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Areas of expertise
Mood & Anxiety Disorders
Mood and anxiety disorders are more common than you might think, and they touch the lives of many people and their families. During my many years working as a Consultant Psychiatrist, I've learned that while these conditions are widespread, the right treatment varies for each individual. It's about understanding you, not just the disorder.
These conditions can occur on their own or together, and they may include depression, mania, anxiety and any degree of their combination. Everyone's experience with these disorders is unique, and your treatment should be unique too. We can explore your concerns and expectations by having open, confidential discussions. We'll look at everything - how you're feeling, your medical history, and even your daily routine. It's not just about treating a condition; it's about understanding what you need and what works for you.
What are the treatment options?
- Medication: If you're hesitant about medication, I hear you. Let's talk through your worries and options. Medication isn’t always necessary for mild cases of anxiety or depression, but it can be helpful if you’re really struggling with symptoms.
- Talking Therapy: Talking things through with a therapist can be a powerful tool in this journey, providing another layer of support and understanding.
- Lifestyle changes: We might consider changing some of your habits around sleep, diet or exercise.
Getting better goes beyond just dealing with symptoms. It's about getting back to being you - enjoying life and finding a sense of normalcy and happiness again. The most rewarding part? Seeing how this change allows you to smile more easily, rediscover what you love doing, and positively affect your life and those around you.
Adult ADHD
Have you ever felt like there's an invisible barrier holding you back in life? For some adults, this barrier could be undiagnosed ADHD. Although ADHD is a common condition that’s usually diagnosed in the teenage years, many adults with more subtle symptoms get missed. Without knowing it’s there, ADHD can impact many parts of your life, including your work, relationships, and mental health. Here are some ways it might show up:
- Work or school performance: Do you often feel like your achievements don't reflect your true potential? This is a common feeling among adults with undiagnosed ADHD. You might see others advancing effortlessly while you feel stuck or overlooked. It's disheartening and can take a toll on your self-esteem, sometimes leading to sadness, anxiety, or depression.
- Relationships: ADHD can subtly influence social interactions, making it hard to feel connected in group settings or maintain focus when talking to your loved ones.
- Mental health: Often, undiagnosed ADHD walks hand-in-hand with anxiety, depression, or substance abuse. It's also common to experience anger, frustration, and mood swings.
The good news is that ADHD is treatable, and getting assessed can be a significant step towards understanding yourself better. Many people are surprised to learn that it can also come with strengths. People with ADHD are often creative, driven, optimistic, and determined – despite their challenges.
How does the ADHD assessment work?
You can expect a detailed conversation about your history using a standardised ADHD interview which usually takes about two hours. Our goal is to understand your challenges together. It might be surprising, but some people with ADHD tend to forget certain details about their experiences or memories. Especially if they're nervous about the assessment or they usually downplay their difficulties. This is completely normal. If it helps, you can bring someone who knows you well to the assessment for support.
Diagnosis & Treatment
If you get diagnosed with ADHD, it might bring up mixed emotions like relief, frustration for the delay in getting it, or tears of joy. That’s why we usually end the session after the assessment and schedule another appointment to talk about the diagnosis and treatment. This gives you time to process everything before we discuss treatment options.
When it comes to treatment, you might wonder if medication is the only option. Although stimulant medications (like Elvanse and Ritalin) are some of the most effective treatments around, seeing a psychologist could also be beneficial. They can help with skills like problem-solving and time management. Additionally, we'll look at lifestyle changes, like improving your sleep routine and exercise, as part of your comprehensive care plan.
Psychosis & Schizophrenia
When a family member has psychosis or schizophrenia, it can feel heartbreaking to see them struggle with reality. Often, they’ll perceive everyday things as threatening or hostile. They might feel like the world, or even you, are against them. It's common for them to hear things that aren't there, which can make them sad or afraid. Often, they just want to be alone because everything seems too much. It's hard on them too; they know their condition affects you and the rest of the family, and that can make them feel guilty.
I've spent many years helping people with psychosis and schizophrenia. A big part of my job is helping those who might be afraid or unsure about treatment. I know it's not easy for them to trust others and be open to change. My approach is always gentle and understanding because I know how important that is.
What are the treatment options?
Choosing the right treatment can seem overwhelming. Feeling confused or even want to put off getting treatment is normal. My job is to be there for you, to make sense of all these options, and to find a way forward that works for you and your family. We'll tackle these challenges together at a pace that feels comfortable for you.
Medication is the most effective treatment for the negative feelings that come with psychosis. I understand that you might worry about medication or its side effects, but there are many different kinds, and we'll find one that suits your loved one best. If the usual treatments aren't working, we can investigate further, for instance using pharmacogenetic testing. Talking therapy is something I believe in strongly, so if you're open to it, I can recommend a good psychologist.
Remember, the journey to recovery is a team effort. Together, we can work towards improving the life of your loved one and restoring a sense of hope and normalcy in your family.
My approach to treatment
I know that seeing a new doctor can feel nerve-wracking. You might be worried about not being heard or understood, or maybe you're just nervous about talking to someone you don't know yet. It's completely normal to feel this way, and it's one reason why some people might wait a while before deciding to get help. If you're feeling vulnerable about opening up to a stranger, that's okay – it can take a little time to get comfortable.
Your first consultation
When you first come in, I'll give you a warm welcome to help you feel as comfortable as possible. We'll also go over how our session will work, including the kinds of questions I'll be asking. These questions are important because they help me get a clear picture of what's going on with you. We'll explore things like your childhood, school experiences, and family background, as well as your medical history and any past medications. Understanding your treatment history is crucial, as sometimes previous treatments might not have worked due to a misunderstanding or lack of information about past medications.
I'm here to find out what you're hoping to achieve from our sessions and how I can best support you.
Personalised treatment plans
At the end of your first consultation, in most cases I’ll put together a treatment plan that's just for you. We'll go through it step by step, and you can ask all the questions you want. It's crucial for us to be on the same page about your goals – after all, this plan is all about supporting you.
My approach to treatment is holistic and flexible. I believe in taking advantage of everything that can help, from the latest research to simple lifestyle changes. As we work together, we’ll keep tweaking your treatment plan based on your feedback.
Here's what your treatment plan might include:
- Medication: We'll find the medication that suits you best with the least amount of side effects. If you've had issues with treatments before, we can look into advanced options like pharmacogenetic testing to find the perfect match for your genetic makeup.
- Talking therapy: A good therapist or psychologist can make a world of difference, and I won't hesitate to recommend one if you're open to it.
- Sleep: As a member of the European Sleep Research Society, I'm always excited to share how crucial good sleep is for our health (like cleaning out toxins from our brain). We'll talk about how good sleep can make a big difference in your life and some simple steps you can take to improve your sleep.
- Physical activity: Let's not forget about exercise! I'm a big believer in staying active myself. It's incredible to see how just moving more can lift your mood and improve your health. Exercise isn't a cure-all, but it's a big part of feeling better, whether you're dealing with things like psychosis, depression, or ADHD.
- Diet: Eating well is not just about enjoying your food; it's about how it can improve your mood and self-esteem over time. If you need, we can bring in experts like dieticians to give you tailored advice.
Medication
Creating a trusting and open relationship is key when we talk about whether medication might be helpful for you. I understand that the idea of taking medication can be a bit daunting. You might be hesitant for several reasons – maybe you've had side effects in the past, or you feel like you should be able to handle things on your own. It's common to worry about how medication might affect you, like changing who you are, causing weight gain, or making you sleep more than you want to.
In my years of working with different patients and conditions, I've learned that listening to your concerns about treatment comes first. Then we can talk about how different options might suit your specific needs. It's really about finding what works for you.
One thing that can be really helpful in some cases, is new advances in pharmacogenetic testing. This means finding the best medication choice based on your unique genetic makeup. It's a great way to figure out the most suitable option for you and can help ease any worries you might have about treatment.
Education & Training
I’m a Consultant Psychiatrist with over 17 years of clinical experience in General Adult Psychiatry. I’m professionally registered with the General Medical Council and the Royal College of Psychiatrists. I am also an International Member of the American Psychiatric Association. I have significant experience in rehabilitation psychiatry, managing complex cases involving co-occurring conditions, as well as in acute psychiatry.
My career spans several prestigious roles, including Medical Director at Cygnet Churchill Hospital, where I established the acute inpatient ward. This ward, known for its outstanding psychology and occupational therapy services, has been recognised as a model of excellence within the group but also by the South London and Maudsley NHS Foundation Trust. I’ve also contributed to groundbreaking research in clinical risk assessment tools and introduced evidence-based physical health monitoring in my practice. My efforts have consistently focused on enhancing patient outcomes, as demonstrated in a service evaluation at Juniper Acute ward, which showed highly significant improvements in patient conditions.
Regarding my education, I pursued my speciality diploma in General Adult Psychiatry at the University of Catania. My research work at the University of Iowa's Department of Psychiatry allowed me to be part of a pioneering team studying how patients with depression process emotions. My ongoing MSc in Advanced Neuroimaging at UCL reflects my commitment to integrating advanced technologies like functional neuroimaging and AI into clinical practice. These experiences have shaped my approach to patient care, emphasising the importance of innovative and evidence-based practices.
Key Publications
- Seclusion Prediction in Psychiatric Care (2017): Dr Loi and Dr Marlowe developed the East London Modified-Broset tool to help predict the need for seclusion in psychiatric intensive care. The study emphasised patient-centred care by providing a method to evaluate the need for seclusion based on individual patient assessments.
- Emotion Recognition in Depression (2013): Dr Loi and his colleagues explored how patients with depression perceive emotions through body language, offering insights into the cognitive effects of depression.
Personal interests
In my free time I enjoy being active in fitness, exploring new places, enjoying a good coffee, and watching movies. I love travelling, especially to seaside places.
