Canybec Sulayman reviewing notes on a laptop in the San Francisco office

Clinical insights

Mental Health Blog

Search by medication, symptom, lab, or question. Start with the pattern you recognize.

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39 articles

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ADHD Aug 1, 2026

Low Ferritin, ADHD, and Medication Response: The Lab That Gets Skipped

Ferritin is the lab I check before changing an ADHD medication dose. Low ferritin impairs the dopamine synthesis pathway that ADHD medications depend on. At levels below 50 ng/mL, stimulant medication can work less effectively — or iron deficiency alone can produce an ADHD-like clinical picture.

7 min read Listen

ADHD Jul 25, 2026

Alcohol, Anxiety, and Depression in Founders: What the Clinical Picture Actually Shows

Founders drink more than the standard clinical intake captures. Patients describe alcohol reliably reducing anxiety, and reliably feeling worse afterward. The cycle is slow enough to miss and fast enough to maintain psychiatric symptoms indefinitely.

8 min read Listen

ADHD Jul 18, 2026

Cannabis, ADHD, Sleep, and Anxiety: What Founders Get Wrong About Self-Medication

Cannabis for anxiety and sleep is common in San Francisco's founder and tech community. The clinical picture often shows the opposite of what patients expect: worsened REM sleep, increased baseline anxiety, and attention problems that look like ADHD medication failure.

8 min read Listen

ADHD Jul 11, 2026

Before Brain Mapping and Neurofeedback: The Psychiatric Differential That Should Come First

Brain mapping and neurofeedback have reached San Francisco's optimization market. The question I want answered before any of it starts: has the standard differential been done, or did the patient jump straight to brainwave training because that is what was sold to them?

8 min read Listen

Women's Mental Health Jul 4, 2026

Hormone Optimization and Mood: When Testosterone, Thyroid, and Estrogen Are and Are Not the Answer

Hormones can matter. They are also not a universal explanation for anxiety, depression, libido, brain fog, ADHD symptoms, or fatigue. The differential has to happen before the optimization.

9 min read Listen

Mental Health Jun 27, 2026

When Wearable Data Makes Anxiety Worse: HRV, Sleep Scores, CGMs, and Founder Health

Some patients do not need more data. They need the data to stop running the room. HRV, sleep scores, and CGMs can help — or they can worsen anxiety, sleep-onset fear, food rigidity, and compulsive self-monitoring.

8 min read Listen

Women's Mental Health Jun 20, 2026

Women in Tech After 40: Perimenopause, ADHD, Anxiety, and Brain Fog

She did not become less capable at 46. The system she used to run on changed. Perimenopause, previously compensated ADHD, sleep disruption, thyroid changes, and medication effects all look like brain fog from the outside.

9 min read Listen

ADHD Jun 13, 2026

Stimulants, Caffeine, GLP-1s, and Under-Eating: When the Activation Stack Breaks Focus

Stimulants plus caffeine plus GLP-1 appetite suppression plus high workload is a very San Francisco pattern. When the stack collides with under-eating, the result looks like medication failure but the medication is not the problem.

8 min read Listen

ADHD Jun 6, 2026

Sleep Debt Looks Like ADHD: What Founders and Tech Workers Need to Know

Sleep debt can wear an ADHD costume convincingly enough to fool a clinician. Before treating distractibility, working memory gaps, and task-initiation problems as ADHD, sleep duration, sleep quality, and sleep apnea need to be in the room.

8 min read Listen

Metabolic Health May 30, 2026

GLP-1s, Sleep Apnea, Mood, and Focus: Why Weight Loss Can Change the Psychiatric Picture

Weight loss can make the psychiatric picture clearer. It can also make it noisier. GLP-1 medications affect sleep apnea, nutrition, medication response, alcohol use, and mood in ways that psychiatry needs to track.

9 min read Listen

ADHD May 23, 2026

When ADHD Medication Stops Working: Sleep Debt, Stimulants, Startup Stress, and Medical Mimics

"My ADHD medication stopped working" is not one problem. Before escalating dose, the differential includes sleep debt, nutrition, caffeine load, blood pressure, and whether the original diagnosis was complete.

8 min read Listen

Women's Mental Health May 19, 2026

Before PT-141: What to Check When Desire Disappears

PT-141 is not a shortcut around diagnosis. The label exclusions are exactly where a real low-desire workup starts.

9 min read Listen

Diagnostic Psychiatry May 16, 2026

Biohacking in San Francisco: What to Check Before NAD, Peptides, Hormones, or GLP-1s

The problem with biohacking is not curiosity. The problem is when the stack gets bigger and the explanation gets weaker.

10 min read Listen

ADHD May 12, 2026

Menopause Brain Fog or ADHD? How to Tell

ADHD does not begin at 48, but perimenopause can make compensated ADHD impossible to ignore.

9 min read Listen

ADHD May 9, 2026

Founder Burnout or Adult ADHD? A San Francisco Diagnostic Psychiatry Guide

A founder can look productive and still be clinically deteriorating. Burnout, ADHD, sleep debt, stimulant load, low ferritin, thyroid disease, and mood disorders can all collapse focus in different ways.

9 min read Listen

Women's Mental Health May 5, 2026

PMDD vs Bipolar Disorder: The Pattern That Changes the Diagnosis

PMDD is cycle-timed. Bipolar disorder is episode-based. The wrong pattern can lead to the wrong medication plan.

9 min read Listen

Women's Mental Health Apr 28, 2026

Vaginal Dryness and Low Libido: Hormones, SSRIs, or Depression?

When sex hurts, desire often disappears. Treating the tissue and ignoring the mood, medication, and avoidance loop can still leave patients stuck.

8 min read Listen

Women's Mental Health Apr 21, 2026

Testosterone for Women: Mental Health Effects Nobody Explains

Testosterone gets sold as the answer for everything. The evidence is much narrower, and the mental health story needs a real workup.

9 min read Listen

Women's Mental Health Apr 14, 2026

Low Libido in Women: Depression, Hormones, SSRIs, or Stress?

Low libido is not one diagnosis. Desire, arousal, pain, orgasm, distress, mood, hormones, and medication history all need to be separated.

8 min read Listen

Medication Guides Apr 7, 2026

Prozac Side Effects in Women: Libido, Weight, Anxiety, and Sleep

If Prozac helped your mood but changed your libido, sleep, appetite, anxiety, or emotional range, the answer is a side-effect review, not shame.

9 min read Listen

Women's Mental Health Mar 31, 2026

Too Much Progesterone? Mood, Sleep, Depression, and Brain Fog Signs

Natural progesterone can still cause side effects. If mood, sleep, or brain fog changed after a hormone change, the timing matters.

8 min read Listen

Women's Mental Health Mar 24, 2026

When Perimenopause Feels Like a Mental Health Crisis

Perimenopause can feel like a mental health crisis, but suicidal thoughts, mania, psychosis, and not sleeping for days are never just hormones.

8 min read Listen

Anxiety Mar 17, 2026

Perimenopause Anxiety: Why It Feels Like Panic Disorder

New anxiety after 40 deserves more than another SSRI. Perimenopause can feel like panic disorder, but the right diagnosis depends on the timeline, sleep, hormones, labs, and medication history.

9 min read Listen

Anxiety Mar 10, 2026

Why Magnesium Deficiency Is Sabotaging Your Sleep, Anxiety, and Recovery

Your 'normal' magnesium level is almost meaningless—serum magnesium represents less than 1% of total body stores. Learn why the right test and the right form of magnesium matter for anxiety, insomnia, and mood.

15 min read Listen

Depression Feb 17, 2026

Hormone Testing After 40: What Actually Helps Depression and Anxiety

Mood symptoms after 40 are not always primary depression. Perimenopause, thyroid disease, low ferritin, sleep disruption, and medication effects can look psychiatric. Hormone labs help selectively, not automatically.

9 min read Listen

Lab Testing Nov 20, 2025

Low Ferritin Symptoms Without Anemia

A normal CBC doesn't rule out low iron stores. I explain low ferritin symptoms, what a full iron panel shows and how sleep and mood fit the pattern.

11 min read Listen

Sleep Nov 6, 2025

Sleep and Mental Health: The Bidirectional Connection Your Doctor May Be Missing

Most psychiatrists treat depression and insomnia as separate problems. Research shows they're often two sides of the same coin--and treating one without the other is why you're still struggling.

14 min read Listen

ADHD Sep 30, 2025

Women's ADHD Signs: Masking, Cycles & Focus

ADHD in women can look like anxiety, perfectionism, burnout, cycle-related brain fog, and emotional exhaustion. The diagnosis gets missed when clinicians only look for the stereotype.

8 min read Listen

ADHD Sep 16, 2025

Adult ADHD Symptoms vs Burnout: How to Tell in Daily Life

Many adults confuse ADHD symptoms with burnout because both involve exhaustion, focus struggles, and low motivation. This post breaks down the daily patterns, subtle differences, and recovery strategies to help you tell them apart, and know when to seek support.

9 min read Listen

Anxiety Mar 12, 2025

Propranolol for Anxiety: Dosage, Timing, and What It Actually Feels Like

Most providers prescribe propranolol for anxiety without investigating why you're anxious in the first place. Physical symptoms tell a story—and propranolol might be masking what your body is trying to tell you.

14 min read Listen

Anxiety Mar 10, 2025

Gabapentin for Anxiety: Benefits, Side Effects, and Dosage Guide

Gabapentin works for anxiety in specific cases—social anxiety, alcohol recovery, chronic pain overlap. Learn dosing, side effects, and why medical testing matters first.

14 min read Listen

Anxiety Mar 9, 2025

Lexapro vs. Zoloft: Which Antidepressant Works Best for Anxiety

Compare Lexapro vs Zoloft: efficacy, side effects, and dosing. Both are legitimate SSRI options, but diagnosis and medical factors change the right choice.

11 min read Listen

Medication Guides Feb 22, 2025

Wellbutrin and Therapy: When Medication Makes the Work Easier

Medication and therapy are not rivals. For the right patient, Wellbutrin can make therapy easier to use by improving energy, motivation, and follow-through. The fit depends on diagnosis, safety, and medical factors.

8 min read Listen

Anxiety Feb 20, 2025

Wellbutrin vs Benzodiazepines for Anxiety: A Psychiatric Provider's Clinical Comparison

Wellbutrin isn't a benzodiazepine. Compare its anxiety evidence and seizure risks with benzodiazepine dependence, withdrawal and prescriber precautions.

13 min read Listen

Anxiety Feb 18, 2025

Wellbutrin vs SSRI for Anxiety: Which Medication Fits the Pattern?

Wellbutrin is not an SSRI. Bupropion is approved for depression, not anxiety disorders. Some SSRIs have specific anxiety indications; diagnosis and safety guide the comparison.

10 min read Listen

Medication Guides Feb 16, 2025

Wellbutrin Side Effects: What to Expect and When to Worry

Wellbutrin can cause insomnia, dry mouth, nausea and anxiety. Know when to contact your prescriber and which symptoms need emergency care.

13 min read Listen

Medication Guides Feb 14, 2025

Wellbutrin Dosage Guide: Finding Your Optimal Dose (XL vs SR, 150mg vs 300mg vs 450mg)

150mg, 300mg, or 450mg? Check the formulation first. Wellbutrin XL, SR, and IR have different dosing schedules and limits. Dose changes need a review of symptoms, side effects, and safety with your prescriber.

10 min read Listen

Weight Management Dec 15, 2024

Semaglutide vs Tirzepatide: Weight Loss, Lean Mass, and Which GLP-1 Works Best

Tirzepatide now has head-to-head data showing greater weight loss than semaglutide, but the better medication still depends on cardiovascular history, sleep apnea, side effects, cost, and monitoring.

7 min read Listen

Weight Management Dec 12, 2024

The Evolution of GLP-1 Agonists: From Diabetes Treatment to Cardiovascular Protection

GLP-1 medications are no longer only diabetes or weight-loss drugs. The current story includes cardiovascular risk reduction, sleep apnea, MASH, and a much higher bar for monitoring.

7 min read Listen

Mental Health Blog

All articles

Most read

Wellbutrin Dosage Guide: Finding Your Optimal Dose (XL vs SR, 150mg vs 300mg vs 450mg)

Low Ferritin Symptoms Without Anemia

Wellbutrin Side Effects: What to Expect and When to Worry

Wellbutrin vs Benzodiazepines for Anxiety: A Psychiatric Provider's Clinical Comparison

Low Ferritin, ADHD, and Medication Response: The Lab That Gets Skipped

Alcohol, Anxiety, and Depression in Founders: What the Clinical Picture Actually Shows

Cannabis, ADHD, Sleep, and Anxiety: What Founders Get Wrong About Self-Medication

Before Brain Mapping and Neurofeedback: The Psychiatric Differential That Should Come First

Hormone Optimization and Mood: When Testosterone, Thyroid, and Estrogen Are and Are Not the Answer

When Wearable Data Makes Anxiety Worse: HRV, Sleep Scores, CGMs, and Founder Health

Women in Tech After 40: Perimenopause, ADHD, Anxiety, and Brain Fog

Stimulants, Caffeine, GLP-1s, and Under-Eating: When the Activation Stack Breaks Focus

Sleep Debt Looks Like ADHD: What Founders and Tech Workers Need to Know

GLP-1s, Sleep Apnea, Mood, and Focus: Why Weight Loss Can Change the Psychiatric Picture

When ADHD Medication Stops Working: Sleep Debt, Stimulants, Startup Stress, and Medical Mimics

Before PT-141: What to Check When Desire Disappears

Biohacking in San Francisco: What to Check Before NAD, Peptides, Hormones, or GLP-1s

Menopause Brain Fog or ADHD? How to Tell

Founder Burnout or Adult ADHD? A San Francisco Diagnostic Psychiatry Guide

PMDD vs Bipolar Disorder: The Pattern That Changes the Diagnosis

Vaginal Dryness and Low Libido: Hormones, SSRIs, or Depression?

Testosterone for Women: Mental Health Effects Nobody Explains

Low Libido in Women: Depression, Hormones, SSRIs, or Stress?

Prozac Side Effects in Women: Libido, Weight, Anxiety, and Sleep

Too Much Progesterone? Mood, Sleep, Depression, and Brain Fog Signs

When Perimenopause Feels Like a Mental Health Crisis

Perimenopause Anxiety: Why It Feels Like Panic Disorder

Why Magnesium Deficiency Is Sabotaging Your Sleep, Anxiety, and Recovery

Hormone Testing After 40: What Actually Helps Depression and Anxiety

Low Ferritin Symptoms Without Anemia

Sleep and Mental Health: The Bidirectional Connection Your Doctor May Be Missing

Women's ADHD Signs: Masking, Cycles & Focus

Adult ADHD Symptoms vs Burnout: How to Tell in Daily Life

Propranolol for Anxiety: Dosage, Timing, and What It Actually Feels Like

Gabapentin for Anxiety: Benefits, Side Effects, and Dosage Guide

Lexapro vs. Zoloft: Which Antidepressant Works Best for Anxiety

Wellbutrin and Therapy: When Medication Makes the Work Easier

Wellbutrin vs Benzodiazepines for Anxiety: A Psychiatric Provider's Clinical Comparison

Wellbutrin vs SSRI for Anxiety: Which Medication Fits the Pattern?

Wellbutrin Side Effects: What to Expect and When to Worry

Wellbutrin Dosage Guide: Finding Your Optimal Dose (XL vs SR, 150mg vs 300mg vs 450mg)

Semaglutide vs Tirzepatide: Weight Loss, Lean Mass, and Which GLP-1 Works Best

The Evolution of GLP-1 Agonists: From Diabetes Treatment to Cardiovascular Protection