Good Enough Shrink

This week, we explore the curious and unnerving world of artificial intelligence (AI) and mental health. We discuss its potential benefits in healthcare for both psychiatrists and patients, as well as risks such as harmful content, liability issues, privacy issues, and blurring the line between what is real and fake. We are excited and wary of this new technology that is inevitably going to be in every aspect of our lives. Join us in the discussion! 

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Welcome to the new year! This episode is about how to approach making a change in your life. Your ambivalence, values, fears, and goals are all crucial parts of what makes you you. It's also important to just take a pause sometimes in this ever-changing world today. So I hope this quick episode will give you that pause and reflection to propel you toward what matters the most in your life! 

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Hello there! This episode is a dense one. We discuss neurosis and anxiety from the perspective of childhood and growth. We go over concepts of “basic anxiety” and “neurotic pride”, reflecting on healthy and unhealthy narcissism fueling anxiety as proposed by the psychoanalyst, Karen Horney. We explore how the DSM anxiety disorders are categorized, the importance of a holistic approach to treatment, and the use of medication in managing anxiety. Lastly, we emphasize the need for us to do our own inner work to understand and manage one's own anxiety to better assist patients. 

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We are back! In this episode, we discuss the nitty gritty, fascinating details of schizophrenia and psychosis. We explore the devastating stigma associated with schizophrenia, the challenges of diagnosing and managing severe mental illnesses, and the importance of honoring the patient as a human being. Join us, as we three child psychiatrists chat about how to build trust and collaboration in mental health care, and keep the hope alive. 

Topics discussed:

• Stigma associated with schizophrenia 
• Comorbidity and shortened life expectancy 
• Definitions and causes of schizophrenia or psychosis
• Cannabis and its link to schizophrenia 
• Autism and its link to schizophrenia 
• Treatment approaches for schizophrenia 

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Hello! We are continuing our conversation on psychosis. In this episode, we focus on differential diagnoses for psychosis, including medical and psychiatric conditions that can often be confused with a truly psychotic disorder like schizophrenia. Specifically, trauma is a big one, leading us to lose ourselves in the imbalance of imagination and reality. Especially in kids! Lastly, we talk about treatment of psychosis, our approach to antipsychotics, and non-pharmacological treatment like individual therapy and family support. This is a really really tough condition to navigate through, and we hope to share our experiences so you don’t feel alone in this journey. 

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Hello! This week, we delve into the fascinating history of how we conceptualize psychosis and schizophrenia. All those with schizophrenia have psychosis, but not all those with psychosis have schizophrenia. From a psychological framework to a biological one, the field of psychiatry has gone back and forth between the two and really struggled to understand schizophrenia. Now, we are just starting to see the interplay between genetic, epigenetic, environmental, and psychological factors at play in the risk of developing schizophrenia. Join us in this whirlwind of conversation by two child psychiatrists trying to tackle this colossal topic! 

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School is back in full swing, and so is everyone's anxiety! We discuss the challenges kids, teens and parents face as they reintegrate back to school after the summer break. We delve into the various reasons for school avoidance and refusal, which are critical in understanding what is actually behind it. We conclude with a discussion on what to do about it -- mainly the importance of early preparation, open communication, accessing school resources, and when necessary, use of therapy and medications for depression and anxiety in children and adolescents. 


Resource Links: 

• AACAP Facts for Families on Schools: https://www.aacap.org/AACAP/Families_and_Youth/Resource_Centers/Schools_Resource_Center/Home.aspx 
• Do's and Don'ts of School Avoidance: https://schoolavoidance.org/advice-from-a-fellow-school-refusal-parent-on-how-to-help-them-get-back-to-school/ 
• IEP Request Template Letter: https://www.disabilityrightsca.org/publications/template-letter-for-a-request-for-assessment

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*Trigger warning for content on self-harm, suicide and eating disorders. Please feel free to opt out and prioritize your sense of safety if you need to do so.*

This is a tough one. The positive effects of social media on mental health can be lifesaving, yet its negative effects may lead to a life taken far too early. We have a nuanced discussion on social media's pros and cons, and how to help your child or someone who may be addicted to it. There is a dire need for change, and it starts with all of us. We list out specific recommendations for social media use in kids and teens, and how to have a conversation with them to develop a family media plan.

Resources:
AACAP: https://www.aacap.org/AACAP/Families_and_Youth/Resource_Centers/Screen_Media_Resource_Center/Home.aspx

AAP: https://www.aap.org/en/patient-care/media-and-children/center-of-excellence-on-social-media-and-youth-mental-health/#:~:text=What%20We%20Do,protect%20youth%20mental%20health%20online

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 We are back! In this episode, we talk about attachment theory from a neuroscientific and neurobiological perspective. We highlight how talking about our emotions can help us regulate them, and make room for empathy and "mentalizing" other people's experiences. We also discuss how attachment trauma can disrupt brain development, and how mindfulness and staying attuned to your body can mitigate this. Finally, we discuss the categorization of attachment experience in the DSM, and the importance of understanding the etiological basis of mental health conditions for effective treatment. 

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In this episode, we take a quick break from attachment theory and dive into a very real, current problem we face today: the stimulant medication shortage for the treatment of ADHD. We explore the complex regulatory systems surrounding stimulants, including supply chain issues and being lumped into the category of Schedule II medications monitored by the Drug Enforcement Agency (DEA) to fight the Opioid Epidemic. The pressures from many layers of control fall on the shoulders of the pharmacist, and worst of all, the patients. Lastly, we discuss how to mitigate this shortage issue for patients, and the need for patient advocacy amongst clinicians. 

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