SSRI’M OK

Season Finale With Macey, Bijan, and Zoe

Thanks for listening this season! We cannot wait for season 2! For updates on future episodes, follow us on X or Instagram @ssrimokpod. In the meantime, feel free to send in your mental health questions or topics you'd like discussed in our next season.
 
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Art is by Zoe Zakson. 
 
Music is “As I Figure” by Kevin MacLeod.
 
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Defining DEI: What It Means and Why It Matters With Dr. Jason West

In this episode of “SSRI’M OK,” hosts Dr. Bijan Zarrabi, a psychiatry resident, and Macey Isaacs, a stand-up comedian, delve into the fascinating intersection of mental health, diversity, equity, inclusion (DEI.) They are joined by Dr. Jason West, the DEI and Belonging chair at Brigham Women’s Hospital and Harvard Medical School.
The discussion begins by defining DEI and its essential role in ensuring that all individuals, regardless of their background, have fair access to opportunities and resources. Equity is framed as an ethical issue, one that is not just a moral imperative but also crucial for the well-being of society as a whole. The conversation then shifts to the practical side of DEI—how these principles can be effectively implemented within institutions, and the common misconceptions that often hinder progress.
The hosts and Dr. West also address the apprehensions many people have when discussing DEI, acknowledging that these conversations can be uncomfortable but are necessary for meaningful change. They explore the concept of homophily, the tendency of people to associate with others who are similar to them, and its relationship to happiness and social cohesion. Dr. West shares his perspective on the wish some have for a world without DEI initiatives, noting that this could lead to less social cohesion and more division within communities.
Finally, the episode delves into the specific challenges of implementing DEI in the mental healthcare setting, where systemic issues and biases can significantly impact patient outcomes. Dr. West offers insights into how mental health professionals can navigate these challenges to create more inclusive and supportive environments for all patients.
 
Resources Mentioned:
https://pubmed.ncbi.nlm.nih.gov/38662413/
https://www.samhsa.gov/data/report/racialethnic-differences-mental-health-service-use
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Art is by Zoe Zakson. 
 
Music is “As I Figure” by Kevin MacLeod.
 
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ADHD with Dr. Saad Rahmat and Jessica Saul (Part 2)

In this episode of "SSRI’M OK," hosts Dr. Bijan Zarrabi, a psychiatry resident doctor, and Macey Isaacs, a stand-up comedian, are joined by Dr. Saad Rahmat and comedian Jessica Saul for this follow-up episode. In part 1, Dr. Rahmat provided an insightful overview of ADHD, and now, in this episode, Jessica Saul shares her personal experience living with the condition.
The conversation dives into the challenges of dealing with anxiety alongside ADHD, exploring how these two conditions often intertwine and exacerbate each other. Jessica opens up about her struggles with negative self-talk and self-criticism, providing a raw and relatable account of the mental hurdles she faces. She also shares her journey with medications like Wellbutrin and Strattera, discussing how these treatments have impacted her life.
The episode also touches on broader topics, such as the differences between American and European attitudes toward productivity and how these cultural perspectives can influence those with ADHD. The hosts and guests discuss how technology has drastically affected our attention spans, making it more difficult to practice sustained focus in today's fast-paced world.
Listeners will gain valuable insights into practical techniques for controlling your environment to better support yourself if you have ADHD. The episode also offers advice on how to help friends and loved ones who are navigating life with ADHD, emphasizing the importance of understanding and empathy.
In a lighter moment, Bijan reveals his old AIM screen name, adding a nostalgic touch to the discussion. Jessica shares a touching and humorous story about her shyness as a child and the moment she truly came out of her shell. She also recounts a memorable encounter with a woman in Target, adding a personal and entertaining anecdote to the episode. Finally, they all talk about the difficulty of not spiraling and the ongoing cycle of self-care. 
Resources Mentioned:
Jessica Saul’s Instagram
https://publications.aap.org/pediatrics/article-abstract/139/2/e20162027/77150/The-Mediterranean-Diet-and-ADHD-in-Children-and
Sleep: https://www.sciencedirect.com/science/article/abs/pii/S1389945710002170
Exercise: https://pubmed.ncbi.nlm.nih.gov/25988743/
Cannabis and ADHD: https://www.sciencedirect.com/science/article/abs/pii/S0376871613003025
Joyful Recollections of Trauma by Paul Scheer
Alcohol, Substance use, and ADHD: https://www.psychiatrist.com/jcp/impact-substance-disorder-adhd-treatment/
Flora app
Forrest app
Focusmate
MotionAI
Go to PureYogaTexas.com/pure-yogatv to become a member today!
 
Art by Zoe Zakson. 
 
Music is “As I Figure” by Kevin MacLeod.
 
Check out our website: ssrimokpod.com
 
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ADHD with Dr. Saad Rahmat (Part 1)

In this episode of "SSRI’M OK," hosts Dr. Bijan Zarrabi, a psychiatry resident doctor, and Macey Isaacs, a stand-up comedian, are joined by Dr. Saad Rahmat. Dr. Rahmat is a Child and Adolescent Psychiatrist at the Brigham and Women’s Hospital, Director of the Child Track in the BWH/HMS Psychiatry Residency Program, and Medical Director of Young Adult Mental Health in the Brigham Psychiatric Specialties. He is passionate about the development of evidence-based psychiatric care for transitional-age youth, particularly those with serious mental illnesses.
In this episode, Dr. Rahmat begins by defining ADHD, explaining what it is and clarifying that "ADD" is no longer a recognized diagnosis, having been subsumed under the broader category of ADHD. He then breaks down the different types of ADHD—Inattentive, Hyperactive, and Combined—and discusses how each presents unique challenges, particularly with impulsivity. The conversation then shifts to the complexities of diagnosing ADHD in adults, including how adult ADHD differs from childhood ADHD and whether ADHD can develop later in life.
Dr. Rahmat also explores the causes of ADHD and walks listeners through the diagnostic process, highlighting the criteria used to determine a diagnosis. Macey shares her personal experience with ADHD medication, specifically Ritalin, providing insight into the lived experience of managing the condition. The episode takes an intriguing historical turn as Dr. Rahmat touches on the use of stimulants in wars, particularly in Japan. The discussion then circles back to modern treatment options, including medication, behavioral techniques, and therapy, while also addressing the widespread misinformation surrounding inattention in ADHD.
Finally, the episode tackles important issues of gender differences and racial inequality in ADHD diagnoses, shedding light on how these disparities affect access to care and treatment. Throughout the conversation, the hosts and Dr. Rahmat aim to provide a comprehensive and engaging overview of ADHD, dispelling myths and offering practical advice for those affected by the condition.
Please listen to part 2 coming out in two weeks with comedian Jessica Saul. Jessica talks about her experience with ADHD and gets to talk to Dr. Rahmat about her struggles. 
Resources Mentioned:
Laurie Kilmartin’s special
Jessica Saul’s Instagram
Go to PureYogaTexas.com/pure-yogatv to become a member today!
 
Art by Zoe Zakson. 
 
Music is “As I Figure” by Kevin MacLeod.
 
Check out our website: ssrimokpod.com
 
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Why Are We Feeling Lonely? with Dr. Brendan Johnson

In this episode of "SSRI’M OK," hosts Dr. Bijan Zarrabi, a psychiatry resident doctor, and Macey Isaacs, a stand-up comedian, are joined by the perceptive Dr. Brendan Johnson. Dr. Johnson was a Visiting Research Scholar at Blackfriars Hall, Oxford, where he conducted research on 'the mental commons' and its enclosure as a paradigm for explaining worsening mental health in society at large. He is the co-host of the “Social Medicine On Air” podcast. 
In this thought-provoking episode, we explore how the structures and pressures of capitalism contribute to widespread unhappiness and anxiety. Dr. Johnson explains why people are more unhappy and anxious than ever before, delving into the societal factors driving these troubling trends. We discuss the increase in deaths of despair and the pervasive feelings of loneliness affecting many individuals today. 
Central to our discussion is the concept of the "mental commons" and how it is being stolen, leading to negative impacts on mental health. Dr. Johnson emphasizes how climate change contributes to anxiety and a sense of hopelessness about the future, framing it as a thief of our collective future. We also touch on the critical role of social determinants in shaping mental health outcomes and provide practical advice and strategies to help individuals feel less isolated and more connected.
Additionally, we delve into the history of the enclosure of the commons and its relevance to today's mental health landscape. The importance of finding a "third place" outside of home and work to foster a sense of community and belonging is discussed, along with why traditional psychiatric answers often fall short in addressing the deeper "why" behind mental health issues.
Tune in to gain a deeper understanding of the intersection between society and mental health, and learn how we can work towards a more holistic approach to mental well-being.
Resources Mentioned:
https://www.hhs.gov/about/news/2023/05/23/surgeon-general-issues-new-advisory-about-effects-social-media-use-has-youth-mental-health.html
https://www.hhs.gov/about/news/2023/05/03/new-surgeon-general-advisory-raises-alarm-about-devastating-impact-epidemic-loneliness-isolation-united-states.html
Bo Burnham’s interview about social media
Case A, Deaton A. Deaths of Despair and the Future of Capitalism. Princeton UP; 2020.
Fairlie S. A Short History of Enclosure in Britain. The Land. 2009;(7).
Hardt M, Negri A. Commonwealth. Belknap; 2009. 
Seo H. America Is Getting Lonelier and More Indoorsy. That’s Not a Coincidence. The Atlantic. 2023.
Smith AB, Johnson CD. Private Equity Ownership in Health Care Linked to Higher Costs, Worse Quality. JAMA. 2023;320(24):2567-2569.
 Wu T. The Attention Merchants: The Epic Scramble to Get inside Our Heads. Knopf; 2016.
“Deep Work” by Cal Newport
“Bowling Alone” by Robert Putnam
“Commonwealth” by Michael Hardt
“Social Medicine on Air” podcast
Go to PureYogaTexas.com/pure-yogatv to become a member today!
 
Art by Zoe Zakson. 
 
Music is “As I Figure” by Kevin MacLeod.
 
Check out our website: ssrimokpod.com
 
Follow us on IG or X @ssrimokpod
 
Contact us: ssrimokpod@gmail.com

Sex and Couples Therapy with Dr. Nikki Haddad

In this episode of "SSRI’M OK," hosts Dr. Bijan Zarrabi, a psychiatry resident doctor, and Macey Isaacs, a stand-up comedian, are joined by the insightful Dr. Nikki Haddad. Dr. Haddad's clinical interests and expertise encompass women's mental health, trauma, and couples and sex therapy.
Join us as we dive deep into Dr. Haddad's journey and discover what inspired her to specialize in couples therapy. We explore the transformative benefits of couples therapy, including how it can strengthen relationships, improve communication, and foster a deeper emotional connection between partners. Dr. Haddad shares valuable insights and practical tips that can help couples navigate their challenges and enhance their relationships.
In this episode, you'll also learn about Dr. Zarrabi's love language, and how money can be more intimate than sex. We discuss the history of psychiatry's approach to sex, and Dr. Haddad's perspective on viewing sex from a pleasure lens rather than a pathological one. The conversation delves into the difference between arousal and desire, understanding sexual trauma, and Low Libido Disorder. We also address SSRI-induced sexual dysfunction, common misconceptions about sex, and the concept that all sex is queer sex.
Whether you're in a relationship or interested in the intricacies of mental health and therapy, this episode offers a wealth of knowledge and engaging conversation.
Tune in to gain a better understanding of the crucial role of couples therapy in promoting emotional well-being and maintaining healthy, fulfilling relationships.
Resources Mentioned:
Couples Therapy on Showtime
Where Should We Begin book (and podcast) by Esther Perel
Masters of Sex on Showtime
Come as You Are by Emily Nagoski
Attached by Amir Levine
Baby Reindeer on Netflix
Sari M. van Anders’ study on The Heteronormativity Theory of Low Sexual Desire in Women Partnered with Men
Sexvangelicals podcast
Nikki Glaser’s Someday You’ll Die special on HBO
Go to PureYogaTexas.com/pure-yogatv to become a member today!
 
Art by Zoe Zakson. 
 
Music is “As I Figure” by Kevin MacLeod.
 
Check out our website: ssrimokpod.com
 
Follow us on IG or X @ssrimokpod
 
Contact us: ssrimokpod@gmail.com

Seasonal Depression with Dr. Cynthia Peng

In this episode of "SSRI’M OK," hosts Macey Isaacs, a stand-up comedian, and Dr. Bijan Zarrabi, a psychiatry resident doctor, are joined by Dr. Cynthia Peng. Dr. Peng, who treats patients with psychiatric conditions in the inpatient, consult, and outpatient settings, will discuss Major Depressive Disorder with a Seasonal Pattern, also known as Seasonal Affective Disorder. It’s getting warmer and MDD with a Seasonal Pattern is not limited to the winter! Do you have that summertime sadness? She will define the disorder, explain how it can be diagnosed, and delve into its history and possible causes. Tune in to learn tips on combating Seasonal Affective Disorder while enjoying some laughs along the way.
Resources Mentioned:
Macey’s Yacht Rock Playlist on Spotify
Go to PureYogaTexas.com/pure-yogatv to become a member today!
 
Art by Zoe Zakson. 
 
Music is “As I Figure” by Kevin MacLeod.
 
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Contact us: ssrimokpod@gmail.com

Religion and Psychiatry: A Happy Medium With Dr. Deborah Park and Comedian Matt Durndak

In this episode of "SSRI’M OK," hosts Macey, a stand-up comedian, and Dr. Bijan Zarrabi, a psychiatry resident doctor, bring a unique blend of humor and mental health insights. They are joined by Dr. Deborah Park, a resident psychiatrist at Brigham and Women’s Hospital, to explore the intersection of religion, psychiatry, and happiness. Later, they are joined by comedian Matt Durndak to present the side of a skeptic. The conversation touches on belief, unbelief, locus of control, and more. 
Resources Mentioned:
“Build the Life You Want” by Arthur Brooks and Oprah Winfrey
Maria Bamford is Down to Join Your Cult on NPR
“The Wounded Healer” by Henri J. Nouwen
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Art by Zoe Zakson. 
 
Music is “As I Figure” by Kevin MacLeod.
 
Check out our website: ssrimokpod.com
 
Follow us on IG or X @ssrimokpod
 
Contact us: ssrimokpod@gmail.com

More on SSRIs With Dr. Montie Meyer

In this episode of "SSRI’M OK," hosts Macey, a stand-up comedian, and Dr. Bijan Zarrabi, a psychiatry resident doctor, bring a unique blend of humor and mental health insights. They are joined by Dr. Montie Meyer, staff psychiatrist at Brigham and Women’s Hospital,  to delve even deeper into the world of SSRIs (Selective Serotonin Reuptake Inhibitors). The conversation touches on the science behind SSRIs, their effects, and common misconceptions, providing listeners with both educational content and lighthearted moments.
Resources Mentioned:
Moncrieff, J., Cooper, R. E., Stockmann, T., Amendola, S., Hengartner, M. P., & Horowitz, M. A. (2023). The serotonin theory of depression: a systematic umbrella review of the evidence. Molecular psychiatry, 28(8), 3243-3256.
 
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Art by Zoe Zakson. 
 
Music is “As I Figure” by Kevin MacLeod.
 
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Contact us: ssrimokpod@gmail.com

What Even Are SSRIs?

In this episode, we briefly discuss what a selective serotonin reuptake inhibitor (SSRI) is since the name of our podcast is “SSRI’M OK” and some people don’t understand the reference and that’s okay. That’s what we get for trying to be creative. We also briefly discuss the history of the discovery of some antidepressant medications like SSRIs and monoamine oxidase inhibitors (MAOIs.)
Key Points:
Your brain is made of cells. The two main types of cells in the brain are neurons, and glial cells, also known as neuroglia.
Neurons communicate with each other using neurotransmitters like serotonin, norepinephrine, and dopamine.
The space between the neurons where neurotransmitters are released is called the synapse.
The neuron (let’s call it neuron A) that drops off neurotransmitters to another neuron (neuron B) has reuptake channels that take back the neurotransmitters that neuron A released. The reuptake channels are named after the specific neurotransmitter they reuptake (serotonin reuptake transporters reuptake serotonin, norepinephrine reuptake transporters reuptake norepinephrine, etc.)
SSRI are “selective serotonin reuptake inhibitors,”  meaning they block the reuptake transporters for serotonin. This leaves more serotonin in the synapse which can lead to downstream changes that are theorized to help treat depression.
The discovery of antidepressant medications and the belief that “low serotonin leads to depression” was started when studying an anti-tuberculosis medication called “Isoniazid.”
While investigating different formulations of isoniazid, they developed a similar medication called Iproniazid which is slightly different to Isoniazid molecularly.
When they were giving Iproniazid to patients in their research trials, they found that anyone who got the drug, regardless of whether or not they had tuberculosis, had “mood elevating” effects. Patients showed improved sleep, sociability, and appetite. A psychiatrist, Max Lurie, coined the term “antidepressant” in reference to the mood effects that iproniazid had on people. [1] 
It turned out that Iiproniazid stops the activity of an enzyme in our brains that breaks down specific neurotransmitters like serotonin, dopamine, and norepinephrine. The enzyme is called MAO, short for monoamine oxidase. 
The pharmaceutical company Eli Lilly began developing molecules that would selectively inhibit the reuptake of serotonin at serotonin transporters to increase serotonin in the synapse, which led to the first report on an SSRI called fluoxetine being published [2]. 
Fluoxetine was approved by the FDA in December of 1987 and was launched to the market in January 1988 under the trade name Prozac.
SSRI examples: Prozac (fluoxetine), Zoloft (sertraline), Celexa (citalopram), Lexapro (escitalopram), Luvox (fluvoxamine), Paxil (paroxetine)Brand names capitalize, generic names are in parentheses. They are the same medications. 
Some SSRIs don’t selectively bind to the serotonin reuptake transporter. For example, fluoxetine also binds to the norepinephrine reuptake transporter. It is sometimes referred to as an “activating” SSRI because norepinephrine is a neurotransmitter linked to alertness and arousal. However, the clinical relevance of this norepinephrine effect is not clear. Fluoxetine is an antagonist at 5HT2C receptors; this has been proposed as a potential mechanism for its activating properties. [3]
Resources Mentioned:
Van Der Walt, M., & Keddy, K. H. (2021). The Tuberculosis-Depression Syndemic and Evolution of Pharmaceutical Therapeutics: From Ancient Times to the Future. Frontiers in psychiatry, 12, 617751. https://doi.org/10.3389/fpsyt.2021.617751
Wong, D. T., Horng, J. S., Bymaster, F. P., Hauser, K. L., & Molloy, B. B. (1974). A selective inhibitor of serotonin uptake: Lilly 110140, 3-(p-trifluoromethylphenoxy)-N-methyl-3-phenylpropylamine. Life sciences, 15(3), 471–479. https://doi.org/10.1016/0024-3205(74)90345-2
Ni, Y. G., & Miledi, R. (1997). Blockage of 5HT2C serotonin receptors by fluoxetine (Prozac). Proceedings of the National Academy of Sciences, 94(5), 2036-2040.
 
Also mentioned in today’s episode is “The Body Keeps the Score” by Bessel van der Kolk. 
 
Go to PureYogaTV.com to become a member today!
 
Art by Zoe Zakson. 
 
Music is “As I Figure” by Kevin MacLeod.
 
Contact us: ssrimokpod@gmail.com