I work for the National Health Service and also in private practice in Cambridge.
I see private patients at the Nuffield Hospital, the Spire Cambridge and the Coach House Clinic.
You can write to me at:
The Nuffield Hospital
4 Trumpington Rd,
Cambridge
CB2 8AF
You can email me directly or call my private secretary’s telephone number below.
I only see patients who are referred by their General Practitioners. This is the route that is advised by the General Medical Council so that you only come to see the right specialist and that your GP is involved in your care.
I have also acted as an expert witness for Courts and Tribunals. And am a member of the Society of Expert Witnesses.
To introduce the meeting I will usually ask about who you live with, what your family situation is and your work. We will discuss what are your current concerns and the symptoms that have led you to want a consultation. This usually focuses on your mood, anxieties, thinking and behaviour, including eating and sleeping. How these problems have affected your ability to function at home and outside. You may have already had some treatment and we will review this.
Many illnesses run in families and I need to find out if any of your relatives have had problems with their health both physical and mental. Your personal history needs to be discussed – birth, childhood, education and work life.
Relationships are an important part of most people’s lives and this can give a good insight into your personality.
Many people have problems with alcohol and drugs even if they do not have an addiction problem and this will be reviewed along with any physical illnesses especially those affecting the brain. I will check what medication you are taking.
There may be particular issues for you that have not been covered in this review and you need to have a chance to bring these up.
The next step is to agree the appropriate diagnosis and make a plan of treatment. You may need some investigations of your physical state either by examination or blood tests and occasionally scans of the brain. We wll also look at lifestyle issues such as exercise and sleep pattern.
Many psychiatric illnesses can be treated with medication and this is an area which we may discuss in detail. We are also likely to review whether you could also benefit from some talking treatment.
We would finish by agreeing whether we should meet again, sometimes with other people who are important such as a partner or relative. At times the history given by a family member can be vital to making an accurate diagnosis. Many patients bring along someone to their first appointment and you are welcome to do so.
You can read more about this process on the website of the Royal College of Psychiatrists.
Six years at medical school is the basic
requirement to be a Doctor. I did the first three years at Cambridge University and then
finished at a Clinical School, St George’s Hospital in London.
After qualification as a Doctor I worked
in Medicine, Surgery and Accident and Emergency in London. Needing to
understand more about the brain I took a six month post in Neurology
before starting to train in Psychiatry.
I did my basic psychiatric training for three years at St
Bartholomew’s Hospital in London with posts also in Hackney. This
led to the exams for Membership of the Royal College of Psychiatrists
(MRCPsych) when I had completed this practical training.
Understanding research is vital for doctors
and so I spent three more years doing a project on the Causes of Recurrence in
Bipolar Disorder. This was a Doctorate thesis leading to a Doctor of Medicine (MD)
degree from the University of London in 1993.
Two more years as a registrar on the Oxford
higher training scheme completed my training.
So 15 years after starting my training I was
appointed as a Consultant Psychiatrist in Cambridge.
I have been interested in bipolar
disorder since I completed my MD thesis and have published a book about the
condition
One question that I am often asked is:
How do I know
if I have Bipolar?
To be bipolar you need to have experienced mania or hypomania. This is a distinct episode of changed mood –
usually elevated mood, sometimes irritable.
It would have lasted at least 4 days but usually longer. This is a high energy state. You are moving more, talking more and
faster. A reduced need for sleep – often
down to just a couple of hours and for several nights in a row.
You
will usually have had some mood problems – depression and anxiety from teenage
years. But these would have been
episodic, that is you will also have had long periods of normal mood. Often the mood problems seem to come from
nowhere.
The
depressed periods are also episodic and are persistent low energy states –
usually lasting several weeks - often sleeping more, not able to concentrate or
motivate yourself.
Some
people lose touch with reality with hallucinations or delusions but only along
with an extreme mood.
Other
people would notice the mood changes – the energy change is usually very clear
even if you try to hide it. You may
not think the elevated mood is abnormal but others will definitely think so.
Signs that mood changes may not be bipolar.
There
are other forms of mood instability such as in borderline personality.
If
you mood changes very quickly – in a moment, in a strong reaction especially to criticism or rejection.
If
you are feeling hyper for a few hours or a night but then crashes.
If
you never have had a stable time in your mood since early teenage years.
If
you find relationships are a real difficulty for you as you can be very intense
but then break up.
If
you are getting persistent psychotic symptoms including paranoia and these
continue even if your mood is not extreme.
If
you think you may be bipolar then read about the various forms of mood
instability and try to track your moods.
If
others are concerned about your mood then that is a strong sign that you should
get an assessment from a psychiatrist who can help you to look at this
diagnosis.
Recognition of any problem
is the major step in dealing with a problem.
This is my
book if you are interested in finding out more:
It is now
available in a kindle version
