In this solo episode with Preston we (me) discuss the neuroscience concept of metacognition and how it may apply to some of our conceptualization of current psych illnesses, along with some loose ruminating of course. For a more comprehensive and scientific review, look here! https://www.nature.com/articles/s41583-026-01081-x Watch on YouTube: @itspresro Listen…
In today's episode we take a look back towards the history of psychiatry and read from the publication “The American Journal of Insanity.” This is the journal that predates the American Journal of Psychiatry (the name was changed in 1921). While some of the terms are outdated, the treatment principles…
In this episode, Margaret and Preston talk about Margaret’s experience halfway into child and adolescent psychiatry fellowship. Margaret discusses the general requirements or parts in child training, discerning child training indications versus other training paths, and how her child training impacts her care for adult psychiatry patients. Watch on YouTube:…
In this episode we're doing another journal club, this time reviewing the first randomized clinical trial comparing image-guided TMS to the traditional method using scalp targeting for depression. We walk through how TMS works, why targeting matters, what the study found at one month, and where the limitations are before…
In today’s episode, Preston and Margaret discuss the psychotherapy paper The Theory of the Crunch, by Paul Libby, a psychoanalyst. In this episode and in the paper, the idea of creating a containing environment, repetition compulsion, and ways of navigating difficult interpersonal dynamics are discussed. In this episode, a more…
In this episode, Margaret and I take on the en vogue topic of GLP-1s. They have been utilized for T2DM for several years and just recently took center stage in the zeitgeist for weight loss (medically indicated or otherwise). Today, we will break down possible risks to mental health in…
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. See notes below for recommendations in the episode. VA/DoD MDD…
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…
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…
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…
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,…
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…
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 patters of disease. We discuss the triumphs of her field as they collaborate with both psychiatry and neurology and then get into…
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…
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…
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…
Today we'll talk through is 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…
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…
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…
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…
In this episode we are joined by my coresident, @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 observationss being in the fitness space as both an athlete and a…
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…
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…
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…