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AMA

See all MNHQ comments on this thread

I'm a medical doctor and NHS psychiatrist. AMA

277 replies

DoctorDr · 29/07/2026 11:09

NHS pyschiatry (inpatient) with several years experience. Please ask away :)

OP posts:
DoctorDr · 29/07/2026 21:41

HangryBrickShark · 29/07/2026 20:55

Thank you for answering my question. I worry I will end up like Mum with dementia, although we were not blood related. It was horrible seeing her decline and slow death from not eating. Here is info in tespect of my question.

Nerve pain drug gabapentin linked to increased dementia, cognitive impairment risks - BMJ Group https://share.google/UgeVXRUCuLr7AO341

Edited

Observational studies are very weak evidence. This suggests a link but is highly susceptible to confounders. Elderly patients are much more likely to have chronic pain or back problems and use gabapentin. Elderly patients are much more likely to have dementia. To therefore say that taking gabapentin is associated with dementia is obvious but doesn't mean much in isolation. On the other hand I suspect untreated chronic pain is also a risk factor for dementia so taking gabapentin could in itself be preventative in certain cases. All we can do it stay healthy and minimse our risk the best we can. I hope your mum did not suffer too much. Dementia is awful

OP posts:
ipcumedopenrehab28 · 29/07/2026 21:51

ipcumedopenrehab28 · 29/07/2026 12:52

Name changed for this as very personal and possibly outing.

How common is my mental health story. As i recently shared witha psychologist ( Though work ) it and she was shocked/impressed?!

When I was 16 I became psychotic which led to being detained on a emergency 72hr where I was admitted to a ipcu ( note my age at the time cahms was found unsuitable). I ended up being detained on a 28 day then a CTO. I spent 6 month's in the ipcu where I was eventually sent down to England to a medium secure unit ( St andrews heathcare) I spent one year there before being sent back to my own hospital where I then spent a further 18 months in a open ward. Apart from the last 3 months I was detained for the entire time. There was some debate between hospitals regarding what was wrong with me but eventually they settled on EUPD and CPTSD.
Im not 34 and haven't had any contact with any mental heath services for 13 yrs now. Most people I believe would be shocked at my history.

Shamelessly reposting my missed question. 😅

Lichenrose · 29/07/2026 21:52

DoctorDr · 29/07/2026 21:33

I'm not sure what an adult child is.

18 would be general adult medicine. Denial of mental health services due to aspergers is bizarre. Are you sure there's not more to this?

No, that’s what they said at his appointment with adult MH services. I accompanied him so heard it first-hand. They said they don’t have training to help him due to his autism and he needs to look for help from autism sevices.
Autism services don’t address OCD or other MH issues though, as they well know.

I am in Ireland, not the UK, so appreciate you have no experience in that system, but it just seems wrong. Echoing a pp, it’s why things escalate.

cheerypip · 29/07/2026 22:02

In your experience of patients with psychosis, do they have memories of their psychotic episodes? It was explained to me by one psychiatrist that memories are not laid down in the same way, so it isn't uncommon for patients to have no memory at all once they have recovered.

Other mental health professionals have suggested the memories are there but repressed.

Scout2016 · 29/07/2026 22:10

DoctorDr · 29/07/2026 20:32

Interesting, generally slightly more men have schizophrenia than women (1.4:1 M:F). Part of that is the neuroprotective effect of oestrogen apparently.

I haven't actually noticed much difference, but interesting that you say that. What kind of work are you in without ID'ing yourself?

Children's services, so often it's families in crisis.

DoctorDr · 29/07/2026 22:38

cheerypip · 29/07/2026 22:02

In your experience of patients with psychosis, do they have memories of their psychotic episodes? It was explained to me by one psychiatrist that memories are not laid down in the same way, so it isn't uncommon for patients to have no memory at all once they have recovered.

Other mental health professionals have suggested the memories are there but repressed.

Really interesting question, it depends a lot on the severity. Full blown PICU / seclusion psychosis, generally no, they don't retain many strong memories and it's typically very fragmented when they do. Similar with mania and in both cases usually sleep is highly disrupted which plays a big part in memory formation.

Good analogy about memories not being laid down in the same way.

OP posts:
Cookingandfoldingthings · 29/07/2026 23:13

Hi @DoctorDr thank you so much for this fascinating AMA.
When I was mid teens in the 1980’s I was diagnosed with depression, anxiety and anorexia.
I was treated by GP with a new medication - Prozac - apparently in an early use in the UK. I’ve subsequently been told by another GP that this medication should not have been prescribed for a teenager and absolutely definitely not in the “large dose” that I was given.
I’ve had significant chronic depression, including post and pre natal, and anxiety for much of my adult life and have taken SSRIs for about 2/3 of the 40+ years since the initial instance.
Is it possible that the treatment with Prozac could have caused damage to my brain chemistry & thus resulted in a lifetime of depression & anxiety?
Thank you so much for your input.

OldForANewMum · 30/07/2026 00:11

TheOcelot · 29/07/2026 18:44

@OldForANewMum it's probably another thread but I find that fascinating because of my own anecdotal experience. I know two families where they adopted babies who later had severe mental health struggles leading to suicide. These were adoptions in the early 60s before abortion was available and babies were easily available for adoptive parents.

The world is divided into people who have direct and recent experience of adoption in close proximity (in their family or close friends, or through work, for example) and those who don't. Those who don't typically retain naively positive views of it in a 'happy ending for all concerned, love conquers all' kind of a way. I leaned towards that view myself before we started in our own adoption journey, although due to a number of adverse events in my own life I was not quite so naive about it. In an ideal world, adoption would never be necessary because it creates trauma in itself. In the world in which we live, it is the least-bad way forward for too many children and families and it can be very positive in many ways for a great number of families. But it is incredibly complicated and young age at point of removal from birth family/ subsequent adoption does not in any way mean things are simple.

Anyway - obviously, there is no child in 2026 who ends up in a position to be adopted who hasn't suffered significant trauma. It's a relatively common situation for a birth mum to have had one or more children removed, and then to become pregnant again (sometimes multiple times). In those situations, children can be removed more or less at birth as social services are already involved and will be monitoring the pregnancy, and preparing the legal paperwork ready to remove the new child. So that is the most extreme version of 'how would the child have bad memories', and it's pretty common.

Two things:

  1. almost no birth mother in that situation will have had an easy, uncomplicated and stress-free pregnancy in which they took care of themselves and the unborn baby well. The usual battle is to try and keep a birth mother clean of drugs and alcohol during this period; even where they are not a factor, it's likely that whatever other issues (the birth mother's own trauma, mental health or life situation, domestic violence, etc etc) the birth mother is experiencing will result in a pregnancy drowning in stress hormones. So the child can be deeply affected by what has happened to them in utero, even with A1 care from the time they are removed from birth mum (although in many cases anyway even if removed at birth they will not only experience a degree of trauma from being removed from birth mum, but also they will be settled with a primary carer who is a foster carer for N weeks or months and then once again removed from all they know and settled with an adoptive family - that's a lot of loss and I'm sure all you birth parents reading this would expect your 2 month old baby to notice if you went away and were replaced by a random person!)

  2. more fundamentally though, the child will grow up knowing they are adopted and were removed from everything they knew. This frequently causes massive issues psychologically and with identity

.. and that's before you get into any genetic susceptibility to any underlying conditions or problems which contributed to birth parents' inability to provide adequate care for a child, which the child can therefore inherit (nature vs nurture argument). For example, predispositions to learning difficulties, learning disabilities, neurodivergence and mental health issues (no, I'm not suggesting that neurodivergent people can't parent, I'm suggesting that it can be one factor in many contributing to inability to parent, for some people. Neurodivergence is hugely over represented in previously looked after children. Some of this is likely to be that trauma creates similar effects on the brain and neurological system to neurodivergent conditions, and some of likely to be the fact that neurodivergence is overrepresented in birth parents whose children are removed, and there is a strong genetic element to most neurodivergent conditions. Again, I'm not suggesting neurodivergent = bad parent, we all know there is a spectrum of different presentations).

In previously looked after children i.e. those who have been in care and grown through it, or in care for a while and then adopted, the rates of everything negative are massively higher than the general population. They are (a lot) more likely to end up with every negative life outcome possible from prison to mental health issues unfortunately up to and including suicide, hugely vulnerable to being victims of abuse of all kinds as teenagers and adults, and less likely to end up with any degree of positive outcomes. And that's despite the fact that becoming an adoptive parent is like the Hunger Games, designed to weed out people who don't really really want it, and actively excluding people over whom social workers have any doubt about motivation, capablity or resilience. Therefore on average adoptive parents are more able to cope than non-adoptive parents. Yet their children still have much worse outcomes despite their best efforts. That tells you how serious the damage done to babies and young children is, and that the effects are lifelong.

So no, it's not at all a surprise (very sadly) to hear of your own experience with your friends.

ScrambledEggs12 · 30/07/2026 07:03

DoctorDr · 29/07/2026 16:22

I said we know that there are local groupchats of young women with EUPD who feign symptoms and suicidality to be admitted together at the same time. Do you have any experience of working with EUPD? Do you understand that manipulative behaviour is part of the diagnostic criteria? We have to stop putting patients with EUPD on a pedestal. Their behaviour is frequently highly destructive, very chaotic and extremely resource intensive. They are not immune from criticism and will almost always have capacity and insight into their actions. Exonerating them of accountability is part of the perpetuating issue and why recovery is difficult.

I think anyone who works in medicine or psychology can tell I absolutely am a psychiatrist, but unfortunately we'll never know for sure. That's the risk you take with anonymous AMA's.

Edited

I find this quite upsetting to read as a person with a diagnosis of EUPD. I take full accountability for my actions.

I have never been in an inpatient psychiatric ward (a crisis house was very helpful on one occasion).

I'm not manipulative, and I mostly just deal with it myself now and suffer inside my head. I have children, a job and I have worked extremely hard to get to this stage. Thankfully although I have had some pretty bad experiences, I have encountered many wonderful and non judgemental professionals.

I'm not saying that isn't your experience, but please try not to make generalisations.

Are you aware of the KUF Personality Disorder training? Not sure if it still exists. But I was trained in delivering it about 15 years ago. Basically it was a service user (I believe we all had an EUPD diagnosis) and a professional (e.g NHS Psychotherapist) working together delivering training to professionals (including psychiatrists).

You sound young though (since you got an A* in an A level), so you might not be aware of it. It's sad that things don't seem to have moved forward.

TofuTuesday · 30/07/2026 07:20

ScrambledEggs12 · 30/07/2026 07:03

I find this quite upsetting to read as a person with a diagnosis of EUPD. I take full accountability for my actions.

I have never been in an inpatient psychiatric ward (a crisis house was very helpful on one occasion).

I'm not manipulative, and I mostly just deal with it myself now and suffer inside my head. I have children, a job and I have worked extremely hard to get to this stage. Thankfully although I have had some pretty bad experiences, I have encountered many wonderful and non judgemental professionals.

I'm not saying that isn't your experience, but please try not to make generalisations.

Are you aware of the KUF Personality Disorder training? Not sure if it still exists. But I was trained in delivering it about 15 years ago. Basically it was a service user (I believe we all had an EUPD diagnosis) and a professional (e.g NHS Psychotherapist) working together delivering training to professionals (including psychiatrists).

You sound young though (since you got an A* in an A level), so you might not be aware of it. It's sad that things don't seem to have moved forward.

The star thing is interesting, op can only be about 34 and recently fully qualified I think if they took a levels the first year stars were included (2010?).

DosPerros · 30/07/2026 07:51

OldForANewMum · 30/07/2026 00:11

The world is divided into people who have direct and recent experience of adoption in close proximity (in their family or close friends, or through work, for example) and those who don't. Those who don't typically retain naively positive views of it in a 'happy ending for all concerned, love conquers all' kind of a way. I leaned towards that view myself before we started in our own adoption journey, although due to a number of adverse events in my own life I was not quite so naive about it. In an ideal world, adoption would never be necessary because it creates trauma in itself. In the world in which we live, it is the least-bad way forward for too many children and families and it can be very positive in many ways for a great number of families. But it is incredibly complicated and young age at point of removal from birth family/ subsequent adoption does not in any way mean things are simple.

Anyway - obviously, there is no child in 2026 who ends up in a position to be adopted who hasn't suffered significant trauma. It's a relatively common situation for a birth mum to have had one or more children removed, and then to become pregnant again (sometimes multiple times). In those situations, children can be removed more or less at birth as social services are already involved and will be monitoring the pregnancy, and preparing the legal paperwork ready to remove the new child. So that is the most extreme version of 'how would the child have bad memories', and it's pretty common.

Two things:

  1. almost no birth mother in that situation will have had an easy, uncomplicated and stress-free pregnancy in which they took care of themselves and the unborn baby well. The usual battle is to try and keep a birth mother clean of drugs and alcohol during this period; even where they are not a factor, it's likely that whatever other issues (the birth mother's own trauma, mental health or life situation, domestic violence, etc etc) the birth mother is experiencing will result in a pregnancy drowning in stress hormones. So the child can be deeply affected by what has happened to them in utero, even with A1 care from the time they are removed from birth mum (although in many cases anyway even if removed at birth they will not only experience a degree of trauma from being removed from birth mum, but also they will be settled with a primary carer who is a foster carer for N weeks or months and then once again removed from all they know and settled with an adoptive family - that's a lot of loss and I'm sure all you birth parents reading this would expect your 2 month old baby to notice if you went away and were replaced by a random person!)

  2. more fundamentally though, the child will grow up knowing they are adopted and were removed from everything they knew. This frequently causes massive issues psychologically and with identity

.. and that's before you get into any genetic susceptibility to any underlying conditions or problems which contributed to birth parents' inability to provide adequate care for a child, which the child can therefore inherit (nature vs nurture argument). For example, predispositions to learning difficulties, learning disabilities, neurodivergence and mental health issues (no, I'm not suggesting that neurodivergent people can't parent, I'm suggesting that it can be one factor in many contributing to inability to parent, for some people. Neurodivergence is hugely over represented in previously looked after children. Some of this is likely to be that trauma creates similar effects on the brain and neurological system to neurodivergent conditions, and some of likely to be the fact that neurodivergence is overrepresented in birth parents whose children are removed, and there is a strong genetic element to most neurodivergent conditions. Again, I'm not suggesting neurodivergent = bad parent, we all know there is a spectrum of different presentations).

In previously looked after children i.e. those who have been in care and grown through it, or in care for a while and then adopted, the rates of everything negative are massively higher than the general population. They are (a lot) more likely to end up with every negative life outcome possible from prison to mental health issues unfortunately up to and including suicide, hugely vulnerable to being victims of abuse of all kinds as teenagers and adults, and less likely to end up with any degree of positive outcomes. And that's despite the fact that becoming an adoptive parent is like the Hunger Games, designed to weed out people who don't really really want it, and actively excluding people over whom social workers have any doubt about motivation, capablity or resilience. Therefore on average adoptive parents are more able to cope than non-adoptive parents. Yet their children still have much worse outcomes despite their best efforts. That tells you how serious the damage done to babies and young children is, and that the effects are lifelong.

So no, it's not at all a surprise (very sadly) to hear of your own experience with your friends.

Thank you for sharing your experiences @OldForANewMum Very troubling to read.

No wish to derail the thread but I wish your post could be read by people who support surrogacy.

ScrambledEggs12 · 30/07/2026 08:03

TofuTuesday · 30/07/2026 07:20

The star thing is interesting, op can only be about 34 and recently fully qualified I think if they took a levels the first year stars were included (2010?).

The earliest she could have qualified is 2023. So you're right with 34. So a maximum of 3 years experience when fully qualified.

somethingnewandexciting · 30/07/2026 08:13

IHaveQuestionsLotsOfQuestions · 29/07/2026 19:36

I have personally done research in this field and have also found a large crossover with autistic traits and non-contact sexual offending in particular - looking at CSAM online, for example.

Obviously that does not mean people with autism are all sexual offenders, but there seems to be something going on in the data that suggests some sort of correlation at least. It’s an uncomfortable topic for sure, but one we shouldn’t shy away from. More research is needed.

Asiding on this - I find it fascinating how different female ASD and male ASD presents, the over sensitivity in women (generalising but majority) seems to buffer them from doing harm to others, whereas men seem to lack the empathy more frequently. I know there are studies on head injuries in the prison population with high correlations for violent offenders, would brain scans help narrow down the differences in the sexes with ASD and possibly help diagnosis?

BeckyAMumsnet · 30/07/2026 11:03

MNHQ here. As with all user-led AMAs, Mumsnet has not independently verified the OP’s professional credentials. The OP is sharing their own experience and views, and their replies should not be treated as personalised medical advice, diagnosis or a substitute for speaking to your own healthcare professional.

If you are worried about your own or someone else’s immediate safety, please seek urgent professional help rather than relying on advice posted on the thread.

Thanks.

TofuTuesday · 30/07/2026 11:09

ScrambledEggs12 · 30/07/2026 08:03

The earliest she could have qualified is 2023. So you're right with 34. So a maximum of 3 years experience when fully qualified.

Not really several years experience then.

https://www.gmc-uk.org/professional-standards/the-professional-standards/using-social-media-as-a-medical-professional/using-social-media-as-a-medical-professional

Backedoffhackedoff · 30/07/2026 11:15

Throughout this thread I’ve been fascinated that both you and @PixeyandDixey seem to have zero awareness that you’re coming across as the EUPd stereotype you’re fighting against

banmusk · 30/07/2026 12:30

It seems to me that what used to be regarded as personality types are now labelled personality disorders. So someone who's quite sensitive, gets upset easily is now someone with a mental health problem?

TofuTuesday · 30/07/2026 12:33

Backedoffhackedoff · 30/07/2026 11:15

Throughout this thread I’ve been fascinated that both you and @PixeyandDixey seem to have zero awareness that you’re coming across as the EUPd stereotype you’re fighting against

How nice for you. Glad we’ve entertained you in your obviously otherwise fulfilled life. Couldn’t possibly be anything other than we are ‘mentally ill’ 🙄

DoctorDr · 30/07/2026 12:34

Backedoffhackedoff · 30/07/2026 11:15

Throughout this thread I’ve been fascinated that both you and @PixeyandDixey seem to have zero awareness that you’re coming across as the EUPd stereotype you’re fighting against

Absolutely spot on unfortunately.

OP posts:
DoctorDr · 30/07/2026 12:37

I did not quality in 2023. Nowhere near. The groupthink and witch hunting is really sad to see on mumsnet. I'm here for casuaul discussion and generalised advice which unfortunately quickly descends into name-calling, accusations and rabbit holes of how old I am or how many years of experience I must have. It's sad to see, especially when it's misinformed.

OP posts:
Trumptontown · 30/07/2026 12:37

DoctorDr · 30/07/2026 12:34

Absolutely spot on unfortunately.

You seem to have a real dislike of anyone with a PD diagnosis to the point where you claim that being manipulative is part of the diagnostic criteria for EUPD (not true!).

TofuTuesday · 30/07/2026 12:38

DoctorDr · 30/07/2026 12:34

Absolutely spot on unfortunately.

Sorry - diagnosing me over a thread, doctor? WTAF, also interesting that EUPD seems to be some sort of insult.

fwiw I’ve posted a few times because I’ve backed up the use of person centred language, commented on your fairly recent a levels and ive added the guidance on social media use. If that’s enough to make a diagnosis the NHS could just use forums to diagnose people rather than pay people.

SilenceInside · 30/07/2026 12:44

"I did not qualify in 2023. Nowhere near. The groupthink and witch hunting is really sad to see on mumsnet. I'm here for casual discussion and generalised advice which unfortunately quickly descends into name-calling, accusations and rabbit holes of how old I am or how many years of experience I must have. It's sad to see, especially when it's misinformed."

At the risk of being labelled with a mental health issue...

I find responses like this to be really disappointing. The behaviour on MN is not different to other platforms wrt to any "groupthink" or "witch hunting". Just ignore posters who disappoint you, report any that make accusations or that call you names and they will be deleted. Engage in good faith with people asking reasonable questions and the thread will remain on topic and useful.

In that spirit, I will repost my original question that did not, as yet, get a response:

Do you think our current society causes a lot of mental distress that could be avoided if we reconfigured our culture (I know that's not a realistic possibility!), or would the people you see still be in the same position regardless of what kind of society they lived in?

PixeyandDixey · 30/07/2026 12:54

TofuTuesday · 30/07/2026 12:38

Sorry - diagnosing me over a thread, doctor? WTAF, also interesting that EUPD seems to be some sort of insult.

fwiw I’ve posted a few times because I’ve backed up the use of person centred language, commented on your fairly recent a levels and ive added the guidance on social media use. If that’s enough to make a diagnosis the NHS could just use forums to diagnose people rather than pay people.

@DoctorDr needs removing from the profession, they're the antithesis of what a good pyschiatrist should be. Judgemental, advice given proven by subsequent posters to be factually incorrect, diagnosing well known people in the public eye with health conditions, diagnosing people on this thread with conditions, going against GMC criteria on social media use, it goes on...

The warning Mumsnet have provided on this thread against this poster is a good start but it needs to go further. If a person is giving advice under a professional label (any label, dr, lawyer, accountant, whatever) they can't be anonymous.

Lay person, do what you like, have whatever crazy off the wall, inaccurate, offensive opinions you like, it's a free world. Posting as a medical professional, no, you have responsibilities and rules laid down by your professional organisation and consequences for breaking them.

Lichenrose · 30/07/2026 13:19

@PixeyandDixey
Some of us are finding this thread useful.

Please know that we are aware enough not to blindly trust what we read on social media.

Your constant criticism is derailing the thread and it’s annoying. You’ve made your point now.

Swipe left for the next trending thread