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How to Be Patient

How to Be Patient

Human Content 69 Episodes Oct 12, 2026

How to Be Patient is a podcast hosted by Dr. Preston Roche and Dr. Margaret Duncan, two mental health professionals who explore the evolving landscape of mental health care. Each week, they engage with stories and perspectives that challenge conventional understanding of various conditions, aiming to foster greater empathy and nuance in treating patients. The show is produced by Dr. & Lady Glaucomflecken and promises a mix of clinical insight and humor.

Episodes

Child Psychiatry Training Explained
Child Psychiatry Training Explained Oct 12, 2026 2364 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
How does image guided TMS stack up against the current method?
How does image guided TMS stack up against the current method? Oct 5, 2026 2860 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://p
The Theory of the Crunch: Holding Difficult Dynamics in Therapy
The Theory of the Crunch: Holding Difficult Dynamics in Therapy Sep 28, 2026 3570 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 therapi
Psychiatric Effects of GLP-1s (What We Know So Far)
Psychiatric Effects of GLP-1s (What We Know So Far) Sep 21, 2026 3524 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  p
Nuances in Prescribing Antidepressants
Nuances in Prescribing Antidepressants Sep 14, 2026 3538 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, 20
Psychiatric Roots in Greek Mythology
Psychiatric Roots in Greek Mythology Sep 7, 2026 3975 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, et
Climate Change Impacts on Mental Health with Child Psychiatrist & Pediatrician Elizabeth Pinsky, MD
Climate Change Impacts on Mental Health with Child Psychiatrist & Pediatrician Elizabeth Pinsky, MD Aug 31, 2026 3247 In today’s episode, Margaret and Preston are joined by pediatrician and child psychiatrist Elizabeth Pinsky, MD. Dr. Pinsky works as a pediatric consult-liaison psychiatrist at Massachusetts General Hospital and her clinical interests lie at the intersection of child mental and physical health, including childhood trauma associated with medical care, fostering resilience in medically ill children,
Lessons from Improv Comedy
Lessons from Improv Comedy Aug 24, 2026 4189 Laugh all you want (please laugh it’s supposed to be funny), Preston has been doing improv from the last year and he has some thoughts. Not just “yes ands” about how it makes him a better doctor, and he is dragging Margaret into the mix starting off with some improv style warm ups and ending with a philosophical commentary about the stage we all perform on. I don’t know why I am talking about Pres
Kung Fu Panda & Residency: Growth Mindset
Kung Fu Panda & Residency: Growth Mindset Aug 17, 2026 3302 Margaret is back and today our episode pulls themes from Carol Dweck’s work and book Growth Mindset, as well as a favorite sophisticated film: Kung Fu Panda. In this episode, Margaret and Preston discuss a frame to make sense of the obstacles we meet as we change levels of training, weather you’re starting med school, doing a post doc, or changing jobs. We walk through phases of growing, including
THROWBACK: Alcohol: Examining Alcohol culture, history, and use disorder (Season 1 Episode 15)
THROWBACK: Alcohol: Examining Alcohol culture, history, and use disorder (Season 1 Episode 15) Aug 10, 2026 5699 In Episode 15, Preston and Margaret open a bottle—of questions, stories, and science—about alcohol use disorder. What do we get wrong about “moderate” drinking? Why is detox more dangerous than most people realize? And how does alcohol quietly reshape identity, relationships, and the brain itself? With their signature blend of honesty and humor, they explore the unexpected ways drinking shows up i
Sex Differences in Aging Cognition with Dr. Sullivan
Sex Differences in Aging Cognition with Dr. Sullivan Aug 3, 2026 3159 In today’s episode we bring on Dr. Campbell Sullivan, PsyD to discuss the interesting field of neuropsychology, a complicated niche that focuses on eliciting deficits in cognition across patters of disease. We discuss the triumphs of her field as they collaborate with both psychiatry and neurology and then get into the places she sees room for improvement, particularly in how we assess and treat c
THROWBACK: The Lithium Episode (Season 2 Episode 14)
THROWBACK: The Lithium Episode (Season 2 Episode 14) Jul 27, 2026 4603 In this preston-led episode, we take a deep dive into the history of lithium and its use in psychiatry. But because Preston is very literal, we are starting at the very beginning, inside of stars where lithium was formed at the beginning of the universe. Then we will follow this wonderful atom through history and past its FDA approval in 1970 to where we are today.  Takeaways: Lithium

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