How does image guided TMS stack up against the current method?

Today, Margaret and Preston return to the topic of internet and screen use, assisted by the framework by the AAP of the “Five C’s of Media Use”. They compare different ages and best practices for screen use, then take it all the way to recommendations for adults! Resources referenced below, plus some additional ones from Margaret. Five C’s of Media Use: https://www.aap.org/en/patient-care/media-and-children/center-of-excellence-on-social-media-and-youth-mental-health/5-cs-quick-guide/ Toddlers 5Cs: https://downloads.aap.org/AAP/PDF/CoE_5Cs_Toddlers_Final.pdf Young Teens 5Cs: https://downloads.aap.org/AAP/PDF/CoE_5Cs_Young_Teens_Final.pdf Older teens 5Cs: https://downloads.aap.org/AAP/PDF/CoE_5Cs_Older_Teens_Final.pdf Internet Addiction: https://pmc.ncbi.nlm.nih.gov/articles/PMC3480687/pdf/CPSR-8-292.pdf PMID scale:https://pmc.ncbi.nlm.nih.gov/articles/PMC4035908/ Social comparison and problematic social media use: Relationships between five different social media platforms and three different social comparison constructs: https://www.sciencedirect.com/science/article/abs/pii/S0191886922003701 Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

 In today’s episode Margaret and I are joined by Dr. Singh Alvarado a PhD neuroscientist to talk about the mysteries and beautiful applications of optogenetics. We discuss how the science came to be, why it won the nobel prize and what weird sci-fi level things it could be used for in the future. Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

In this solo episode with Preston we (me) discuss the neuroscience concept of metacognition and how it may apply to some of our conceptualization of current psych illnesses, along with some loose ruminating of course. For a more comprehensive and scientific review, look here!https://www.nature.com/articles/s41583-026-01081-x Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

In today's episode we take a look back towards the history of psychiatry and read from the publication “The American Journal of Insanity.” This is the journal that predates the American Journal of Psychiatry (the name was changed in 1921). While some of the terms are outdated, the treatment principles and pathology remain eerily similar. It really shows us how far we’ve come and how little has changed in the last 150 years. Listen along to the articles and let us know what you think! Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, Margaret and Preston talk about Margaret’s experience halfway into child and adolescent psychiatry fellowship. Margaret discusses the general requirements or parts in child training, discerning child training indications versus other training paths, and how her child training impacts her care for adult psychiatry patients.  Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode we're doing another journal club, this time reviewing the first randomized clinical trial comparing image-guided TMS to the traditional method using scalp targeting for depression. We walk through how TMS works, why targeting matters, what the study found at one month, and where the limitations are before this becomes standard of care. Find the paper here: https://pubmed.ncbi.nlm.nih.gov/42340706/ Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

In today’s episode, Preston and Margaret discuss the psychotherapy paper The Theory of the Crunch, by Paul Libby, a psychoanalyst. In this episode and in the paper, the idea of creating a containing environment, repetition compulsion, and ways of navigating difficult interpersonal dynamics are discussed. In this episode, a more expansive, compassionate frame will be introduced both for the therapist and patient to understand how to make it through confusing and sometimes painful clinical work.  Paper: The Theory of the Crunch by Paul Libby Russel: https://www.proquest.com/openview/c5d466aa2f6d7bcd126f98b6591861f7/1?pq-origsite=gscholar&cbl=32944 Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, Margaret and I take on the en vogue topic of GLP-1s. They have been utilized for T2DM for several years and just recently took center stage in the zeitgeist for weight loss (medically indicated or otherwise). Today, we will break down possible risks to mental health in patients using these medications and, on the flipside, potential areas where we could possibly use GLP-1s  primarily to treat mental illness.  Paper used: Sa B, Maristany A, Subramaniam A, et al. Psychiatric effects of GLP-1 receptor agonists: A systematic review of emerging evidence. Diabetes Obes Metab. 2026;28(1):50-59. doi:10.1111/dom.70198 Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, Margaret and Preston present how two psychiatrists think about prescribing medications for depression. Using different common clinical scenarios, they discuss standard clinical guidelines, navigating weight gain and loss with SSRIs, augmentation of SSRI’s, and sexual side effects.  See notes below for recommendations in the episode.  VA/DoD MDD treatment guidelines, 2022 https://www.healthquality.va.gov/guidelines/MH/mdd/ American College of Physicians Depression  https://www.acpjournals.org/doi/10.7326/M22-2056 Weight Change and Antidepressants https://pubmed.ncbi.nlm.nih.gov/33022115/ Pregnancy/Perinatal/Breastfeeding https://womensmentalhealth.org/specialty-clinics/psychiatric-disorders-during-pregnancy/ Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

The Greeks described two kinds of madness, and both are fun to talk about on our pod. Inspired by the recent hullabaloo around The Odyssey, we are going to be breaking down the DSM-V diagnoses we see in the series and run through the historical roots and the stories of what we see today in mental health. Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices