Episodes

In this episode, Margaret and Preston present how two psychiatrists think about prescribing medications for depression. Using different common clinical scenarios, they discuss standard clinical guidelines, navigating weight gain and loss with SSRIs, augmentation of SSRI’s, and sexual side effects.

The Greeks described two kinds of madness, and both are fun to talk about on our pod. Inspired by the recent hullabaloo around The Odyssey, we are going to be breaking down the DSM-V diagnoses we see in the series and run through the historical roots and the stories of what we see today in mental health.

In today’s episode, Margaret and Preston are joined by pediatrician and child psychiatrist Elizabeth Pinsky, MD. Dr. Pinsky works as a pediatric consult-liaison psychiatrist at Massachusetts General Hospital and her clinical interests lie at the intersection of child mental and physical health, including childhood trauma associated with medical care, fostering resilience in medically ill children, and climate change. In this episode, we discuss the current understanding of climate change on mental health and wellbeing for all, why “climate anxiety” locates the problem in the wrong place, and how healthcare workers can help in collective action to improve the climate’s health to improve all our health.

Laugh all you want (please laugh it’s supposed to be funny), Preston has been doing improv from the last year and he has some thoughts. Not just “yes ands” about how it makes him a better doctor, and he is dragging Margaret into the mix starting off with some improv style warm ups and ending with a philosophical commentary about the stage we all perform on. I don’t know why I am talking about Preston like I am not the one writing this. Hi it’s me, Preston. Enjoy the episode!

Margaret is back and today our episode pulls themes from Carol Dweck’s work and book Growth Mindset, as well as a favorite sophisticated film: Kung Fu Panda. In this episode, Margaret and Preston discuss a frame to make sense of the obstacles we meet as we change levels of training, weather you’re starting med school, doing a post doc, or changing jobs. We walk through phases of growing, including failing, flailing, and flourishing, and give examples along the way from our growth-minded Panda friend.

In this week's throwback episode to Season 1, 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 today’s episode we bring on Dr. Campbell Sullivan, PsyD to discuss the interesting field of neuropsychology, a complicated niche that focuses on eliciting deficits in cognition across patterns of disease. We discuss the triumphs of her field as they collaborate with both psychiatry and neurology and then get into the places she sees room for improvement, particularly in how we assess and treat cognition in the aging female brain.

In this Preston-led episode, we take a deep dive into the history of lithium and its use in psychiatry. But because Preston is very literal, we are starting at the very beginning, inside of stars where lithium was formed at the beginning of the universe. Then we will follow this wonderful atom through history and past its FDA approval in 1970 to where we are today.

In this episode of historical psychiatric diagnoses we continue the “arc” (get it) with the story of a young girl with vivid hallucinations who galvanized the French army and a wise king who lost his sanity late in life. The interesting thing about these cases, however, is that they may have more underlying medical issues and in fact, the psychospiritual and somatic issues of the past are just as intertwined as they are today. Even to the point where we have to correct ourselves and realize that we may have been calling these incorrectly for a while.

We're pulling a throwback from season two for this one, and it's the episode I will go to the mat for as one of the most clinically useful hours of psychiatry content we've ever put out. Margaret literally calculates QTc off this episode every time she's on call and her CL attending called her out for it the other day, like, "Look at her recalculating." So when she said we should bring this one back, I didn't argue. If you're a resident, an attending who consults psych in the hospital, or a patient or family member trying to understand what it means to live after a cardiac event, start here.

Today we'll talk through this one study from 2010 out of the Oxford Department of Experimental Psychology, "Task-related default mode network modulation and inhibitory control in ADHD: effects of motivation and methylphenidate", that I want to walk you through, because the way it reframed ADHD for me as a resident is one of the more useful brain-flips I've had this year.

We're going back to one of our oldies but besties. This is our motivational interviewing episode from season one, which Margaret and I both agree is probably the best episode we made that whole first run. And it holds up, maybe even better now that we're further along in training and have actually used a lot of these tools in real clinical work. If you're a trainee, an educator, or just someone who's ever tried to gently move a person you love toward a change they keep half-saying they want, start here.

I figured we'd do something I've been wanting to do for a while: story time. Specifically, the kind where I take some of history's most famous figures, walk you through what actually happened to them, and then put on my psychiatry resident hat and try to figure out what we'd actually diagnose them with today. We will be analyzing King of France, Charles VI and Mary Todd Lincoln. Get ready to hear me yap about psychiatric history!

We're doing a throwback! This was our second episode ever, way back when I was at the beginning of fourth year of med school and Margaret and I were still figuring out the rhythm of this whole podcast thing. I'm now at the end of my first year of child fellowship, and somehow attachment theory keeps coming back around no matter what lens I try to look through, existential therapy, child psych, even our death anxiety episode. Pretty much every road leads back to it. So we wanted to bring it back, dust it off, and let y'all hear where we started.

In this episode we are joined by my co-resident, @undercoverdoc who has a special interested in fitness culture and bodybuilding. With the protein intake, food weighing and gym discipline also comes “extracurriculars,” or anabolic steroids. Rob describes his observations being in the fitness space as both an athlete and a physician and we discuss the impact of steroid use, its prevalence and what it can actually look like.

Code ORANGE. We had to break the between-seasons hiatus for this one. If you've been on healthcare TikTok in the last month and you haven't seen the burnt-out fruit basket emerging, you have some catching up to do. And it all started with Dr. Orange. Margaret and I sat down with the anonymous primary care doctor behind the orange filter that's been unleashing the truest, funniest, most honest takes on what it's actually like to practice medicine in 2026. We get into all of it. Why she finally hit record. How she picked an orange. What she actually wishes she could change about her day-to-day if she had a magic wand. Her thoughts on direct pay, PSLF golden handcuffs, and the unhinged loyalty arc she's developing toward Tropicana.

As we wrap up Season 3, Margaret and I are looking back at the long journey from our first late-night recording sessions in 2025 to where we are now: mid-fellowship for Margaret and fourth year for me. This season wasn't just about "yapping"; it was a masterclass in learning how to podcast and excavating the narratives hidden inside clinical papers.

In the final episode of a four part series on existential psychotherapy, Margaret and I take on the problem of meaning. This one is a little different that the other problems of man but they all intertwine like a single cable when it comes to living your life. Join us for discussion of philosophy, purpose and how to talk to your patients about your questions of meaninglessness.

Margaret and I decided to tackle the questions that have been circling our DMs, including the controversial continuum of harm reduction, where does "good enough" care end and "enabling" begin? We also touch on the complexities of diagnosing autism across genders, the "stolen valor" of internet neuroscientists, and why I’m convinced that oppositional defiant disorder (ODD) might sometimes just be a side effect of adults who’ve forgotten how to listen.

I’m flying solo for most of this one while Margaret is off saving dolphins (or just finishing a hospital admission ), but I’ve brought in a heavy hitter to help me tackle one of the most awkward parts of medical training: feedback. Paul Tran, the creative force behind Alimentary School, joins me to discuss why the feedback we give and receive in the clinic usually, to put it bluntly, sucks. We dive into the "Politeness Concept," where supervisors give a quick "good job" just to save face and get out of the room, leaving learners with zero actionable data. Paul introduces the concept of "Wise Feedback", 19 words that can completely change how a student engages with their work, and we break down the "Four T’s" of delivery: Tact, Timing, Intent, and Tone. From the trauma of childhood soccer critiques about our noses to the "glass-shattering" realizations of a former competitive figure skater, this episode is about turning subjective observations into meaningful coaching.

In this journal club episode, we break down the recent findings from a landmark (in my opinion) study on the associated risks between caffeine consumption and dementia risk. Spoiler alert! More coffee might actually be protective against dementia; however, we need to take these findings with a grain of salt (or creamer) and understand how the nuance of this information can help both our lives and our understanding of neurodegenerative diseases.

A topic that we were silent on during our Aphasia episode was the importance of Speech-Language Pathologists in the care of patients with Aphasia and, more broadly, throughout different types of care for patients in the hospital, in rehab, and outpatient. Today, we are joined by SLPs and co-hosts of Speech Talk Eva Johnson and Emily Brady to ask all our questions about how SLPs approach cognition, dysphasia, and values in care. Check out their podcast (which is also part of the Human Content family!) at Speech Talk!

Spoiler Alert! The key to not feeling isolated is to (wait for it) be around other people! Humans are naturally driven social creatures, but the ways in which we attempt to run from isolation become the problem. In this episode, we discuss how isolation is an ever-present fear, how existential isolation differs from interpersonal and intrapersonal isolation, and how meaningful, balanced relationships can form to fill the void. In our Patreon section, Margaret and I review some of Carl Rogers ' therapy film (play by play) in his humanistic approach to therapy with a central emphasis on relationship

In the second part of our intro to DBT episodes, we welcome expert education and DBT clinician, Dr. Kiki Fehling. We talk about how Dr. Fehling found DBT, how her teaching made it to TikTok, and then get into cases about how to talk about DBT with patients and what an introductory session might sound like. In our Patreon section, we go further into some favorite exercises in DBT with Dr. Fehling. Oh, Margaret also has to walk back an error she made on the previous DBT episode, and Preston gets to enjoy seeing Margaret be wrong.