“Men’s Mental Health: Redefining Strength in a Changing World.” Men die by suicide at nearly 4x the rate of women We need to stop missing it 🔗 www.psychiatrictimes.com/view/mens-me... #MensMentalHealth #Psychiatry #MentalHealth

A lot of “treatment-resistant depression” is just missed bipolar disorder #Antidepressants keep failing Everyone blames the depression Before calling it TRD, rule out bipolar disorder Wrong diagnosis ≠ treatment resistance #Psychiatry #BipolarDisorder #Depression #MentalHealth #mentalhealthmatters

A lot of “treatment-resistant depression” isn’t true treatment resistance

Too many clinicians know how to start psych meds Not enough know when to stop them

Forget “own the first 10 minutes.” I try to own the first 30 That’s where the shift happens If people want it, I’ll do a part 2 on bedtime routines #MentalHealth #Psychiatry #LifestyleMedicine #ShrinksInSneakers

Happy #MatchDay2026! 🎉 First a thank you to every #Medicalstudent I worked with this year. You challenge me, push me to grow, and make me a better #doctor. We don't say that enough Congratulations to all who matched. See you in July. 🩺 #Medical #FuturePhysicians #medicalschool

Happy #MatchDay2026! 🎉 First a thank you to every #Medicalstudent I worked with this year. You challenge me, push me to grow, and make me a better #doctor. We don't say that enough Congratulations to all who matched. See you in July. 🩺 #Medicalstudents #FuturePhysicians #medicalschool

We talk a lot about #postpartum #depression and we should But one of the biggest clinical mistakes is failing to distinguish it from postpartum blues or missing signs of postpartum psychosis #Psychiatry is full of nuance. This is one of those moments where nuance matters #womensmentalhealth

Not every postpartum mood change is postpartum depression #psychiatry #depression #Anxiety #postpartum #babyblues #mentalhealth This video is for education only and is not medical advice.

We talk a lot about postpartum #depression, and we should But #postpartum psychosis is the diagnosis you cannot afford to miss #psychiatry #mentalhealth #mentalhealthmatters

#FDA update on #leucovorin It was approved for a rare genetic disorder that impairs folate delivery to the brain not #autism ✔️ Best signal → language improvements ✔️ Some effect → social communication ✔️ Biggest responders → abnormal folate metabolism Evidence > hype #mentalhealth #ASD #medication

pubmed.ncbi.nlm.nih.gov/41785480/ The first FMT RCT in bipolar depression was But it failed on the primary outcome for depressive symptoms My take? The hype is ahead of the evidence but these may become useful adjuncts #psychiatry #probiotics #Gutbrainaxis #depression #bipolar

Some of you are still mentally living in a courtroom Rumination is not growth Self-punishment is not healing Pain on repeat is still pain At some point you have to say: “This thought is no longer useful. I’m not feeding it anymore” #psychiatry #mentalhealth #MedX #psychology #therapy

🚨 New in @PsychTimes: Ketogenic Diet and Schizophrenia: Promising Metabolic Therapy, Not a Cure 🧠🥑 www.psychiatrictimes.com/view/ketogen...

FDA update on leucovorin It was approved for a rare genetic disorder that impairs folate delivery to the brain not autism Important reminder: Evidence > hype 👟🧠 #Psychiatry #ShrinksInSneakers #Autism #mentalhealth #ASD #psychiatrist

One of those weeks… Covering while a colleague Still, I wanted to shout out Psychiatric times for giving me a platform to write from my perspective on important topics Article catalog: www.psychiatrictimes.com/authors/garr... What topic should I cover next? #Psychiatry #MentalHealth #doctorlife

Patients don’t ask for “supplements.” They ask for hope that feels safer than medicine. My new Psychiatric Times article: Natural Products in Psychiatry: Evidence vs Hype www.psychiatrictimes.com/view/natural... #Psychiatry #MentalHealth #Supplements #mentalhealthmatters #psychiatrist

KT-110 is a mechanism-driven combo for severe AUD turn down the noradrenergic “craving gas” + strengthen serotonergic “impulse brakes.” Phase 2 RCT (n=154, 12 wks) ↓ total alcohol consumption vs placebo Not hype signal worth watching #psychiatry #mentalhealth #alcohol #addiction #AUD

PGx testing myth: “It’ll tell us the perfect antidepressant.” 🧬💊 Reality: APA’s updated review says evidence still doesn’t support current combinatorial PGx tools for med selection in MDD Precision starts with diagnosis + dose/duration + measurement-based care #psychiatry #mentalhealth #depression

The “board-certified docs don’t do holistic care” take is just wrong Lifestyle medicine matters: sleep, nutrition, exercise, metabolic health, connection. But some people still have severe depression/OCD/bipolar/psychosis despite doing everything right. #psychiatry #MentalHealth #holistic #lifestyle

Modern society rewards the “work version” of you But the real question is: who are you when no one is watching? the real you is who you are in private when the audience disappears So… who are you? What would you do if survival wasn’t the driver? #mentalhealth #psychiatry #doctor #therapy

For YEARS we’ve treated this like a “clinical vibe” choice Now we’ve got head-to-head data Quetiapine vs Lithium augmentation ✅ Quetiapine → greater reduction in depressive symptoms ⏳ No difference in discontinuation 💸 Quetiapine more cost-effective #psychiatry #psychiatrist #mentalhealth

Your social media feed has one message: You are not enough. It’s focused on lack But here’s the truth: More won’t make you happy It will just make someone else rich Clarity about your values > chasing someone else’s Let what doesn’t matter… not matter #selfhelp #mentalhealth #psychiatry #marketing

It’s National Eating Disorders Awareness Week tips: • AN: olanzapine can ↑ weight, but core ED symptom • AN + depression: treat when clinically significant • BN: fluoxetine 60 mg > 20 mg • BED: lisdexamfetamine; topiramate has RCT support #mentalhealth #eatingdisorders #psychiatry #anorexia

Psilocybin for TRD: Phase 3 update 🧠🍄 Real signal just don’t let the hype do your thinking

Antipsychotic use in older adults is rising and the “who’s prescribing” is shifting. JAMA Psych: • 2.67/100 (2015) → 4.05/100 (2024) • Long-term use increasing too • Psychiatrist involvement 30% → 20% #Mentalhealth #psychiatry #psychiatrist #antipsychoatics #geriatrics

Geri psych pearl: many “aging problems” are drug-induced. 4 events to watch: QTc prolongation Anticholinergic burden Benadryl For Sleep Orthostasis #psychiatrist #MentalHealthAwareness #MentalHealthMatters #psychiatry #doctor #medical #geriatrics

The biggest danger is often the med list, not the diagnosis Quick screen in every 65+ pt: ✅ Count CNS meds (if ≥3, pause) 🚩 Red flag: benzo + opioid → additive sedation/respiratory depression risk 🎯 One change at a time + patient education #mentalhealth #depression #psychiatry #geriatrics #benzos

We’re not “moving into” geriatric psychiatry 61.2M Americans are 65+ By 2030: ~71M (≈1 in 5) ~1 in 5 older adults have significant MH/SUD needs <1,400 geriatric psychiatrists to cover it So PCPs + general psych are carrying the load #psychiatry #mentalhealth #medicalcare #geriatricpsych #geriatrics

Probiotics for Major Depressive Disorder: promising… not magic🧠🦠 Some RCTs with multi-strain probiotics show symptom reductions vs placebo in MDD Your experience helpful or hype? 👇 Educational only. Views my own #psychiatry #mentalhealth #depression #probiotics #metablichealth #depressiontreatment

The supplement industry makes ~$200B/year Most products were never FDA-approved Yet patients trust them more than prescription meds Some supplements work Many don’t Natural ≠ safe Here’s the unfiltered 60-second breakdown 👇 #psychiatry #evidencebased #mentalhealth #supplements #psychiatryunfiltered

Valentine’s Day isn’t romantic for everyone. For many, it’s grief + loneliness on steroids

New JAMA cohort analysis found caffeinated coffee + tea were associated with lower dementia risk observational ≠ causation Real brain health = sleep + BP/DM control + exercise + hearing + less smoking/alcohol + social connection. #psychiatry #coffee #tea #dementia #mentalhealth #brainhealth

Silver lining of politicized health debates: lifestyle medicine finally has a platform. Hopeful we’ll get funding for bigger studies which diets for which people Until then: don’t oversell early data #Mentalhealth #diet #exercise #ketodiet #psychiatry

Keto for TRD:🥑🧠 JAMA Psychiatry RCT : keto control Both improved fast At 6 wks: keto slightly better: PHQ-9 diff −2.18 By 12 wks: not significant Clinical take: ✅ reasonable adjunct for selected 🚫 not a cure / not “replace meds.” #Psychiatry #MedTwitter #MedX #mentalhealth #ketodiet #keto

A full life requires the ability to love, work, and play. We obsess over the first two. Play is what quietly disappears. #MentalHealthMatters #MentalHealthAwareness #MentalWellness

What if it doesn’t work? A patient asked me this about ECT My answer: we’ll cross that bridge if we get there Worrying about an unpredictable future steals energy from recovery happening right now This moment is all you have #MentalHealth #Psychiatry #Recovery

Is keto a cure for schizophrenia? No, and the science doesn’t support that claim. ✔️ Improves metabolic health ✔️ May help as an adjunct ❌ No evidence of cure ❌ No med-free remission Hope is good. Hype isn’t. 🎥 60-second breakdown below #Psychiatry #Schizophrenia #NutritionalPsychiatry #ketodiet #keto

A full life requires the ability to love, work, and play. We obsess over the first two Play is what quietly disappears People who play well tend to live and function better So here’s the question: What do you do purely for fun? #mentalhealth #psychiatry #doctorlife #stressmanagement #therapy

Agitation isn’t a sedation problem. It’s usually an untreated illness problem. De-escalation works best when patients have: • choice • dignity • meds that treat the cause not just behavior #psychiatry #mentalhealth #doctor #agitation #inpatientpsych #psych #mentalhealthmatters

Kicking off 2026 with my first research update in the February issue of The Report focused on antipsychotic-induced weight gain Independent. Evidence-based. No industry influence. This is how we move patient care forward. @chrisaikenmd.bsky.social #psychiatry #mentalhealth #schizophrenia

• Slow taper + therapy = same relapse risk as staying on antidepressants • Fast taper w/o support = relapse rates ≈ cold turkey • 1 relapse prevented for every 5 patients with supported tapering How you stop matters more than whether you stop. #mentalhealth #antidepressants #depression #psychiatry

Depression+ MRI showing white matter hyperintensities • Poor SSRI response • Start with vascular risk control • TMS & tDCS show promise • ECT still works even with vascular burden Different disease. Different strategy. #Psychiatry #MedX #MedTwitter #mentalhealthtips #mentalhealth #depression

Violence in psychiatry is not “part of the job.” In Florida, licensed therapist Rebecca White was murdered by a former client during an evening session www.psychiatrictimes.com/view/violenc... #Psychiatry #HealthcareViolence #ClinicianSafety @apapsychiatric.bsky.social

Violence in inpatient psychiatry is not “just part of the job.” I break down the data, my own experiences, and the urgent need for real reform. 👇 Read & RT to push this into the conversation: www.psychiatrictimes.com/view/violenc... #psychiatry #healthcareviolence #mentalhealth #psychiatrist #doctor

Antidepressants “not working”? • Alcohol even moderate—can kill antidepressant response • Daily cannabis = worse depression outcomes • Schedule III ≠ medical endorsement • Real risks: psychosis + addiction Treatment failure isn’t always the med. #Psychiatry #mentalhealth #depression #antidepressants

Early inpatient lesson: Not every “almost manic” patient has #bipolar disorder. Some have hyperthymic temperament a stable, lifelong elevation in energy, mood, and drive. High functioning. Low sleep. Creative. Risk-tolerant. Often misdiagnosed → mistreated. #Psychiatry #depression #mentalhealth

We were seeing progress on overdose deaths and engagement in treatment. Now that momentum is at risk If we want the U.S. to be the gold standard in addiction & mental health care, now is the time to invest more, not less Lives are on the line #MentalHealth #Addiction #psychiatry #medicine #medical

340 million antidepressant prescriptions is too many. I agree. But the problem isn’t that antidepressants “don’t work.” It’s how we diagnose depression. 🧵

The headline is coming: “Exercise is as effective as antidepressants.” Depression isn’t one disease. Treatment isn’t a zero-sum game. Personalized care > ideology. #PsychiatryUnfiltered #ShrinksInSneakers #depression #depressiontreatment #therapy #exercise #lifestylemedicine #medical #psychiatry