Doc Martin GP

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

04/06/2026

Often our thoughts get stuck on a worst case scenario, especially when it comes to health. The intense emotional feelings we get when we think about the worst case leads to such a feeling of threat that we can’t think of any other explanation for a problem until that threat is removed. And so we need to practise being able to think in a different way, which may not come easily at first!

So, have a go at thinking about what could be causing my tremor! I really won’t be worried about what you come up with, and this is not a test about your ability to make a diagnosis, it’s an experiment in thinking broadly so that you can teach your mind to not get stuck in threat mode. Even if you know the cause for certain I’d like you to think of at least one alternative explanation, more if you can! The experiment here is to hypothesise and think of a differential diagnosis. When my trainees come to talk to me about a patient, I will often say to them, ‘what else do you think it could be?’ - even if they probably have the right diagnosis!

As a GP I do need to consider worst case scenarios - we call this marginalising danger - and then, once I have ruled out anything dangerous, I can consider what are the most likely explanations, what best fits the symptoms and whether I need to find out any more information (through more questions, examination or tests) to work out the best fit.

So have a go - I’d love to hear your thoughts in the comments, but whether you comment or not try to think of as many possible explanations for my tremor as you can, and then practise this way of thinking in other areas of your life! 😊👍

03/06/2026

It’s very common to fall into a circular pattern of thinking where anxious or negative thoughts go round and round in our heads, achieving nothing and causing us distress. It might be we are prone to catastrophising and worryi about every worst case scenario about what might happen, or maybe we tend to go over and over in our heads about something in our past that we can’t let go of.

If this is happening to you, it can really help to understand if you are prone to worrying about the future, or ruminating about the past, because the way of dealing with it will be very different. For worry, we need to learn how to accept uncertainty; we might use techniques like worry time, or imagine our worry as an unruly monster that is trying to keep us safe, but needs to be trained. It is all about not letting fear about the future ruin our present.

Rumination is quite different, since what we need to learn to accept is not the future we are uncertain about, but the past we cannot change. It might be that there are issues from our past that we would do well to work through, or unresolved trauma we need help with. It is all about not letting our past ruin our present, and finding hope for our future.

Some things can help with both worry and rumination, and this particularly involves focusing on the present, like grounding techniques where we draw our attention to what we can see, hear and feel, as well as physical exercise and distraction.

What do you think? Is it helpful to distinguish worrying from rumination like this? What have you found helpful?

03/06/2026

This post is not a sob story looking for sympathy, but it has come from a point of frustration when I hear GPs being accused of working part time when they are actually doing a 44 hour week! And even the fact that it is an accusation, which it so often is, shows a prejudice towards part time working. Some GPs work 2 days a week, which is part time (it would be about a 30 hour week) but surely that is ok? We must fight against the stigma that is attached to part time working as somehow not fulfilling your moral obligation to society!

The truth is that very few GPs work more than 3 days a week of coal face GP work, because that really is the new full time and any more is not sustainable over a career. We need the BMA and the government to recognise this, and, most of all, we need the support and understanding of our patients. Thank you for listening and understanding. Maybe share this post with your own GP if you can, or give them a shout out in the comments. And for fellow GPs out there, however many sessions you work, you are doing an amazing job! 😊❤️👏

27/05/2026

If you are affected by RSD (Rejection Sensitive Dysphoria) then what are your treatment options when it comes to medication? I’m afraid I am at great odds here with Dr William Dodson, the man who coined the term RSD, since he recommends alpha-2-agonists like clonidine or guanfacine - BUT there is no published trial data at all to back this up.

It’s important to note that these are unusual drugs. They are a treatment for ADHD in children (although I have never known a child be prescribed them) but they are not licenced in the UK or USA for ADHD in adults. So this is not like optimising ADHD treatment, it is trialling something new - and when you do that you need evidence that the benefits outweigh the harms.

Dr Dodson quotes success rates of around 30% in his clinical practice, but this is not from a trial, it is just his clinical experience. This could be placebo, it could be 3 patients out of 10 or 300 out of 1000 - we don’t know as he hasn’t shown anyone the data. And yet, because he has written about it online, if you Google it you will be quoted this figure as if it is established proof!

Dr Dodson justifies his recommendation to treat without trial evidence on the grounds that people need treatment now and so it would be unethical to wait for the evidence. That is a very dangerous path in medicine and medical history is littered with treatments that were thought to be beneficial but did more harm than good. And what if he’s right and they are good treatments? Well without good trial evidence they will never become established as a mainstream treatment and people will miss out!

These drugs are also not without their issues - stopping them suddenly can cause a huge spike in blood pressure for instance - but then that’s ok because when did anyone with ADHD ever forget to take their medication??! He also recommends drugs called monoamine oxidase inhibitors (MAOIs) - really? These are old fashioned antidepressants that may have helped some people but caused a lot of problems, especially in their interactions with other medicines (including ADHD meds) and a wide range of foods. No thanks!

16/05/2026

Whenever someone complains to me that they ‘never get to see the same doctor twice these days’ it feels like a little bit inside me dies 😔 I know how hard we work at our practice to help patients see the doctor who knows them, and how many of our patients regularly see the same doctor, and I can’t be responsible for their experience, but as a GP I feel like I am somehow responsible for their complaint!

But also, I know what an easy complaint it is to make and how often it is made by people who don’t actually mind which doctor they see, because they don’t have a longterm condition and when they are unwell they just want to be seen quickly - in other words they rightly value speed of access over continuity of care. I’d be grateful if these people could kindly stop complaining about not having something they don’t really care about! 🥺

For some people, though, continuity of care does matter, but when I ask them if they tell the practice which doctor they would prefer to see, they look surprised that I could suggest such a thing! It seems too impertinent to ask and so they wait to see who they are given - but then complain about a lack of continuity of care if they don’t get it! If it matters to you then please let the practice know, and please tell them how urgent the problem is and how long you are happy to wait.

If you do all this and still never see the same doctor twice then maybe you do have something to complain about (but perhaps you could complain to your practice and not to me?! 😉)

02/05/2026

I’ve not invented a word before, but this is such an important concept that I thought it deserved its own word, and autocoregulation seemed to fit the bill! What do you think? I’d love it to catch on! 😊

It’s more than just self-soothing or calming your nervous system through grounding techniques or mindfulness (important as these are), it’s about recognising that our inner voice has an emotional temperature, defined by things like tone, pace, pitch and volume (and even though it is an unheard voice it still has all these qualities inside our head) and that how our body is feeling will naturally coregulate with the emotional tone of this inner voice.

If we want our body to feel less stressed or anxious, therefore, it is helpful to pay attention to this inner voice first. If we can pay attention to how we speak to ourselves and practise calming the inner voice, then the emotions in our body will naturally follow suit and autocoregulation will become a useful ally in dealing with stress. Once we start autocoregulating in a helpful way, then grounding techniques or distraction will be so much more effective 😊👍

What do you think? Do you relate to how we coregulate with our own inner voice? How do you calm your own voice and how does that help you? What do you think of the word autocoregulation? I’d love to hear your views! 😊👍

30/04/2026

This is such a great book from Carys Sonnenberg and her colleagues. It’s packed full of all the information you need for women’s health and is laid out in an accessible way that makes it a fantastic resource to learn a topic in detail or as a reference book for whenever you need to check something.

And in mental health it has a great section covering areas like PMS, PMDD, perinatal mental health and neurodiversity in women, which is obviously of great interest to me.

It’s been published by as part of their fabulous ‘made easy’ range of books. Scion provides fantastic books for GPs (including my own book on the consultation, The GP Consultation Reimagined, a Tale of Two Houses! 😊😉)

Full disclosure - I am yet to meet Carys in person but we have had some great interactions on social media and I love her work. She kindly sent a copy of the book to me and my practice which is how I got to look at it 😊

22/04/2026

wellbeing survey has shown that 85% of doctors report increased stress levels at work, while nearly half state that stress is putting their own physical and mental health at risk, and could put patients at risk due to the increased the risk of errors at work. These are concerning figures.

No-one goes into medicine expecting it to be easy, and it remains a hugely rewarding occupation, but we need to recognise the high stress levels within healthcare and do everything we can to support our work force, for the sake of both staff and patients. There are wider, systemic pressures that we can’t control, but a local Trust or GP practice can ensure some very simple steps are in place to support their staff.

Being able to connect with your colleagues during the working day can make such a difference; it engenders a shared sense of purpose and reduces the isolation a doctor can so often feel. When I meet my colleagues for coffee, it is the laughter and human connection I need as much as a few moments away from the coalface, or the food and drink. Food and drink is important, too, though - I, for one, become inefficient and irritable when I am hungry or thirsty! Doctors need to work in an environment where healthy food and drink are available and breaks are valued, which is why the MDU is calling for the government to ensure NHS employers provide staff catering and rest facilities, including for those working out of hours.

As doctors, we also need to learn to prioritise these simple measures ourselves - to make time to connect, take breaks to refuel, and also make sure that our life outside of work always has space for the things that bring us joy, and truly help us to rest and recharge when we are away from work. What do you think? If you are in healthcare, do you have the opportunity to take breaks and eat and drink healthily when you are at work? What measures are most important for helping you to deal with stress in your job? I would love to hear your thoughts in the comments! 😊

18/04/2026

How do we recover when we are unwell with a mental illness, maybe it’s burnout, or anxiety, or depression? If we’ve been signed off work we may never have prepared for this, or we may have a colleague who is signed off and not understand what that means or what they should be doing to get themselves well.

Well, obviously we may need to rest, but that doesn’t mean lying in bed with the curtains drawn. Mental rest could be quite active - it may well involve exercise or picking up a sport that we have long neglected but always found did us good, it may involve something creative like art, music or gardening. It might involve some time on our own, but could involve meeting a friend for coffee, or something social, like joining a community garden or a walking group. It might well mean doing things you enjoy, which might be hard to get your head around when you feel guilty about being off work.

It will be important to maintain routine, so that our sleep pattern doesn’t slip, to eat healthily and be careful around alcohol. We will need to say no to some things and say yes to others, with the emphasis shifting from what we feel duty bound to do towards what will help us recover and thrive once more, so that then we can be in the best place to pick up things that are important to us, like going back to work.

If we feel guilty about being away from work then it may help to recognise that as we take care of ourselves so we are also taking care of our colleagues by doing the right things so that we can return in the right way and at the right time.

And if your colleague is off work, then maybe the best message you can send them is one that encourages them to do something you know they have always enjoyed but not had time for recently.

If you’ve needed to recover from struggles with your mental health, what has helped you the most? I’d love to hear! 😊👍



The e

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! 😊👍

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