Psych Congress Family & Friends Podcast, Episode 5: We’re Too Addicted to Our Own Good Ideas

In this episode, Drs Rakesh Jain and Craig Chepke reflect on how the words we use—and the habits we form—shape the way we practice. The pair also take a fresh look at the serotonin story, talk through new ways of understanding depression, and share why long-acting treatments might be a better fit for bipolar care than we think.

Episode Highlights:

• A candid look at the "serotonin myth" and how it shaped clinician and patient understanding
• The case for norepinephrine in various treatment models
• Why overly simplistic biological explanations can undermine trust and treatment success
• Updates on a new subcutaneous long-acting risperidone for bipolar I disorder (pending FDA review)
• The overlooked power of long-acting injectables (LAIs) in preventing relapse
• Partial adherence as a dynamic clinical reality and how to address it
• How psychiatry’s language around LAIs may be harming uptake
• A “12-step” reframing for clinicians stuck in old models of bipolar care

Rakesh Jain, MD, MPH, attended medical school at the University of Calcutta in India. He then attended graduate school at the University of Texas School of Public Health in Houston, where he was awarded a “National Institute/Center for Disease Control Competitive Traineeship”. His research thesis focused on impact of substance abuse. He graduated from the School of Public Health in 1987 with a Masters of Public Health (MPH) degree.

Dr Jain served a 3-year residency in Psychiatry at the Department of Psychiatry and Behavioral Sciences at the University of Texas Medical School at Houston. He followed that by obtaining further specialty training, by undergoing a two-year fellowship in Child and Adolescent Psychiatry. In addition, Dr Jain completed a postdoctoral fellowship in Research Psychiatry at the University of Texas Mental Sciences Institute, in Houston. He was awarded the “National Research Service Award” for the support of this postdoctoral fellowship.

Craig Chepke, MD, DFAPA, is a Board-Certified psychiatrist in clinical practice as the medical director of Excel Psychiatric Associates in Huntersville, NC, and is an Adjunct Associate Professor of Psychiatry for the Sandra and Leon Levine Psychiatry Residency Program at Atrium Health. He attended NYU School of Medicine and completed his psychiatry training at Duke University. As part of an interdisciplinary treatment team in his practice, he employs a person-centered care model to tailor treatments to each individual's needs, integrating traditional pharmacotherapy with psychotherapeutic and physical health and wellness interventions. His clinical and academic interests include serious mental illness, movement disorders, ADHD, and sleep medicine. Dr Chepke is the Scientific Director for the Psych Congress portfolio of CME conferences, and he has been recognized as a Distinguished Fellow of the American Psychiatric Association.