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.
Inflammatory depression is real and it changes how antidepressants work
If your patient has a CRP > 3, here’s what the evidence actually says
If your patient has a CRP > 3, here’s what the evidence actually says
December 11, 2025 at 7:56 PM
Inflammatory depression is real and it changes how antidepressants work
If your patient has a CRP > 3, here’s what the evidence actually says
If your patient has a CRP > 3, here’s what the evidence actually says
My book pick this month is a classic I still recommend to patients:
It’s old-school CBT, but the skills are timeless: challenging distortions, building healthier habits
Not for everyone but extremely practical for many
#PsychiatryUnfiltered #ShrinksInSneakers #CBT #therapy #psychiatry #mentalhealth
It’s old-school CBT, but the skills are timeless: challenging distortions, building healthier habits
Not for everyone but extremely practical for many
#PsychiatryUnfiltered #ShrinksInSneakers #CBT #therapy #psychiatry #mentalhealth
December 10, 2025 at 10:53 PM
My book pick this month is a classic I still recommend to patients:
It’s old-school CBT, but the skills are timeless: challenging distortions, building healthier habits
Not for everyone but extremely practical for many
#PsychiatryUnfiltered #ShrinksInSneakers #CBT #therapy #psychiatry #mentalhealth
It’s old-school CBT, but the skills are timeless: challenging distortions, building healthier habits
Not for everyone but extremely practical for many
#PsychiatryUnfiltered #ShrinksInSneakers #CBT #therapy #psychiatry #mentalhealth
Here’s a hard truth about anger:
👉 The things that trigger us most are usually reflections of something unresolved within us.
If someone calls you incompetent and it enrages you, part of you fears they might be right.
#mentalhealth #psychiatry #anger #therapy #SelfAwareness #Healing
👉 The things that trigger us most are usually reflections of something unresolved within us.
If someone calls you incompetent and it enrages you, part of you fears they might be right.
#mentalhealth #psychiatry #anger #therapy #SelfAwareness #Healing
December 9, 2025 at 6:12 PM
Here’s a hard truth about anger:
👉 The things that trigger us most are usually reflections of something unresolved within us.
If someone calls you incompetent and it enrages you, part of you fears they might be right.
#mentalhealth #psychiatry #anger #therapy #SelfAwareness #Healing
👉 The things that trigger us most are usually reflections of something unresolved within us.
If someone calls you incompetent and it enrages you, part of you fears they might be right.
#mentalhealth #psychiatry #anger #therapy #SelfAwareness #Healing
Stop calling it anxiety
Start asking what’s driving it
Anxiety isn’t a defect it’s a check engine light
When it spikes, ask:
• What did my alarm system detect?
• Is this real danger or an old fear?
#ShrinksInSneakers #Anxiety #Psychiatry #Neuroscience #MentalHealth #anxietytreatment
Start asking what’s driving it
Anxiety isn’t a defect it’s a check engine light
When it spikes, ask:
• What did my alarm system detect?
• Is this real danger or an old fear?
#ShrinksInSneakers #Anxiety #Psychiatry #Neuroscience #MentalHealth #anxietytreatment
December 8, 2025 at 4:01 PM
Stop calling it anxiety
Start asking what’s driving it
Anxiety isn’t a defect it’s a check engine light
When it spikes, ask:
• What did my alarm system detect?
• Is this real danger or an old fear?
#ShrinksInSneakers #Anxiety #Psychiatry #Neuroscience #MentalHealth #anxietytreatment
Start asking what’s driving it
Anxiety isn’t a defect it’s a check engine light
When it spikes, ask:
• What did my alarm system detect?
• Is this real danger or an old fear?
#ShrinksInSneakers #Anxiety #Psychiatry #Neuroscience #MentalHealth #anxietytreatment
We all carry scars life guarantees that.
Here’s a hard truth about anger:
👉 The things that trigger us most are usually reflections
If someone calls you incompetent and it enrages you, part of you fears they might be right
#ShrinksInSneakers 👟🧠
#therapy #mentalhealth #emotion #mentalhealthmatters
Here’s a hard truth about anger:
👉 The things that trigger us most are usually reflections
If someone calls you incompetent and it enrages you, part of you fears they might be right
#ShrinksInSneakers 👟🧠
#therapy #mentalhealth #emotion #mentalhealthmatters
December 6, 2025 at 5:31 PM
We all carry scars life guarantees that.
Here’s a hard truth about anger:
👉 The things that trigger us most are usually reflections
If someone calls you incompetent and it enrages you, part of you fears they might be right
#ShrinksInSneakers 👟🧠
#therapy #mentalhealth #emotion #mentalhealthmatters
Here’s a hard truth about anger:
👉 The things that trigger us most are usually reflections
If someone calls you incompetent and it enrages you, part of you fears they might be right
#ShrinksInSneakers 👟🧠
#therapy #mentalhealth #emotion #mentalhealthmatters
Not chasing letters these days
Chasing alignment
AACP certification in Community & Public Psychiatry felt right it matches the work I live every day
Next up: Lifestyle Medicine
Because lifestyle change is medicine
Happy Friday 👟🧠
#psychiatry #doctor #lifestyle #medicine #mentalhealth
Chasing alignment
AACP certification in Community & Public Psychiatry felt right it matches the work I live every day
Next up: Lifestyle Medicine
Because lifestyle change is medicine
Happy Friday 👟🧠
#psychiatry #doctor #lifestyle #medicine #mentalhealth
December 5, 2025 at 10:37 PM
Not chasing letters these days
Chasing alignment
AACP certification in Community & Public Psychiatry felt right it matches the work I live every day
Next up: Lifestyle Medicine
Because lifestyle change is medicine
Happy Friday 👟🧠
#psychiatry #doctor #lifestyle #medicine #mentalhealth
Chasing alignment
AACP certification in Community & Public Psychiatry felt right it matches the work I live every day
Next up: Lifestyle Medicine
Because lifestyle change is medicine
Happy Friday 👟🧠
#psychiatry #doctor #lifestyle #medicine #mentalhealth
A resident asked what I’m passionate about in psychiatry.
Easy the work.
Hard the system.
You can’t medicate someone out of:
🏚️ homelessness
🥫 hunger
🧊 no heat
🚫 no safety
💸 no stability
#MentalHealth #Psychiatry #PublicHealth #SDoH #HealthEquity
#ShrinksInSneakers #mentalhealthmatters
Easy the work.
Hard the system.
You can’t medicate someone out of:
🏚️ homelessness
🥫 hunger
🧊 no heat
🚫 no safety
💸 no stability
#MentalHealth #Psychiatry #PublicHealth #SDoH #HealthEquity
#ShrinksInSneakers #mentalhealthmatters
December 4, 2025 at 4:06 PM
A resident asked what I’m passionate about in psychiatry.
Easy the work.
Hard the system.
You can’t medicate someone out of:
🏚️ homelessness
🥫 hunger
🧊 no heat
🚫 no safety
💸 no stability
#MentalHealth #Psychiatry #PublicHealth #SDoH #HealthEquity
#ShrinksInSneakers #mentalhealthmatters
Easy the work.
Hard the system.
You can’t medicate someone out of:
🏚️ homelessness
🥫 hunger
🧊 no heat
🚫 no safety
💸 no stability
#MentalHealth #Psychiatry #PublicHealth #SDoH #HealthEquity
#ShrinksInSneakers #mentalhealthmatters
Is TRD just undertreatment?
Sometimes
But some patients fail every modality we have
Because our tools treat symptoms not causes
Not all failure is effort
Sometimes it’s biology we don’t understand
#Psychiatry #MentalHealth #ShrinksInSneakers #mentalhealthtreatment #mentalhealthawareness
Sometimes
But some patients fail every modality we have
Because our tools treat symptoms not causes
Not all failure is effort
Sometimes it’s biology we don’t understand
#Psychiatry #MentalHealth #ShrinksInSneakers #mentalhealthtreatment #mentalhealthawareness
December 3, 2025 at 7:18 PM
Is TRD just undertreatment?
Sometimes
But some patients fail every modality we have
Because our tools treat symptoms not causes
Not all failure is effort
Sometimes it’s biology we don’t understand
#Psychiatry #MentalHealth #ShrinksInSneakers #mentalhealthtreatment #mentalhealthawareness
Sometimes
But some patients fail every modality we have
Because our tools treat symptoms not causes
Not all failure is effort
Sometimes it’s biology we don’t understand
#Psychiatry #MentalHealth #ShrinksInSneakers #mentalhealthtreatment #mentalhealthawareness
We’re eroding the physician–patient relationship.
Stable ADHD patient. No early refills. No red flags.
But someone assumes: “drug-seeking.”
Result: delayed care, unnecessary testing, and a patient who feels judged.
#psychiatry #mentalhealth #patients #doctor #doctorlife #mentalhealthmatters
Stable ADHD patient. No early refills. No red flags.
But someone assumes: “drug-seeking.”
Result: delayed care, unnecessary testing, and a patient who feels judged.
#psychiatry #mentalhealth #patients #doctor #doctorlife #mentalhealthmatters
December 2, 2025 at 3:02 PM
We’re eroding the physician–patient relationship.
Stable ADHD patient. No early refills. No red flags.
But someone assumes: “drug-seeking.”
Result: delayed care, unnecessary testing, and a patient who feels judged.
#psychiatry #mentalhealth #patients #doctor #doctorlife #mentalhealthmatters
Stable ADHD patient. No early refills. No red flags.
But someone assumes: “drug-seeking.”
Result: delayed care, unnecessary testing, and a patient who feels judged.
#psychiatry #mentalhealth #patients #doctor #doctorlife #mentalhealthmatters
Most people don’t realize this:
If you’re in weekly therapy + monthly psychiatry, you spend 0.7% of your entire year in direct mental health care.
The other 99.3% is where the real work happens.
#Therapy and #Psychiatry gives you the plan
Your daily habits create the change.
#MentalHealth #habits
If you’re in weekly therapy + monthly psychiatry, you spend 0.7% of your entire year in direct mental health care.
The other 99.3% is where the real work happens.
#Therapy and #Psychiatry gives you the plan
Your daily habits create the change.
#MentalHealth #habits
December 1, 2025 at 9:54 PM
Most people don’t realize this:
If you’re in weekly therapy + monthly psychiatry, you spend 0.7% of your entire year in direct mental health care.
The other 99.3% is where the real work happens.
#Therapy and #Psychiatry gives you the plan
Your daily habits create the change.
#MentalHealth #habits
If you’re in weekly therapy + monthly psychiatry, you spend 0.7% of your entire year in direct mental health care.
The other 99.3% is where the real work happens.
#Therapy and #Psychiatry gives you the plan
Your daily habits create the change.
#MentalHealth #habits
Psilocybin will help some patients.
But a miracle cure?
Still this is a massive shift in the future of psychiatric care
New Jersey just stepped onto the psychedelic stage
#ShrinksInSneakers #Psilocybin #Psychiatry #Medical #mentalhealth #mentalhealthishealth #mentalhealthmatters
But a miracle cure?
Still this is a massive shift in the future of psychiatric care
New Jersey just stepped onto the psychedelic stage
#ShrinksInSneakers #Psilocybin #Psychiatry #Medical #mentalhealth #mentalhealthishealth #mentalhealthmatters
November 29, 2025 at 9:53 PM
Psilocybin will help some patients.
But a miracle cure?
Still this is a massive shift in the future of psychiatric care
New Jersey just stepped onto the psychedelic stage
#ShrinksInSneakers #Psilocybin #Psychiatry #Medical #mentalhealth #mentalhealthishealth #mentalhealthmatters
But a miracle cure?
Still this is a massive shift in the future of psychiatric care
New Jersey just stepped onto the psychedelic stage
#ShrinksInSneakers #Psilocybin #Psychiatry #Medical #mentalhealth #mentalhealthishealth #mentalhealthmatters
We don’t choose our parents and we don’t choose our genetics. Some people hit the biological jackpot. Most don’t.
If you didn’t win the genetic lottery, your habits matter even more.
🥗 Eat real food
🧠 Go to therapy
💊 Take the meds that keep you stable
🏋️ Move your body
#psychiatry #mentalhealth
If you didn’t win the genetic lottery, your habits matter even more.
🥗 Eat real food
🧠 Go to therapy
💊 Take the meds that keep you stable
🏋️ Move your body
#psychiatry #mentalhealth
November 28, 2025 at 6:24 PM
We don’t choose our parents and we don’t choose our genetics. Some people hit the biological jackpot. Most don’t.
If you didn’t win the genetic lottery, your habits matter even more.
🥗 Eat real food
🧠 Go to therapy
💊 Take the meds that keep you stable
🏋️ Move your body
#psychiatry #mentalhealth
If you didn’t win the genetic lottery, your habits matter even more.
🥗 Eat real food
🧠 Go to therapy
💊 Take the meds that keep you stable
🏋️ Move your body
#psychiatry #mentalhealth
I’m grateful for:
🧠 Patients who show up with courage
🥾 Clinicians doing the impossible
🏥 #Community #mentalhealth holding the line
If today is hard, you’re not alone.
If you’re working, thank you.
If you’re surviving, I’m grateful for you.
Happy #Thanksgiving. 🦃
#psychiatry #doctorlife #meded
🧠 Patients who show up with courage
🥾 Clinicians doing the impossible
🏥 #Community #mentalhealth holding the line
If today is hard, you’re not alone.
If you’re working, thank you.
If you’re surviving, I’m grateful for you.
Happy #Thanksgiving. 🦃
#psychiatry #doctorlife #meded
November 27, 2025 at 5:10 PM
I’m grateful for:
🧠 Patients who show up with courage
🥾 Clinicians doing the impossible
🏥 #Community #mentalhealth holding the line
If today is hard, you’re not alone.
If you’re working, thank you.
If you’re surviving, I’m grateful for you.
Happy #Thanksgiving. 🦃
#psychiatry #doctorlife #meded
🧠 Patients who show up with courage
🥾 Clinicians doing the impossible
🏥 #Community #mentalhealth holding the line
If today is hard, you’re not alone.
If you’re working, thank you.
If you’re surviving, I’m grateful for you.
Happy #Thanksgiving. 🦃
#psychiatry #doctorlife #meded
A new JAMA Psychiatry study just linked soft drink consumption to major depression and the gut microbiome is the middleman
👇
Takeaway:
Skip the probiotic hype.
Fix the diet.
Your gut talks to your brain loudly.
#GutBrainAxis #Depression #Psychiatry #UltraprocessedFoods #ShrinksInSneakers
👇
Takeaway:
Skip the probiotic hype.
Fix the diet.
Your gut talks to your brain loudly.
#GutBrainAxis #Depression #Psychiatry #UltraprocessedFoods #ShrinksInSneakers
November 25, 2025 at 10:36 PM
A new JAMA Psychiatry study just linked soft drink consumption to major depression and the gut microbiome is the middleman
👇
Takeaway:
Skip the probiotic hype.
Fix the diet.
Your gut talks to your brain loudly.
#GutBrainAxis #Depression #Psychiatry #UltraprocessedFoods #ShrinksInSneakers
👇
Takeaway:
Skip the probiotic hype.
Fix the diet.
Your gut talks to your brain loudly.
#GutBrainAxis #Depression #Psychiatry #UltraprocessedFoods #ShrinksInSneakers
The FDA only recommends testing 3 enzymes: CYP2D6, CYP3A4, CYP2C19
I’ve seen plenty of “red light meds” work beautifully.
Medication response is way more complex than a color-coded report.
Evidence > algorithms.
Science > marketing.
I’ve seen plenty of “red light meds” work beautifully.
Medication response is way more complex than a color-coded report.
Evidence > algorithms.
Science > marketing.
November 21, 2025 at 4:14 PM
The FDA only recommends testing 3 enzymes: CYP2D6, CYP3A4, CYP2C19
I’ve seen plenty of “red light meds” work beautifully.
Medication response is way more complex than a color-coded report.
Evidence > algorithms.
Science > marketing.
I’ve seen plenty of “red light meds” work beautifully.
Medication response is way more complex than a color-coded report.
Evidence > algorithms.
Science > marketing.
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 👇
How do you use valproate levels in your practice?
Hard rule, soft guide, or only when things aren’t adding up?
#Depakote #Valproate #PsychTwitter #MedEd #BipolarDisorder #Epilepsy #Migraine
Hard rule, soft guide, or only when things aren’t adding up?
#Depakote #Valproate #PsychTwitter #MedEd #BipolarDisorder #Epilepsy #Migraine
November 19, 2025 at 4:20 PM
How do you use valproate levels in your practice?
Hard rule, soft guide, or only when things aren’t adding up?
#Depakote #Valproate #PsychTwitter #MedEd #BipolarDisorder #Epilepsy #Migraine
Hard rule, soft guide, or only when things aren’t adding up?
#Depakote #Valproate #PsychTwitter #MedEd #BipolarDisorder #Epilepsy #Migraine
#psychiatry #mentalhealth #njpa #shrinkinsneakers #doctors #psychiatrist #depression #medtwitter #meded #residentlife #wellbeing #lifestylepsychiatry #TMS #ECT #AI #digitalpsychiatry
November 18, 2025 at 6:38 PM
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
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
Until more research is published, address sleep problems at their root:
🧘♀️ CBT-I
🌅 Consistent sleep schedule
🚫 Limit stimulants
💭 Treat underlying mood disorders
Your body makes melatonin naturally. Maybe it’s telling us something.
#Cardiology #SleepMedicine #Psychiatry #ShrinksInSneakers #Insomnia
🧘♀️ CBT-I
🌅 Consistent sleep schedule
🚫 Limit stimulants
💭 Treat underlying mood disorders
Your body makes melatonin naturally. Maybe it’s telling us something.
#Cardiology #SleepMedicine #Psychiatry #ShrinksInSneakers #Insomnia
November 7, 2025 at 8:12 PM
Until more research is published, address sleep problems at their root:
🧘♀️ CBT-I
🌅 Consistent sleep schedule
🚫 Limit stimulants
💭 Treat underlying mood disorders
Your body makes melatonin naturally. Maybe it’s telling us something.
#Cardiology #SleepMedicine #Psychiatry #ShrinksInSneakers #Insomnia
🧘♀️ CBT-I
🌅 Consistent sleep schedule
🚫 Limit stimulants
💭 Treat underlying mood disorders
Your body makes melatonin naturally. Maybe it’s telling us something.
#Cardiology #SleepMedicine #Psychiatry #ShrinksInSneakers #Insomnia
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