In Part 2 of our anxiety series, we’re going deeper, breaking down what anxiety actually is, what’s happening in your brain and body, and how medications fit into the picture.

If you’ve ever wondered why anxiety feels so physical (racing heart, nausea, chest tightness, dizziness), this episode explains the physiology behind it in a way that actually makes sense. We walk through the anxiety response, including the role of the nervous system, fight-or-flight, and why your brain sometimes sounds the alarm when nothing is actually wrong.

We also talk about anxiety medications—what they do, how they work, and common misconceptions people have about them. As mental health providers, we share real-world insight into when medications can be helpful and what to expect if you’re considering them.

Whether you deal with generalized anxiety, panic attacks, or chronic overthinking, this episode will help you understand your symptoms in a way that feels less confusing and a lot less scary.

Because once you understand what your anxiety is doing, it becomes a lot easier to work with it instead of against it.

Welcome to Part 1 of our anxiety series where we’re making anxiety a little less scary and a lot more relatable.

In this episode, we introduce the Catastrophe Scale, a funny but insightful way to understand how anxiety turns small moments into full-blown spirals. From unread texts to awkward social interactions, we rate everyday situations from mild concern to complete mental chaos.

Along the way, we break down why anxious thoughts escalate so quickly and how to start catching yourself before you hit a level 10 spiral.

If you struggle with overthinking, social anxiety, or constantly expecting the worst-case scenario, this episode will help you feel seen (and maybe laugh at your brain a little too).

Because sometimes your brain is dramatic… and it’s okay to call it out.

Hosted by Amanda Smith, MA, MSW, LCSW and Amanda Mitchell, DNP, APRN, PMHNP-BC with special guest Amber Herpfer, BA, MSWi

We’re wrapping up our Mental Health Spring Cleaning series with the step that actually creates change.

In Spring Cleaning Pt. 4, we break down the final piece of CBT: changing your thoughts. Using our simple framework, check it, challenge it, change it, we show you how to reframe negative thinking patterns and shift your mindset in a realistic, sustainable way.

We’re also joined by our intern Amber, who helps us tie together everything we’ve covered in this series. From identifying thought patterns to challenging them and finally learning how to replace them, we work through the CBT process giving you some real tools to take home with you.

In this episode, you’ll learn:

• How to reframe negative or distorted thoughts
• What “changing your thoughts” actually looks like in real life
• Why reframing isn’t toxic positivity (and what to do instead)
• How to start building healthier thinking patterns

If you struggle with overthinking, anxiety, or self-doubt, this episode gives you practical tools you can start using immediately.

Hosted by Amanda Smith, MA, MSW, LCSW and Amanda Mitchell, DNP, APRN, PMHNP-BC

Your thoughts feel true—but what if they’re not?

In Spring Cleaning Pt. 3 of our Mental Health series, we’re breaking down cognitive distortions - the automatic thinking patterns that can fuel anxiety, overthinking, and self-doubt.

As mental health providers, we see these patterns all the time and, chances are, you’re experiencing them too without even realizing it. From mind reading to catastrophizing, we explain how these thoughts show up in real life and why your brain is so quick to believe them.

This episode will help you:

• Identify common cognitive distortions
• Understand why your brain jumps to worst-case scenarios
• Start separating thoughts from facts

We also address overthinking, anxiety spirals, and how to tell if a thought is actually true.

✨ Not every thought deserves your trust—and this episode will show you why.

In this episode of The Off-Label Podcast, we’re continuing our Mental Health Spring Cleaning series by diving deeper into Cognitive Behavioral Therapy (CBT) and the first step to changing your thoughts: awareness.

If you’ve ever struggled with overthinking, anxiety, or negative thought spirals, this episode is for you. Most of the thoughts that drive stress and self-doubt happen automatically, and if you don’t notice them, you can’t change them.

We break down how to identify automatic thoughts, why your brain jumps to worst-case scenarios, and how to start catching the mental “clutter” that’s been running in the background. Using real-life examples (and a little humor), we make CBT practical, relatable, and actually doable in your day-to-day life.

In this episode, we cover:

• What automatic thoughts are and why they matter
• Why overthinking feels uncontrollable
• How to start noticing negative thought patterns
• Simple CBT techniques to build awareness
• How your thoughts impact anxiety, mood, and behavior

Whether you’re new to therapy concepts or already working on your mental health, this episode will help you take the first step toward a clearer, calmer mind.

Don’t forget to follow, rate, and share with a friend who could use a little mental spring cleaning.

Hosted by Amanda Smith, MA, MSW, LCSW and Amanda Mitchell, DNP, APRN, PMHNP-BC

In this bonus episode, we’re coming to you hot off the heels of the Psychotherapy Networker Symposium in Washington, DC! We’re breaking down our biggest takeaways, favorite moments, and the sessions that left a lasting impact on how we think about therapy, trauma, and real-world mental health work.

We dive into powerful presentations from Britt Rathbone, LCSW-C, ACSW, BCD, CGP on Dialectical Behavior Therapy (DBT), Nadine Burke Harris, MD, MPH, FAAP on Adverse Childhood Experiences (ACEs), and Bessel van der Kolk, MD, author of The Body Keeps the Score, who led an engaging and thought-provoking discussion on trauma and healing. We also highlight insights from Terri Cole, MSW, LCSW on high-functioning codependency and boundaries.

Beyond the sessions, we reflect on how attending a major mental health conference reignited our passion, challenged us to grow, and inspired us to show up more fully in our own community and clinical work. And of course, we share some of our funniest and most chaotic moments navigating DC along the way.

If you’re a therapist, mental health professional, or just someone interested in trauma, therapy techniques, and personal growth, this episode is packed with insight, inspiration, and real talk.

Hosted by Amanda Smith, MA, MSW, LCSW and Amanda Mitchell, DNP, APRN, PMHNP-BC

Spring cleaning isn’t just for your house — sometimes your brain needs it too.

In this episode of the Off-Label Podcast, we’re talking about mental health spring cleaning and the thoughts we keep holding onto that might need to go. You know the ones: “I should be further along by now,” “Everyone is judging me,” “If I rest I’m being lazy,” and the classic mental junk drawer of overthinking, guilt, and negative self-talk.

As a psychiatric nurse practitioner and a licensed clinical social worker, we break down the common thought patterns that contribute to anxiety, burnout, people-pleasing, and perfectionism, and talk about how to start letting some of that mental clutter go.

We also explore why our brains hang onto unhelpful beliefs, how cognitive distortions show up in everyday life, and a few practical ways to challenge the thoughts that keep us stuck.

If you’ve ever felt overwhelmed by overthinking, comparison, or the pressure to have everything figured out, this episode is your reminder that sometimes the healthiest thing you can do is clean out the mental junk drawer.

Hosted by Amanda Smith, MA, MSW, LCSW and Amanda Mitchell, DNP, APRN, PMHNP-BC

We played a game called “Horrible Therapist”… and it sparked a deeper conversation about something a lot of people quietly wonder:

How do you know if your therapist is actually good?

In this episode of The Off-Label Podcast, we break down:• Red flags in therapy• Green flags in therapy• What good therapy should feel like• How to know if therapy is working• How to tell if your therapist is the right fit

Therapy should feel collaborative, safe, and grounded in real clinical skill — not awkward, dismissive, or performative. We talk about the difference between discomfort that leads to growth and discomfort that signals something isn’t right.

If you’ve ever wondered, “Is this normal in therapy?” this episode is for you.

As always, this podcast is for educational purposes only and is not a substitute for individualized therapy or medical advice.

Hosted by Amanda Smith, MA, MSW, LCSW and Amanda Mitchell, DNP, APRN, PMHNP-BC

In this episode of The Off-Label Podcast, we talk about how to cope when the news feels overwhelming and the world feels heavy.

From constant headlines and social media updates to global crises and political tension, many people are experiencing increased anxiety, stress, and emotional exhaustion. We break down why our brains are wired to react so strongly to negative news — and what you can actually do about it.

We cover:

• ​ How doomscrolling can get the best of you• Signs you’re experiencing news-related anxiety• How to set healthy boundaries with media consumption• Therapy tools to manage overwhelm and uncertainty• Staying informed without sacrificing your mental health

If you’ve been feeling anxious, helpless, angry, or emotionally drained by current events, this episode offers grounded, research-based strategies to help you stay steady in unstable times.

This conversation is educational and not a substitute for therapy, but we hope you walk away thinking: “I’ve never thought of it like that.”

Hosted by Amanda Smith, MA, MSW, LCSW and Amanda Mitchell, DNP, APRN, PMHNP-BC with special guest Amber Herpfer, BA, MSWi

In this Ask the Amandas episode, two mental health professionals answer some of the most common questions people have about therapy, mental health, and emotional wellbeing. Licensed clinicians Amanda and Amanda discuss what therapy actually looks like, how to support someone who is resistant to seeking help, and how mental health shows up in everyday life.

This mental health Q&A explores the connection between ADHD, CPTSD, and childhood trauma, what it means when therapy “gets worse before it gets better,” and how mental health professionals set work-life boundaries to prevent burnout. The Amandas also share their personal paths into the mental health field and what a good mental health day looks like for them.

This episode is for anyone curious about therapy, navigating anxiety or burnout, supporting a loved one, or wanting a clearer understanding of how mental health care really works.

Topics covered include:

• How to support someone resistant to therapy

• ADHD, CPTSD, and childhood trauma

• Explaining therapy and mental health work to others

• Burnout and boundaries for helping professionals

• What progress in therapy actually looks like

If you’ve ever wondered whether therapy is right for you, or how to talk about mental health more openly, this episode offers practical insight and reassurance.