Critically Speaking

Have you or someone you loved considered taking antidepressants for mental health, but had concerns? Listen in as Dr. Andrew Novick talks about the research and the science behind these drugs and other options for those struggling with MDD and other mental health concerns. 
 
In this episode, Therese Markow and Dr. Andrew Novick discuss major depressive disorder (MDD) and its treatment options. Dr. Novick explains the key characteristics of MDD and discusses some of the many treatment options, which include psychotherapy, particularly cognitive-behavioral therapy, and pharmacological interventions like SSRIs. He highlights the effectiveness of esketamine for treatment-resistant MDD, and also addresses the controversy surrounding SSRIs and the potential of new treatments like psilocybin, noting ongoing research and regulatory challenges.
 
 Key Takeaways:
Major Depressive Disorder (MDD) can begin in childhood, but can often show up as irritability rather than other traditional depressive symptoms that we would see in adults. It's also more common to see it manifest during puberty, rather than before.

Treating MDD does not require starting with psychotherapy. Medication can help more immediately, especially because there is an obstacle to accessible therapy for a lot of people. It can also be a tool used in tandem with therapy. 

While there are no blood tests or simple diagnostic tests to see if you have depression, like with an infectious disease model, there are some brain scans that can show signs of depression, especially across wide populations of individuals. 

There is no one gene that is associated with MDD. However, through research, many different genes have been identified, often related to brain function and stress response. 

 
"If depression goes untreated, the most awful consequence of that is potential suicide." —  Dr. Andrew Novick

 
Connect with Dr. Andrew Novick:
Professional Bio: https://som.cuanschutz.edu/Profiles/Faculty/Profile/29109 
ResearchGate:  https://www.researchgate.net/profile/Andrew-Novick 
LinkedIn: linkedin.com/in/annovick 
 
Connect with Therese:
Website:  www.criticallyspeaking.net
Bluesky: @CriticallySpeaking.bsky.social
Instagram: @criticallyspeakingpodcast
Email: theresemarkow@criticallyspeaking.net
 
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.

From testosterone craze headlines to myths about prostate cancer, fertility, and aggression, men are getting a lot of confusing messages about their sexual health. Today, urologist and men's health expert Dr. Justin Dubin cuts through the noise with science-backed answers to the questions men are often too embarrassed to ask.
 
In this episode, Therese Markow and Dr. Justin Dubin discuss listener questions regarding men's sexual health. Dr. Dubin explains the nuances of testosterone levels, noting that normal ranges vary and can impact overall health. He highlights the importance of addressing low testosterone, which can lead to significant health issues, including all-cause mortality. He dives into the risks and benefits of testosterone replacement therapy, emphasizing the need for proper medical guidance. Additionally, Justin addresses the stigma around men's health, the role of direct-to-consumer testosterone sales, and the impact of prostate cancer treatments on sexual function. 
 
 Key Takeaways:
Health is not just about living longer; it should also be about living better. 

There are different forms of testosterone. The majority of it, about 98%, is bound to other proteins. Free testosterone is what can bind to your receptors.

There is really good data suggesting that men with low testosterone die at a younger age; they have a higher all-cause mortality. It's not just a mood; it's not just a sex thing. It is an overall marker for your health.

If you are interested in future fertility and you have low testosterone, do not take real testosterone replacement therapy; there are alternative options.

Before you go on any medication, you should know the risks and benefits of what you are thinking of taking.

 
"If I can stop making men think with their penises and start making them think about their penises, I think we can get a lot more guys healthier, a lot more guys happier, and a lot more guys doing the things that they want to be able to do inside and outside the bedroom." —  Dr. Justin Dubin

 
Episode References:
Guideline-Discordant Care Among Direct-to-Consumer Testosterone Therapy Platforms: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2799297 

 
Connect with Dr. Justin Dubin:
Professional Bio: https://baptisthealth.net/doctors/justin-dubin/5921802 
Website: https://www.themanuppod.com/ 
Man Up Podcast: https://open.spotify.com/show/1FkEhH04XdxruNg1xxsEdo 
YouTube: http://youtube.com/@themanuppod 
LinkedIn: https://www.linkedin.com/in/justin-dubin-m-d-9a9b7917/ 
Instagram: https://www.instagram.com/justindubinmd/?hl=en 
Linktree: https://linktr.ee/JustinDubinMD 
 
Connect with Therese:
Website:  www.criticallyspeaking.net
Bluesky: @CriticallySpeaking.bsky.social
Instagram: @criticallyspeakingpodcast
Email: theresemarkow@criticallyspeaking.net
   
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.

Do you ever feel exhausted by home life, even when the chores look "even"? This episode uncovers the hidden mental load running beneath every household and reveals how it quietly shapes stress, careers, and relationships.
 
Today, Therese Markow and  Dr. Allison Daminger discuss her research on cognitive labor, which reveals gender inequality in household decision-making. Allison interviewed 92 couples, and they discuss the results found between both queer and heterosexual couples throughout the study. These decisions were categorized into 10 domains, ranging from maintenance to health to childcare. Throughout the episode, Allison emphasizes the need for couples to recognize and address the imbalances, suggesting starting with low-hanging fruit and fostering a growth mindset to achieve a more equitable division of labor. 
 
 Key Takeaways:
In different-sex households, cognitive labor is overwhelmingly shouldered by women, with roughly 80% of such homes being woman-led across domains like schedules, childcare coordination, finances, and home maintenance.

Same-sex couples tend to divide cognitive labor more deliberately and flexibly, often discussing who does what and viewing roles as changeable rather than fixed by gender stereotypes.

Unequal cognitive labor carries real costs - chronic exhaustion, career compromises, and relationship strain - making it crucial for couples to name this work, question "it just happened this way" narratives, and experiment with small, intentional rebalances in specific domains.

Women's lives changed dramatically in the second half of the twentieth century, in a way that men's lives did not. However, there is now an emerging trend that seems to show more men feeling a pull toward the traditional household cognitive load often carried by women.

 
"One reason that my research has resonated with a lot of people is that it's given them language to explain something that they experience every day. People know that they're doing a lot, but until they recognize this as a form of work that is taxing, it can be easy to kind of downplay what you're contributing to your family, especially when it feels like you and your partner are sharing the physical work relatively equitably." —  Dr. Allison Daminger
 
Connect with Allison:
Professional Bio: https://www.allisondaminger.com/about 
Substack: https://allisondaminger.substack.com/   
Website: https://www.allisondaminger.com/ 
LinkedIn: https://www.linkedin.com/in/allisondaminger 
Book: What's On Her Mind: The Mental Workload of Family Life - https://bookshop.org/p/books/what-s-on-her-mind-the-mental-workload-of-family-life-allison-daminger/585e2aa7eac0a0ea 
 
Connect with Therese:
Website:  www.criticallyspeaking.net
Bluesky: @CriticallySpeaking.bsky.social
Instagram: @criticallyspeakingpodcast
Email: theresemarkow@criticallyspeaking.net
 
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.

In this episode, Therese Markow and psychologist Dr. Elizabeth Scott discuss narcissism, its clinical definition, and the characteristics of "malignant narcissism". Dr. Scott explains that narcissism involves patterns of grandiosity, a need for constant admiration, a lack of empathy, high levels of manipulation, and the narcissist's "kryptonite" - criticism. They view themselves as the victim, never at fault. Despite their arrogance, they are very insecure. Dr. Scott also discusses why treatment is challenging and why therapy often focuses on managing symptoms rather than the deeper core issues. They can't see that they have a problem, and thus are resistant to treatment.
 
 Key Takeaways:
The myth of Narcissus illustrates the danger of excessive self-focus, which is the hallmark of narcissism in clinical terms and is becoming increasingly common in some aspects of our modern society. 

Narcissists are very good at manipulation. They consciously will do things to sort of manage their image in the eyes of others. They may appear to show empathy at times in a relationship, but it's usually more of a means to an end than a genuine concern for the feelings of others.

Criticism is like kryptonite to a narcissist, so even the mildest critique can provoke a strong defensive reaction: anger, denial, or shifting the blame to somebody else.

You cannot change a narcissist's behavior, but you can control your own responses to it. Think about limits and then give yourself leeway within those to protect your own mental health. 

 
"[Narcissists] might mimic empathetic behaviors to achieve their own ends, but it's more about manipulation than genuine caring. So they can understand maybe what empathy looks like, but not really get how it feels and how it's supposed to feel and how those behaviors are supposed to be rooted in something inside them." —  Elizabeth Scott, Ph.D.
 
Connect with Elizabeth Scott, Ph.D.:
Twitter: https://x.com/ElizabethScott 
Facebook: https://www.facebook.com/AboutStressManagement/ 
Website: https://drelizabethscott.com/  
Instagram: https://www.instagram.com/dr.elizabethscott/ 
Book: 8 Keys to Stress Management: https://www.amazon.com/Keys-Stress-Management-Mental-Health-ebook/dp/B00AJUKO5M 
 
Connect with Therese:
Website:  www.criticallyspeaking.net
Bluesky: @CriticallySpeaking.bsky.social
Instagram: @criticallyspeakingpodcast
Email: theresemarkow@criticallyspeaking.net
 
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.

What if the biggest risk factor for cancer, heart disease, and dementia isn't your genes, diet, or blood pressure but aging itself? Listen in as biogerontologist Dr. Matt Kaeberlein reveals how understanding the biology of aging could add not just years to our lives, but healthy decades, and why your dog might hold some of the most important clues.
 
In this episode, Therese Markow and Dr. Matt Kaeberlein discuss aging research. He explains that aging is characterized by damage accumulation and loss of resilience, leading to functional decline. Matt highlights the hallmarks of aging, such as deregulation of nutrient sensing and DNA damage, and the potential of interventions like rapamycin to slow aging. He notes that biological age is a significant risk factor for major diseases, and that understanding and addressing aging biology could significantly extend human lifespan. They also discuss the Dog Aging Project, with 55,000 participating dogs, which aims to uncover genetic and environmental factors influencing health and longevity in pets.
 
 Key Takeaways:
Our bodies are constantly being exposed to stress, and stress can move us out of the optimal zone of function. When we're young, we're very resilient and able to come back to optimal function. As we get older, we lose that resilience.

When we slow aging in laboratory animals, we prevent the onset and progression of all of the major age-related functional declines and diseases simultaneously, because we've slowed biological aging. Based on what's possible in mice, it is estimated that we could potentially gain 2-3 additional decades of life if we can achieve this in humans.

There is a genetic component to longevity; however, how big that genetic component is to longevity is hotly debated. The environment is also a large contributor. 

 
"Biological age is the single greatest risk factor for nine of the top 10 killers in the United States, and it's not a small effect. The magnitude of effect from biological aging dwarfs all of the other risk factors combined…it's useful to appreciate how important biological age is to the risk of developing many of the chronic diseases and functional declines that limit quality and quantity of life for most people." —  Dr. Matt Kaeberlein
 
Episode References: 
Dog Aging Project: https://dogagingproject.org/ 

Dog Aging Institute: https://dogaginginstitute.org/ 

Longevity for Dogs: https://www.youtube.com/@LongevityForDogs 

 
Connect with Dr. Matt Kaeberlein:
Professional Bio: https://halo.dlmp.uw.edu/people/matt-kaeberlein/ 
Publications: https://pubmed.ncbi.nlm.nih.gov/?term=%22kaeberlein+m%22[author]   
YouTube: https://www.youtube.com/@mkaeberlein 
LinkedIn: https://www.linkedin.com/in/mkaeberlein/ 
 
Connect with Therese:
Website:  www.criticallyspeaking.net
Bluesky: @CriticallySpeaking.bsky.social
Instagram: @criticallyspeakingpodcast
Email: theresemarkow@criticallyspeaking.net
 
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.