effect (and several hundreds of £s!)

The second issue is that if all you do is stimulate the vagus nerve then you are only dealing with half of our stress system and are ignoring the flight and fight response of the sympathetic nervous system, it really is like pressing the brake without taking your foot off the accelerator! We need to reduce sympathetic stimulation as much as stimulate the vagus nerve!

Thankfully, many of the techniques that’s are recommended for stimulating the vagus nerve are actually relaxation or grounding techniques that affect both sides of the equation. So when you read advice about controlling your breathing, singing or humming, meditation, gentle exercise or laughter, these are all great things to do, and they do stimulate the vagus nerve, but they do a whole lot more than that! And we don’t need to dress it up in the language of neuroscience to know these things are good for us - they are just obviously a good idea! 😊👍

What do you think? I’d love to hear! 🤔😊👍❤️

25/02/2026

There’s a lot of talk about being a ‘people pleaser’ but is it a helpful label? The problem when we use a label like that is that we are describing the person, rather than the activity. Someone may sometimes fall into a pattern of thinking that involves people pleasing, but this does not define them - at other times they will not be thinking this way at all. What is more, someone who often ends up people pleasing worries about what people think of them, so giving them a negative label like this is doubly harmful, since it gives them another reason to feel bad about themselves 🥺

People pleasing is a pattern of thinking where the primary driver is anxiety about what people think of us and stems from overthinking, often associated with a strong driver for perfectionism and a high degree of empathy for others. If we can see it as a pattern of thinking, rather than something that defines a person, then they can spot themselves doing it, challenge their thinking and learn new patterns of thought. They will be better able to tell the difference between pleasing another person (when our motive is the joy of making someone happy) and people pleasing (when our motive is driven by worry about what others might think).

What do you think? Is being a ‘people pleaser’ a useful label or a burden? If you find yourself people pleasing how have you identified that this is what you are doing, and how have you managed to change your thinking? I’d love to hear your thoughts! 😊🤔❤️

07/02/2026

If you’ve already read Reasons to Stay Alive by I’d love to know what you think about it. It’s a book I keep coming back to because it is full of gems, and has the authenticity of someone who has lived through every word he has written.

The book is raw at times, Haig has been to some dark places and the journey out of them is not easy, you feel his pain and despair. But you also respond to the hope in both his story and his words. This is no organised, structured self-help book, but full of poetic passages, streams of consciousness, lists of people who have inspired, music or books that have fed his soul when he most needed it. Most of all, there are gems of insights that will stay with you, and might help you when you most need it! 😊👍

05/02/2026

This is such an important message that I need to keep saying it - burnout is NOT a sign of weakness. If you have had burnout, or are in the middle of it now, please hear this as you need to know that you weren’t too weak, you just got overloaded. More likely you were too strong and didn’t notice what a heavy load you were carrying.

And if you think you are immune from burnout, that it could never affect you, then please listen too - it can happen to anyone. That doesn’t mean it will happen to you, but the more you think it couldn’t happen to you, the more you make yourself vulnerable. This is because you won’t spot the signs, you will take on too much, and you won’t prioritise checking in on yourself or doing things that keep you well.

The signs of burnout are not the signs of someone not coping - these come too late. The early signs, the ones you want to look out for, are moments of irritability, brief feelings of being overwhelmed, being close to tears before pulling yourself back together, being less patient than usual, feeling less able to empathise. Those who know you best will notice first, and one of our best safety valves is if those people feel able to tell us what they are noticing, without fearing how we might react. The time to check they can do this is when we are well, so it is good to ask ourselves who in our lives would notice, and have we given them permission to tell us if they have concerns?

I was looking back and realised that I first posted this two years ago this week! It’s such an important message that I thought it was definitely worth putting it out there again! 😊👍

I also have to acknowledge Tim Cantopher’s excellent book Depressive Illness the Curse of the Strong as the first time I heard and understood the nature of burnout.

31/01/2026

The Mould effect is really fun, and has fascinated physicists as they have worked out why the beads fly up into the air like that! Do check out here and on YouTube for a full explanation about how he discovered it and why the beads seem to defy gravity like this. What is interesting is that he was trying to solve a problem (how to visually demonstrate a self-siphoning fluid) and asked himself a ‘what if? question - what is I use a chain of beads to show how the laminar flow of the liquid works? And that is how he made his remarkable, and unexpected, discovery.

‘What if?’ questions are an essential part of being human. It is how we solve problems, make discoveries, become creative and more - new ideas would never come about if our brains didn’t do this. What makes anxious ‘what if?’ questions so challenging is not that our brains have had an idea, but that the idea is coupled to a fear response - often based on our past experience. When anxiety is a problem, if we can shift the focus from the ‘what if?’ question to how to manage the fear response then we can really make progress with our anxiety, and ideas will just be that - ideas, nothing more.

The techniques for uncoupling the fear response are all about calming the nervous system, and involve things like managing our breathing, grounding techniques that draw our attention from future uncertainty to physical reality, and distraction. I have written about some of these techniques in my book Your Worry Makes Sense, and will keep posting about it, so follow to see more posts on this! 😊

24/01/2026

How doctors communicate is probably as important as how well we diagnose and treat. We can heal with the words we use, and we can also harm and even traumatise. Sometimes this language is endemic in a system, and serves the system rather than patients.

Describing a patient as ‘not meeting threshold’ serves the system. It justifies restricting access to a stretched service and makes clear to the referring GP which patients will be accepted and which won’t - it certainly acts as a strong disincentive to refer patients who might not be accepted. But what does it do to the patient?

Any GP will tell you how it can leave patients feeling, because we see them after they have received the letter that describes them in this way; so often we have to work hard with them to rebuild trust, validate their experience and find a way forward. It really isn’t going too far to say that they are often left traumatised by being told they are not ill enough to be worthy of help, when they probably can’t imagine feeling more ill than they do right know. Can you imagine a cancer patient being told their cancer isn’t bad enough to meet threshold?!

I know that mental health services are stretched, and that it is not the same as cancer. I know that they can’t support everyone I would like them to, and that other services might be more suited to some of the patients I refer, but a simple change of language would make such a difference! Explain to people, in a kind and humane way, that there is a better service for them, or even that you would like to support them but don’t have capacity, and they will find it so much easier to navigate. They might be disappointed, unhappy even, but they won’t feel invalidated or traumatised like they do now.

There are many good people working in mental healthcare, and maybe you have a kinder way of handling this - if so I would love to hear what you do differently. If you have been a patient, what has been your experience? Or if you work in primary care, what happens in your area? I would love to see a change here, and it shouldn’t be hard! 😊🙏👍

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