What is placebo? The original meaning of the word placebo is, “I will please.” That statement comes from a time when doctors didn’t have our modern code of ethics, and they would prescribe whatever would make the person feel better. They probably had the best intentions, but they also would have known that whatever they were prescribing might not have been a real medication for the symptoms the patient was experiencing. Doctors, even then, knew that suggestion was powerful, sometimes more powerf...
Nov 29, 2018•1 hr 1 min
For many, motherhood is a beautiful, unique, and meaningful experience. The mother-child bond is a relationship that has the potential to be a deeply loving and positive experience for both the mother and child. However, motherhood can be distressing, which is why it is imperative that we, as providers, understand the unique psychiatric issues that are associated with this time period in a woman’s life. Perinatal mood and anxiety disorders, or PMAD for short, is the term used to describe mood an...
Nov 15, 2018•58 min
Episode CME activity objectives: In the context of a therapeutic alliance, apply the information given in this episode to help draw out meaning in others. Identify who Viktor Frankl was and how his work and legacy have shaped how we understand and utilize meaning in psychiatry. Define psychic determinism. Recognize that meaning is idiosyncratic and unique to each individual. Recognize the multitude of ways people can find meaning in their lives and the various ways they can express and convey th...
Oct 30, 2018•45 min
Delirium is an acute change in a person’s sensorium (the perception of one’s environment or understanding of one’s situation). It can include confusion about their orientation, cognition or mental thinking. With hyperactive delirium , a patient can become aggressive, violent and agitated with those around them. A patient experiencing delirium can have hallucinations and hear things, they can become paranoid, and they are overall confused. A family or non-psychiatric medical staff might be concer...
Oct 08, 2018•50 min
On this week’s episode of the podcast, I interview Dr. Cummings, a reputable psychopharmacologist, about ketamine. We talk about psychedelics, the research behind it, both the positives and the negatives. We will look at how it is or is not helpful in psychiatric treatments. (Disclaimer: There are no conflicts of interest to report. Neither Dr. Puder or Cummings is affiliated with any companies in favor of ketamine and other drug companies.) Ketamine Although ketamine has recently become a medic...
Sep 25, 2018•38 min
On this week’s episode of the podcast, I interviewed Allison Maxwell, a social worker and PhD student of clinical social work. I refer patients to her regularly for psychoanalysis, and she has had a wonderful impact on their mental health journey. What is psychodynamic theory? Psychodynamic therapy is a form of talk therapy where the practitioner work focuses on the patient’s emotion, fantasies, dreams, unconscious drives and wishes, early and current life relationships, and the relationship tha...
Sep 20, 2018•50 min
Timothy Lee has talked to thousands of medical students about how to applying for residency programs, and here, he gives us a few tips on how to make it through the gauntlet, and how to have your best chance at landing the program you want. Here is what Timothy Lee says: Stay calm Many students have been fine tuning their personal statements, and trying to get their resume just right, or hurrying to press the faculty to write letters of recommendation. It can be very stressful. It’s okay to turn...
Sep 16, 2018•11 min
What is a therapeutic alliance? The therapeutic alliance is a collaborative relationship between the physician and the patient. Together, you jointly establish goals, desires, and expectations of your working partnership. Every interview with a patient, whether it’s for diagnostic, intake, evaluative, or psychopharmacology purposes, has therapeutic potential. The treatment starts from your first greeting—how you listen, empathize, and even how you say goodbye. It’s built from a partnership and d...
Sep 06, 2018•46 min
What is trauma? Emotional trauma comes from stress that is overwhelms a person’s neurological system. Some stress can be good and formative, or it can be bad and get stuck in the brain, causing someone deep emotional pain. Think of climbing Mount Everest. Some people choose to do that, and it’s easily one of the most stressful situations you can put yourself in on purpose. That’s good stress if you have trained for years and are ready for it. If someone forced you to climb Mount Everest, it woul...
Aug 23, 2018•1 hr 10 min•Ep. 27
What are boundaries? When we refer to boundaries, we are talking about emotional walls that are healthy. Boundaries are meant to keep us in relationship with the people that we love. Think of them as your property lines around your house. You know where your lines are, where your property ends and your neighbors begins. Therefore you know what you are supposed to take care of and what your neighbor is supposed to take care of. A boundary defines our self. Within ourselves, our “property” consist...
Aug 11, 2018•52 min
In this episode we discuss: The history of bipolar illness, mood stabilizers, common treatments, psychopharmacology, psychotherapy goals, and more. For paraphrased transcription and blog: go here For more detailed notes by Dr. Cummings, go to my resource page . By listening to this episode, you can earn 0.75 Psychiatry CME Credits. Link to blog. Link to YouTube video. Join David on Instagram: dr.davidpuder Twitter: @DavidPuder Facebook: DrDavidPuder...
Aug 02, 2018•52 min
In this week’s episode of the podcast, Dr. Michael Cummings and I talk about the history of antidepressants, and their use in overcoming depression and anxiety disorders. By listening to this episode, you can earn 1 Psychiatry CME Credits. Link to blog. Link to YouTube video. Join David on Instagram: dr.davidpuder Twitter: @DavidPuder Facebook: DrDavidPuder...
Jul 24, 2018•59 min
Polyvagal theory by Stephen Porges explains three different parts of our nervous system, and their responses to stressful situations. Once we understand those three parts, we can understand our emotional reactions to trauma or high amounts of stress. Why is polyvagal theory important? For therapists, and pop-psychology enthusiast alike, understanding polyvagal theory can help with: Understanding trauma and PTSD Understanding the dance of attack and withdrawal in relationships Understanding how e...
Jul 10, 2018•1 hr 38 min
What is procrastination? Procrastination is the act of avoiding something through delay or postponement. You might be procrastinating when: There is a gap between your intention and action You feel like avoiding something You find yourself easily distracted You feel overwhelmed by tasks at the last minute You always feel rushed to complete a project You’re hesitant to truthfully update someone on your progress It usually brings about feelings of: Shame Guilty Anxiety Regret Anger Inauthenticity ...
Jul 03, 2018•47 min
Do you ever feel out of touch with your emotions? Or have you ever felt like you had to hide your real emotions? When people do that—emotionally detach—they develop what therapists call “incongruence.” Most therapy is actually centered around getting patients back in touch with their emotions. On this week's podcast, Ginger Simonton and I talk about the different methods we use to help our patients develop and maintain healthy emotional congruence. By listening to this episode, you can earn 1 Ps...
Jun 30, 2018•1 hr 2 min
In the latest podcast, Dr. Cummings and I talked about antipsychotics, the particular branch of psychopharmacology that deals with medicines that treat psychotic experiences and other mental disorders, such as: Schizophrenia Severe depression Severe anxiety Bipolar disorder Psychosis exhibiting hallucinations and delusions By listening to this episode, you can earn 0.75 Psychiatry CME Credits. Link to blog. Link to YouTube video. Join David on Instagram: dr.davidpuder Twitter: @DavidPuder...
Jun 19, 2018•46 min
In the latest episode of the Psychiatry and Psychotherapy Podcast, Dr. Puder interviews Dr. Cummings, a psychopharmacologist. They discuss the way medicine works in our bodies, and if medicine or therapy is more effective for treating different disorders. They also talk about the different factors that affect absorption rates, such as gastrointestinal surgeries, liver health and actual dosage. By listening to this episode, you can earn 0.75 Psychiatry CME Credits. Link to blog. Link to YouTube v...
Jun 12, 2018•51 min
Can strength training help alleviate depression? In this episode, Dr. David Puder is joined by Trent Jones, a Starting Strength athlete, to discuss how systematic strength training can significantly impact mental health. From boosting confidence and assertiveness to reducing symptoms of depression, we explore the science and personal stories behind this powerful intervention. Key topics include: The transformative mental health benefits of resistance training. Insights from research studies show...
May 29, 2018•52 min
In the third and final installment on microexpressions, Ariana Cunningham and Dr. David Puder talk about how learning microexpressions can help you build empathy and connect with other people. As Paul Eckman demonstrated in his research, they can be potent glimpses into someone’s emotional experience. In this episode we talk about: How emotions come into play in our dreams and other unconscious ways. How to use what we learn from them carefully and with curiosity, rather than with a know-it-all ...
May 24, 2018•42 min
Microexpressions are brief, involuntary facial expressions that are cues to the true emotions that someone is feeling. We see microexpressions in tiny twitches of the brows, the lips and nose. They can last for as little as 1/15th of a second on the face. In this episode, we describe the science of the microexpressions of fear, disgust, and surprise and how to use it to connect with others. By listening to this episode, you can earn 0.75 Psychiatry CME Credits. Link to blog. Link to YouTube vide...
May 15, 2018•46 min
Microexpressions are brief, involuntary facial expressions that are cues to the true emotions that someone is feeling. We see microexpressions in tiny twitches of the brows, the lips and nose. They can last for as little as 1/15th of a second on the face. In this episode we describe the science of microexpressions, emotion and how to use it to connect with others. For full PDF of the episode with links to videos of each emotion go to: https://psychiatrypodcast.com/resources By listening to this ...
May 08, 2018•1 hr 22 min
New research on hormonal contraceptives, “the pill”, and how it influences mental health. Dr. David Puder and Dr. Mona Mojtahedzadeh explore: Claims about the mental health consequences of hormonal contraception Unique Influences of progesterone and estrogen on the brain How ovulation changes attraction and desire Discuss the controversy around recent studies that show that hormonal contraception increases the risk of depression Critique of those studies and counters to those critiques Kelly Bro...
May 03, 2018•37 min
Overcoming Postpartum Depression Link to show on: iTunes , Google Play , Stitcher , Overcast , PlayerFM , PodBean , TuneIn , Podtail , Blubrry , Podfanatic This week on the podcast, I joined with Dr. Pereau to talk about postpartum depression, both from a personal level and as those who treat it in our patients. Dr. Pereau is incredibly honest and vulnerable in this emotional episode as she shares her story. Throughout it, she talks about the symptoms of her postpartum depression, including: Int...
Apr 24, 2018•50 min
Our bodies are “wired” to perform. Learning how to consciously modulate your internal sympathetic state is the key to unlocking optimal performance. The autonomic nervous system (ANS) facilitates survival by generating the fight-or-flight response and promotes recovery following activation (the ability to relax). The ANS achieves this by balancing two complementary systems: the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). For example, your ANS is currently adjus...
Apr 17, 2018•52 min
Learn: Why to optimize medical issues like hypertension and diabetes Change psychiatric and non-psychiatric medications to optimize brain function Optimize sleep to obtain rest and increase brain function How drugs influence the brain short and long term to change sensorium How viewing yourself without "free will" influences brain function By listening to this episode, you can earn 0.75 Psychiatry CME Credits. Link to blog. Link to YouTube video. For PDF with citations and full notes go to: http...
Apr 05, 2018•47 min
Western society faces is the most unhealthy we’ve ever been. It’s reached epidemic proportions: depression, anxiety, poor focus and sensorium issues, chronic stress, and diseases of chronic stress (like diabetes). The solution is simple—exercise and healthy eating. In this episode, I will be going through 17 studies on how exercise influences and improves these factors. I will cover how it works, and how to develop an exercise program from the perspective of a doctor, not just for body sculpting...
Mar 23, 2018•37 min
What are the best diets for the brain and cognitive function? How much does diet influence our sensorium? What particular foods are important? How do we change our genes to optimize our brain? By listening to this episode, you can earn 0.5 Psychiatry CME Credits. Link to blog. Link to YouTube video. For PDF with citations and detailed notes go to: My Resource Page Ask David questions on Instagram: dr.davidpuder Twitter: @DavidPuder Facebook: DrDavidPuder...
Mar 15, 2018•24 min
In this episode, Dr. Puder addresses the fascinating realm of schizophrenia with Dr. Cummings, a previous guest in the show. Dr. Cummings is a psychiatrist with a wealth of experience from working at Patton State Hospital in California, one of the biggest forensic hospitals in the world. -Defining Schizophrenia -Living with Schizophrenia and Perception of Reality -Are Negative Symptoms in Schizophrenia Precipitated by Medications? -Emil Kraepelin, and the Early Studies on Schizophrenia -The Path...
Mar 06, 2018•57 min
This week I had a discussion with Dr. Darcy Trenkle on the difficulty of providers to get psychiatric treatment, using ourselves as the examples. In a recent article nearly 40% of physicians surveyed said they would be reluctant to seek formal medical care for treatment of a mental health problem because of concern that this may put their medical license in jeopardy. Physicians have three times the national average for suicide and have unique stressors and often a culture not conducive to seekin...
Feb 28, 2018•47 min
Sensorium is the total brain capacity for focusing, processing, and interpreting. It is not a static state—it can fluctuate throughout the day. It can be influenced by sleep, food, stress, exercise, drugs, medications, and long term, through epigenetic phenomenon. If there is damage to the structure of the brain, it can permanently lowered. It is a slope, which we all move up and down on, based on our baseline, but then also influenced by many factors. In your 20s and 30s you are very far on the...
Feb 19, 2018•42 min
