Episodios

  • Fighting the Wave of Bipolar

    Fighting the Wave of Bipolar
    Apr 10 2025
    In this podcast episode, Dr. Faisal Rafiq shares a case of a patient with bipolar disorder who had difficulty responding to traditional mood stabilizing medications. He also discusses the classical model of treating bipolar disorder and when it may break down. He suggests adapting the framework, removing mood stabilizers in some cases and using antipsychotics as a primary anchor. Dr. Rafiq also provides some clinical pearls and final thoughts, emphasizing the importance of working with a supervisor and having a strategy and when.
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    15 m
  • De-Prescribing "When Less is More"

    De-Prescribing "When Less is More"
    Apr 10 2025
    In this episode of The Supervised Mind, Dr. Faisal Rafiq discusses the often-overlooked topic of deprescribing in clinical practice. He shares a compelling case study of a young patient to illustrate the complexities of medication management and the importance of understanding when to reduce or stop medications. The conversation emphasizes the need for clinicians to approach deprescribing with care, supervision, and a focus on the patient's current story rather than past diagnoses. Practical tips for young clinicians are provided, highlighting the relational aspect of deprescribing as a critical skill in psychiatry.
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    10 m
  • Lithium Power

    Lithium Power
    Apr 23 2025
    In this episode, Dr. Faisal Rafiq describes the unmatched effectiveness of lithium as a mood stabilizer, highlighting its role in treating bipolar disorder and its unique status as one of the few naturally occurring psychiatric medications. He discusses key side effects—including the classic “peeing like a racehorse”—as well as important monitoring protocols, and the differences between extended-release and immediate-release formulations. A must-listen for clinicians seeking clarity on lithium’s powerful role in mood disorder management.
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    18 m
  • Complex PTSD: When Nothing Makes Sense (and the Kitchen Sink)

    Complex PTSD: When Nothing Makes Sense (and the Kitchen Sink)
    Apr 29 2025
    In this episode, Dr. Faisal Rafiq explores the complexity of Complex PTSD (cPTSD)—a condition shaped by chronic, repeated trauma that often masquerades as mood, personality, or anxiety disorders. Through a trauma-informed lens, this episode walks clinicians through recognizing cPTSD’s emotional and somatic layers, differentiating it from BPD or TRD, and understanding why traditional diagnostic frameworks often fall short. Dr. Rafiq breaks down symptom clusters, guides clinicians on medication strategies, and introduces emerging treatments like Rexulti and Auvelity, while also revisiting underutilized options like Elavil for trauma-linked insomnia and pain. A critical theme is the importance of sequencing care properly—using medication to stabilize before engaging in deep trauma therapy such as EMDR or IFS. With supervision reflections woven throughout, the episode reinforces the message: Complex PTSD isn’t a broken brain—it’s an adapted one.
Treatment begins with safety, structure, and steady presence.
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    15 m
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