Shows
Psychofarm PodcastYou Tell Me | Adderall for All?, Surgeons Gone Shrink, Codependency isn't NeurobiologicalIn the pilot episode of You Tell Me, the hosts dive into the controversial question: “What’s the harm in more widespread stimulant use?” They explore Silicon Valley’s productivity culture, stimulant risks, and the ethical dilemma of turning psychiatry into a tool for optimization. From there, the conversation shifts into a lighter segment on the stereotypes of medical specialties. The episode ends with a candid discussion on trauma, codependency, and why inpatient psychiatry often misses the mark.This off-the-cuff episode blends unfiltered opinions with occasional psychiatric insights… approachable for clinicians, medical students, or anyone curious about the cultur...2025-07-2353 min
Psychofarm PodcastWhat Is OCD? How to Understand It, Recognize It, and Treat ItJoin us in this podcast episode focused on Obsessive Compulsive Disorder, where we explore the DSM‑5 criteria, differentiate OCD vs generalized anxiety, and discuss the neurobiological roots of compulsive behavior. We cover practical guidance on exposure response prevention (ERP), using the Yale‑Brown Obsessive Compulsive Scale as a screener, and outline medication strategies like high‑dose SSRIs to support psychological treatment. Ideal for clinicians and anyone seeking to understand or treat OCD effectively. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substa2025-07-0955 min
Psychofarm PodcastPsychiatrist's Guide to Anxiety Medications: First Line to Last ResortWe unpack the anxiety medication algorithm, moving from first-line SSRI picks like Sertraline and Escitalopram to augmentation with buspirone, gabapentin and lavender. CBT, mindfulness and evidence-based psychopharmacology weave throughout the podcast, so clinicians prescribe appropriately and with the right psychoeducation. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com2025-06-251h 01
Psychofarm PodcastUnderstanding Anxiety, GAD, and Treatments of AnxietyIn this episode, we explore anxiety not as a disease in itself, but as a critical signal from your mind and body. We discuss how this signal can point to deeper issues like hidden emotions or relational trauma, and why common diagnoses like GAD (Generalized Anxiety Disorder) often miss the true source of the problem. We also cover the fundamental brain science of fear, the key differences between anxiety, panic, and worry, and introduce five different treatment models designed to help you find and resolve the root cause. This is a public episode. If you would...2025-06-111h 00
Psychofarm PodcastAssessment of Personality: Practical Assessment in a Short TimeframeThis episode looks at the practical assessment of personality. We explore the nuances of psychiatric diagnosis, moving beyond simplistic heuristics with a focus on the DSM-5's Alternative Model for Personality Disorders. Learn about assessing self-functioning (identity, self-direction) and interpersonal functioning, using clinical interviewing, psychosocial history, and even your countertransference as vital tools for a more comprehensive understanding of personality pathology in busy clinical settings. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com2025-05-271h 05
Psychofarm PodcastTreating Borderline Personality Effectively aka How To Be A Good Psychiatrist Through GPMThis episode delves into Good Psychiatric Management (GPM), a practical framework developed by John Gunderson for treating Borderline Personality Disorder (BPD), though its principles offer broad utility across diagnoses. The hosts discuss the importance of integration, managing expectations (both patient and provider), and robust psychoeducation regarding BPD's features, heritability, and treatment course. Key GPM tenets are explored, including focusing on life outside therapy (work/relationships), the adjunctive role of medication, fostering accountability, and the significance of the therapeutic relationship itself as part of the treatment. This is a public episode. If you would like to discuss...2025-05-1357 min
Psychofarm PodcastPTSD Medications: Integrating Pharmacotherapy, Therapy, and the Treatment Frame | Episode 22Dive deep into the practicalities of psychiatric medication management for PTSD in this clinical discussion. We explore the often limited evidence base and the necessity of off-label prescribing, focusing on strategies for stabilization, safety, and trust… the first stage of trauma treatment. Learn about experience-based approaches using SSRIs like sertraline, sleep aids such as trazodone and gabapentin, the cautious use of antipsychotics, and why benzodiazepines are discouraged. The conversation also touches on managing sleep disturbances and dissociation, situating medication as a supportive tool alongside essential psychotherapy and lifestyle changes, guided by principles like Pierre Janet's three-stage model. 2025-04-2956 min
Psychofarm PodcastUnderstanding Trauma and PTSD, Diagnosis and Dissociation | Episode 21Join us for an in-depth exploration of trauma and Post-Traumatic Stress Disorder (PTSD). This episode moves beyond common language to establish a clinical definition of trauma, detailing the DSM-5 criteria required for a PTSD diagnosis. The hosts break down the core PTSD symptom clusters – intrusion, avoidance, negative alterations in cognitions/mood, and arousal/reactivity – providing clear examples like flashbacks, hypervigilance, and negative self-beliefs. They delve into the concept of dissociation, its role in trauma, and the challenges it presents in assessment. Listeners will gain crucial insights into the diagnostic process, common misdiagnoses (like mistaking PTSD for depression), the vital impo...2025-04-151h 00
Psychofarm PodcastLessons from Forensic Psychiatry: Insanity Defense, Subtle Patients and CulpabilityThis conversation explores key aspects of forensic psychiatry, including the insanity defense, dissimulating patients, and how clinical practice intersects with legal systems. It highlights the importance of open-ended dialogue, nuanced diagnosis, and maintaining empathy without succumbing to cynicism. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com2025-04-0154 min
Psychofarm PodcastInvoluntary Treatment & Agency, Thoughts and Feelings | Episode 19Join us in a conversation about involuntary commitment, and the legal framework behind psychiatric treatment. We discuss real-world scenarios, share insights into how clinicians juggle patient autonomy versus societal protection. Whether you are new to the field or a seasoned professional, this episode offers valuable perspectives on balancing ethical duties, legal obligations, and patient care. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com2025-03-121h 00
Psychofarm PodcastThe Deficit Model in Psychiatry & Difficult to Treat Depression with Dr. Chris Aiken | Episode 18In this episode, we sit down with Dr. Chris Aiken to look at a big question: when do we treat an underlying deficit in psychiatric illness? Focusing on difficult-to-treat depression, our conversation delves into the deficit model and looks at different paradigms, from neuroprotective strategies and lifestyle interventions to the nuanced use of medications like SSRIs, lithium, and thyroid hormones, as well as targeted supplements. Tune in for a thought-provoking discussion that looks at when we approach treating depression by focusing on its underlying causes.http://www.carlatreport.comhttps://chrisaikenmd.com/partners/...2025-03-0542 min
Psychofarm PodcastChoosing Antipsychotics in Schizophrenia: Side-Effects, Maximizing Efficacy, and Finding the Right Medication | Episode 17Schizophrenia treatment is complex, and choosing the right antipsychotic can make all the difference. In this episode, we take a deep dive into schizophrenia medications... breaking down the pros and cons of different antipsychotics, metabolic risks, sedation issues, and the challenges of adherence. We discuss how to tailor treatment to individual patients, avoid unnecessary side effects, and improve long-term outcomes. Whether you're a clinician prescribing antipsychotics or someone looking to understand schizophrenia medications better, this discussion offers practical insights and evidence-based strategies for optimizing treatment. This is a public episode. If you would like to discuss...2025-02-261h 01
Psychofarm PodcastThe Future of Psychiatry: Spravato, Vagus Nerve Stimulation, Trigeminal Nerve Stimulation, PRISM Neurofeedback, TMS and much more with Dr. Owen Muir | Episode 16What is the future of psychiatric treatment? In this episode we explore groundbreaking innovations in neuromodulation, AI driven diagnostics, and the evolving business of mental healthcare. Dr Owen Muir discusses why business and policy are as crucial as clinical advancements in ensuring that cutting edge treatments like accelerated TMS, noninvasive vagus nerve stimulation, and AI assisted tardive dyskinesia detection actually reach patients. From reshaping psychiatric training to rethinking what it means to cure mental illness, this conversation challenges how we view progress in psychiatry. Tune in to discover how technology, policy, and medical practice are converging to transform the...2025-02-181h 01
Psychofarm PodcastBeyond Medications: The Best Lifestyle Treatments for Mental HealthMedications and therapy are the foundation of mental health treatment, but what else can you do to improve your well-being? In this episode, we explore the essential lifestyle changes that can make a profound impact on mental health. From exercise and behavioral activation to socialization, sleep, and mindfulness, we break down practical, evidence-based strategies that go beyond prescriptions. We also discuss how avoiding substances and engaging with the right self-help resources can support long-term recovery. Whether you're a clinician, a patient, or just someone looking to optimize mental well-being, this episode offers actionable insights to help build a sustainable...2025-02-1250 min
Psychofarm PodcastTMS and The Future of Psychiatry, Part 1 with Dr. Owen MuirIn this engaging episode, Dr. Owen Muir dives into the science and practice of Transcranial Magnetic Stimulation (TMS), exploring its transformative role in modern psychiatry. The conversation begins with a historical look at how TMS emerged from groundbreaking research in the 1980s, evolving into an FDA-approved, noninvasive treatment for mental health disorders such as treatment-resistant depression, OCD, and bipolar disorder. Listeners are taken on a journey through the mechanics of TMS, from precise brain mapping and neural synchronization to the innovative use of accelerated TMS protocols that offer rapid symptom relief.Dr. Owen Muir unpacks how TMS...2025-02-0455 min
Psychofarm PodcastProbably The Most Important Topic in Psychiatry: Therapeutic Alliance and FrameExplore the fundamentals of the Therapeutic Alliance and Frame in this podcast episode, where we highlight how trust, clear communication, and structured boundaries form the bedrock of effective psychiatric practice. Learn practical strategies for aligning treatment goals, clarifying diagnostic expectations, and navigating challenges like medication hesitancy or “trauma dumping.” Perfect for psychiatrists, therapists, and mental health enthusiasts, this discussion offers real-world examples, expert insights, and actionable tips to build a more collaborative and successful therapeutic relationship. This is a public episode. If you would like to discuss this with other subscribers or get access to b...2025-01-291h 09
Psychofarm PodcastThe Best Bipolar Medication Review From The Best Bipolar ExpertHumbly…. we explore a practical overview of bipolar disorder, from refining your diagnostic approach to navigating effective treatments. In this episode, we highlight how sleep patterns play a pivotal role, how substances and antidepressants can complicate clinical presentations, and the fundamentals of evidence-based medication choices, spanning mood stabilizers and second-generation antipsychotics. Discover best practices for acute mania management, bipolar depression strategies, and why lifestyle interventions are crucial for long-term stability. Whether you’re a seasoned clinician or just starting out, this conversation offers valuable insights on delivering comprehensive, balanced care for individuals with bipolar disorder. This is a...2025-01-1557 min
Psychofarm PodcastTreating Depression: Practical Tips & Pearls for Anti-Depressant MedicationsThis episode delves into the pearls of treating depression with medications, offering practical strategies for clinicians and patients alike. From identifying the root causes of depressive symptoms to exploring evidence-based medication and lifestyle interventions, this discussion provides actionable insights for improving mental health outcomes. Learn about personalized treatment options, managing side effects, and the importance of a strong therapeutic alliance in achieving sustained remission. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com2025-01-061h 11
Psychofarm PodcastUnderstanding Borderline Personality Disorder with Dr. Mark L. RuffaloJoin renowned therapist Dr. Mark Ruffalo as he unpacks the complexities of Borderline Personality Disorder (BPD). This discussion delves into the relational patterns, effective communication of diagnoses, core anxieties, and the need-fear dilemma. Whether you're a mental health professional or someone seeking understanding, Dr. Ruffalo provides invaluable insights. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com2024-12-171h 01
Psychofarm PodcastInsomnia and Sleep Medications in PsychiatryIn this episode, we dive into the use of sleep medications in psychiatry. Is insomnia a standalone condition or a symptom of deeper issues? We discuss our clinical approach to treating sleep disturbances in psychiatric patients, focusing on medications to the nuanced use of trazodone, gabapentin, and antihistamines. Along the way, we explore the intersections of sleep and psychiatric illnesses, and the role of medications in patient recovery. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com2024-12-041h 14
Psychofarm PodcastNancy McWilliams on Psychoanalytic Diagnoses, Part 2: Depressive Personality, Histrionic Personality, OCPDIn part two of our conversation with Dr. Nancy McWilliams, we explore a diverse range of personality dynamics, from the socially expressive yet vulnerable histrionic style to the introspective and reserved schizoid personality. Dr. McWilliams offers unique insights into how cultural and social contexts shape personality types, especially the often misunderstood histrionic style, which she discusses from her own personal perspective. We also examine the attraction between histrionic and schizoid personalities, uncovering the push-pull dynamics that can both challenge and enrich these relationships. Rounding out the discussion, we turn to obsessive-compulsive personality, investigating its roots in control, morality, and...2024-11-2653 min
Psychofarm PodcastPsychosis: History, Delusions, Diagnosis, Theories, and Modern CareWe explore the evolution of psychosis diagnoses from the early DSM days to modern psychiatry, unpack the role of language in shaping delusions, and discuss how treatment has (and hasn’t) progressed. From Lacanian theories to real-world clinical challenges, this episode bridges the gap between theory and practice while tackling stigma head-on. Perfect for clinicians, patients, and anyone curious about the mind’s mysteries. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com2024-11-181h 13
Psychofarm PodcastNancy McWilliams on Psychoanalytic Diagnoses, Part 1: Personality, Defenses, Themes, Paranoid PersonalityIn this episode, Dr. Nancy McWilliams explores the foundations of personality, tracing how our unique defenses and core life themes shape who we are and how we relate to others. She discusses the concept of personality as a tapestry woven from central themes rather than fixed traits, revealing how these themes serve as guiding narratives that influence our behaviors and relationships. The conversation takes a deep dive into the paranoid personality style, examining its key features of trust, betrayal, and sensitivity to perceived threats. Dr. McWilliams also discusses how early life experiences and family dynamics can lead individuals to...2024-11-131h 01
Psychofarm PodcastHealthy Personality Traits, Trauma vs. Personality, and Why Trauma Doesn’t Explain It AllThis episode is a continuation of our previous conversation on personality. We dive deep into the complex world of personality disorders and healthy personality traits. From the misconceptions that plague psychiatric diagnoses to the often-overlooked truths about how we develop emotionally… We discuss the difference between normal development and personality disorders, discuss the stigma surrounding diagnoses like borderline personality disorder, and explore how trauma shapes our sense of self, but doesn’t quite explain everything. This is a public episode. If you would like to discuss this with other subscribers or get access to bonu...2024-10-2231 min
Psychofarm PodcastWhat Psychiatrists Get Wrong About Personality DisordersIn this episode, we take a peak into the often-misunderstood world of personality disorders. We explore common misconceptions that psychiatrists and clinicians make when diagnosing and treating personality disorders, shedding light on why these errors happen and how to approach personality pathology in a more integrative, effective way. The conversation challenges the traditional views and advocates for a more nuanced understanding of self and others. Whether you're a clinician, mental health professional, or someone interested in psychology, this episode offers a nifty perspective on the complexities of personality, pathology, and the therapeutic journey.🔴PsychoFarm YouTube💡Anti-depressant Course📖 PsychoFarm's Treating Depressio...2024-10-1539 min
Psychofarm PodcastADHD Again, But Juicier: Unpacking Misdiagnosis, Medication Overuse, and Cultural TrendsIn this episode, Dr. Fu rejoins us as we take a deep dive into the world of ADHD—beyond the usual headlines and social media buzz. We’ll talk about how ADHD is often misunderstood, misdiagnosed, and even overhyped. Join us as we explore why so many people are getting diagnosed, the real role of medication, and why it's dangerous to use 1 thing to explain behavior. We’ll also dig into how cultural trends and social media are shaping our views on ADHD, and why it’s essential to see the whole picture when it comes to mental health. 🔴Ps...2024-10-021h 04
Psychofarm PodcastADHD... Diagnosis, What is ADHD? Is ADHD real? Do I have ADHD? Is ADHD biological?Unfortunately my co-host Dr. Fu is missing from today. But in this episode, we dive deep into the topic of ADHD, exploring its diagnosis, challenges with the DSM criteria, and the complexities of executive functioning deficits that define the disorder. We tackle the common question, “Is ADHD real?” and discuss how the history of ADHD has shaped the way it is understood today. We also explore the nature versus nurture debate and discuss the influence of biological and environmental factors on ADHD. Throughout the conversation, we challenge traditional thinking, encouraging listeners to approach ADHD from a broader perspective, considering both...2024-09-2446 min
Psychofarm PodcastBipolar Misunderstandings, Integrating Biology & Personality, & Broader ConceptualizationsIn this episode, we dive into the challenges of diagnosing bipolar disorder, especially when it overlaps with personality disorders. We discuss how psychiatric training often focuses on severe cases, which can make it harder to recognize milder forms. You'll hear about the importance of gathering detailed patient history and why short-term observations can be misleading. We also touch on the limitations of the DSM-5 and the need for a more holistic approach to diagnosis, incorporating biological, psychological, and social factors. Finally, we explore an alternative model for understanding personality disorders that goes beyond the traditional DSM framework.🔴Psy...2024-09-0444 min