In this episode, David Puder, M.D., and Victoria Agee discuss possible links between marijuana use and psychosis. There a multiple studies which reveal links in genetics and marijuana potency that can lead to an increase in schizophrenia and psychosis. Link to blog. Link to YouTube video....
On this week’s episode we will be covering a special topic-interviewing well-for psychiatry residency, and even in other interviews post residency. I am interviewing Neal Christopher, a 4th year, chief resident and the host of a podcast for the APA, The American Journal of Psychiatry Residents’ Journal Podcast. Link to blog. Link to YouTube video. AJP Resident Podcast with Dr. Christopher...
People often think of emotions as ethereal, complicated depths that are difficult to explore. They are actually adaptive physical reactions to stimuli. There are a few main categories, and as we will discover, they are concrete, identifiable, and usually in a healthy therapeutic alliance, they can be discussed and even when emotions are painful to express or come with shame or linked with traumatic memories, can be disarmed and understood. By listening to this episode, you can earn 1 Psychiatry ...
This week on the Psychiatry and Psychotherapy Podcast, I am joined by Dr. Mark Ard, a chief resident physician at Loma Linda University’s Psychiatry program, to talk about holds and capacity evaluations as it relates to medicine and psychiatry. By listening to this episode, you can earn 1.25 Psychiatry CME Credits. Link to blog. Link to YouTube video....
In the previous episode on Suicide , we discussed epidemiology, general risk factors, and associations of suicide with various mental health disorders. Now, in this second part of this series, we will focus on genetic and environmental factors associated with suicide. The data here might be cold and distant, and so is the nature of suicide. It cuts at the core of families that have struggled with it. I have had many patients who have had family members commit suicide, and it devastates them fore...
On this week’s episode of the podcast, I interview Dr. Drew Ramsey , a nutritional psychiatrist. When I was a resident, I saw him give a lecture on diet and how it affects our mood, and I’ve been wanting to interview him for a long time. He is the author of several books about diet and health. By listening to this episode, you can earn 0.75 Psychiatry CME Credits. Link to blog. Link to YouTube video....
Lithium is indicated for a number of things. Most clearly, as a mood stabilizer in bipolar spectrum disorders. It is unique among mood stabilizers in that it is very robustly anti-manic. The medication treats and prevents manic episodes from occurring, providing fairly robust prophylaxis against mood cycling. Lithium is also effective in treating bipolar depression, though not as effectively. Very few of the other mood stabilizers are effective for the depressed pole of bipolar illness. By liste...
This week the Psychiatry and Psychotherapy Podcast is joined by Dr. Walter A. Brown, Clinical Professor Emeritus in the Department of Psychiatry and Human Behavior at Brown University, author of the brand new book “ Lithium: A Doctor, a Drug, and a Breakthrough ”. In order to capture the full experience of this week’s episode, I’ve posted a transcript of my interview with Dr. Brown which you can access in the article link below. By listening to this episode, you can earn 0.75 Psychiatry CME Cred...
One of the more controversial components of the Neuralink presentation was Musk’s inclusion of his beliefs about the future of humanity and artificial intelligence. During the press release he stated one of his goals was to create the ability to achieve a “full symbiosis with artificial intelligence,” essentially removing the “existential threat of AI” which he believes will one day “leave us behind” (Neuralink, 2019) . This goal has been met with a bit more skepticism, especially by the nationa...
Working with a good therapist often requires fewer sessions than other therapists to see improvement; in contrast, working with a therapist you don’t connect with, or with inadequate training, may require an extended number of sessions ( Okiishi et al. 2003 ). People that see effective therapists are more likely to recover or partially recover, whereas those that work with a “bad” therapist are more likely to see no change or an increase in symptoms ( Okiishi et al. 2006 ). By listening to this ...
On this week’s episode of the podcast, I interview Jaeger Ackerman, 4th year medical student about suicide risk factors and treatments. As a therapist, attempt to closely approximate their reality of feeling suicidal with words. When I first hear their thoughts and feelings, I try to clarify with the patient to make sure I’m understanding their feelings. I usually try to put it into other words, and echo back to them. I’ll say something like, “I hear that you feel like there’s no other way out, ...
In this episode of the podcast, I interview Steven, one of my patients who had a rare form of a stroke—in the right orbital frontal cortex. He participated in a psychiatric program that I run. He tells his story of how his function and emotions changed, and how he dealt with it. At the end of the episode, I talk more with Jaeger Ackerman (a 4th year medical student) about the science and neurology of his case so other mental health professionals can have a basis for how to think about approachin...
What is Psychodermatology? At the most basic level, Psychodermatology encompasses the interaction between mind and skin. It is the marriage between the two disciplines of psychiatry and dermatology, uniting both an internal focus on the non-visible disease, as well as an external focus on the visible disease. This tight interconnection between mind and skin is maintained at the embryological level of the ectoderm throughout life. According to this article , although the history of psychodermatol...
What is an eating disorder? One of the most important things about anorexia and bulimia is understanding that they are caused by a complex interplay of genetics, epigenetics, early development, and current stressors. They can lead to dangerous outcomes because of how the eating disorder changes both the body and the brain. Many therapists and nutritionists, as you’ll hear in my conversation with Sarah Bradley, don’t treat from multiple angles, and often lack empathy into this condition. There ar...
Grief is the multifaceted response—emotional, behavioral, social—to a loss or major life adjustment (like a divorce, loss of a job, etc.). Bereavement is the process of grieving specific to the loss of affection or bond to a person or animal ( Parkes & Prigerson, 2013 ; Shear, Ghesquiere & Glickman, 2013 ; Shear, 2015 ). Some of the signs and symptoms of grief are: -somatic symptoms (e.g. choking or tightness in the throat, abdominal pain or feeling of emptiness, chest pain) -physiologic...
What is clozapine? Not only is clozapine the gold standard medication for treatment-resistant schizophrenia, it is also one of the most unique drugs used in psychiatry. It was synthesized 1958, only eight years after chlorpromazine, the first antipsychotic drug, was created. At that time, researchers tested for antipsychotic properties by taking various compounds and testing to see if lab mice developed dystonia and catalepsy. When researchers tested clozapine, they found that it did not cause d...
PTSD, or Post Traumatic Stress Disorder, occurs when someone experiences or subjectively experiences a near death or psychologically overwhelming event and then goes on to develop specific symptoms. Different types of trauma/stressors that can lead to PTSD include sexual violence, combat experience, medical conditions (e.g. myocardial infarction), and natural disasters (e.g. hurricane) ( Chivers-Wilson, 2006 ; Edmondson et. al, 2012 ; Grieger et al., 2006 ; Hussain, Weisaeth & Heir, 2011 ). ...
Schizophrenia is a diagnosis of exclusion. Doctors and therapists need to be able to rule everything else out before they can land on schizophrenia as an official diagnosis. There are specific symptoms are known as “first-rank symptoms,” which we will cover later in the article, that will help with diagnosing patients ( Schneider, 1959 ). Eighty-five percent of people with schizophrenia endorse these symptoms, but be wary of jumping to conclusions because they are not specific to schizophrenia a...
Clinical manifestations Many people worry that they have schizophrenia. I receive messages or inquires often of people asking about symptoms and manifestations. If you have those types of questions, or if you’re a mental health professional who needs to brush up on symptoms and medications, this article should help you. There are many clinical observations of how schizophrenia presents itself. Cognitive impairments usually precede the onset of the main symptoms [1] , while social and occupationa...
What is schizophrenia? It is a psychotic disorder that typically results in hallucinations and delusions, leaving a person with impeded daily functioning. The word schizophrenia translates roughly as the "splitting of the mind," and comes from the Greek roots schizein ( "to split") and phren- ( " mind "). The onset of the disease typically occurs in young adulthood; for males, around 21 years of age, for females, around 25 years of age. We don’t know exactly what causes schizophrenia. There are ...
On today’s episode of of the podcast, I will discuss marijuana use and how it affects mental health with Daniel Binus, the chief psychiatrist at Beautiful Minds, near Sacramento, California. Also joining us is a third-year medical student, Victoria Agee. There are a few reasons we believe this is important to talk about. First, as medical professionals, we often see patients who want help with their anxiety, depression, ADD and suicidality. They say they use cannabis, and that they need cannabis...
On today’s episode of the podcast, I interview Ginger Simonton, a PhD student finishing her dissertation. We will cover her in-depth research on alleviating the symptomology of childhood sexual abuse. We will specifically be talking about the link between women who have been sexually abused, never given a chance to heal, and how it has affected their mental and physical health, and programs that can benefit them. What is childhood sexual abuse? “The CDC defines the act of CSA as “inducing or coe...
On this week’s episode of the podcast, I talk about the power of forgiveness. It’s scientifically proven that forgiveness can impact our health. As mental health professionals, this has important impacts both personally and professionally. I have also included a downloadable PDF for you to give your patients to help you walk them through the act of forgiving. As a therapist, when I say the word “forgiveness,” my patients can shut down if I don’t explain it properly. Why? Because just the need fo...
What is transference? Historically the term “transference” refers to the feelings, fantasies, beliefs, assumptions and experiences unconsciously displaced on the therapist that originate in the patients’ past relationships. More recently, transference is seen as the here and now, valid experience the patient has of the therapist. It is “a mixture of real characteristics of the therapist and aspects of the patient’s figures from the past—in effect, it’s a combination of old and new relationships....
In this episode of Psychiatry & Psychotherapy , Dr. David Puder dives into the critical issue of inpatient violence with special guests Dr. Gillian Friedman and Nate Hoyt, MS4. Explore the latest evidence-based strategies to predict, prevent, and manage aggression in psychiatric settings. Discover key insights on: Risk factors for inpatient violence, including diagnoses and history of aggression. Effective de-escalation techniques and innovative interventions like Safewards and environmental...
On this week’s episode of the podcast, I am joined by Dr. Carolina Osorio, a geriatric psychiatrist (and one of my favorite people). After she finished her psychiatry residency, she also went on to finish a fellowship in geriatric psychiatry to take care of her favorite people. Dr. Osorio runs a special program that treats elderly people with depression and anxiety. By listening to this episode, you can earn 1 Psychiatry CME Credits. Link to blog. Link to YouTube video. Instagram: dr.davidpuder ...
On this week’s episode of the podcast, I interview...quite a few people! We are covering Ted Bundy, America’s most infamous serial killer, and since the world has been fascinated by him lately, I figured I’d get a group of mental health professionals in a room to talk about him. His horrific acts made the news and have scared people for decades now, and rightfully so. Did media and pornography cause this? What was his diagnosis and was it correct? We have so many questions... As my special guest...
The words “aggression” and “violence” are sometimes used synonymously, but in reality, aggression can be physical or non-physical, and directed either against others or oneself. Violence is more of a use of force with an intent to inflict damage. One study looked at the principle types of aggression and violence that occur in psychiatric patients, and broke it down into three categories: Impulsive violence (the most common category) Predatory violence (purposeful and planned violence) Psychotica...
Empathy is the ability to understand another’s state of mind or emotions. It is also is being able to feel, understand and share with someone else in what they are saying, their meaning of life, their motivations and values. In research there are 3 types of empathy that are commonly described: cognitive, affective, and compassionate . By listening to this episode, you can earn 1 Psychiatry CME Credits. Link to blog. Link to YouTube video. Instagram: dr.davidpuder Twitter: @DavidPuder Facebook: D...
People who truly have ADHD typically experience inattentive and hyper symptoms across all areas of their life. For example, if they are in a job that requires periods of attention to complete or organize a project, it will be inherently more difficult for people with ADHD. One of the things that’s important in diagnosing people (particularly younger people) is their collateral history. People around the person with suspected ADHD are often more aware of the person’s deficits than the person them...
