Psychofarm Podcast

This 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 this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com

Dive 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. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com

Join 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 importance of earning therapeutic trust, and effective interviewing techniques for sensitive topics, ultimately highlighting why accurate identification is key to 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.com

This 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.com

Join 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.com

In this discussion, Dr. Chris Aiken, a psychiatrist and assistant professor, dives into the complexities of treating difficult-to-treat depression. He critiques the traditional serotonin model and emphasizes the importance of integrating lifestyle changes and neuroprotective strategies into psychiatric care. The conversation also explores the role of thyroid hormones, methylfolate, and even testosterone supplementation in managing depression. Aiken advocates for personalized treatment approaches, moving beyond the label of 'treatment-resistant' to focus on holistic patient well-being.

Schizophrenia 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 this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com

What 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 field. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com

Discover practical lifestyle changes that can supercharge mental health beyond medications. Explore how exercise boosts well-being and fosters social connections. Unpack the importance of sleep and natural light for enhancing mood. Dive into mindfulness techniques that offer personal empowerment. Learn about the detrimental effects of substances on recovery and the need for supportive relationships. This engaging discussion underscores that combining lifestyle habits with traditional treatments can lead to more holistic mental health management.

In 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 harnesses magnetic fields to stimulate neural circuits, effectively “resetting” brain rhythms and boosting neuroplasticity. They discuss real-world clinical applications, sharing insights on how tailored coil positioning and stimulation patterns can lead to significant improvements in mood regulation and cognitive function. The podcast also addresses practical challenges, including optimizing treatment intervals, insurance hurdles, and the future of neuromodulation in psychiatry.Whether you’re a clinician looking to stay up to speed on the latest in TMS research or a patient exploring nonpharmacological options for mental health care, this episode provides a comprehensive and accessible overview of TMS technology and its promising impact on mental health treatment. Join us as we decode the complexities of TMS and reveal how this innovative therapy is reshaping the landscape of mental health 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.com