Psychiatry, honestly.

Writing about psych meds, diagnoses, and the work itself.
By the people who do it for a living.

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Treatment

AI therapy chatbots, clinical perspective

Patients started bringing up Woebot a few years back, and at this point half the guys under thirty who walk into a psychiatry appointment have at some point…

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Recent writing

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Treatment · 8 min read

ECT (Electroconvulsive Therapy)

ECT (electroconvulsive therapy, the one with the bad PR from the Jack Nicholson movie) works better than any antidepressant we have, and almost nobody who needs it gets…

Jun 1, 2026
Treatment · 9 min read

EMDR

EMDR stands for eye movement desensitization and reprocessing, which is a mouthful and also kind of misleading because the eye movements may not actually be the active ingredient.…

Jun 1, 2026
Treatment · 8 min read

Involuntary holds: OR/WA specifics

Oregon and Washington don’t use the California 5150/5250 numbering, which confuses people who moved up here from the Bay Area expecting that vocabulary. The thing being described is…

Jun 1, 2026
Treatment · 8 min read

Ketamine clinics: legit vs grift

The ketamine clinic boom of the last five years is two different things wearing one storefront. One is a real treatment with real data for the kind of…

Jun 1, 2026
Treatment · 8 min read

MAT (Medication-Assisted Treatment) full landscape

If you have opioid use disorder, medication is the actual treatment. Not therapy first, not 12-step first, not the white-knuckle abstinence approach that’s been the default for forty…

Jun 1, 2026
Treatment · 8 min read

Microdosing: what controlled trials actually show

The honest answer on microdosing is that the controlled trials don’t show much, the open-label data shows a lot, and the difference between those two things is mostly…

Jun 1, 2026

Most of this is simpler than the internet makes it sound, and harder than a pill makes it look.

About

Everybody who writes here is a working clinician. It's the day job, not a side project. The stuff on this site is meant to be educational, not medical advice, and nothing here replaces an actual conversation with whoever's prescribing for you. If you're in crisis right now, please call 988 or get to an ER.