Tally Repro Psych

05/12/2026

Okay sometimes I literally say out loud “that was a good one and I might reuse it later.” 😂 My most recent one was: “Setting boundaries is like holding up an umbrella in a rain storm, you can prevent the rain from falling on you, but you don’t have any control of where it goes after that and that’s okay.” I think this is the hardest part of setting boundaries for most people. People fear that if they set a boundary, they will be responsible for the consequences. Everyone is responsible for their own behaviors. As long as you’re setting the boundary to be kind to yourself without the intent of harming someone, it’s not mean. Actually, there’s an ethical principle to this I just learned about from that trolley article.

When you go to set a boundary, you may foresee a possible negative consequence, but as long as you do not intend the negative consequence, you’re probably good. Just make sure your intention is protecting your peace.



Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC6642460/

05/12/2026

Some patients come in really worried and self conscious about their caffeine use. Maybe I should be more vigilant about patients caffeine use, but that would be so hypocritical of me! I’m a 3-6 caffeine drinks a day person. Too much of anything is bad for you. There are even case reports of people drinking caffeine and having psychosis or mania, but that is when drinking a lot of caffeine. As long as you’re using in moderation, don’t sweat it. 1-2 cups of coffee a day in the morning is preferred, but I definitely have patients who drink coffee before bed to settle down and no judgement! This does actually work from some people with ADHD specifically. It’s called a paradoxical reaction. Now, I am a huge advocate of quitting all the other extracurricular substances. I would much rather someone reduce those substances before even worrying about caffeine.

It is helpful to be aware of how much caffeine is in your drinks. Many of the big coffee brands have 2-3 times the normal amount of caffeine in them compared to the coffee you would drink at home. So sip your fancy coffees a little slower than your home ones and order a small.

How many cups of coffee do you need a day?

05/12/2026

So many women think they cannot have healthy pregnancies because they take psychiatric medications. There actually are a lot of options for management of mental health conditions during pregnancy and postpartum. Mother to baby and Lact med are two great resources for patients and providers to stay up to date on recommendations. Like, Share, Follow and Subscribe for more original content by Tally Reproductive Psychiatrist, Jamie Lee Sorenson, MD on Women’s Mental Health and the Bendy Boy Mom life. Taking new patients in FL, GA, CO, TN, and MA. All patients 12 years and older are welcome. Now accepting patients in MA! Disclaimer: Posts are for education and entertainment only. No medical advice given. This information is for general knowledge and not meant to diagnose or treat any conditions. www.tallyrepropsych.com || info@tallyrepropsych.com ll

05/12/2026

Ahhh the classic trolley problem and medical ethics… lord have mercy. I was just trying to film some boring b rolls and ended up striking gold. This is not acting, but genuine reactions to this source.

Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC6642460/

05/12/2026

Now I just need a better solution than gabbing with my girlfriends. 👯‍♀️ I know a lot of people get upset when antidepressants are prescribed for pain, but they definitely help reduce pain and pain perception. I think the biggest problem with these prescriptions are that they aren’t coming from psychiatrists who understand the poor tolerability of these medications at high doses. For example, neurologists will start amitriptyline at 50-100 mg. I start it at 10 mg and usually patients max out at 25 mg which is okay as long as they are getting benefits and side effects are tolerable!

05/12/2026

Only 2% of mammals menstruate the way women do and we don’t even bother to consistently study cycling hormones in animal models that approximate women. Even though there are rodent options, specifically the spiny mouse, that would be reasonable alternatives to rats and mice. I know animal testing is a difficult subject for some people, but if we are going to do animal testing at least make their “sacrifice” worth it and generalizable to the population you are trying to study!

Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC6541669/

05/12/2026

Honestly, I’m not surprised about anything anymore. I don’t understand how these people sleep at night. Get a clue. Women will have babies when they feel safe and think they can afford to take care of them. Birth rates will continue to decline if you don’t support mothers. Like, Share, Follow and Subscribe for more original content by Tally Reproductive Psychiatrist, Jamie Lee Sorenson, MD on Women’s Mental Health and the Bendy Boy Mom life. Taking new patients in FL, GA, CO, TN, and MA. All patients 12 years and older are welcome. Now accepting patients in MA! Disclaimer: Posts are for education and entertainment only. No medical advice given. This information is for general knowledge and not meant to diagnose or treat any conditions. www.tallyrepropsych.com || info@tallyrepropsych.com ll

05/11/2026

When I share this story with other psychiatrists I can’t believe their reactions. They have all been horrified which is very validating. I’m less mad at the patient and more mad at the supervisor. My supervisor was a real sociopath. I think he had a lot of aggression towards me that he wanted to take out on me and used this patient as his pawn to do it. Almost any rational person would not send a person to sit alone with someone who was threatening them week after week, but this supervisor insisted that I had to sit with a threatening man in a room alone for an hour every week for a year. Then I had to sit for an hour with the supervisor every week and be interrogated about my experience and “sexual feelings” towards the person threatening me (and also 50 years older than me) under the guise of “psychodynamic therapy training” because obviously if someone was threatening me with R&P3 it was actually “my fault.” Mind you, I was 27 years old, happy, healthy and newly married to the man of my dreams.

The justice in this situation is that I did learn a lot from this experience. I learned that a sociopath like that supervisor can hide in plain sight and be enabled for years by an academic medical center to slowly terrorize young women. I also learned to feel sorry for him because his experience of life and the world was empty and meaningless. I’m not into hating people, but I think pitying this supervisor is actually the most demeaning thing I could do to him so that’s what I do.

05/11/2026

Pulse dosing is a really great option for a person that has consistent cycles and is organized enough to remember taking a different medication regimen for the second half of their cycle. That said, it’s completely understandable if you’re not in that camp! I often prescribe different regimens throughout the month. I would say less than half of women prefer to take different medications during their luteal phase, I’m in that camp myself. Most women decide to take their medication throughout the whole month to address luteal phase symptoms. I try to make sure all my patients’ symptoms are managed well throughout the entire month before we land on a medication regimen. There are so many things that are culturally wrong with how we think about the menstrual cycle, first that we do not even acknowledge it or allow women to rest more when needed (not to mention lack of adequate pain control). I think another issue is that we accept it’s normal to have mood disturbances in the second half of our cycle. It’s common, but it’s not normal. There are treatment options and you absolutely do not have to suffer through luteal phase exacerbations each month.

FYI, if you have a mood disorder, you cannot be diagnosed with PMDD, it is considered a premenstrual exacerbation. That said, I tagged PMDD because it’s the most commonly known way of describing this phenomenon. I use many of the same interventions for PME as I do for PMDD.

05/11/2026

Not medical advice, but you can definitely ask your doctor if this is a treatment option for you. People with bipolar disorder should usually avoid Prozac because it can induce hypomania or mania. That said, sometimes you have to break the rules to be well and that’s okay too. The most important thing is that you trust your doctor to monitor your symptoms closely and respond appropriately.

Also, Venlafaxine is a really great medication, but sometimes people need to or want to stop it which is totally understandable. It’s kind of notorious for having the worst withdrawal symptoms which is why I included it in this reel. That said, you can have withdrawal symptoms from any antidepressant. They would include fatigue, electric shocks (iykyk), headache, nausea, dizziness, muscle aches. The other antidepressants that are known for withdrawal syndromes are: duloxetine and Paroxetine.

The trick with the fluoxetine dosing is that it’s very long acting so it can smooth out the taper you have going on. I tell my patients that one of the benefits of fluoxetine is that you can stop it at any dose at any time without withdrawal symptoms because it’s so long acting that it actually tapers itself out of your system.

Did you have any issues discontinuing an antidepressant? And how did you cope?

Work with your doctor on what’s the best fit for you!

05/11/2026