Deep Dive with Lindsay Hill, DNP, PMHNP - Psych NP Mentor - PMHNP Mentor

Deep Dive with Lindsay Hill, DNP, PMHNP - Psych NP Mentor - PMHNP Mentor

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Deep Dive with Lindsay Hill, DNP, PMHNP - Psych NP Mentor - PMHNP Mentor episodes

  • Managing Trisomy 21, Unmasking FASD, and Recognizing Dysmorphology

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    Dive into the complex landscape of developmental disorders with a comprehensive look at managing Trisomy 21, Fetal Alcohol Spectrum Disorders (FASD), and clinical dysmorphology. We explore the psychiatric comorbidities of Down syndrome, offering evidence-based pharmacologic strategies for treating depression, anxiety, and ADHD while challenging implicit biases that limit patient potential. Expert insights reveal why over 85% of FASD cases are misdiagnosed and provide practical screening techniques to identify alcohol-related neurodevelopmental deficits that lack physical markers. The discussion extends to recognizing subtle genetic signs, such as those in 22q deletion syndrome, to help clinicians look beyond behavioral symptoms for underlying causes. We also evaluate new research on using topiramate to mitigate antipsychotic-induced weight gain and discuss the safety concerns surrounding vortioxetine in pediatric populations. This episode equips psychiatric NPs with the diagnostic tools and treatment updates necessary to improve long-term outcomes for neurodiverse youth.
    16 min
  • Brexpiprazole Claims, Perinatal Psych, and Metformin Guidelines

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    In this episode, we critically evaluate the expanding clinical profile of brexpiprazole, analyzing its recent FDA approval for agitation in Alzheimer’s dementia alongside the data behind its rejection for PTSD. We dive into perinatal mental health with Dr. Amritha Bhat, who offers expert guidance on navigating the risk-benefit analysis of psychotropics during pregnancy, the use of zuranolone, and first-line management for postpartum psychosis. Listeners will also discover new consensus guidelines that recommend prescribing metformin concurrently with high-risk antipsychotics to prevent metabolic side effects. We round out the discussion with recent research updates on the dose-dependent antidepressant effects of Vitamin D and the efficacy of service dogs for veterans. These evidence-based insights are essential for psychiatric nurse practitioners aiming to optimize treatment plans across the lifespan, from reproductive psychiatry to geriatric care.
    15 min
  • Beyond Symptom Reduction: The Science and Practice of Wellness

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    This episode explores the transformative power of integrating wellness-centric interventions into psychiatric practice, moving beyond mere symptom reduction to the cultivation of true mental well-being.... Listeners will discover the neurobiology behind the "HERO" traits—Happiness, Enthusiasm, Resilience, and Optimism—and how specific lifestyle interventions like the WILD 5 Wellness program can target inflammation and improve clinical outcomes.... We discuss practical augmentation strategies that combine traditional psychopharmacology with evidence-based practices in exercise, nutrition (specifically the MIND diet), sleep hygiene, mindfulness, and social connectedness.... You will learn how to implement measurement-based care using tools like the HERO Wellness Scale to track progress and address the "Wellness Deficit Disorder" often prevalent in chronic psychiatric conditions1011. Join us to understand why addressing the mind-body connection is essential for preventing relapse and empowering patients to lead more fulfilling lives1213.
    16 min
  • Managing Complex Withdrawals, Medical Mimics, and Functional Neurological Disorder

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    This episode equips psychiatric nurse practitioners with advanced strategies for managing complex withdrawal syndromes and identifying medical mimics in clinical practice. Listeners will explore evidence-based protocols for treating buprenorphine-precipitated withdrawal—including the efficacy of administering additional buprenorphine—and review a novel inpatient pathway for methamphetamine withdrawal. We also dive into the diagnosis and management of Functional Neurological Disorder (FND), emphasizing the importance of identifying positive physical signs and providing clear patient education. Furthermore, the episode details how to distinguish psychiatric symptoms from medical conditions like anti-NMDA receptor encephalitis and acute intermittent porphyria to prevent misdiagnosis. Finally, we discuss practical interventions for akathisia, such as the use of low-dose mirtazapine, ensuring you can effectively address this distressing side effect.
    13 min
  • Cultural Psychiatry, Neuroscience-Based Nomenclature, and Climate Anxiety

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    In this episode, we explore culturally competent assessment strategies with Dr. Dakota Carter, demonstrating how to bridge Western medicine with diverse family beliefs through the lens of a First-Generation youth case study. We also dive into Neuroscience-Based Nomenclature (NbN), a pharmacological classification system that reduces stigma and improves patient education regarding off-label prescribing. Dr. Laelia Benoit joins us to reframe climate anxiety not as a pathology to be cured, but as a rational response that requires validation and collective action. Additionally, we review the latest clinical updates on pediatric mania, comparing the efficacy and metabolic profiles of ziprasidone, lithium, and quetiapine to inform your prescribing choices. These insights provide essential tools for modernizing your clinical approach, managing referrals effectively, and fostering stronger therapeutic alliances.
    18 min
  • Uncovering Missed FASD and Addressing Bias in Trisomy 21

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    In this episode, we uncover the high rates of misdiagnosis in Fetal Alcohol Spectrum Disorders (FASD) and provide specific screening questions, such as the "4Ps Plus" method, to improve detection in your clinical practice. We dive into the psychiatric management of Trisomy 21, outlining appropriate pharmacologic interventions for comorbidities like anxiety, ADHD, and autism-related irritability while addressing the impact of implicit bias on care. The discussion extends to dysmorphology essentials, highlighting when to suspect genetic conditions like 22q deletion syndrome in patients presenting with behavioral challenges. We also navigate the legal and ethical landscape of decision-making for young adults with intellectual disabilities, comparing guardianship with supported decision-making models to preserve patient autonomy. Finally, we review recent research on using topiramate to mitigate antipsychotic-induced weight gain and examine critical safety data regarding vortioxetine use in pediatric populations.
    15 min
  • Treating Irritability, Suicidality, and Psychosis in Autistic Youth

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    This episode provides a comprehensive guide to managing complex psychiatric challenges in autistic youth, specifically addressing irritability, suicidality, and psychosis. We explore a step-by-step treatment algorithm for irritability that prioritizes functional goals and evidence-based off-label pharmacotherapy, such as guanfacine, memantine, and low-dose naltrexone, to help you avoid premature escalation to antipsychotics. Listeners will gain critical insights from Dr. Paul Lipkin on adapting suicide risk assessments using the ASQ tool and from Dr. Kristin Cadenhead on distinguishing true psychotic symptoms from baseline autistic traits. The discussion also reviews recent research on ADHD interventions, offering practical takeaways to enhance your diagnostic precision and treatment planning. By integrating these expert strategies, you can better navigate the nuances of neurodiverse care and improve outcomes for your patients.
    21 min
  • Brain Energy: A New Path to Healing Anxiety and Depression

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    🧠 Brain Energy: The "Cliff Notes" Version ⚡

    🚨 The Big Reveal

    Hold onto your neurons—Dr. Christopher Palmer is flipping the script. The central thesis is a game-changer: Mental disorders are not just chemical imbalances or psychological issues; they are metabolic disorders of the brain.

    Whether it's anxiety, depression, ADHD, or schizophrenia, the root cause traces back to the same biological problem: your brain cells aren't getting the right energy at the right time.

    🦠 The Tiny Villains (and Heroes): Mitochondria

    Remember hearing that mitochondria are the "powerhouses of the cell" in high school biology? Well, they are actually the drivers of the human body.

    • The Role: They don't just pump out energy (ATP); they control on/off switches for cells, manage hormones, and regulate inflammation.
    • The Malfunction: When mitochondria go rogue ("mitochondrial dysfunction"), brain cells misfire. They might become overactive (hello, anxiety and mania), underactive (depression and brain fog), or simply stop working (dementia).

    🚗 The "Traffic" Analogy (Because Biology is Complex)

    Think of your body as a city and metabolism as the traffic flow.

    • Car A (The Cali Cruiser): Drives in perfect weather on smooth roads. Life is easy.
    • Car B (The Snow Warrior): Drives in a blizzard (trauma/adversity). It uses 4-wheel drive, tires wear out, and gas mileage tanks. The car is stressed, but it’s reacting normally to a bad environment. This is a mental state (like grief or acute stress).
    • Car C (The Glitchy Ride): Drives in sunny weather but has the windshield wipers on full blast, headlights off at night, and drives 20 mph on the highway. This car has a disorder. The internal systems are broken.

    🔗 Connecting the Dots

    Ever wonder why people with depression often get diabetes? Or why heart disease and anxiety go hand-in-hand?

    • It's not a coincidence. Mental and metabolic disorders share a common pathway: mitochondrial dysfunction.
    • This explains why physical and mental illnesses overlap so frequently—they are essentially the same problem showing up in different organs.

    🛠️ The Fix: The Metabolic Treatment Plan

    The good news? Metabolism is malleable. You can actually fix the engine.

    • Change the Fuel: The Ketogenic Diet isn't just a fad; it’s a powerful medical intervention that changes brain metabolism and can put serious mental disorders into remission.
    • Upgrade the Hardware: Exercise signals your cells to build more mitochondria (mitochondrial biogenesis), increasing your brain's horsepower.
    • Reset the Clock: Regulating sleep and getting morning sunlight helps sync your biological rhythms.
    • Find Purpose: Surprisingly, having meaning and love in your life lowers stress hormones and boosts metabolic health.

    The Bottom Line: Mental health is metabolic health. By treating the metabolism, we can finally heal the brain.

    16 min
  • Navigating the Addiction Continuum: Meds, Psychotherapy, and Brixadi

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    In this episode, we explore the addiction treatment continuum to help you determine when to prioritize pharmacotherapy versus psychotherapy for opioid, stimulant, and alcohol use disorders. We provide a deep dive into Brixadi, a new long-acting injectable buprenorphine, comparing its weekly and monthly dosing options to Sublocade and discussing its potential role in rapid induction protocols34. Expert insights on Motivational Interviewing and 12-Step Facilitation offer practical communication strategies to resolve patient ambivalence and improve engagement with recovery communities56. You will also learn about emerging evidence for microinduction strategies in hospitalized patients and the safety of initiating injectables in the emergency department47. These clinical pearls will equip you with the latest evidence-based tools to tailor treatment plans and enhance recovery outcomes for your patients.
    16 min
  • Bringing Childhood Back to Earth

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    Episode Description Imagine sending your 10-year-old to live on Mars. They aren't evolved for the low gravity, the alien environment, or the isolation. According to social psychologist Jonathan Haidt, this is exactly what we did to Generation Z when we traded a "play-based childhood" for a "phone-based childhood" in the early 2010s. In this episode, we dive into Haidt’s The Anxious Generation to understand the sudden, global surge in adolescent mental illness and, more importantly, how we can bring our children back to Earth.

    Key Topics Covered:

    • The Great Rewiring (2010–2015): How the rapid adoption of smartphones and social media coincided with a sharp decline in teen mental health, marking the end of the play-based childhood.

    • The "Mars" Metaphor: Why the virtual world acts as an "experience blocker," preventing kids from getting the embodied social interactions, risky play, and cultural apprenticeships they need to mature.

    • The Four Foundational Harms: We explore the primary ways a phone-based childhood disrupts development:

    1. Social Deprivation: The replacement of synchronous, embodied play with asynchronous, disembodied interaction.

    2. Sleep Deprivation: How screens steal the rest growing brains desperately need.

    3. Attention Fragmentation: How constant notifications fracture focus and executive function.

    4. Addiction: How tech companies engineered "loops" to hack the brain’s dopamine reward system.

    • The Gender Gap:

    ◦ Girls: How visual social media (Instagram, TikTok) fuels perfectionism, social comparison, and sociogenic illnesses like anxiety and tic disorders.

    ◦ Boys: How the digital world pulls boys away from real-world engagement into video games and pornography, contributing to a "failure to launch".

    • The Solution—Collective Action: We are trapped in a "collective action problem" where it is hard for one parent to say "no" if everyone else says "yes." The episode outlines how parents, schools, and governments can coordinate to break this trap.

    Actionable Takeaways: The Four Foundational Reforms Haidt proposes four specific norms to reverse these trends and restore childhood independence:

    1. No Smartphones Before High School: Give children basic phones (talk/text only) until roughly age 14.

    2. No Social Media Before 16: Protect children during the most vulnerable years of puberty and brain development.

    3. Phone-Free Schools: Students should not have access to phones (bell-to-bell) during the school day to restore focus and socialization.

    4. More Independence and Free Play: Roll back "safetyism" and allow children more unsupervised play and responsibility in the real world.

    Memorable Quotes:

    • "It’s as if we gave our infants iPads loaded with movies about walking, but the movies were so engrossing that kids never put in the time or effort to practice walking".

    • "Experience-expectant brains need to wire up by practicing skills such as running, fighting, and befriending".

    • "We can’t make children learn, but we can let them learn"

    17 min

About Deep Dive with Lindsay Hill, DNP, PMHNP - Psych NP Mentor - PMHNP Mentor

From the publisher's feed

Welcome to my podcast. I am Lindsay Hill, DNP, PMHNP BC, and this show is my space to slow down and really unpack what psychiatric care looks like in real life.

Each episode is built from the…