Mental Health Episodes

This is the episode I wish we never had to make—and also the one I wish I’d had from the beginning. Margaret and I talk about suicide from inside the profession: what it’s like to lose a patient, how we carry that grief (or numbness), and why the aftermath is rarely as clear-cut as people think. We talk about the fear of getting it “wrong,” the complicated relief that can come when a patient is finally at peace, and the moments when you realize you’re not the only one who saw it coming. And maybe the most important part? We talk about how hard it is to talk at all. This one’s raw. And necessary. And still full of tenderness.

It’s Part 2 of our deep dive into eating disorders—and this time, we’re going even deeper. We kick off by unpacking our mock therapy session with Dr. Helen Liljenwall, which unexpectedly hit close to home for all of us. Then we take a sharp turn into the medical realities of starvation, including refeeding syndrome, the female athlete triad, and why your heart is always in the equation (literally). But what happens when patients refuse to eat—and we have to decide whether they need a psychiatric hold? Who gets to say when a person with an eating disorder has lost capacity? And is “terminal anorexia” a compassionate truth—or a dangerous excuse? If you’ve ever wondered what it really takes to treat eating disorders, this is the episode to hear. It's raw, real, and it doesn’t flinch.

This is Part 1 of our two-part deep dive into eating disorders—and we’re starting at the beginning. Margaret and I sit down with psychiatrist and eating disorder specialist Helen Sanon, MD to walk through the basics: What are the major types of eating disorders? What do they actually look like in real life? And how do we treat something that’s rooted in both biology and culture? We cover everything med school skipped—then try to practice what we’ve learned in a fake (but emotionally real) therapy session with Dr. Helen as the patient. Spoiler: it got uncomfortable in all the right ways.

This episode hit harder than I expected. Margaret and I talk about what it feels like to care for patients who remind us a little too much of ourselves, especially when we’re also the ones filling out the paperwork for a psychiatric hold. We dig into what a 5150 (or 5585) really means, how to sit with that kind of authority, and the emotional mess of seeing a patient’s fear reflect your own. This one’s about boundaries, over-identification, supervision, and the heartbreak of sometimes needing to say, “I care about you and I can’t be your doctor anymore.”

In this episode, Margaret and I take on burnout—what it actually is, where the term came from, and how to tell when you’re not just tired, but something deeper is cracking. We dig into the history, the Maslach Inventory, moral injury, and why burnout isn’t in the DSM (yet). We also share our own unhinged burnout moments (yes, mine involves harmonica) and explore how to tell the difference between burnout, depression, and just being in the wrong place.

Season 1: complete! In this wrap-up episode, Margaret and I reflect on what it’s been like building this show from scratch—while also being full-time psychiatry residents. We talk about favorite episodes, unexpected challenges, what we’re still figuring out, and what’s ahead for Season 2. We also answer listener questions about training, creativity, psychedelics, and the eternal search for balance when your brain wants art and your calendar says “clinic.” There’s some honesty, some gratitude, and a whole lot of behind-the-scenes chaos.

In Part 2 of our conversation with Dr. Nikki Haddad, we went from couples therapy theory to Simpsons cosplay, and yes—it was as chaotic and illuminating as it sounds. Margaret and I roleplay Homer and Marge in a fictional session while Nikki breaks down what’s actually happening between us (emotionally, not just cartoonishly). Along the way, we talk about heteronormativity, escapism, parenting exhaustion, and the red flags that get mistaken for romance. It’s part improv, part therapy, part meltdown. But somehow, it makes sense.

In this episode, we sat down with Dr. Nikki Haddad —Margaret's residency best friend, couples and sex therapist, and one of the most thoughtful psychiatrists I know—to break down what makes romantic relationships so damn hard. We get into myths we’ve carried (and tried to shake), how sexual issues are rarely just about sex, and why our training in medicine doesn’t prepare us to talk about any of this. Nikki then walks us through the five developmental stages of a relationship and this is only Part 1. Be sure to stay tuned next week for Part 2 of the conversation!

We opened up the inbox and wow… y’all really came through. In this first-ever Q&A episode, Margaret and I answer your questions about coping during med school, surviving feedback, dealing with emotional exhaustion in residency, and why outpatient goodbyes feel like actual breakups. I also overshare about marathon training (again), Margaret brings the wisdom and the theater metaphors, and we all learn what bald eagles actually sound like. It’s a mix of serious, strange, and unexpectedly honest—basically, peak us.

This week, I learned I have a pelvic floor. And yes, I realize I’m a doctor and should’ve known that already. Margaret and I talk with pelvic floor physical therapist and viral educator Dr. Alicia Jeffrey-Thomas, who somehow made me breathe through my butt on mic. We cover everything from incontinence and pelvic pain to TikTok fame, trauma-informed care, and the surprisingly emotional world of core stability. Alicia breaks down the science and the stigma behind one of the most misunderstood parts of the body—and I try to keep up while sitting on a pillow and trying not to Kegel too hard.

In the last episode, Preston demonstrated to Margaret how to properly conduct a mindfulness meditation session. Due to popular demand, the sage spiritual guide is back.

In Episode 16, Preston and Margaret dive into the chaos of overnight residency, the reality of sleep deprivation, and how mindfulness can backfire when your brain just won’t sit still. From ruined meditations to hot girl walks through hospital hallways, they unpack what real-world coping actually looks like—before, during, and after the hardest moments.

In Episode 15, Preston and Margaret open a bottle—of questions, stories, and science—about alcohol use disorder. What do we get wrong about “moderate” drinking? Why is detox more dangerous than most people realize? And how does alcohol quietly reshape identity, relationships, and the brain itself? With their signature blend of honesty and humor, they explore the unexpected ways drinking shows up in medicine, the myths that keep us stuck, and the messy, meaningful path to redefining recovery.

In Episode 14, Preston and Margaret dive into social anxiety disorder and the loneliness epidemic. From embarrassing childhood memories to awkward club encounters, they explore how social anxiety shows up in everyday life and how it differs from normal nerves. They also discuss the surgeon general’s definition of loneliness, the role of social media in increasing perceived judgment, and the neuroscience behind facial recognition, fear responses, and serotonin's impact on the amygdala.

In this episode Margaret takes the lead as she welcomes art therapist, psychotherapist, and author Amelia Knott to discuss the ethics of being online, parasocial relationships, and the impact of social media on mental health. We explore the blurred lines between personal and professional identities in digital spaces, the therapeutic power of art, and how social media fosters both connection and disconnection.

In this episode we are joined by Priyanka Patel, a pharmacist, content creator, and soon-to-be author, to discuss mental health misinformation, ADHD, and the challenges of navigating online discourse about mental health. Priyanka shares her personal journey with ADHD, the barriers she faced in getting a diagnosis, and how social media both helps and harms conversations about neurodivergence.

In this episode Preston and Margaret explore the endocannabinoid system, cannabis, and its impact on mental health. They break down the science behind CB1 and CB2 receptors, explain why marijuana affects people so differently, and discuss the complex relationship between THC, CBD, and dopamine. Along the way, they tackle myths about cannabis use, addiction, and medical marijuana, shedding light on what we actually know—and what remains a mystery due to historical barriers to research.

In this episode Preston and Margaret are joined by Dr. David Roberts to explore the fascinating world of motivational interviewing (MI)—a counseling technique designed to help patients navigate ambivalence and commit to meaningful change. Dr. Roberts shares insights from his years of experience training psychiatrists and therapists, breaking down MI into practical techniques that anyone can use to foster deeper, more effective conversations. We even do a fake therapy session with our producer Aron Korney!

In this episode Preston and Margaret take a deep dive into the complex relationship between exercise, nutrition and mental health. They discuss the science behind how movement impacts the brain, debunk common myths about fitness, and explore the psychological barriers that prevent people from incorporating exercise into their lives.

In this episode Preston and Margaret tackle one of the most talked-about topics in mental health today—ADHD. From the historical roots of the diagnosis to the impact of modern social media trends, they explore how our understanding of ADHD has evolved over time. They discuss the challenges of diagnosing ADHD in both children and adults, the role of social media in spreading information (and misinformation), and the real-life impact of the disorder.

In this episode Preston and Margaret explore the complex concept of rapport in healthcare. They reflect on the challenges of building meaningful connections with patients and the impact these relationships have on medical outcomes. From awkward early encounters in medical school to techniques they've developed as psychiatry residents, this episode unpacks what it means to truly connect.

In this episode Preston and Margaret embrace the season with a deep dive into Seasonal Affective Disorder (SAD). From the science behind melatonin and serotonin to the cultural and emotional frameworks that shape how we experience winter, this episode covers the biopsychosocial dynamics of seasonal depression. Along the way, they share personal anecdotes, including the surprising benefits of light therapy and reframing winter as an opportunity for growth.

In this episode Preston and Margaret dive into the science and personal experiences surrounding attachment theory. They discuss its origins, its modern-day interpretations, and how it shows up in everyday relationships.

In this debut episode of How to Be Patient, psychiatry residents Preston Roche and Margaret Duncan open up about their personal journeys into medicine and the challenges they’ve faced in connecting with patients—and themselves. From navigating early patient interactions to grappling with their own vulnerabilities, they explore the balance between authenticity and professionalism. With humor, candid storytelling, and a dash of introspection, this episode sets the stage for a season of thoughtful discussions on empathy, growth, and the art of being present in healthcare. Get ready for the tale of two doctors!