Doc Martin GP (2026)

13/12/2025

We should never underestimate the impact of stress on the body, and Broken Heart Syndrome is one of the most dramatic examples of just how the body can respond to stress. There is often the assumption that if test results are abnormal then an illness is more ‘real’ whereas if it is caused by stress then it is somehow less valid. Takotsubo Cardiomyopathy is surely an example of how real stress can be!

There are many times when a doctor will consider whether symptoms could be caused by stress or anxiety. Clearly alternatives need to be considered, and ruled out, and the suggestion it might be stress needs to be said in an empowering, collaborative way rather than dismissing someone’s concerns, but we need to consider stress as a possible cause just as much as any other cause!

06/12/2025

The news has been full of talk about over diagnosis in mental health with the review by the health secretary and now reporting a survey from GPs suggesting it is an issue. I just don’t see it this way, and it worries me that patients are being blamed - yet again - for seeking help. Going to see your GP when you have been bereaved, or if your relationship breaks up, is not a sign of not being tough enough to get through life’s struggles, it’s a perfectly reasonable thing to do and can be enormously helpful. It is reasonable - and helpful- to want to understand your mental health, and asking about a diagnosis can be a very important part of that, but I very rarely have someone push for a diagnosis against my advice; usually it’s the opposite!

What also worries me about the emphasis on diagnosis is that it will distract from the real issue, which is a lack of funding, and inefficiencies in the system that mean so many people lack the support that could really make a difference. Like trauma work, or having a consistent support worker who can help them put plans into place rather than just tell them what to do. So much time is spent in crisis work that wouldn’t happen if people felt cared for, or in expensive MDT meetings rejecting referrals because people ‘don’t meet threshold’

When it comes to the strain on GP services, it is not patients seeking a diagnosis that is the problem, it’s the need to fill this gap in services when people have nowhere else to turn, or firefighting the consequences of trauma, ADHD and more because these issues are unresolved. So much to look at! Best wishes, Wes, I’d love to have a chat about it! 😊👍

What do you think? I’d love to hear your views too! 😊

29/11/2025

This might seem to be away from my usual topic of mental health, but, as a GP, I see patients get ill with prostate cancer, but also how the harms of treatment for prostate cancer affect both physical and mental health, and I know that many of the men affected never needed to go on that cancer journey- their cancer would have been so slow growing that they would never have known they had prostate cancer if it hadn’t been for the PSA test, and they would have been fine.

If you have had prostate cancer picked up through screening, then of course you will assume you might have died if it hadn’t been picked up early, and if someone you know has died of prostate cancer then of course it is natural to assume they would have lived if only there had been a screening programme. But screening for cancer is more complex than it seems - some cancers evade the screening test and break through anyway while (especially with prostate cancer) the idea that we should always pick up cancer early isn’t always right - in reality, the majority of prostate cancers picked up on screening are picked up far too early and most would be better not known about. This is why only proper clinical trials can tell us about the harms and benefits of screening, and that is what the screening committee will have looked at.

As a GP I see the full impact of how people can and still do die from cancer, but I also see the enormous impact, physically, emotionally and socially, of being put on the cancer journey, and I would like to see both fewer people die from cancer and fewer people go on that journey unnecessarily.

I really celebrate the fact we have a screening committee in the UK that can look at these tough decisions. It is vital that they are free from the influence of politicians, lobby groups and celebrities and can make these difficult decisions based purely on the evidence of harm versus benefit.

In the meantime, if a man still wants to be screened they can still ask their GP for a PSA test, but it might help him to read the report from the UKNSC first, or the excellent advice provided by Cancer Research UK.

23/11/2025

I keep thinking about moral distress and its role in burnout, within the caring professions and a wide range of other roles, both paid and unpaid. And yet I hear so little spoken about it. It really does seem to me to be a multiplier, so that the burden of stress we carry feels so much worse when we are placed in a situation that takes us outside our values.

In the video I show how it can double, or quadruple the effect of the stress we are feeling, but I also believe that a supportive, open work culture can lead to a reduction in the impact of stress. I don’t know a term for this - maybe we need to make up a new one? Moral affirmation? Value alignment? I’m not sure, but there is something in the idea that the right culture and support around you can make the impact of stress so much easier to deal with. What do you think?? 🤔😊 If love to hear your views! How does moral distress impact your world?

I first posted this reel almost exactly 2 years ago, but have not come across anything about moral distress since then, so I thought it needed another airing! 😊

15/11/2025

The move away from using the term ‘commit su***de’ has been a very positive one, but change takes time and there is a long way to go before this phrase is consigned to history. The implication that su***de is something that is committed, like a crime or a sin, is a hangover from the past that brings implications of stigma and shame that should be long past us.

We need to be gentle with people who do use it - it has been in such common use that it takes time to change our language, but if you can help me, and others in the mental health world, to spread this message, that would be fantastic!

And thank you to and Dominic Sambrook for a great podcast! I really enjoyed the recent series on Nelson, despite the references to committing su***de, and when I hear an episode where you talk about a historical character who died by su***de and avoid using the c word then I will give a loud cheer from wherever I am listening!! 😊

***de

08/11/2025

So much of anxiety is summed up with the words ‘what if?’. These two, innocent-sounding words can leave us exhausted, because there are so many future ‘what if’ moments to worry about. Most of them never happen, and so we are robbed of the present moment while we spend all our time worrying about an unavoidably uncertain future.

It can make such a difference if we can reframe our thinking to ‘even if, then’. ‘Even if’ doesn’t pretend that bad things don’t happen, it accepts that they do and allows some planning ahead, without obsessing about the details. It might be simply ‘even if it’s bad news then I’ll deal with it’, or it could be ‘then I’ll call my mum’ or ‘I’ll do my grounding technique.’ The key thing is that it allows us to tolerate some uncertainty about the future, which help us let go of some of the fear associated with ‘what ifs?’ Many of the imagined futures that haunted us before start to lose their power and we can enjoy the present once again.

How have you managed this? Are you exhausted by ‘what ifs?’ Have you found a way to learn to change them into ‘even if, then,’ ? How have you done that? I’d love to hear your thoughts! 😊👍❤️

02/11/2025

It’s Sunday evening, how are you feeling about the night to come? Many of us get the Sunday Scaries in the evening before the working week starts, and that may be part of the problem, but the single biggest reason for poor sleep on a Sunday night is that tempting lie-in we enjoyed this morning!

It’s so easy to lie-in on a Sunday morning, but it can destroy our sleep quality the next night because we don’t build up enough sleep pressure, which is what we need to sufficiently overcome wakefulness and have a good night’s sleep.

There is no bigger factor in sleep pressure than how long we have been awake for (usually this needs to be at least 16 hours). Other factors such as early morning light and being active, especially early in the day also play a part. When we lie-in we often miss out on that early light and activity, and try to sleep when we just haven’t been awake long enough!

There is no need to be consistent with the time we go to bed - we should go to bed when we feel sleepy, but waking up at a consistent time, even at weekends, can be the single most useful thing we can do for good sleep 😊👍

What’s your experience? How well do you sleep on a Sunday, especially compared to other days? What has helped you? 🤔

22/10/2025

You may have heard on the news this morning about a major study which ranked antidepressants according to their link with weight gain, as well as other effects on the body like pulse rate and cholesterol. It was a large meta-analysis and compared a huge number of antidepressants - some of which I’ve never heard of, and most of which I have never prescribed! But I was interested in the findings for the ones I do prescribe, which are mirtazapine, citalopram (and escitalopram which is basically the same thing) as well as sertraline and fluoxetine.

What really surprised me was that, apart from mirtazapine, which is well known to be linked with weight gain and often used to help stimulate an appetite, all the others were more linked with weight loss than weight gain! That’s not to say that some individuals don’t gain weight on these tablets - some do - but the overall effect is a small amount of weight loss. While I will still mention weight gain as a possible side effect, I think this will change how I talk to patients about these tablets! What do you think?!

And now I have posted about antidepressants, I wonder how long it will be before someone comments that antidepressants only do bad and should never be prescribed, or that GPs are useless and only push drugs, or that we get paid to prescribe them! (All of which is wrong, of course, and only adds to prejudice and stigma around mental health so does make me sad, but there you are!) 🥹

Here is the address for the study: https://www.thelancet.com/callback?red_uri=%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2825%2901293-0%2Ffulltext&code=GkfrZxZwgZqqP6VKEO2EJxar58T2XTBZi0cRI6jP&state=16424592390

10/05/2025

I’m on holiday so not posting about mental health this week, but I’ll leave you with some hares as I’ve been listening to the audiobook Raising Hare by Chloe Dalton and what a lovely, uplifting book it is! I can thoroughly recommend it as a powerful reminder that we don’t have to go everywhere and do everything or experience everything to be living a life worth living, and that there is so much, here and now that can touch us, change us, even heal us, if we only take the time to notice it 😊❤️

30/03/2025

I’ve had such a great weekend with my book launch for ‘Your Worry Makes Sense’ yesterday, with family around me and wonderful weather for spending time in the garden today. It was fantastic to be in conversation with , looking at some of her superb illustrations in the book and exploring how she came up with the ideas that she brought to life so wonderfully.

There was such a good turnout of 200-250 people and an excited buzz about the place. I’m also getting so many encouraging comments about the book, about how easily people are relating to it and the new insights it is giving them. The chapter on Health anxiety is proving particularly helpful to many people (confirming my belief that there just isn’t enough being said about this area of anxiety), and many people are relating to the section on burnout too.

Most of all, people keep telling me how the book really is helping them to make sense of anxiety and to understand it in a new way 😊

Thank you so much to everyone who came to the launch, who has had enough faith in me to buy a copy of the book or to recommend it to others and who have given me their feedback and encouragement about how it is helping them, either personally, or as they support someone else, or in their work as a healthcare professional. I’m so very grateful 😊😊😊

If anyone is wondering where to get the book, the order links for UK, Canada and USA are in my bio and I understand it can now be preordered (for June delivery) as far away as Australia! 😊🎉

26/03/2025

I’m so grateful for the lovely, encouraging Amazon reviews that have been submitted since my book came out last week! 😊❤️

They are really helpful in getting the word out there about the book, so that people who might benefit can find it and know what they can expect if they get a copy. It is a chance to say what you think about the book so that others know how it comes across and why you like it (or don’t like it!)

If you have got a copy and have been taking a look then it would be AMAZING if you could leave a review on Amazon (or Waterstones or wherever you got your copy). I have had so many encouraging messages about how enjoyable the book is to read, how people are relating to it and how they have felt seen (especially about health anxiety!) And, most of all, how it really does make sense!! 😊🎉 Thank you all! It’s been quite a week! 😊

All the links to order or leave a review are in my bio 😊👍

17/01/2025

I’m so grateful to and Dr Tim Cantopher for taking the time to read my book ‘Your Worry Makes Sense’ and for their wonderful prepublication endorsements! 😊❤️ They were the first people beyond my family and to read the manuscript and so their encouraging feedback meant so much! Thank you!! 😊😊😊

The book is out on 21st March. You can preorder in the UK and US with links in the bio (I believe it can be preordered on Amazon in Canada and Ireland also).

I can’t wait for you to read it and tell me what you think! My hope is that people will really feel empowered once the can make more sense of their worry, and that this will help them make tangible progress as they learn to manage anxiety or recover from burnout.

And it’s all been brought to life with wonderful illustrations from 😊❤️😊

I’ll be having a book launch in Guildford on Saturday 29th March! All are welcome - watch out for details to follow! 😊🎉

Doc Martin GP