199. A Psychiatrist's Guide to Political Anxiety and Medication Myths with Dr. Michael Ziffra

In this episode, I sit down with Dr. Michael Ziffra, a psychiatrist and associate professor at Northwestern University who specializes in anxiety disorders. Dr. Ziffra has been writing a Substack series called "Wise Mind in Anxious Times," exploring how we can better navigate the intersection of mental health and our turbulent political landscape.

We begin by discussing the alarming advice that made headlines—a Yale psychiatrist suggesting people should avoid family members who voted differently than them. Dr. Ziffra and I unpack why avoidance is the exact opposite of what we'd normally recommend for anxiety, and how vilifying language creates a vicious cycle that intensifies fear and paranoia. He offers practical wisdom on how softening our language can open doors to genuine dialogue.

From there, we dive deep into the world of psychiatric medication. Dr. Ziffra helps demystify the "chemical imbalance" theory, explaining why "dysfunction" is a better term than "imbalance" since we can't actually measure neurotransmitter levels the way we can check vitamin D. We explore fascinating territory including opioid receptors and depression, how low-dose naltrexone works, the dangers of chronic benzodiazepine use, and why tapering off medications requires far more patience than most people realize. We also discuss the overlooked impacts of birth control on young women's mental health, sleep disorders that masquerade as psychiatric conditions, and the emerging questions around weight loss drugs and ketamine for treatment-resistant depression.

Dr. Michael Ziffra is a psychiatrist and Associate Professor at Northwestern University, specializing in anxiety and mood disorders. Dr. Ziffra also is the author of “Wise Mind in Anxious Times”, a series on Substack exploring the interface between mental health and our sociopolitical climate. Its aim is to provide analysis and commentary from a mental health specialist with insight into why we experience anxiety about particular issues and happenings, and how to better manage that anxiety. Follow him on Substack, X, or Instagram.

[00:00:00] Start
[00:00:40] Guest Introduction: Dr. Michael Ziffra
[00:02:28] Yale Psychiatrist's Bad Advice on Family
[00:09:39] What Does a Psychiatrist Actually Do?
[00:12:03] The Chemical Imbalance Theory Explained
[00:18:02] Low-Dose Naltrexone and Opioid Receptors
[00:23:27] Benzodiazepines: Dangers and Dependence
[00:31:00] Safe Medication Tapering Strategies
[00:38:29] Nicotine Addiction and Smoking Cessation
[00:43:15] Psychiatry Beyond Just Medication
[00:47:30] Birth Control and Mental Health
[00:51:47] Sleep Disorders That Mimic Depression
[00:55:01] Weight Loss Drugs: Psychological Effects
[01:00:52] Ketamine for Treatment-Resistant Depression
[01:12:06] Where to Find Dr. Ziffra

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