Like many people, I have always been fascinated by true crime books and documentaries. As a psychiatrist, that fascination goes beyond the mystery itself. I find myself trying to understand the psychology behind the choices people make, the vulnerabilities that shape behavior, and the invisible emotional forces operating beneath the surface.

Last week, I watched Netflix’s Should I Marry A Murderer?, a three-part documentary told from the perspective of Dr. Caroline Muirhead, a physician in Glasgow who unexpectedly became entangled in a shocking criminal case involving her fiancé.

Throughout the series, viewers watch an intelligent, highly educated professional woman make a series of increasingly troubling choices. At times, she appears caught between two competing forces: the desire to do the right thing and an overwhelming inability to pull herself away from a toxic and psychologically consuming relationship. As the story unfolds, the audience is almost forced to ask themselves:

What would I have done in her position?

It is easy to watch a documentary like this through a lens of judgment. Many viewers will inevitably ask how a doctor — someone trained to think critically and analytically — could become involved in such chaos. Yet the more I reflected on the series, the more I found myself moving away from criticism and toward curiosity and compassion.

Because when we examine the broader context surrounding her story, her vulnerability begins to make far more sense.

The Perfect Storm of Vulnerability

The Context: Isolation During the Pandemic

The events took place in 2020, during the height of the COVID-19 pandemic. Lockdowns, uncertainty, and social isolation created profound loneliness for many people. Human beings are wired for connection, and prolonged isolation can dramatically alter emotional decision-making.

Under those circumstances, it is not difficult to imagine how someone could become vulnerable to a whirlwind romance, intense attachment, or love-bombing. When people are emotionally deprived, attention and affection can feel intoxicating.

The documentary reveals that Dr. Muirhead had recently exited an eight-year relationship that she believed would end in marriage, only for it to end in betrayal instead.

Experiences of heartbreak and rejection can significantly impact self-esteem and emotional vulnerability. After a major disappointment, many people become especially susceptible to seeking reassurance, validation, or a sense of finally being “chosen.”

That emotional context matters.

The Societal Pressure Many Women Still Feel

Dr. Muirhead was 29 years old and single. Although society has evolved in many ways, many women still internalize enormous pressure surrounding marriage and timelines for adulthood.

One of the most striking moments in the documentary was her admission that despite all of her professional accomplishments, she still felt sadness over never having been “chosen.”

That statement speaks to something painfully human. Achievement does not immunize people against insecurity, loneliness, or the longing for love and belonging.

The Myth That Doctors “Should Know Better”

One aspect of the documentary that particularly stood out to me was the assumption that her profession should somehow have protected her from manipulation or poor judgment.

Sadly, this belief can be harmful.

Doctors are not immune to emotional vulnerability, abusive relationships, substance use, depression, or mental illness. In fact, physicians experience disproportionately high rates of burnout, substance misuse, depression, and suicide. The expectation that highly educated people should always make rational choices ignores the reality of how human psychology works under stress.

Intelligence does not eliminate emotional needs.

Mental Health, Stress, and Psychological Decompensation

As the series progresses, viewers witness what appears to be a significant psychological decline involving substance misuse, emotional instability, and symptoms suggestive of mania or psychosis.

The documentary does not provide enough information to make assumptions about her psychiatric history, nor would it be appropriate to diagnose someone based on a television series. However, it naturally raises questions many mental health professionals might wonder about:

• Was there a pre-existing vulnerability?
• Did extreme stress, isolation, sleep deprivation, and substance use contribute to psychiatric decompensation?
• Or was it some combination of all of the above?

Psychological breakdowns rarely emerge from a single cause. More often, they result from multiple vulnerabilities converging at once.

Neurodivergence and the Women Who Are Often Missed

In recent years, I have found myself increasingly thinking about neurodivergence — particularly in the populations that are most commonly overlooked: adults, women, and highly functioning individuals.

Dr. Muirhead fits all three categories.

Again, I cannot and would not diagnose someone I observed in a documentary. But there were subtle aspects of her presentation that made me reflect on how autism spectrum disorder and ADHD can sometimes appear in intelligent adult women — often in ways that are misunderstood or completely missed.

Some of the traits that stood out included:

• A reportedly photographic memory
• A career path in pathology, a field that often attracts highly detail-oriented thinkers
• Emotional intensity combined with difficulty interpreting certain interpersonal dynamics
• Missing obvious relationship red flags
• Vulnerability to love-bombing and intense attachment
• Becoming deeply consumed by a new relationship
• Vulnerability to substance misuse
• Internal conflict between a strong moral compass and marked impulsivity

Many neurodivergent women become experts at masking. They may appear outwardly successful while privately struggling with emotional regulation, social interpretation, impulsivity, rejection sensitivity, or obsessive attachment patterns.

Unfortunately, because they are intelligent and high-achieving, their struggles are often minimized or missed entirely.

Moving From Judgment to Compassion

True crime stories often invite us to distance ourselves from the people involved. We reassure ourselves that we would have seen the warning signs, made better decisions, or behaved more rationally.

But psychology is rarely that simple.

Human beings are profoundly influenced by loneliness, trauma, attachment wounds, neurobiology, stress, sleep deprivation, social pressure, and mental health vulnerabilities. Under the right circumstances, even highly intelligent people can make choices that seem incomprehensible from the outside.

Rather than asking, “How could she do this?”, perhaps the more meaningful question is:

What vulnerabilities existed beneath the surface that made these choices possible?

That shift — from judgment to curiosity — is often where compassion begins.