Psychiatry & Psychotherapy Podcast

In this essential episode of the Psychiatry & Psychotherapy Podcast, Dr. David Puder sits down with internationally renowned expert Dr. Veerle Bergink, Director of Mount Sinai's Women's Mental Health Center, for an in-depth discussion of postpartum psychosis. Covering early warning signs and symptoms, differential diagnosis including anti-NMDA receptor encephalitis and thyroid issues, a highly effective acute treatment algorithm using benzodiazepines, antipsychotics, and lithium, the remarkable 98% remission rates with proper care, lithium's superior role in preventing relapse during the first postpartum year, the simple but powerful prophylaxis strategy of "baby out, lithium in" for high-risk women with bipolar disorder or prior episodes, the urgent need for mother-baby psychiatric units in the U.S., and the ongoing push to formally classify postpartum psychosis in the DSM.
 
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In this episode, Dr. Puder talks with reproductive psychiatrist and psychoanalyst Dr. Alyson Gorun and Dr. Fredric Busch about postpartum depression and problem-focused psychodynamic psychotherapy. They focus on the five core conflicts (difficulty tolerating anger, idealized expectations of parenthood, struggles with dependence, fear of separation and abandonment, and fear of intrusion) that often underlie symptoms, shame, attachment reactivation, and stuck behaviors in the perinatal period.
This episode explores:
-How these dynamics emerge even when parents know what they "should" do
-How to integrate psychodynamic insight with medication, sleep, social support, and evidence-based care
-Practical ways clinicians can help mothers and fathers mentalize their experiences, reduce guilt, and improve bonding.
 
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In this episode of the Podcast, Dr. David Puder sits down with reproductive psychiatrist Dr. Katie Unverferth, Director of the UCLA Women's Life Center and Medical Director of the UCLA Maternal Mental Health Program, to clarify the critical differences between common postpartum intrusive thoughts of infant harm, postpartum OCD, and true postpartum psychosis. They discuss how nearly all new mothers experience ego-dystonic thoughts of accidental or intentional harm, how to screen without triggering concealment, when severity and compulsions cross into OCD, the role of high-dose SSRIs plus exposure and response prevention (ERP), red-flag signs of ego-syntonic content, agitation, insomnia, and delirium-like states that signal psychosis, and the strong evidence for lithium prophylaxis and acute treatment in high-risk patients. 
 
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In this episode, Dr. David Puder and his psychodynamic psychotherapy training cohort apply reflective function (RF) and mentalization concepts to John Steinbeck's masterpiece East of Eden. They examine how Reflective Function collapses under shame, rejection, threat, and attachment arousal across key characters. The discussion highlights that true personality health is not the absence of aggression, dependency, or guilt but the growing capacity to recognize conflicting self-parts, stay in contact with reality, and remain related to imperfect people.
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In this essential episode, Dr. David Puder sits down with board-certified reproductive psychiatrist Dr. Katrina Furey to unpack postpartum psychosis. They cover its early warning signs, symptoms, diagnostic challenges, risk assessment, and evidence-based treatment. They discuss classic onset within days to weeks after delivery, common delusions centered on the infant, fluctuating mental status, the critical distinction from postpartum OCD, elevated risks of filicide and suicide, strong links to bipolar spectrum disorders, and the vital roles of lithium, antipsychotics, sleep protection, ECT, medical workup, and family support. Learn why this psychiatric emergency demands rapid intervention, how most women fully recover, and practical guidance for clinicians and families navigating this rare but treatable condition.
 
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