Inside Mental Health

What happens when therapy and medication don’t work? Treatment-resistant depression can feel like a dead end — but it’s not. In this episode, clinical psychologist and ADAA member expert Dr. Jill Emanuele unpacks the nuanced differences between sadness, grief, and major depressive disorder — and why misusing these terms can delay real help.But the conversation doesn’t stop there. What happens when traditional treatments for depression don’t work? You’ve probably heard the term treatment-resistant depression, and it may sound terrifying. Dr. Emanuele and host Gabe Howard dig deep into what this label actually means — and spoiler alert: It’s more about strategy than severity.

You’ll also discover lesser known but evidence-backed options that go beyond talk therapy and antidepressants, including:


transcranial magnetic stimulation (TMS)

ketamine and esketamine treatments

radically open dialectical behavior therapy (RO-DBT)

electroconvulsive therapy (ECT) without the Hollywood horror spin

psychedelic-assisted therapy using psilocybin 


Key takeaways:


the difference between sadness, grief, and clinical depression

what treatment resistant actually means

a breakdown of advanced, research-backed treatment options

why individualization is key to recovery


This episode is your roadmap for understanding treatment-resistant depression on a deeper level — and for finding hope when treatment doesn’t seem to be working. Whether you’re managing this yourself or supporting someone who is, you’ll walk away knowing there are more options — and find that labels aren’t life sentences.

This episode has been sponsored by the Anxiety and Depression Association of America (ADAA).



Our guest, Jill M. Emanuele, PhD, is Founder and Executive Director of Urban Yin Psychology, PLLC, based in New York City.  She is also Secretary and board member for the Anxiety and Depression Association of America (ADAA). 

Dr. Emanuele completed her undergraduate studies with degrees in Psychology and Music from the University of Richmond, and her Ph.D. in clinical psychology from George Mason University. Dr. Emanuele has presented at academic medical centers, professional conferences, public and private schools, and community organizations on the topics of mindfulness, adolescent depression and suicide, adolescent self-injury, DBT, and adolescent borderline personality disorder, and co-authored book chapters on some of these important topics.  She also provides education through multiple forms of media including television, radio, internet, and podcasts. 

Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. Gabe is also the host of the "Inside Bipolar" podcast with Dr. Nicole Washington.

Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com.
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We’re sold the fairy tale from birth: find “the one,” make them your everything, and you’ll live happily ever after. But what happens if that one person can’t meet all your needs - or ever could? In this convention challenging conversation, sex experts Dr. Danielle Harel and Celeste Hirschman take aim at America’s deeply rooted ideas about monogamy, intimacy, and what makes for a fulfilling - and lasting - relationship.

Host Gabe Howard points out America’s strange mix of selling sex while shaming it, and together they unpack why so many couples struggle in silence instead of having honest, non-blaming conversations about their desires. Along the way, they reveal how redefining intimacy, owning your choices, and using your “sexual energy” as a navigation system can lead to more connection, better sex, and improved mental health.

Key Take-aways:


Why “the one” isn’t true for everyone and could set you up for failure.

How monogamy, open relationships, and other structures can all work - if you choose them deliberately.

Practical tips for starting sensitive sex conversations without triggering alarm bells.


If you’ve ever wondered whether your relationship rules are helping or hurting your love life, this episode just might change everything.



“So monogamy is originated in feudalist society when there was like, someone who had money and, you know, possession. We moved into needing to know who our offsprings are. And that's exactly what monogamy started, because we wanted to know where are we inheriting our money to and the church came in and religion and it started to become like a, a standard to live by. But it's not necessarily our nature and it's not necessarily what everyone should be doing.” ~Dr. Danielle Harel



Our guests, Danielle Harel, Ph.D., and Celeste Hirschman, M.A., are pioneers in intimacy, sexuality, and relationship coaching. Co-founders of the Somatica® Institute, they’ve transformed how love and connection are taught through their experiential, science-based Somatica Method. Together, they’ve trained over 1,000 coaches and helped countless individuals and couples embrace vulnerability, rediscover desire, and create deeply fulfilling relationships. Authors of three influential books—Making Love Real, Coming Together, and Confidence—Danielle and Celeste blend authenticity, humor, and bold honesty to inspire transformation. Their relatable insights into intimacy and connection make them captivating guests, offering audiences practical tools to enhance relationships and live passionately.



Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. Gabe is also the host of the "Inside Bipolar" podcast with Dr. Nicole Washington.

Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com.



Thank you for tuning in! Show ideas? Hit us up at show@psychcentral.com.
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Ever feel like your fear of judgment is holding you back from college life? In this no-nonsense episode, host Gabe Howard teams up with ADAA member expert Ken Goodman, LCSW, to cut through the noise and tackle social anxiety head-on. Discover how everyday moments — like dropping a napkin or saying hello — can spiral into overwhelming anxiety and how you can flip the script.

Ken offers real-world strategies that empower you to face your fears, transform awkward encounters into opportunities, and build lasting connections. Whether you're dodging parties or stuck with your head down in class, learn how to challenge your mindset and step boldly into social situations. Tune in and get ready to break free from isolation, unlock your true potential, and make the most out of your college experience.

This episode has been sponsored by the Anxiety and Depression Association of America (ADAA).



“People with social anxiety perceive that other people are judging them constantly, but they're not. They're thinking about their day. They're thinking about their own problems. They're not thinking about you. If they do have a thought about you, it's pretty transient. It's pretty quick. It's not like they're dwelling on it like the person with social anxiety is.” ~Ken Goodman, LCSW



Our guest, Ken Goodman, LCSW, specializes in the treatment of anxiety disorders and OCD.  He is on the board of directors for the Anxiety and Depression Association of America and is Founding Director of QuietMindSolutions.com. He has authored and produced several self-help courses and books including The Anxiety Solution Series: Your Guide to Overcoming Panic, Worry, Compulsions and Fear, a 12-hour audio course and Break Free from Anxiety, a coloring self-help book. His latest book, The Emetophobia Manual, is the first self-help book for those who suffer with the fear of vomit. Most recently he recorded and produced a ten-session video course for people with emetophobia. He lectures at universities and organizations across the country. He earned his bachelor’s and master’s degrees from UCLA and operates his online private practice in Los Angeles.

Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. Gabe is also the host of the "Inside Bipolar" podcast with Dr. Nicole Washington.

Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com.
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What do you really know about schizophrenia? Guest host Rachel Star Withers — who lives with schizophrenia — takes us beyond the headlines and horror movies in this powerful, honest, and enlightening episode of Inside Mental Health. Joined by neuropsychologist and schizophrenia researcher Dr. Derin Cobia, Rachel explores what schizophrenia is, what it isn’t, and how it silently shapes the lives of millions.

They break down the real symptoms — including hallucinations, delusions, cognitive disruptions, and depression — and discuss why “positive” and “negative” symptoms are misleading terms. Rachel shares personal stories of psychosis, navigating daily life, and the lifesaving importance of support, while Dr. Cobia unpacks the science: from genetics to stigma to what the media consistently gets wrong.

Whether you’ve never met someone with schizophrenia (spoiler: you have) or you’re supporting a loved one, this episode replaces fear with empathy and misunderstanding with clarity. You’ll come away informed, moved, and maybe even surprised.

Key takeaways:


the truth about schizophrenia’s symptoms and causes

why stigma is deadly — and how to dismantle it

what support systems really make a difference

how schizophrenia affects cognition, not just perception


Hit play to get past the stereotypes and meet the human reality.



Cold Open Transcript:Rachel Star Withers (guest host): I'm sure there's some listeners right now who are thinking, well, I don't have schizophrenia. No one close to me does. Why should I care?

Dr. Derin Cobia: You know, schizophrenia, it indirectly affects everyone and it affects us economically, socially, and culturally. Even though somebody may not be dealing with somebody with schizophrenia, now, who's to say they won't in the future? And even if they don't, I would say just general education and awareness about it reduces this stigma.



Our guest, Dr. Derin Cobia, is a neuropsychologist and neuroscientist with particular interest in utilizing neuroimaging techniques to study how changes in brain structure influence cognition and behavior. He is also a professor at Brigham Young University.

Dr. Cobia's laboratory is focused on the implementation of computational anatomy tools to study neuropsychiatric diseases, particularly schizophrenia. His interests are in the clinical and biological heterogeneity that exists in schizophrenia by taking a cognitive neuroscience perspective. His work has involved linking cognitive and neurobiological characteristics to important clinical dimensions of the illness.

Our guest host, Rachel Star Withers creates videos documenting her schizophrenia, ways to manage, and let others like her know they’re not alone and can still live an amazing life. She has written “Lil Broken Star: Understanding Schizophrenia for Kids” and a tool for schizophrenics, “To See in the Dark: Hallucination and Delusion Journal.” Learn more at RachelStarLive.com.

To listen to the Inside Schizophrenia podcast, please visit the official show page at psychcentral.com/IS or use your favorite podcast player.

Please Note: Our regular host, Gabe Howard, will be back next week!
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Is it trauma? Obsessive-compulsive disorder (OCD)? Or both? Can trauma trigger OCD? Can OCD feel like trauma?

In this episode, Dr. Nathaniel Van Kirk, a ADAA member and leading clinical psychologist and trauma expert, joins Gabe Howard to unpack the complex relationship between trauma and OCD. While both terms are widely used, few understand how deeply they can intertwine — or how often they’re misunderstood.

Dr. Van Kirk explains why a traumatic event might trigger OCD in some people, how OCD symptoms can mimic trauma responses, and why compulsions often become misguided tools for managing fear. He also dives into the surprising statistic that up to 90% of people experience a traumatic event, and explores how our brains are hardwired to both break down and heal.



Takeaways include:


the difference between trauma, PTSD, and OCD

why OCD isn’t usually considered a trauma disorder — but sometimes should be

how clinicians decide which disorder to treat first

why healing often means separating fear from fact


If you’ve ever had intrusive thoughts or wanted to better understand the mental health impact of trauma, this episode is essential listening.  

This episode has been sponsored by the Anxiety and Depression Association of America (ADAA).



“For about 19% of individuals with OCD, they tend to have a comorbid PTSD diagnosis. I think that's much higher than what we initially thought as a field. Initially we thought it was rare, and part of the challenge is that for many years these two things were treated as silos. You were either a PTSD and trauma therapist or an OCD therapist. And very rarely did we cross over. It turns out that was not the great approach, because in reality, there's actually a lot more overlap than we thought. And finding out that it's actually a very common experience that people just didn't talk about.” ~Nathaniel Van Kirk, PhD



Our guest, Nathaniel Van Kirk, PhD, is a licensed clinical psychologist, specializing in severe anxiety disorders, obsessive compulsive disorder (OCD), and trauma/PTSD. At McLean Hospital, Dr. Van Kirk is the director of psychological services at the OCD Institute. He is a member of the hospital’s Patient and Family Advisory Committee and Interdisciplinary Recovery Oriented Practice Committee, and also serves as the site facilitator for McLean’s Schwartz Rounds Committee.

Dr. Van Kirk’s clinical research focuses on the role of motivation across treatment and the impact of trauma on treatment outcomes, and on promoting innovative methods to assess and conceptualize recovery. Additionally, he is involved in efforts to reduce mental health stigma (such as participating in McLean Hospital’s Deconstructing Stigma campaign), emphasizing the importance of bridging the gap between therapists, researchers, and those with mental health challenges, including individuals who work in the mental health field.



Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. Gabe is also the host of the "Inside Bipolar" podcast with Dr. Nicole Washington.

Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com.
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