Dr. G
@shrinksinsneakers.bsky.social
I’m on a mission to make psychiatry accessible and understandable for everyone. Through this website I will be translating the complex science of psychiatry into actionable insights.
Families sometimes tell me I’m a “bad doctor” because a commercial pharmacogenomic panel said their loved one’s meds are “wrong.”
November 21, 2025 at 4:14 PM
Families sometimes tell me I’m a “bad doctor” because a commercial pharmacogenomic panel said their loved one’s meds are “wrong.”
Lithium blood levels: evidence or tradition?
We talk about lithium like it has one “magic number”… but the data tells a different story.
Here’s what the evidence actually supports 👇
We talk about lithium like it has one “magic number”… but the data tells a different story.
Here’s what the evidence actually supports 👇
November 21, 2025 at 1:18 AM
Lithium blood levels: evidence or tradition?
We talk about lithium like it has one “magic number”… but the data tells a different story.
Here’s what the evidence actually supports 👇
We talk about lithium like it has one “magic number”… but the data tells a different story.
Here’s what the evidence actually supports 👇
Depakote Levels: Science or Just Vibes?
We quote valproate “therapeutic ranges” (50–100 or 50–125) like they’re sacred.
But the evidence is very different depending on what you’re treating.
We quote valproate “therapeutic ranges” (50–100 or 50–125) like they’re sacred.
But the evidence is very different depending on what you’re treating.
November 19, 2025 at 4:20 PM
Depakote Levels: Science or Just Vibes?
We quote valproate “therapeutic ranges” (50–100 or 50–125) like they’re sacred.
But the evidence is very different depending on what you’re treating.
We quote valproate “therapeutic ranges” (50–100 or 50–125) like they’re sacred.
But the evidence is very different depending on what you’re treating.
NJPA FALL CONFERENCE
THE FUTURE OF PSYCHIATRY
Shrinks in Sneakers Edition
🔥 AI | Lifestyle | Neuromodulation | Mindfulness 🔥
THE FUTURE OF PSYCHIATRY
Shrinks in Sneakers Edition
🔥 AI | Lifestyle | Neuromodulation | Mindfulness 🔥
November 18, 2025 at 6:38 PM
NJPA FALL CONFERENCE
THE FUTURE OF PSYCHIATRY
Shrinks in Sneakers Edition
🔥 AI | Lifestyle | Neuromodulation | Mindfulness 🔥
THE FUTURE OF PSYCHIATRY
Shrinks in Sneakers Edition
🔥 AI | Lifestyle | Neuromodulation | Mindfulness 🔥
70% of patients hide suicidal thoughts.
Here’s why that matters.
Here’s why that matters.
November 17, 2025 at 10:40 PM
70% of patients hide suicidal thoughts.
Here’s why that matters.
Here’s why that matters.
TMS vs. Meds is the wrong question. Ask: what stage is the patient in?
After 2+ adequate meds, remission odds for another med are usually ~10–20%. rTMS in TRD delivers ~50–60% response and ~25–35% remission, with fewer systemic AEs. Sequence smarter
#TMS #TRD #Psychiatry #depression #neuro #meds
After 2+ adequate meds, remission odds for another med are usually ~10–20%. rTMS in TRD delivers ~50–60% response and ~25–35% remission, with fewer systemic AEs. Sequence smarter
#TMS #TRD #Psychiatry #depression #neuro #meds
November 15, 2025 at 5:50 PM
TMS vs. Meds is the wrong question. Ask: what stage is the patient in?
After 2+ adequate meds, remission odds for another med are usually ~10–20%. rTMS in TRD delivers ~50–60% response and ~25–35% remission, with fewer systemic AEs. Sequence smarter
#TMS #TRD #Psychiatry #depression #neuro #meds
After 2+ adequate meds, remission odds for another med are usually ~10–20%. rTMS in TRD delivers ~50–60% response and ~25–35% remission, with fewer systemic AEs. Sequence smarter
#TMS #TRD #Psychiatry #depression #neuro #meds
Where did “mood stabilizer” come from?
It wasn’t always part of psychiatry’s language
But the term was never clearly defined just catchy
#Psychiatry #BipolarDisorder #Lithium #ShrinksInSneakers #bipolar #psychiatrist
It wasn’t always part of psychiatry’s language
But the term was never clearly defined just catchy
#Psychiatry #BipolarDisorder #Lithium #ShrinksInSneakers #bipolar #psychiatrist
November 13, 2025 at 9:23 PM
Where did “mood stabilizer” come from?
It wasn’t always part of psychiatry’s language
But the term was never clearly defined just catchy
#Psychiatry #BipolarDisorder #Lithium #ShrinksInSneakers #bipolar #psychiatrist
It wasn’t always part of psychiatry’s language
But the term was never clearly defined just catchy
#Psychiatry #BipolarDisorder #Lithium #ShrinksInSneakers #bipolar #psychiatrist
Melatonin isn’t the harmless “natural sleep aid” we’ve been sold.
A new analysis (130K+ patients) found long-term users had:
⚠️ 90% ↑ risk of heart failure
⚠️ 3.5× ↑ hospitalizations
⚠️ Nearly 2× ↑ mortality
youtu.be/IhpV5zD7TL4
#Melatonin #Insomnia #Sleep #Psychiatry #CBTI #ShrinksInSneakers #sleepmed
A new analysis (130K+ patients) found long-term users had:
⚠️ 90% ↑ risk of heart failure
⚠️ 3.5× ↑ hospitalizations
⚠️ Nearly 2× ↑ mortality
youtu.be/IhpV5zD7TL4
#Melatonin #Insomnia #Sleep #Psychiatry #CBTI #ShrinksInSneakers #sleepmed
Melatonin and Insomnia: Why “Natural” Doesn’t Always Mean Safe
YouTube video by Shrinks In Sneakers
youtu.be
November 13, 2025 at 9:20 PM
Melatonin isn’t the harmless “natural sleep aid” we’ve been sold.
A new analysis (130K+ patients) found long-term users had:
⚠️ 90% ↑ risk of heart failure
⚠️ 3.5× ↑ hospitalizations
⚠️ Nearly 2× ↑ mortality
youtu.be/IhpV5zD7TL4
#Melatonin #Insomnia #Sleep #Psychiatry #CBTI #ShrinksInSneakers #sleepmed
A new analysis (130K+ patients) found long-term users had:
⚠️ 90% ↑ risk of heart failure
⚠️ 3.5× ↑ hospitalizations
⚠️ Nearly 2× ↑ mortality
youtu.be/IhpV5zD7TL4
#Melatonin #Insomnia #Sleep #Psychiatry #CBTI #ShrinksInSneakers #sleepmed
Every month I read one book
This month: The Body Keeps the Score
The book validates survivors and highlights what many of us know meds play a minimal role in healing.
True trauma work is holistic: EMDR, neurofeedback, body-based therapy. Access remains the challenge
#Psychiatry #Trauma #PTSD
This month: The Body Keeps the Score
The book validates survivors and highlights what many of us know meds play a minimal role in healing.
True trauma work is holistic: EMDR, neurofeedback, body-based therapy. Access remains the challenge
#Psychiatry #Trauma #PTSD
November 11, 2025 at 9:00 PM
Every month I read one book
This month: The Body Keeps the Score
The book validates survivors and highlights what many of us know meds play a minimal role in healing.
True trauma work is holistic: EMDR, neurofeedback, body-based therapy. Access remains the challenge
#Psychiatry #Trauma #PTSD
This month: The Body Keeps the Score
The book validates survivors and highlights what many of us know meds play a minimal role in healing.
True trauma work is holistic: EMDR, neurofeedback, body-based therapy. Access remains the challenge
#Psychiatry #Trauma #PTSD
Melatonin might not be as harmless as we think.
A new @American_Heart study found people who took melatonin for ≥1 year had:
⬆️ 90% higher risk of heart failure
⬆️ 3.5x higher risk of heart-failure hospitalization
⬆️ Nearly 2x higher risk of death
A new @American_Heart study found people who took melatonin for ≥1 year had:
⬆️ 90% higher risk of heart failure
⬆️ 3.5x higher risk of heart-failure hospitalization
⬆️ Nearly 2x higher risk of death
November 7, 2025 at 8:12 PM
Melatonin might not be as harmless as we think.
A new @American_Heart study found people who took melatonin for ≥1 year had:
⬆️ 90% higher risk of heart failure
⬆️ 3.5x higher risk of heart-failure hospitalization
⬆️ Nearly 2x higher risk of death
A new @American_Heart study found people who took melatonin for ≥1 year had:
⬆️ 90% higher risk of heart failure
⬆️ 3.5x higher risk of heart-failure hospitalization
⬆️ Nearly 2x higher risk of death
There’s a rise in people saying AI told them to kill themselves
Let’s be honest AI is a tool, not a therapist
It can’t replace empathy, connection, or care
If you’re in crisis, please reach out to a human
📞 Call or text 988 Crisis Lifeline
#Mentalhealth #MentalHealthMatters #AI #AIethics #psychiatry
Let’s be honest AI is a tool, not a therapist
It can’t replace empathy, connection, or care
If you’re in crisis, please reach out to a human
📞 Call or text 988 Crisis Lifeline
#Mentalhealth #MentalHealthMatters #AI #AIethics #psychiatry
November 7, 2025 at 6:30 PM
There’s a rise in people saying AI told them to kill themselves
Let’s be honest AI is a tool, not a therapist
It can’t replace empathy, connection, or care
If you’re in crisis, please reach out to a human
📞 Call or text 988 Crisis Lifeline
#Mentalhealth #MentalHealthMatters #AI #AIethics #psychiatry
Let’s be honest AI is a tool, not a therapist
It can’t replace empathy, connection, or care
If you’re in crisis, please reach out to a human
📞 Call or text 988 Crisis Lifeline
#Mentalhealth #MentalHealthMatters #AI #AIethics #psychiatry
Part of my 2025 goals was to re-engage in academic psychiatry the work that brings me real joy
I didn’t hit every goal, but I did take the AACP certification exam
Community mental health is where I learned who I am
#mentalhealth #psychiatry #community #psychiatrist #medical #AACP
I didn’t hit every goal, but I did take the AACP certification exam
Community mental health is where I learned who I am
#mentalhealth #psychiatry #community #psychiatrist #medical #AACP
November 6, 2025 at 2:55 PM
Part of my 2025 goals was to re-engage in academic psychiatry the work that brings me real joy
I didn’t hit every goal, but I did take the AACP certification exam
Community mental health is where I learned who I am
#mentalhealth #psychiatry #community #psychiatrist #medical #AACP
I didn’t hit every goal, but I did take the AACP certification exam
Community mental health is where I learned who I am
#mentalhealth #psychiatry #community #psychiatrist #medical #AACP
Doing the right thing when it’s risky that’s being a doctor
It’s easy to avoid clozapine or lithium when things look complicated. But medicine isn’t about doing what’s easy it’s about doing what’s right
That’s clinical courage
#Psychiatry #DoctorLife #ShrinksInSneakers #mentalhealth #clinical
It’s easy to avoid clozapine or lithium when things look complicated. But medicine isn’t about doing what’s easy it’s about doing what’s right
That’s clinical courage
#Psychiatry #DoctorLife #ShrinksInSneakers #mentalhealth #clinical
November 5, 2025 at 3:20 PM
Doing the right thing when it’s risky that’s being a doctor
It’s easy to avoid clozapine or lithium when things look complicated. But medicine isn’t about doing what’s easy it’s about doing what’s right
That’s clinical courage
#Psychiatry #DoctorLife #ShrinksInSneakers #mentalhealth #clinical
It’s easy to avoid clozapine or lithium when things look complicated. But medicine isn’t about doing what’s easy it’s about doing what’s right
That’s clinical courage
#Psychiatry #DoctorLife #ShrinksInSneakers #mentalhealth #clinical
GLP-1 meds are being hyped as the next big thing even in psychiatry
But are we repeating the same mistakes
Each promised a cure. Each had a cost we learned about too late
In medicine, when something seems too good to be true… it usually is
#GLP1 #Psychiatry #Medicine #ShrinksInSneakers #weightloss
But are we repeating the same mistakes
Each promised a cure. Each had a cost we learned about too late
In medicine, when something seems too good to be true… it usually is
#GLP1 #Psychiatry #Medicine #ShrinksInSneakers #weightloss
November 4, 2025 at 4:57 PM
GLP-1 meds are being hyped as the next big thing even in psychiatry
But are we repeating the same mistakes
Each promised a cure. Each had a cost we learned about too late
In medicine, when something seems too good to be true… it usually is
#GLP1 #Psychiatry #Medicine #ShrinksInSneakers #weightloss
But are we repeating the same mistakes
Each promised a cure. Each had a cost we learned about too late
In medicine, when something seems too good to be true… it usually is
#GLP1 #Psychiatry #Medicine #ShrinksInSneakers #weightloss
Daylight Savings Time can actually improve depression. ☀️
That extra morning light helps regulate circadian rhythm, boost serotonin, and lift mood.
I try to start my day with sunlight and a walk 😅
#ShrinksInSneakers #Depression #MentalHealth
That extra morning light helps regulate circadian rhythm, boost serotonin, and lift mood.
I try to start my day with sunlight and a walk 😅
#ShrinksInSneakers #Depression #MentalHealth
November 3, 2025 at 10:30 PM
Daylight Savings Time can actually improve depression. ☀️
That extra morning light helps regulate circadian rhythm, boost serotonin, and lift mood.
I try to start my day with sunlight and a walk 😅
#ShrinksInSneakers #Depression #MentalHealth
That extra morning light helps regulate circadian rhythm, boost serotonin, and lift mood.
I try to start my day with sunlight and a walk 😅
#ShrinksInSneakers #Depression #MentalHealth
Psychiatry is full of ghosts 👻
• The trauma we pretend isn’t there
• The memories that replay like cursed loops
• The defenses we build to survive
On Halloween, remember: not every haunting is supernatural🧠💀
#ShrinksInSneakers #Psychiatry #Halloween #MentalHealth
• The trauma we pretend isn’t there
• The memories that replay like cursed loops
• The defenses we build to survive
On Halloween, remember: not every haunting is supernatural🧠💀
#ShrinksInSneakers #Psychiatry #Halloween #MentalHealth
October 31, 2025 at 2:17 PM
Psychiatry is full of ghosts 👻
• The trauma we pretend isn’t there
• The memories that replay like cursed loops
• The defenses we build to survive
On Halloween, remember: not every haunting is supernatural🧠💀
#ShrinksInSneakers #Psychiatry #Halloween #MentalHealth
• The trauma we pretend isn’t there
• The memories that replay like cursed loops
• The defenses we build to survive
On Halloween, remember: not every haunting is supernatural🧠💀
#ShrinksInSneakers #Psychiatry #Halloween #MentalHealth
New RCT (KARMA-Dep 2) found no benefit of serial IV ketamine vs midazolam for inpatients w/ moderate–severe depression.
Maybe it’s not “does ketamine work?”
It’s “for whom and where?”
#ShrinksInSneakers #Psychiatry #Ketamine #ECT #Depression
Maybe it’s not “does ketamine work?”
It’s “for whom and where?”
#ShrinksInSneakers #Psychiatry #Ketamine #ECT #Depression
October 28, 2025 at 9:02 PM
New RCT (KARMA-Dep 2) found no benefit of serial IV ketamine vs midazolam for inpatients w/ moderate–severe depression.
Maybe it’s not “does ketamine work?”
It’s “for whom and where?”
#ShrinksInSneakers #Psychiatry #Ketamine #ECT #Depression
Maybe it’s not “does ketamine work?”
It’s “for whom and where?”
#ShrinksInSneakers #Psychiatry #Ketamine #ECT #Depression
New RCT (KARMA-Dep 2): 8 IV ketamine infusions = no better than midazolam for inpatient depression.
No gains in mood, cognition, or QoL.
Study highlights: unblinded raters (>90%), underpowered sample, high placebo expectancy.
When blinding holds, ketamine’s magic fades.
#Psychiatry #RCT #Depression
No gains in mood, cognition, or QoL.
Study highlights: unblinded raters (>90%), underpowered sample, high placebo expectancy.
When blinding holds, ketamine’s magic fades.
#Psychiatry #RCT #Depression
October 27, 2025 at 9:23 PM
New RCT (KARMA-Dep 2): 8 IV ketamine infusions = no better than midazolam for inpatient depression.
No gains in mood, cognition, or QoL.
Study highlights: unblinded raters (>90%), underpowered sample, high placebo expectancy.
When blinding holds, ketamine’s magic fades.
#Psychiatry #RCT #Depression
No gains in mood, cognition, or QoL.
Study highlights: unblinded raters (>90%), underpowered sample, high placebo expectancy.
When blinding holds, ketamine’s magic fades.
#Psychiatry #RCT #Depression
Have you ever wondered why trazodone is the go-to for insomnia in depression?
It’s not just about sleeping longer it’s about better sleep.
Trazodone boosts stage N3 (deep restorative sleep) the kind that leaves you feeling rested
#Psychiatry #SleepMedicine #Trazodone #Depression #ShrinksInSneaker
It’s not just about sleeping longer it’s about better sleep.
Trazodone boosts stage N3 (deep restorative sleep) the kind that leaves you feeling rested
#Psychiatry #SleepMedicine #Trazodone #Depression #ShrinksInSneaker
October 21, 2025 at 8:38 PM
Have you ever wondered why trazodone is the go-to for insomnia in depression?
It’s not just about sleeping longer it’s about better sleep.
Trazodone boosts stage N3 (deep restorative sleep) the kind that leaves you feeling rested
#Psychiatry #SleepMedicine #Trazodone #Depression #ShrinksInSneaker
It’s not just about sleeping longer it’s about better sleep.
Trazodone boosts stage N3 (deep restorative sleep) the kind that leaves you feeling rested
#Psychiatry #SleepMedicine #Trazodone #Depression #ShrinksInSneaker
What people get wrong about using prazosin 🧠💊
Prazosin is one of the few medications that consistently helps with PTSD-related nightmares and autonomic arousal from trauma but it’s also one of the most misused.
#Psychiatry #ShrinksInSneakers #PTSD #Sleep #Psychopharmacology #MentalHealth #Prazosin
Prazosin is one of the few medications that consistently helps with PTSD-related nightmares and autonomic arousal from trauma but it’s also one of the most misused.
#Psychiatry #ShrinksInSneakers #PTSD #Sleep #Psychopharmacology #MentalHealth #Prazosin
October 17, 2025 at 2:47 PM
What people get wrong about using prazosin 🧠💊
Prazosin is one of the few medications that consistently helps with PTSD-related nightmares and autonomic arousal from trauma but it’s also one of the most misused.
#Psychiatry #ShrinksInSneakers #PTSD #Sleep #Psychopharmacology #MentalHealth #Prazosin
Prazosin is one of the few medications that consistently helps with PTSD-related nightmares and autonomic arousal from trauma but it’s also one of the most misused.
#Psychiatry #ShrinksInSneakers #PTSD #Sleep #Psychopharmacology #MentalHealth #Prazosin
Elvin Semrad taught generations of psychiatrists that our job isn’t to remove pain, but to help people bear it.
He worked with the most psychotic patients and saw humanity where others saw illness.
That message still matters.
#Psychiatry #ShrinksInSneakers #therapy #mentalhealth #mentalhealthmatters
He worked with the most psychotic patients and saw humanity where others saw illness.
That message still matters.
#Psychiatry #ShrinksInSneakers #therapy #mentalhealth #mentalhealthmatters
October 16, 2025 at 4:37 PM
Elvin Semrad taught generations of psychiatrists that our job isn’t to remove pain, but to help people bear it.
He worked with the most psychotic patients and saw humanity where others saw illness.
That message still matters.
#Psychiatry #ShrinksInSneakers #therapy #mentalhealth #mentalhealthmatters
He worked with the most psychotic patients and saw humanity where others saw illness.
That message still matters.
#Psychiatry #ShrinksInSneakers #therapy #mentalhealth #mentalhealthmatters
🥼 The goal of a psychiatrist or therapist is different from other physicians
While most doctors aim to relieve pain and suffering, we aim to help people bear it and live with it
💡 That’s the paradox of healing in psychiatry
#Psychiatry #MentalHealth #Therapy #mentalhealthawareness
While most doctors aim to relieve pain and suffering, we aim to help people bear it and live with it
💡 That’s the paradox of healing in psychiatry
#Psychiatry #MentalHealth #Therapy #mentalhealthawareness
October 15, 2025 at 4:24 PM
🥼 The goal of a psychiatrist or therapist is different from other physicians
While most doctors aim to relieve pain and suffering, we aim to help people bear it and live with it
💡 That’s the paradox of healing in psychiatry
#Psychiatry #MentalHealth #Therapy #mentalhealthawareness
While most doctors aim to relieve pain and suffering, we aim to help people bear it and live with it
💡 That’s the paradox of healing in psychiatry
#Psychiatry #MentalHealth #Therapy #mentalhealthawareness
There’s one scenario where medication response really matters 👇
Start a patient on an antidepressant for depression → next visit they’re sleeping less, talking fast, launching a new business idea
It’s mania
#ShrinksInSneakers #Psychiatry #MentalHealth #BipolarDisorder #Antidepressants #bipolar
Start a patient on an antidepressant for depression → next visit they’re sleeping less, talking fast, launching a new business idea
It’s mania
#ShrinksInSneakers #Psychiatry #MentalHealth #BipolarDisorder #Antidepressants #bipolar
October 14, 2025 at 1:22 PM
There’s one scenario where medication response really matters 👇
Start a patient on an antidepressant for depression → next visit they’re sleeping less, talking fast, launching a new business idea
It’s mania
#ShrinksInSneakers #Psychiatry #MentalHealth #BipolarDisorder #Antidepressants #bipolar
Start a patient on an antidepressant for depression → next visit they’re sleeping less, talking fast, launching a new business idea
It’s mania
#ShrinksInSneakers #Psychiatry #MentalHealth #BipolarDisorder #Antidepressants #bipolar
Can medication response make a psychiatric diagnosis?
👉 Not really
Response ≠ diagnosis
Antipsychotics treat bipolar depression
Stimulants improve focus in anyone
We know drugs work symptomatically not necessarily why
#Psychiatry #MedEd #MentalHealth #mentalhealthmatters #medication #healthcare
👉 Not really
Response ≠ diagnosis
Antipsychotics treat bipolar depression
Stimulants improve focus in anyone
We know drugs work symptomatically not necessarily why
#Psychiatry #MedEd #MentalHealth #mentalhealthmatters #medication #healthcare
October 13, 2025 at 12:14 PM
Can medication response make a psychiatric diagnosis?
👉 Not really
Response ≠ diagnosis
Antipsychotics treat bipolar depression
Stimulants improve focus in anyone
We know drugs work symptomatically not necessarily why
#Psychiatry #MedEd #MentalHealth #mentalhealthmatters #medication #healthcare
👉 Not really
Response ≠ diagnosis
Antipsychotics treat bipolar depression
Stimulants improve focus in anyone
We know drugs work symptomatically not necessarily why
#Psychiatry #MedEd #MentalHealth #mentalhealthmatters #medication #healthcare
People think therapy is a gentle guide toward a clear goal.
It’s not.
Uncertainty is the process.
Wanting certainty kills the spontaneity
The best therapy sessions often start in the fog and that’s exactly where change begins.
#Psychiatry #Therapy #Psychotherapy #ShrinksInSneakers
It’s not.
Uncertainty is the process.
Wanting certainty kills the spontaneity
The best therapy sessions often start in the fog and that’s exactly where change begins.
#Psychiatry #Therapy #Psychotherapy #ShrinksInSneakers
October 11, 2025 at 3:44 PM
People think therapy is a gentle guide toward a clear goal.
It’s not.
Uncertainty is the process.
Wanting certainty kills the spontaneity
The best therapy sessions often start in the fog and that’s exactly where change begins.
#Psychiatry #Therapy #Psychotherapy #ShrinksInSneakers
It’s not.
Uncertainty is the process.
Wanting certainty kills the spontaneity
The best therapy sessions often start in the fog and that’s exactly where change begins.
#Psychiatry #Therapy #Psychotherapy #ShrinksInSneakers