Newest articles
Every article in one chronological feed, newest first. Showing 217-252 of 302 posts.
Couples Therapy for substance use
If one partner has a drinking or drug problem and they're in a relationship, the partner is part of the treatment whether anybody signs them up for it or…
Jun 6, 2025Group Therapy: what actually happens in the room
Group therapy is the treatment I refer to most often and the one patients fight me hardest on. The fight is almost always the same: I don’t want…
Jun 4, 2025
Internal Family Systems (IFS)
IFS (internal family systems, the therapy model that asks the patient to relate to different aspects of himself as if they were distinct internal parts…
Jun 1, 2025
Addiction, Explained
Addiction is what happens when the brain's reward wiring gets dragged hard in one direction.
May 31, 2025Acceptance and Commitment Therapy (ACT)
ACT (acceptance and commitment therapy, a “third-wave” behavioral therapy that grew up out of the CBT lineage in the late 80s and 90s) has built itself into a…
May 30, 2025
Hair loss: what works, what’s hype
Finasteride, dutasteride, minoxidil, PRP, microneedling, transplants. The math of male pattern hair loss, the meds that bend it, and the things sold to you that mostly don't.
May 29, 2025
Prolonged Exposure for PTSD
Prolonged exposure is one of the two gold-standard treatments for PTSD (post-traumatic stress disorder, the trauma-spectrum condition that follows certain…
May 27, 2025
Pristiq (Desvenlafaxine)
Pristiq is what happens when you take Effexor, skip a metabolic step, and sell it as a new drug. That's not a dig, that's the actual mechanism.
May 27, 2025
Self-Harm in Adult Men
Self-harm in adult men is a thing we don’t talk about much, because the cultural picture of self-harm is a teenage girl with a razor and her arms,…
May 24, 2025
Body Dysmorphic Disorder in men
Body dysmorphic disorder in men is more common than most clinicians catch, and it shows up differently from how the textbook describes it because the…
May 22, 2025
The Difference Between Depression and Just Being Sad
Not every bad day is depression and not every hard week means you need medication.
May 21, 2025
Alcohol Use Disorder diagnostic criteria
Most guys who have alcohol use disorder don’t think they have it, because they think alcoholism means falling-down-drunk and missing work, and they’re not doing that. They’re functional,…
May 19, 2025
Sleep, Stress, and Your Brain
Sleep deprivation isn't something you can think your way out of. Chronic stress and five hour nights make everything else on your psych chart worse.
May 18, 2025
Complicated Grief / Prolonged Grief Disorder
Prolonged grief disorder made it into the DSM-5-TR (the most current version of the psychiatric diagnostic manual) in 2022, and the diagnosis is useful…
May 17, 2025
Burnout (ICD-11)
Burnout picked up an actual ICD-11 (the international diagnostic codebook used outside the U.S.) designation in 2019, and the conversation since then has…
May 14, 2025
You mad, bro?
A lot of guys think anger is the problem because anger is the part everybody sees...
May 11, 2025
PMDD (for the partners who live with it)
This one's for the husbands, because most of the guys who come in with a wife who has PMDD (premenstrual dysphoric disorder, the severe, predictable mood…
May 11, 2025
Weight Management
The weight management conversation got rewritten in the last three years and most people still haven't caught up.
May 9, 2025
Persistent Depressive Disorder (Dysthymia)
Persistent depressive disorder, what used to be called dysthymia, is the diagnosis for guys who've been depressed for so long they don't remember what…
May 9, 2025
Mood Disorders Treatment
"Mood disorder" is a category, not a diagnosis.
May 7, 2025
Why “Rock Bottom” Is Bullshit
Rock bottom is bullshit.
May 6, 2025
Bipolar I vs Bipolar II vs Cyclothymia
These three diagnoses get confused constantly, including by clinicians, and the difference matters because the treatments diverge in important ways.
May 6, 2025
Loneliness as diagnosable risk factor
Loneliness isn't a DSM diagnosis and nobody's going to pretend it is, but it functions like one in terms of risk, and the data on it for middle-aged men…
May 3, 2025
Narcissist diagnosis misused: clinical reality
The word narcissist has been so thoroughly hijacked by TikTok and pop psychology that you can't use it in a clinical conversation anymore without first…
May 1, 2025
The Real Reason You Keep Self-Sabotaging
People sabotage themselves constantly and they can't tell you why. Get within sight of something working out and they blow it up.
Apr 30, 2025
Sleep apnea + depression in middle-aged men
If you’re a guy in your forties or fifties who feels depressed, exhausted, foggy, and irritable, and the SSRI (selective serotonin reuptake inhibitor, the most common antidepressant class,…
Apr 28, 2025
Melatonin
Melatonin is one of the most misunderstood things sold in a drugstore, and the misunderstanding got there with help from the supplement industry, the…
Apr 26, 2025
Cannabis-induced psychosis (2025 evidence)
The data on cannabis and psychosis is no longer ambiguous, and saying so out loud is going to lose some readers in the first paragraph.
Apr 26, 2025
How to Know If Your Provider Is Actually Helping
Most people who fire their psychiatrist wait about a year too long to do it.
Apr 25, 2025
Caplyta (Lumateperone)
Caplyta is the antipsychotic that came out in 2019 and made a bunch of psychiatrists do a double-take at the receptor pharmacology, then another…
Apr 23, 2025
Post-COVID brain fog as a diagnostic entity
Post-COVID brain fog is real and we still don't have a clean blood test for it, which means most of what gets done with these patients is ruling out the…
Apr 23, 2025
Adult ADHD diagnostic surge
The number of adults walking into psychiatric offices in 2026 asking to be evaluated for ADHD is something nobody saw coming on this scale.
Apr 20, 2025
Stimulants and cardiovascular safety in adults
For decades the conversation about stimulant cardiovascular risk was muddled, with primary care doctors being more cautious than the data warranted and psychiatrists being maybe a little too…
Apr 18, 2025
The Playlist Changed. So Did We.
There's probably a song you still know by heart that taught you something about love before you were old enough to question it. Not in some dramatic way.
Apr 16, 2025
Lurasidone (Latuda)
Lurasidone is the drug you reach for when somebody walks in with bipolar depression and a body that's already been wrecked by Seroquel.
Apr 16, 2025
Gabapentin
Gabapentin is the drug American psychiatry is in a quiet relationship with that nobody really wants to talk about publicly. It's prescribed constantly.
Apr 15, 2025