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Adderall
Medications · 9 min read

Adderall

Adderall is amphetamine.

Jul 29, 2025
Off Script · 14 min read

How to Actually Access Your Mental Health Benefits

Insurance companies in this country have figured out a quietly profitable trick. They sell you a plan that technically includes mental health coverage, they staff a member-services line…

Jul 29, 2025
Remeron
Medications · 10 min read

Remeron

Remeron is the antidepressant nobody picks first and a lot of guys end up grateful for.

Jul 29, 2025
Performance Anxiety Isn’t Just About Sex
Conditions · 9 min read

Performance Anxiety Isn’t Just About Sex

Performance anxiety doesn't show up the way the name suggests it does.

Jul 26, 2025
What Every Insurance Term Actually Means (And Which Ones Matter)
Off Script · 14 min read

What Every Insurance Term Actually Means (And Which Ones Matter)

Insurance companies don't write their paperwork to be understood. They write it to be unfalsifiable, which is a different problem.

Jul 26, 2025
How Health Insurance Actually Works
Off Script · 15 min read

How Health Insurance Actually Works

Health insurance is confusing on purpose.

Jul 24, 2025
Lunesta
Medications · 8 min read

Lunesta

Lunesta is the Z-drug you reach for when Ambien isn't holding the night together. Same family, different shape, slightly longer half-life.

Jul 23, 2025
Solopreneur Logistics: From LLC to PC
Off Script · 15 min read

Solopreneur Logistics: From LLC to PC

Most clinicians who leave a W-2 job to go solo lose money in their first year, and a fair number of them don't even notice until they sit down with…

Jul 21, 2025
PTSD, Explained
Conditions · 10 min read

PTSD, Explained

PTSD is what happens when your brain encodes a memory wrong.

Jul 19, 2025
Licensure vs Certification: What Actually Defines Your Scope of Practice
Off Script · 15 min read

Licensure vs Certification: What Actually Defines Your Scope of Practice

Most of us came out of training knowing how to interview a patient, how to write a note, and how to talk a guy down off a bad week, and…

Jul 18, 2025
E&M Codes for Psych: Choosing the Right Level
Off Script · 15 min read

E&M Codes for Psych: Choosing the Right Level

Most psych clinicians are undercoding their visits, and it's not because they're being modest, it's because nobody taught them how E&M (evaluation and…

Jul 16, 2025
Stimulants Help Most People Focus. That Isn’t an ADHD Test.
Off Script · 14 min read

Stimulants Help Most People Focus. That Isn’t an ADHD Test.

The single most common ADHD diagnostic story I hear in the room goes like this...

Jul 13, 2025
Modafinil and the productivity stack
Off Script · 9 min read

Modafinil and the productivity stack

Modafinil is the drug a lot of guys in tech, finance, and the productivity-bro corners of the internet are taking off-label, often without a prescription,…

Jul 10, 2025
AI girlfriends and male loneliness
Off Script · 9 min read

AI girlfriends and male loneliness

The number of guys using Replika, Character.ai, and the half-dozen newer AI companion apps has gone vertical in the last couple of years, and it’s showing up in…

Jul 8, 2025
Anxiety, Explained
Conditions · 10 min read

Anxiety, Explained

The public conversation about anxiety treatment and the clinical reality have drifted about as far apart as it's possible for two conversations on the…

Jul 7, 2025
Decline of male friendship after 40
Off Script · 9 min read

Decline of male friendship after 40

The data on this is what it sounds like.

Jul 5, 2025
Jonathan Haidt’s Anxious Generation: what’s right and overstated
Off Script · 9 min read

Jonathan Haidt’s Anxious Generation: what’s right and overstated

Haidt’s argument in The Anxious Generation is that smartphones and social media, hitting kids hard around 2012, broke teen mental health. The data on adolescent depression and anxiety…

Jul 3, 2025
Men’s Mental Health: Why Asking for Help Feels Impossible
Treatment · 12 min read

Men’s Mental Health: Why Asking for Help Feels Impossible

You already know something's off, and you've probably known for a while... months, maybe years.

Jul 1, 2025
PCP-psychiatrist handoff: when to switch
Off Script · 9 min read

PCP-psychiatrist handoff: when to switch

A lot of the psychiatric medication in this country is prescribed by primary care doctors, not psychiatrists.

Jun 30, 2025
Mental health records: background checks, gun ownership, licensure
Off Script · 9 min read

Mental health records: background checks, gun ownership, licensure

This is one of the questions that comes up in the first appointment most often, particularly from guys who own firearms or work in jobs with security…

Jun 27, 2025
Off-label prescribing: what it means
Off Script · 8 min read

Off-label prescribing: what it means

A huge percentage of what psychiatrists prescribe is off-label, and most patients have no idea, which is its own problem.

Jun 25, 2025
Low T vs. Depression: What You Actually Need to Know
Comparison · 10 min read

Low T vs. Depression: What You Actually Need to Know

Guys come in convinced they have low T when they're actually depressed, and other guys come in convinced they're depressed when their testosterone is in…

Jun 25, 2025
Long-term med use realities (20-year horizons)
Off Script · 9 min read

Long-term med use realities (20-year horizons)

The honest answer to "can I stay on this medication for the rest of my life" is: we don't fully know what happens at 30 or 40 years out, because…

Jun 22, 2025
Antidepressant withdrawal vs relapse: distinguishing
Off Script · 9 min read

Antidepressant withdrawal vs relapse: distinguishing

Guys stop their antidepressant, feel terrible a couple weeks later, assume the depression is back, restart the medication. Sometimes that's right.

Jun 20, 2025
Depression, Explained
Conditions · 13 min read

Depression, Explained

Depression ≠ sadness. Sadness has a thing it's about. Depression doesn't, it just follows you around like a Dementor sucking the light out of the world.

Jun 19, 2025
Why some clinicians won’t take insurance
Off Script · 8 min read

Why some clinicians won’t take insurance

I take insurance. A lot of psychiatrists in private practice don't.

Jun 17, 2025
PHP vs IOP vs Outpatient
Treatment · 8 min read

PHP vs IOP vs Outpatient

These three terms get used like everybody knows what they mean and most patients don't, so they end up in the wrong level of care.

Jun 14, 2025
Freedom Costs Blood. Mental Health Costs Choices.
Off Script · 6 min read

Freedom Costs Blood. Mental Health Costs Choices.

Freedom isn’t free. Neither is good mental health.

Jun 13, 2025
Zoloft
Medications · 9 min read

Zoloft

Zoloft is the drug I prescribe more than anything else, and the one patients ask the most questions about before they're willing to swallow the first pill.

Jun 13, 2025
Psychiatric hospitalization: what to expect
Treatment · 7 min read

Psychiatric hospitalization: what to expect

Most people who get hospitalized for a psychiatric reason have never been inside one and have no idea what's about to happen, which makes a scary thing…

Jun 12, 2025
ADHD in Adults Isn’t About Being Hyper
Conditions · 9 min read

ADHD in Adults Isn’t About Being Hyper

Most people picture ADHD as a kid bouncing off the walls, can't sit still, disruptive in class. That's one version of it, mostly in children.

Jun 12, 2025
The Story I’m Telling Myself Is…
Off Script · 6 min read

The Story I’m Telling Myself Is…

Most people don't get taken out by facts first. They get taken out by what the facts start to mean. You send a text and don't hear back.

Jun 11, 2025
Trintellix (Vortioxetine)
Medications · 11 min read

Trintellix (Vortioxetine)

Trintellix is the antidepressant pharma reps spent a decade trying to make happen.

Jun 9, 2025
CBT-I deep dive (beyond the mention)
Treatment · 8 min read

CBT-I deep dive (beyond the mention)

CBT-I (cognitive behavioral therapy for insomnia, the structured-protocol kind that actually has a syllabus, not the talk-about-your-sleep-feelings kind)…

Jun 9, 2025
Expectations Hurt Us More Than People Do
Off Script · 6 min read

Expectations Hurt Us More Than People Do

A lot of disappointment starts long before anyone actually does anything wrong. It starts in the quiet little contract we made in our own head.

Jun 8, 2025
Why Men Avoid Therapy
Treatment · 8 min read

Why Men Avoid Therapy

Men kill themselves at roughly four times the rate women do in the US, that gap has held year after year, the pandemic didn't close it, the recession…

Jun 7, 2025