Psychofarm Podcast

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.

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Latest Episodes:

Psychiatrist's Guide to Anxiety Medications: First Line to Last Resort Jun 25, 2025

Show notes

We unpack the anxiety medication algorithm, moving from first-line SSRI picks like Sertraline and Escitalopram to augmentation with buspirone, gabapentin and lavender. CBT, mindfulness and evidence-based psychopharmacology weave throughout the podcast, so clinicians prescribe appropriately and with the right psychoeducation.

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

Understanding Anxiety, GAD, and Treatments of Anxiety Jun 11, 2025

Show notes

In this episode, we explore anxiety not as a disease in itself, but as a critical signal from your mind and body. We discuss how this signal can point to deeper issues like hidden emotions or relational trauma, and why common diagnoses like GAD (Generalized Anxiety Disorder) often miss the true source of the problem. We also cover the fundamental brain science of fear, the key differences between anxiety, panic, and worry, and introduce five different treatment models designed to help you find and resolve the root cause.

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

Assessment of Personality: Practical Assessment in a Short Timeframe May 27, 2025

Show notes

This episode looks at the practical assessment of personality. We explore the nuances of psychiatric diagnosis, moving beyond simplistic heuristics with a focus on the DSM-5's Alternative Model for Personality Disorders. Learn about assessing self-functioning (identity, self-direction) and interpersonal functioning, using clinical interviewing, psychosocial history, and even your countertransference as vital tools for a more comprehensive understanding of personality pathology in busy clinical settings.

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

Treating Borderline Personality Effectively aka How To Be A Good Psychiatrist Through GPM May 13, 2025

Show notes

This episode delves into Good Psychiatric Management (GPM), a practical framework developed by John Gunderson for treating Borderline Personality Disorder (BPD), though its principles offer broad utility across diagnoses. The hosts discuss the importance of integration, managing expectations (both patient and provider), and robust psychoeducation regarding BPD's features, heritability, and treatment course. Key GPM tenets are explored, including focusing on life outside therapy (work/relationships), the adjunctive role of medication, fostering accountability, and the significance of the therapeutic relationship itself as part of the treatment.

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

PTSD Medications: Integrating Pharmacotherapy, Therapy, and the Treatment Frame | Episode 22 Apr 29, 2025

Show notes

Dive deep into the practicalities of psychiatric medication management for PTSD in this clinical discussion. We explore the often limited evidence base and the necessity of off-label prescribing, focusing on strategies for stabilization, safety, and trust… the first stage of trauma treatment. Learn about experience-based approaches using SSRIs like sertraline, sleep aids such as trazodone and gabapentin, the cautious use of antipsychotics, and why benzodiazepines are discouraged. The conversation also touches on managing sleep disturbances and dissociation, situating medication as a supportive tool alongside essential psychotherapy and lifestyle changes, guided by principles like Pierre Janet's three-stage model.

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

Understanding Trauma and PTSD, Diagnosis and Dissociation | Episode 21 Apr 15, 2025

Show notes

Join us for an in-depth exploration of trauma and Post-Traumatic Stress Disorder (PTSD). This episode moves beyond common language to establish a clinical definition of trauma, detailing the DSM-5 criteria required for a PTSD diagnosis. The hosts break down the core PTSD symptom clusters – intrusion, avoidance, negative alterations in cognitions/mood, and arousal/reactivity – providing clear examples like flashbacks, hypervigilance, and negative self-beliefs. They delve into the concept of dissociation, its role in trauma, and the challenges it presents in assessment. Listeners will gain crucial insights into the diagnostic process, common misdiagnoses (like mistaking PTSD for depression), the vital importance of earning therapeutic trust, and effective interviewing techniques for sensitive topics, ultimately highlighting why accurate identification is key to recovery.

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

Lessons from Forensic Psychiatry: Insanity Defense, Subtle Patients and Culpability Apr 01, 2025

Show notes

This conversation explores key aspects of forensic psychiatry, including the insanity defense, dissimulating patients, and how clinical practice intersects with legal systems. It highlights the importance of open-ended dialogue, nuanced diagnosis, and maintaining empathy without succumbing to cynicism.

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

Involuntary Treatment & Agency, Thoughts and Feelings | Episode 19 Mar 12, 2025

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Join us in a conversation about involuntary commitment, and the legal framework behind psychiatric treatment. We discuss real-world scenarios, share insights into how clinicians juggle patient autonomy versus societal protection. Whether you are new to the field or a seasoned professional, this episode offers valuable perspectives on balancing ethical duties, legal obligations, and patient care.

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

The Deficit Model in Psychiatry & Difficult to Treat Depression with Dr. Chris Aiken | Episode 18 Mar 05, 2025

Show notes

In this episode, we sit down with Dr. Chris Aiken to look at a big question: when do we treat an underlying deficit in psychiatric illness? Focusing on difficult-to-treat depression, our conversation delves into the deficit model and looks at different paradigms, from neuroprotective strategies and lifestyle interventions to the nuanced use of medications like SSRIs, lithium, and thyroid hormones, as well as targeted supplements. Tune in for a thought-provoking discussion that looks at when we approach treating depression by focusing on its underlying causes.

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https://chrisaikenmd.com/partners/

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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

Choosing Antipsychotics in Schizophrenia: Side-Effects, Maximizing Efficacy, and Finding the Right Medication | Episode 17 Feb 26, 2025

Show notes

Schizophrenia treatment is complex, and choosing the right antipsychotic can make all the difference. In this episode, we take a deep dive into schizophrenia medications... breaking down the pros and cons of different antipsychotics, metabolic risks, sedation issues, and the challenges of adherence. We discuss how to tailor treatment to individual patients, avoid unnecessary side effects, and improve long-term outcomes. Whether you're a clinician prescribing antipsychotics or someone looking to understand schizophrenia medications better, this discussion offers practical insights and evidence-based strategies for optimizing treatment.

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