Podcast
Psychofarm Podcast
Hosted by Psychiatry, Skepticism, and Integration. · EN
PsychoFarm Podcast is a deep dive into the intersection of psychiatry, psychopharmacology, and the evolving understanding of mental health. Hosted by 2 psychiatrists, the podcast explores complex topics such as diagnosing mood and personality disorders, the role of medications in treatment, and the challenges of psychiatric training. Each episode breaks down the clinical insights and philosophical debates surrounding mental health care, providing both practitioners and curious listeners with thoughtful analysis, expert opinions, and practical advice.
psychofarm.substack.com
psychofarm.substack.com
26episodes
Episodes
Newest firstAll episodes
Antidepressant Tier List: Psychiatrists Rank Depression Medications for MDD
1w ago01:14:22Tap to summarizePsychiatrists rank antidepressants for major depressive disorder, including SSRIs like sertraline, escitalopram, fluoxetine, and paroxetine; SNRIs like venlafaxine and duloxetine; and atypical options like bupropion and mirtazapine. They also cover lithium, low-dose aripiprazole, trazodone, esketamine, stimulants, benzodiazepines, TCAs, and MAOIs, with emphasis on diagnosis, side effects, withdrawal, weight gain, sexual dysfunction, anxiety, insomnia, and why “which antidepressant is best” depends on the patient. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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Mindfulness in Psychiatry: How to Teach It as a Clinical Treatment Skill
3w ago00:52:29Tap to summarizeMindfulness in psychiatry is the focus of this episode, with Doctors Malzberg and Fu treating it as a practical clinical skill rather than vague wellness advice. They define mindfulness as deliberate attention to the present moment without judgment, then connect it to DBT, MBCT, ACT, anxiety, depression, PTSD, substance use, and trauma-informed care. The conversation also covers when mindfulness should be modified, why it is not always a standalone treatment, and how clinicians can teach it through short, scheduled practice, DBT “what skills,” grounding techniques, and careful follow-up. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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Psychiatric Technique for Diagnostic Interviewing and Therapy: 6 Mantras Every Clinician Should Know
Apr 2100:46:03Tap to summarizePsychotherapeutic techniques are the subject of this episode, as the conversation lays out six memorable therapy mantras for better diagnosis, formulation, and treatment. Rather than focusing on abstract theory, the discussion shows how clinicians can stay close to patient material, clarify vague symptom language, notice countertransference, rewind key moments, and make links that improve both psychotherapy and medication management. It’s a practical lesson in interviewing: ask simpler questions, tolerate not knowing too quickly, observe contradictions, and avoid getting lost in content when the process is where the diagnostic data actually lives. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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Psychodynamic Technique and Therapeutic Intervention: Containment
Apr 800:58:18Tap to summarizePsychodynamic technique is the throughline of this episode, which argues that the core skills of therapy belong at the center of psychiatry, not at the margins. The conversation maps five levels of intervention, from level zero through interpretation, while stressing that the most important work usually happens earlier: frame, alliance, follow the affect, and technical containment. Rather than glamorizing clever interpretations, the episode shows why reflective listening, emotionally accurate language, and careful therapeutic interventions help patients think, regulate, and elaborate on their experience. It’s a practical discussion for clinicians who want to improve interviewing, formulation, and treatment across everyday psychiatric practice.Lots of material from this lecture is from here: https://www.appi.org/Products/Psychotherapy/Clinician-Technique-in-Personalized-Psychotherapy This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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Tips to Avoid Burnout in Psychiatry (Outpatient, mostly)
Mar 2400:55:25Tap to summarizeIn this episode, Dr. Fu and Dr. Malzberg share practical systems for time protection: start on time, end on time, finish documentation inside the visit, and use tools like AI scribes and quiet typing gear. They also lay out clear messaging rules so emails, texts, and forms do not become off-the-clock clinical care, plus the value of emergency slots. The deeper work is emotional: process the job with mentors or supervision, know your limits, and build a real life outside medicine so you can stay effective for the long game. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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CPTSD vs BPD: How to Think About the Difference and What to Do About It
Mar 1000:56:14Tap to summarizeIn this episode, Dr. Malzberg and Dr. Fu tackle one of psychiatry’s hottest diagnostic debates: complex PTSD versus borderline personality disorder. They walk through the DSM-5 and ICD-11 definitional differences, the historical roots of the C-PTSD concept in Judith Herman’s work, and the real clinical distinctions clinicians can use to differentiate the two. More than a theoretical argument, the conversation zeroes in on how to communicate these diagnoses to patients, why BPD stigma drives some of the debate, and what therapies fit each presentation… from DBT and mentalization-based therapy to EMDR and trauma-focused approaches. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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Detecting Subtle Signs of Psychosis: Assessment of Voices, Delusions, and Psychosis
Feb 2400:35:02Tap to summarizeSubtle psychosis can be missed when you rely on checklists or slip into an interrogator stance. We break down a clinician-friendly approach to detecting psychosis early: use countertransference as a signal, mirror emotion without agreeing with delusions, and clarify the patient’s narrative without derailing it. You’ll also get an OLDCARTS-style framework for taking a voice-hearing history (onset, location, duration, character, and more), plus practical alliance moves for paranoia. We close with how to bridge the treatment gap once you’re seeing the pattern clearly. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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How to Diagnose Bipolar Disorder: The Interview Framework That Beats Screening Questions
Feb 1000:54:58Tap to summarizeBipolar diagnosis is tricky without labs, so this episode lays out a practical, semi-structured interview you can use in real clinics. We start with what many clinicians skip: a medication and substance timeline, plus medical causes, before jumping into mood symptoms. Then we map major depressive episodes, screen for hypomania with narrative follow-ups, and compare behavior to baseline instead of trusting yes/no answers. Along the way we cover classic pitfalls and mimics, including PTSD insomnia, borderline traits, psychosis-related agitation, and ADHD mislabeling. Finally, we talk about when tools like the MDQ or Rapid Mood Screener help, and why collateral history can change the case. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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What Makes a Belief a Delusion? Delusions, Thought Disorder, the TALD Scale
Jan 2700:45:55Tap to summarizeHow do you actually evaluate a “delusion” in the room, especially when the belief could be plausible, culturally reinforced, or tied to mood or substances? In this episode, we break down a practical approach to psychosis language, why “fixed false belief” is often insufficient, and the interview questions that help clarify origin, certainty, flexibility, and function. We also use the TALD framework to expand beyond the usual linear vs circumstantial vs tangential model of thought disorder, then apply everything to a case vignette where a single supplement becomes the explanation for an entire life collapse. Educational and clinically focused.TALD: https://ars.els-cdn.com/content/image/1-s2.0-S0920996414005933-mmc1.docxUnderstanding Delusions Paper: https://journals.lww.com/inpj/fulltext/2009/18010/understanding_delusions.2.aspx This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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What is Psychosis? Look at the DSM, Common Mimics, and a Framework for the Differential
Jan 1301:00:18Tap to summarizeWhat does “psychosis” actually mean, and how do clinicians recognize it in practice? In this episode, we define psychosis as a syndrome (not a single diagnosis) and walk through the core symptom domains: delusions, hallucinations, disorganized thinking/speech, disorganized behavior, and negative symptoms. We focus on the differential diagnosis, including how to distinguish schizophrenia-spectrum and schizoaffective disorders from mood disorders with psychotic features, trauma-related phenomena, borderline personality disorder, neurodevelopmental presentations (including autism spectrum traits), and substance-induced psychosis. We share red flags that can be easy to miss, like new-onset suspiciousness, functional decline, social withdrawal, and subtle thought disorganization, and we emphasize the value of collateral history and longitudinal follow-up. We close with treatment implications: when antipsychotics are helpful, why risks and benefits need to be individualized, and when psychotherapy and supportive interventions are the better first move. Educational disclaimer: This episode is for educational purposes only and is not medical advice. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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