Épisodes

  • How does image guided TMS stack up against the current method?

    How does image guided TMS stack up against the current method?
    Oct 5 2026
    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 this becomes standard of care. Find the paper here: https://pubmed.ncbi.nlm.nih.gov/42340706/ Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices
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    48 min
  • The Theory of the Crunch: Holding Difficult Dynamics in Therapy

    The Theory of the Crunch: Holding Difficult Dynamics in Therapy
    Sep 28 2026
    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 expansive, compassionate frame will be introduced both for the therapist and patient to understand how to make it through confusing and sometimes painful clinical work. Paper: The Theory of the Crunch by Paul Libby Russel: https://www.proquest.com/openview/c5d466aa2f6d7bcd126f98b6591861f7/1?pq-origsite=gscholar&cbl=32944 Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices
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    1 h
  • Psychiatric Effects of GLP-1s (What We Know So Far)

    Psychiatric Effects of GLP-1s (What We Know So Far)
    Sep 21 2026
    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 patients using these medications and, on the flipside, potential areas where we could possibly use GLP-1s primarily to treat mental illness. Paper used: Sa B, Maristany A, Subramaniam A, et al. Psychiatric effects of GLP-1 receptor agonists: A systematic review of emerging evidence. Diabetes Obes Metab. 2026;28(1):50-59. doi:10.1111/dom.70198 Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices
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    59 min
  • Nuances in Prescribing Antidepressants

    Nuances in Prescribing Antidepressants
    Sep 14 2026
    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 treatment guidelines, 2022 https://www.healthquality.va.gov/guidelines/MH/mdd/ American College of Physicians Depression https://www.acpjournals.org/doi/10.7326/M22-2056 Weight Change and Antidepressants https://pubmed.ncbi.nlm.nih.gov/33022115/ Pregnancy/Perinatal/Breastfeeding https://womensmentalhealth.org/specialty-clinics/psychiatric-disorders-during-pregnancy/ Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices
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    59 min
  • Psychiatric Roots in Greek Mythology

    Psychiatric Roots in Greek Mythology
    Sep 7 2026
    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. Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices
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    1 h et 6 min
  • Climate Change Impacts on Mental Health with Child Psychiatrist & Pediatrician Elizabeth Pinsky, MD

    Climate Change Impacts on Mental Health with Child Psychiatrist & Pediatrician Elizabeth Pinsky, MD
    Aug 31 2026
    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. Noted articles: Thermoregulation in Schizophrenia as a sign article: Redundant clothing: A readily observable marker for schizophrenia in the psychiatric emergency room population. ⁠⁠https://www.sciencedirect.com/science/article/abs/pii/000579169390007J⁠⁠ Climate communicator recommended: ⁠⁠https://www.katharinehayhoe.com/⁠⁠ Resources Referenced: ⁠⁠https://www.climatepsychology.us/⁠⁠ ⁠⁠https://www.climatepsychiatry.org/⁠⁠ Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices
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    54 min
  • Lessons from Improv Comedy

    Lessons from Improv Comedy
    Aug 24 2026
    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! Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠howtobepatientpod.com Learn more about your ad choices. Visit megaphone.fm/adchoices
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    1 h et 10 min
  • Kung Fu Panda & Residency: Growth Mindset

    Kung Fu Panda & Residency: Growth Mindset
    Aug 17 2026
    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. Check out some info on Dr. Dweck’s work: https://ctl.stanford.edu/students/growth-mindset Check out a paper as well from a few years ago on limitations/evolving learning on growth mindset as a frame (we love nuance here): Yeager DS, Dweck CS. What can be learned from growth mindset controversies? Am Psychol. 2020 Dec;75(9):1269-1284. doi: 10.1037/amp0000794. PMID: 33382294; PMCID: PMC8299535. Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠howtobepatientpod.com Learn more about your ad choices. Visit megaphone.fm/adchoices
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    55 min