Off Script, unfiltered.
Essays and observations from working clinicians. Mental health, broader than a diagnosis.
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Jump to what you came for, instead of scrolling. 12 topics, each linking to every essay tagged with it.
Orthosomnia: When Sleep Tracking Backfires
A sleep tracker can show useful trends, but a nightly score can also turn sleep into a performance review. Here's how to use it without spiraling.
Jul 28, 2026
Evidence Gets Hot and Cold on Sauna vs. Cold Plunge
Sauna has long term observational data. Cold water has real studies too, but not the same exposures, outcomes, or safety profile.
Jul 24, 2026
Confidence Is Built by Receipts, Not Vibes
Confidence isn't a feeling you wait for. It's evidence you build by turning intention into specific action.
May 8, 2026
Ibogaine: Real Promise, Real Risk
Ibogaine might be the strangest substance in the whole psychedelic treatment conversation, because the promise is real and the risk is real and they sit…
Mar 21, 2026
Ayahuasca for Depression: Promising, Strange, and Still Early
Ayahuasca has a real but early depression signal. The hard part is separating clinical research from retreat hype and real safety risk.
Mar 18, 2026
Dextromethorphan for Depression: The Legal, Overlooked One
Dextromethorphan’s the weird one in this whole conversation because unlike MDMA or psilocybin or ayahuasca, it isn’t hiding behind a Schedule I wall. It’s been sitting on pharmacy…
Mar 16, 2026
Motivation Is Overrated
People wait to feel motivated before they do things. They wait for inspiration, for the right mood, for the moment when they feel like doing it...
Nov 7, 2025
The Problem with “I Can’t Help It”
"I can't help it" is one of the most common sentences people bring into a psychiatry office, and one of the most expensive things they can say out loud...
Oct 30, 2025
Consequences Aren’t Punishment
Consequences are just what happens next. You don't sleep, you feel like shit, that's biology.
Oct 27, 2025
It’s Just a White Lie. So What?
Most lies don't look like lies.
Oct 27, 2025
Psilocybin for Depression
Psilocybin for depression still isn't FDA-approved, but the trials and 2026 FDA actions make it one of the psychedelic treatments worth watching closely.
Oct 20, 2025
MDMA-Assisted Therapy for PTSD
MDMA-assisted therapy for PTSD isn't approved yet. The trials looked strong, but the FDA asked for another study because the evidence package had real holes.
Oct 18, 2025