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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

    Advertise

    Copyright: © Human Content, Inc. 2024

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    Latest Episodes:
    Excerpts from the American Journal of Insanity (July 1851) Oct 19, 2026
    Show notes

    In today's episode we take a look back towards the history of psychiatry and read from the publication “The American Journal of Insanity.” This is the journal that predates the American Journal of Psychiatry (the name was changed in 1921). While some of the terms are outdated, the treatment principles and pathology remain eerily similar. It really shows us how far we’ve come and how little has changed in the last 150 years. Listen along to the articles and let us know what you think!





    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


    Child Psychiatry Training Explained Oct 12, 2026
    Show notes

    In this episode, Margaret and Preston talk about Margaret’s experience halfway into child and adolescent psychiatry fellowship. Margaret discusses the general requirements or parts in child training, discerning child training indications versus other training paths, and how her child training impacts her care for adult psychiatry patients.




    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


    How does image guided TMS stack up against the current method? Oct 05, 2026
    Show notes

    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


    The Theory of the Crunch: Holding Difficult Dynamics in Therapy Sep 28, 2026
    Show notes

    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


    Psychiatric Effects of GLP-1s (What We Know So Far) Sep 21, 2026
    Show notes

    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


    Nuances in Prescribing Antidepressants Sep 14, 2026
    Show notes

    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


    Psychiatric Roots in Greek Mythology Sep 07, 2026
    Show notes

    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


    Climate Change Impacts on Mental Health with Child Psychiatrist & Pediatrician Elizabeth Pinsky, MD Aug 31, 2026
    Show notes

    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


    Lessons from Improv Comedy Aug 24, 2026
    Show notes

    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


    Kung Fu Panda & Residency: Growth Mindset Aug 17, 2026
    Show notes

    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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