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    Health & Fitness

    How to Be Patient

    You may have noticed a new trend lately. Everyone is loud and proud about their mental health struggles (and thank goodness)! For practitioners, this movement is as exciting as it is frustrating. As each mental health taboo falls by the wayside as it enters the cultural zeitgeist, a new aspect of our specialty thus emerges. One we just don’t have enough hours in the day to keep track of, let alone engage with. From better understanding our patients’ (and our own) relationships with their conditions in a changing world, it’s more important than ever that we learn: HOW TO BE PATIENT!

    Each week, join Dr. Preston Roche (Psychiatry Resident & Digital Influencer) and Dr. Margaret Duncan (Psychiatrist & Content Creator) on their quest to better understand the patients we dedicate our lives to and the evolving paths they’re bound to travel beyond the clinic. By engaging with stories and perspectives that challenge our shared understanding of a condition, we hope you’ll similarly gain new perspectives as we look at our patients, and their mental health struggles, with further nuance and empathy. (And with Dr. & Lady Glaucomflecken producing, we’ve been mandated to include plenty of weird medical jokes too).

    Speaking of which, a key part of this is hearing YOUR stories! What’s changed your understanding of patient care? Do you have an experience that shines new light on something we’ve discussed on-air? Get in touch at: howtobepatientpod.com

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    Copyright: © Human Content, Inc. 2024

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    Latest Episodes:
    Alcohol: Examining Alcohol culture, history, and use disorder Apr 14, 2025
    Show notes

    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 honesty and humor, they explore the unexpected ways drinking shows up in medicine, the myths that keep us stuck, and the messy, meaningful path to redefining recovery.


    Takeaways:

    What if “just a drink” isn’t so simple? Preston and Margaret explore how subtle patterns can blur the line between social drinking and something more.


    Could quitting be more dangerous than drinking? There’s a reason detox needs to be taken seriously—and it’s not what you think.


    What does alcohol really do to your brain? Let’s just say it’s a little more complicated than relaxation and red wine.


    Why don’t we talk about medication for alcohol use disorder? The answers are as cultural as they are clinical.


    Is recovery a destination—or something else entirely? Margaret and Preston unpack a version of success that doesn’t always fit the script.


    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


    Social Anxiety & the Loneliness Epidemic Apr 07, 2025
    Show notes

    In Episode 14, Preston and Margaret dive into social anxiety disorder and the loneliness epidemic. From embarrassing childhood memories to awkward club encounters, they explore how social anxiety shows up in everyday life and how it differs from normal nerves. They also discuss the surgeon general’s definition of loneliness, the role of social media in increasing perceived judgment, and the neuroscience behind facial recognition, fear responses, and serotonin's impact on the amygdala.


    Takeaways:

    Social Anxiety Is More Than Shyness: It becomes a disorder when it causes persistent distress, distorted perceptions of judgment, and leads to avoidance of meaningful activities.


    Loneliness Is Subjective—and Epidemic: According to the U.S. Surgeon General, loneliness stems not just from solitude but from perceived lack of meaningful connection, and it has major mental and physical health consequences.


    Social Media Can Amplify Anxiety: Being constantly seen—and judged—online may intensify social anxiety, even for those who appear confident or well-known.


    Your Brain Is Wired to Care: Structures like the amygdala, insula, and anterior cingulate cortex play key roles in social fear, facial recognition, and rejection sensitivity—and they’re all modifiable with therapy and medication.


    Healing Is Gradual and Personal: CBT, SSRIs, and compassionate exposure therapy can retrain the brain’s fear circuits—but treatment must match the individual’s goals, beliefs, and readiness for change.


    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


    Marathoning and Mental Health Mar 31, 2025
    Show notes

    In this episode, Preston and Margaret take a deep dive into the science of running, exercise culture, and its impact on mental health. They explore the history of running, how it went from an obscure activity to a cultural phenomenon, and the physiological and psychological mechanisms that make it such a powerful mental health tool. They also unpack the identity crisis that can come with being an athlete, how running became the millennial version of church, and why dance might actually be a better form of exercise for mental health than running (gasp!).



    Takeaways:

    Running Changes the Brain: It increases BDNF (brain-derived neurotrophic factor), neuroplasticity, and ketone metabolism, all of which may protect against depression and cognitive decline.


    The History of Running is Wild: Running wasn’t always a mainstream activity—it went from being a niche Olympic event to one of the most popular fitness trends of the modern era.


    Exercise Culture Shapes Identity: Many athletes struggle to transition after competitive sports, often searching for structure, purpose, and a new relationship with movement.


    Dance Might Actually Be Better for Mental Health: Research suggests dancing has stronger effects on mood and cognition than running, likely due to its social, rhythmic, and sensory components.


    The Best Exercise is the One You’ll Do: While running has profound mental health benefits, the most effective workout is one that is enjoyable and sustainable for the long term.


    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


    Parasocial Relationships, Social Media, & How Art Can Help Mental Health Mar 24, 2025
    Show notes

    In this episode Margaret takes the lead as she welcomes art therapist, psychotherapist, and author Amelia Knott to discuss the ethics of being online, parasocial relationships, and the impact of social media on mental health. We explore the blurred lines between personal and professional identities in digital spaces, the therapeutic power of art, and how social media fosters both connection and disconnection.


    Takeaways:

    Parasocial Relationships Feel Real—But Aren’t Always Balanced: The one-sided intimacy we form with online figures can create expectations that don’t match reality.


    Art Can Be a Pathway to Self-Discovery: Engaging in creative expression helps process emotions in a way that words alone sometimes can’t.


    The Internet Blurs Professional Boundaries: Therapists, doctors, and other professionals must carefully navigate how much of themselves to share online while maintaining ethical standards.


    Social Media Shapes How We See Ourselves: Being constantly observed—even by an imagined audience—can change how we experience our lives and make choices.


    Digital Well-Being Requires Intentionality: There’s no perfect fix for screen overuse, but being mindful of why and how we engage with digital spaces can help create a healthier relationship with technology.


    —

    Want more Amelia Knott:

    Instagram and TikTok: @art_therapy_irl

    Facebook: @art.therapy.irl

    Website: https://www.arttherapyinreallife.com/


    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


    ADHD, Misinformation, and the Chaos of Online Mental Health Mar 17, 2025
    Show notes

    In this episode we are joined by Priyanka Patel, a pharmacist, content creator, and soon-to-be author, to discuss mental health misinformation, ADHD, and the challenges of navigating online discourse about mental health. Priyanka shares her personal journey with ADHD, the barriers she faced in getting a diagnosis, and how social media both helps and harms conversations about neurodivergence.


    Takeaways:

    Not All Mental Health Content is Created Equal: Social media is full of both helpful education and misleading oversimplifications, making media literacy crucial when consuming mental health content.


    ADHD in Women is Still Underdiagnosed: Many women with ADHD don’t receive a diagnosis until adulthood, often being dismissed as “lazy” or “disorganized” instead of receiving the support they need.


    Pharmacogenetics and Gender Differences Matter: Research suggests that women may metabolize ADHD medications differently, yet most treatment guidelines are based on studies conducted on men.


    ADHD is Not Just a "Quirk": While humor can help destigmatize neurodivergence, romanticizing ADHD as a personality trait can overshadow the serious struggles people with the condition face.


    Online Conversations Need More Nuance: Creators should balance authenticity with responsibility, ensuring that personal experiences are clearly distinguished from clinical advice to prevent misinformation.


    —

    Want more Priyanka Patel:

    Instagram & Tik Tok: @littlemiss_adhd


    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


    Genetic Counseling (How to Approach the Unknown) Mar 10, 2025
    Show notes

    In this episode we sit down with genetic counselor Julia Castro to demystify the world of genetic testing and counseling. They explore how genetic information can help (or sometimes confuse) patients, why more testing isn't always better, and the ethical dilemmas of knowing too much about your future health.


    Takeaways:

    Genetic Counseling is More Than Just Testing: It’s about helping patients navigate uncertainty, understand their risks, and make informed decisions about their health and their families.


    More Testing Isn’t Always Better: Sometimes broad genetic screening raises more questions than answers, creating unnecessary anxiety without clear clinical benefits.


    Genetics in Psychiatry is Evolving: While tests like pharmacogenetics panels claim to predict medication responses, their real-world usefulness is still debated in psychiatry.


    Knowing Your Genetic Risks Can Be Empowering—But Also Overwhelming: Predictive genetic testing for diseases like Alzheimer’s or Huntington’s can help some people plan for the future, but for others, it may cause unnecessary distress.


    The Future of Genetics in Medicine is Expanding Fast: As research grows, neurology, psychiatry, and genetic counseling will continue to overlap, helping doctors and patients make more personalized healthcare decisions.


    —

    Want more Dr. Julia Castro:

    Instagram: @julia_mariec


    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


    Cannabis and Coping: A Mixed Relationship Mar 03, 2025
    Show notes

    In this episode Preston and Margaret explore the endocannabinoid system, cannabis, and its impact on mental health. They break down the science behind CB1 and CB2 receptors, explain why marijuana affects people so differently, and discuss the complex relationship between THC, CBD, and dopamine. Along the way, they tackle myths about cannabis use, addiction, and medical marijuana, shedding light on what we actually know—and what remains a mystery due to historical barriers to research.


    Takeaways:

    The Endocannabinoid System is Vast and Mysterious: CB1 and CB2 receptors exist throughout the body, influencing pain, pleasure, nausea, and more—but the full scope of their role remains unclear.


    Marijuana’s Effects Depend on the User: Some people experience relaxation and appetite stimulation, while others develop anxiety, paranoia, or even worsening nausea with chronic use.


    The THC-to-CBD Ratio Matters: Over time, cannabis strains have been bred to increase THC potency, which may contribute to heightened psychiatric risks, including psychosis.


    Cannabis Can Have Severe Side Effects: Long-term use can lead to cannabinoid hyperemesis syndrome (CHS)—a condition causing severe nausea and vomiting—and may increase the risk of cannabis-induced psychosis in predisposed individuals.


    Medical Cannabis Outpaced the Research: While cannabis is now widely used for medical purposes, much of its effectiveness is anecdotal, and research on its long-term mental health impacts is still catching up.


    —


    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


    Motivational Interviewing Feb 24, 2025
    Show notes

    In this episode Preston and Margaret are joined by Dr. David Roberts to explore the fascinating world of motivational interviewing (MI)—a counseling technique designed to help patients navigate ambivalence and commit to meaningful change. Dr. Roberts shares insights from his years of experience training psychiatrists and therapists, breaking down MI into practical techniques that anyone can use to foster deeper, more effective conversations. We even do a fake therapy session with our producer Aron Korney!


    Takeaways:

    Motivational Interviewing Bridges Ambivalence: MI helps people resolve mixed feelings about change by guiding them to articulate their own reasons for making a shift.

    Change Talk Sparks Action: Encouraging patients to express their desire, ability, reasons, and need for change strengthens their motivation to take action.

    Reflections Deepen Understanding: Simple and complex reflections help mirror a patient’s thoughts and feelings, making them feel heard while subtly guiding them toward insight.

    Pacing Matters: Being too directive can lead to resistance, while being too passive may feel ineffective—MI teaches a balanced approach that fosters real conversations.

    Practice Makes Progress: MI is a learnable skill that improves with intentional practice, making difficult conversations about change smoother and more effective over time.


    —


    Want more Dr. David Roberts:

    https://providers.uthscsa.edu/providers/david-l-roberts-1255650917/


    Want more Aron Korney:

    Human Values Podcast: https://podcasts.apple.com/us/podcast/human-values/id1622760459



    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


    Treating Back Pain and Trending on Tik Tok Feb 17, 2025
    Show notes

    In this episode Preston and Margaret welcome their first guest, neurosurgeon and content creator Dr. Betsy Grunch (aka Lady Spine Doc), for a deep dive into pain—how we treat it, how we misunderstand it, and how the system often fails those who experience it.


    Takeaways:

    Pain Is Not Just Physical: Chronic pain isn’t just about physical damage—it involves neurological, psychological, and emotional factors that make treatment complex.

    Back Surgery Isn’t Always the Answer: Failed back surgery syndrome is common, often because patients receive the wrong procedure or aren’t properly prepared for surgery.

    Empathy Improves Patient Outcomes: Research shows that patients who feel heard and understood by their doctors have better surgical and pain management outcomes.

    Social Media Shapes Medical Conversations: Platforms like TikTok have transformed how patients and doctors discuss pain, sometimes for better—but also with risks of misinformation.

    Medical Training Can Be Dehumanizing: The culture of surgery often discourages emotional connection, but rediscovering empathy is key to being a great physician.


    —


    Want more Dr. Betsy Grunch:

    TikTok: https://www.tiktok.com/@ladyspinedoc?_t=8rhZfY7LgLe&_r=1

    Twitter: http://www.twitter.com/ladyspinedoc

    Instagram: http://www.instagram.com/ladyspinedoc

    Facebook: https://www.facebook.com/ladyspinedoc

    YouTube: https://youtube.com/@ladyspinedoc

    LinkedIn: https://www.linkedin.com/in/drgrunch

    Amazon: https://www.amazon.com/shop/ladyspinedoc



    Watch on YouTube: @itspresro

    Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc.

    —


    Produced by Dr Glaucomflecken & Human Content

    Get in Touch: howtobepatientpod.com


    Citations:

    Chapters 1.16 and 27.15. Sadock, Benjamin J, et al. Kaplan & Sadock’s Comprehensive Textbook of Psychiatry. 11th ed. Philadelphia, Wolters Kluwer, 2025.


    Oliveira CB, Maher CG, Pinto RZ, Traeger AC, Lin CC, Chenot JF, van Tulder M, Koes BW. Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J. 2018 Nov;27(11):2791-2803. doi: 10.1007/s00586-018-5673-2. Epub 2018 Jul 3. PMID: 29971708.


    Stanford Center for Chronic Pain and American Chronic Pain Association Guide.

    https://www.acpanow.com/acpa-stanford-guide.html#/


    George SZ, Fritz JM, Silfies SP, Schneider MJ, Beneciuk JM, Lentz TA, Gilliam JR, Hendren S, Norman KS. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. J Orthop Sports Phys Ther. 2021 Nov;51(11):CPG1-CPG60. doi: 10.2519/jospt.2021.0304. PMID: 34719942; PMCID: PMC10508241.


    https://pubmed.ncbi.nlm.nih.gov/30265840/


    https://www.ncbi.nlm.nih.gov/books/NBK219252/#:~:text=Pain%20is%20a%20subjective%20experience,relieving%20or%20terminating%20the%20experience.

    Learn more about your ad choices. Visit megaphone.fm/adchoices


    Exercise, Nutrition and Mental Health Feb 10, 2025
    Show notes

    In this episode Preston and Margaret take a deep dive into the complex relationship between exercise and mental health. They discuss the science behind how movement impacts the brain, debunk common myths about fitness, and explore the psychological barriers that prevent people from incorporating exercise into their lives.


    Takeaways:

    Exercise Impacts Mental Health Bi-Directionally: Movement not only improves mental health, but mental health conditions can also act as barriers to engaging in exercise.

    Fitness Advice Often Lacks Specificity: Many healthcare providers acknowledge the benefits of exercise but rarely provide concrete strategies to help patients incorporate it into their lives.

    Movement Should Be Enjoyable: Finding a form of exercise that brings joy—whether it's dancing, hiking, or lifting—makes it easier to sustain and integrate into daily life.

    Setting Small, Achievable Goals is Key: Utilizing SMART goals (Specific, Measurable, Achievable, Relevant, Time-bound) can help create consistency without overwhelming pressure.

    Exercise Isn't Just About Weight: Shifting the focus from aesthetics to function, strength, and mental well-being can create a healthier and more sustainable relationship with movement.


    —

    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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