Off the Couch Psychology

Jerry L. Cunningham
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  • Mental Health
  • Updated weekly

Off the Couch Psychology Podcast is your go-to source for understanding mental health, breaking the stigma around mental illness, and learning how to take control of your mind and your life. Hosted by Dr. Jerry Cunningham, psychologist, author, and podcast host, this show breaks down complex psychological topics into real, practical conversations you can actually use in your everyday life. Each episode explores mental health in a way that is clear, relatable, and grounded in real science. From anxiety, depression, ADHD, trauma, and burnout to cutting-edge psychological research and treatment approaches, you'll gain a deeper understanding of what's really going on in your mind—and what you can do about it. This isn't therapy—but it might be the closest thing you can get in your car, at the gym, or sitting on your couch. If you've ever struggled with stress, overthinking, emotional exhaustion, or just found yourself wondering, "What is going on in my mind?"—this podcast is for you. You'll learn: • How anxiety, depression, and other mental health disorders actually work • Evidence-based therapy approaches that professional use and coping strategies you can use • How to manage stress, overthinking, and emotional overwhelm • Information about mental health medications and treatment options • Practical tools to improve your mental health and daily life This podcast is designed to educate, motivate, and empower you to take action—because understanding your mind is the first step to changing your life.

  1. 1 day ago

    The Rules Your Family Never Said

    What happens when someone breaks a rule nobody ever said out loud? An elevator ride turns awkward. A family dinner goes quiet. A conversation about money becomes an argument, and neither person knows how it started. In this crossover episode of Quest for Success and Off the Couch Psychology, you'll hear how unwritten rules shape what feels safe, what causes tension, and what you expect from the people closest to you. Through the Crenshaw family's story, you'll see how some rules bring people together while others make it hard to speak up. You may even recognize a rule you've been following for years without knowing it was there. Key Takeaways Notice the unspoken expectations behind everyday conflicts. Recognize family rules worth keeping and rules worth questioning. Understand why a small change in behavior can cause a big reaction. Start a conversation without expecting someone to read your mind. Examine the money beliefs your family passed down. Listen in, then visit www.Quest-Success.com for more. Suggested Reading Harold Garfinkel, Studies in Ethnomethodology. Judee K. Burgoon, "A Communication Model of Personal Space Violations: Explication and an Initial Test". Harriet Lerner, The Dance of Anger. People and Shows Mentioned #HaroldGarfinkel #JudeeBurgoon #Bridgerton #LadyWhistledown #Mandy

  2. 3 days ago

    When Anxiety Steals Your Voice

    What happens when you know exactly what you want to say, but anxiety will not let the words come out? Selective mutism is often mistaken for shyness, stubbornness, or a child simply refusing to talk, but there is much more happening behind the silence. In this episode of Off the Couch Psychology Podcast, you'll meet nine-year-old Amber and follow her through a typical day to see how selective mutism can change dramatically from home to school. You'll learn why a child may talk nonstop around family yet struggle to say a single word in another setting, what anxiety and the brain's fear response have to do with it, and why telling someone to "just talk" can actually make speaking harder. Most importantly, you'll discover how gradual exposure, stimulus fading, positive reinforcement, speech-language support, family involvement, and other treatment approaches can help someone slowly expand where and with whom they can comfortably use their voice. If you've ever wondered what is really happening behind selective mutism—or how you can better support someone experiencing it—this episode is for you. Key Takeaways Selective mutism is not simply a choice to remain silent. Anxiety can make speaking extremely difficult in particular settings. Pressure and coercion can increase anxiety rather than improve communication. Small, gradual speaking experiences can help build confidence. Parents, schools, therapists, and speech-language professionals can work together to support progress. The goal is not to force a voice out, but to make using that voice feel safer. For more episodes, resources, and information from Dr. Jerry Cunningham, visit Quest-Success.com. Suggested Reading & Resources American Speech-Language-Hearing Association — Selective Mutism. A detailed overview of assessment, behavioral and cognitive-behavioral approaches, exposure, desensitization, stimulus fading, speech-language services, and treatment across settings. Read the ASHA Selective Mutism guide Selective Mutism Association — Treatment Statement. Explains why selective mutism should be approached through anxiety reduction rather than pressure to speak and discusses gradual movement from nonverbal to verbal communication. Read the Selective Mutism Association Treatment Statement Selective Mutism Association — Treating Selective Mutism. An accessible resource covering behavioral and cognitive-behavioral treatment, psychotherapy, medication, and speech-language intervention. Explore Selective Mutism treatment options American Academy of Child & Adolescent Psychiatry — Anxiety and Children. Provides additional information about childhood anxiety, including selective mutism and when professional evaluation may be appropriate. Read AACAP's guide to childhood anxiety James Clear — Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones. Mentioned in the episode for its broader concept of making change easier through small, manageable steps. Selective mutism itself is not a habit, but the book's small-step concept provides a useful analogy for understanding gradual progress. Learn more about Atomic Habits Mentioned in This Episode #AtomicHabits #JamesClear

  3. 11 Sept

    Can Weight Loss Hurt Your Mental Health?

    Losing weight is supposed to make you feel better—but what happens when the scale goes down and your anxiety, depression, or body-image struggles don't go with it? In this episode of Off the Couch Psychology Podcast, you'll discover why improving your physical health doesn't automatically resolve what's happening psychologically. We'll look at research involving restrictive dieting, unhealthy weight-loss methods, bariatric surgery, and significant weight loss—and why the way you lose weight may matter as much as the number of pounds you lose. You'll also meet Kathy, a woman who believed bariatric surgery would finally help her feel comfortable with herself. Her experience shows how anxiety about regaining weight, changes in eating, loose skin, old emotional wounds, and unrealistic expectations can follow someone even after successful weight loss. If you're losing weight, considering weight-loss treatment, or supporting someone who is, this episode will help you think beyond the scale and focus on becoming healthier both physically and mentally. Key Takeaways Weight loss can improve health without automatically eliminating depression or anxiety. Extreme or unhealthy weight-loss methods can be associated with greater psychological distress. Major weight loss may create unexpected challenges involving food, body image, and fear of regaining weight. Bariatric surgery often improves mental health, but some people continue to struggle or experience new psychological concerns. (PubMed) Mental health deserves to be monitored along with weight, nutrition, and physical health. Successful weight loss should be measured by overall health—not simply the number on the scale. For more episodes and resources, visit Quest-Success.com. Suggested Reading & Research Law et al. (2023), "Bariatric Surgery and Mental Health Outcomes: An Umbrella Review." A broad review examining both the mental-health benefits and potential psychological risks associated with bariatric surgery. (PubMed) Read on PubMed Castaneda et al. (2019), "Risk of Suicide and Self-Harm Is Increased After Bariatric Surgery." A systematic review and meta-analysis examining self-harm and suicide risk following bariatric surgery. (PubMed) Read on PubMed Martinelli et al. (2024), "Bariatric Surgery and New-Onset Substance Use Disorders." Research examining the risk of developing new substance-use problems following bariatric surgery. (PubMed) Read on PubMed "Weight Loss Methods and Risk of Depression" (2025). An analysis of more than 9,000 adults that distinguishes healthier weight-loss approaches from potentially harmful strategies associated with depressive symptoms. (PubMed) Read on PubMed "Depressive Symptoms at Short-, Medium-, and Long-Term Follow-Up After Bariatric Surgical Procedures" (2025). A systematic review of more than 13,000 people showing that depressive symptoms generally improve after bariatric surgery while also identifying a subgroup whose symptoms worsen. (PubMed) Read on PubMed

  4. 8 Sept

    Is It ADHD or Anxiety?

    Your child can't focus, avoids homework, struggles in class, or seems restless. Is it ADHD—or could anxiety be driving the behavior? In this episode of Off the Couch Psychology Podcast, Dr. Jerry Cunningham breaks down why ADHD and anxiety in children can look surprisingly similar on the outside while very different things may be happening underneath. You'll learn what research tells us about attention, mistakes, worry, task avoidance, and social situations—and why understanding the reason behind a child's behavior matters. Through the stories of Kavion and Rhonda, you'll hear how ADHD-related distractibility can differ from attention that gets hijacked by fear, perfectionism, or worry. You'll also learn practical clues parents and teachers can watch for and how those observations can help professionals make a more accurate diagnosis. If you've ever wondered whether a child's difficulty concentrating is ADHD, anxiety, or possibly both, this episode will give you a clearer way to think about the question. Key Takeaways ADHD and anxiety can produce similar-looking attention problems for different reasons. ADHD may involve broader difficulties regulating and sustaining attention. Anxiety can pull attention toward worry, threat, mistakes, and fear of judgment. Task avoidance can come from distractibility or from fear of failure and perfectionism. Patterns across home, school, and social situations provide important diagnostic clues. ADHD and anxiety can occur together, making a thorough professional evaluation important. (American Academy of Pediatrics) For more episodes, articles, books, and resources from Dr. Jerry Cunningham, visit Quest-Success.com. Suggested Reading & References American Academy of Pediatrics — Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents. The guideline emphasizes evaluating symptoms across multiple settings and screening for conditions such as anxiety that can coexist with or resemble ADHD. (American Academy of Pediatrics) Read the AAP guideline Jarrett & Ollendick — "Attention Mechanisms in Children With Anxiety Disorders and in Children With Attention Deficit Hyperactivity Disorder." This is the study discussed in the episode comparing attention patterns in children with ADHD and anxiety, including selective and sustained attention and attention toward threatening faces. (PubMed) View the study on PubMed American Academy of Child and Adolescent Psychiatry — Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Anxiety Disorders. Reviews evidence supporting treatments including cognitive behavioral therapy and, when appropriate, medication. (PubMed) View the anxiety guideline on PubMed Centers for Disease Control and Prevention — Diagnosing ADHD. A practical overview explaining why there is no single test for ADHD and why clinicians consider other possible causes of similar symptoms, including anxiety. (CDC) CDC: Diagnosing ADHD Centers for Disease Control and Prevention — Treatment of ADHD. Covers behavior therapy, parent training, school interventions, and medication recommendations for children with ADHD. (CDC) CDC: Treatment of ADHD People & Topics Mentioned #ADHD #Anxiety #ChildhoodAnxiety #ChildPsychology #MentalHealth #Parenting #Attention #CognitiveBehavioralTherapy

  5. 4 Sept

    Why Can't I Throw It Away?

    When does clutter become something more serious? Hoarding disorder isn't simply having a messy house or refusing to throw things away. The possessions you see are often only the visible part of a much more complicated struggle. In this episode of Off the Couch Psychology Podcast, you'll learn what separates hoarding disorder from ordinary clutter and collecting, why getting rid of seemingly worthless objects can cause genuine distress, and how decision-making and emotional attachment can keep the cycle going. We'll also step inside a realistic hoarding scenario to see what the disorder can look like for the person experiencing it—and why family members saying, "Just throw it away," rarely solves the problem. You'll also hear about specialized CBT for hoarding disorder, in-home interventions, reducing excessive acquiring, the Buried in Treasures approach, and why cleaning out a home without treating the underlying problem may not produce lasting change. (American Psychological Association) If you've watched the television shows and wondered, How does someone get to this point?, this episode takes you beyond the piles and into the psychology behind them. Key Takeaways Hoarding disorder is different from ordinary clutter, collecting, and OCD. (American Psychiatric Association) Difficulty discarding often involves powerful emotional attachments, beliefs about usefulness, and distress over making decisions. Forced cleanouts may change the environment without addressing the psychological patterns behind the hoarding. Specialized CBT can target discarding, acquiring, organization, and decision-making skills. (Hoarding) Progress is about making a home safe and functional—not turning someone into a minimalist. Long-term improvement requires continuing to practice new ways of relating to possessions. For more episodes and resources, visit Quest-Success.com. Suggested Reading & Resources Tolin, D. F., Frost, R. O., & Steketee, G. — Buried in Treasures: Help for Compulsive Acquiring, Saving, and Hoarding, 2nd ed. This is the book behind the Buried in Treasures approach discussed in the episode. (Oxford University Press) Buried in Treasures — Oxford Academic Steketee, G., & Frost, R. O. — Treatment for Hoarding Disorder: Workbook, 2nd ed. A research-based workbook focused on CBT strategies for hoarding disorder. (OUP Academic) Treatment for Hoarding Disorder: Workbook American Psychological Association — "Treating People With Hoarding Disorder." An accessible overview of the characteristics, research, brain science, and treatment of hoarding disorder. (American Psychological Association) Read the APA article International OCD Foundation — "Treatment of HD: Cognitive Behavioral Therapy." More information about specialized CBT and the role of practicing sorting and discarding within the home. (Hoarding) Read about CBT for Hoarding Disorder Mayo Clinic — "Hoarding Disorder: Diagnosis and Treatment." A useful overview for listeners wanting to learn more about evaluation and treatment options. (Mayo Clinic) Mayo Clinic Hoarding Disorder Guide People, Books & Shows Mentioned #HoardingDisorder #BuriedInTreasures #GailSteketee #RandyFrost #DavidTolin #HoardingShows

  6. 1 Sept

    PMDD: More Than Bad PMS

    For years, severe premenstrual symptoms were sometimes dismissed as simply "bad PMS." But Premenstrual Dysphoric Disorder—PMDD—is a recognized disorder that can seriously affect mood, relationships, work, and everyday functioning. In this episode of Off the Couch Psychology Podcast, you'll learn what separates PMDD from typical PMS, why the timing and pattern of symptoms are so important, and why the problem may involve the brain's response to normal hormonal fluctuations rather than simply having "too many hormones." You'll also meet Connie and see how PMDD can play out in everyday life when ordinary situations suddenly feel much harder to manage. Most importantly, we'll explore what can actually help. From symptom tracking and therapy to SSRIs, hormonal approaches, lifestyle strategies, and emerging areas of research, you'll get a practical introduction to the treatment options being studied and used today. If you—or someone you care about—seems to become a dramatically different person during the same part of the menstrual cycle each month, this episode may help you understand why. Suggested Reading & References American College of Obstetricians and Gynecologists (ACOG), "What I Wish Everyone Knew About Premenstrual Dysphoric Disorder." A listener-friendly overview of PMDD symptoms and treatment. (ACOG) Read the ACOG PMDD overview American College of Obstetricians and Gynecologists (ACOG), Clinical Practice Guideline: Management of Premenstrual Disorders. Evidence-based guidance covering diagnosis and pharmacologic, psychological, lifestyle, and other treatment approaches. (ACOG) Read the ACOG clinical guideline Mishra, S., Elliott, H., & Marwaha, R., "Premenstrual Dysphoric Disorder," StatPearls. Reviews diagnostic criteria, symptom patterns, biology, assessment, and treatment. (NCBI) Read the StatPearls PMDD review Cochrane Review, "Selective Serotonin Reuptake Inhibitors for Premenstrual Syndrome and Premenstrual Dysphoric Disorder." Reviews evidence for SSRI treatment, including continuous and luteal-phase dosing. (PubMed) View the review on PubMed Key Takeaways PMDD is more than ordinary PMS; symptoms can significantly interfere with relationships, work, and daily functioning. The cyclical timing of symptoms is an important part of recognizing PMDD. Daily symptom tracking across menstrual cycles can provide valuable information for diagnosis and treatment planning. PMDD appears to involve an increased sensitivity to normal hormonal fluctuations rather than simply abnormal hormone levels. Treatment may include SSRIs, hormonal approaches, psychotherapy, lifestyle strategies, or a combination of approaches. (ACOG) Newer treatments are being researched, but experimental approaches should not be confused with established PMDD treatments. For more episodes, resources, and information from Dr. Jerry Cunningham, visit: Quest-Success.com

  7. 28 Aug

    You're Probably Not Antisocial

    You skip the party. You avoid small talk. The gas pump says, "See cashier for receipt," and suddenly you decide you never really needed that receipt anyway. So you call yourself antisocial. But is that actually the right word? In this episode of Off the Couch Psychology Podcast, you'll discover why antisocial and asocial describe two very different patterns of behavior—and why mixing them up can completely change what you're saying about yourself. Through the stories of Amy and Becca, you'll hear how these differences show up in everyday life without getting buried in psychological jargon. We'll explore when enjoying solitude is simply a preference, when social withdrawal may signal something more, and why true antisocial behavior goes far beyond wanting people to leave you alone. And we'll finish with one of cinema's most memorable examples: Travis Bickle from Taxi Driver, a character who gives us a fascinating look at how antisocial and asocial behaviors can exist in the same person. If you've ever proudly announced, "I'm antisocial," this episode might make you reconsider your choice of words. Key Takeaways Antisocial and asocial behavior are not interchangeable terms. Preferring solitude does not automatically indicate a psychological disorder. Antisocial behavior involves disregard for the rights, safety, or well-being of others. Social withdrawal can have very different causes, including preference, anxiety, depression, or other psychological factors. Social Anxiety Disorder involves more than simply not wanting to socialize. Understanding why someone avoids people is often more important than noticing that they avoid them. For more episodes, resources, and information, visit Quest-Success.com. Suggested Reading & Resources American Psychiatric Association — APA Dictionary of Psychology: Antisocial Personality Disorder. A concise clinical explanation of the chronic pattern of disregarding and violating the rights of others associated with ASPD. (APA Dictionary) Read the APA definition Torrico, T. J., & Hany, M. — "Antisocial Personality Disorder," StatPearls. An in-depth review covering diagnosis, development, associated behaviors, differential diagnosis, and treatment. (NCBI) Read the StatPearls review at NCBI Bookshelf Merck Manual Professional Edition — "Antisocial Personality Disorder." Reviews the clinical features, diagnosis, and treatment of Antisocial Personality Disorder. (Merck Manuals) Read the Merck Manual overview National Institute of Mental Health — "Social Anxiety Disorder: What You Need to Know." Explains how Social Anxiety Disorder differs from simply preferring less social interaction and reviews symptoms and treatment options. (National Institute of Mental Health) Read the NIMH guide **American Psychiatric Association — Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). ** The diagnostic reference discussed in the episode for understanding Antisocial Personality Disorder and related mental-health diagnoses. Mentioned in This Episode #TaxiDriver #TravisBickle #RobertDeNiro #MartinScorsese #DSM5TR

  8. 25 Aug

    When Feeling Down Becomes Normal

    What happens when depression doesn't feel like a crisis—it just feels like you? Persistent Depressive Disorder, or PDD, can exist quietly for years. You may still work, maintain relationships, laugh, and handle your responsibilities while living with a low-grade sadness that has become the background static of everyday life. In this episode of Off the Couch Psychology Podcast, Dr. Jerry Cunningham explains how PDD differs from Major Depressive Disorder, the symptoms that often go unnoticed, and why people sometimes mistake chronic depression for their personality. You'll meet "Jessica," a fictional composite based on patterns seen in clinical practice, and discover how persistent depression can affect energy, confidence, decisions, relationships, and hope without completely shutting life down. Most importantly, we'll look at what actually helps—from psychotherapy and behavioral activation to medication, meaningful social connection, values, and practical changes that can help turn down that background static. If "I've always been this way" sounds familiar, this episode may give you a different question to ask. Key Takeaways Persistent depression can become so familiar that it feels like personality rather than a treatable condition. PDD is defined not simply by severity, but by its long-lasting pattern. Someone with PDD can function, laugh, work, and have good days while still experiencing chronic depression. Treatment may include psychotherapy, behavioral activation, medication, lifestyle changes, or a combination. Chronic does not mean permanent, and recognizing the pattern can be the beginning of meaningful change. For more episodes and resources, visit Quest-Success.com. Suggested Reading & References American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). The primary diagnostic reference for Persistent Depressive Disorder. Patel, R. K., Aslam, S. P., & Rose, G. M. "Persistent Depressive Disorder." StatPearls. A detailed overview of diagnosis, clinical presentation, history, and treatment. (NCBI) Schramm, E., Klein, D. N., Elsaesser, M., Furukawa, T. A., & Domschke, K. "Review of dysthymia and persistent depressive disorder: history, correlates, and clinical implications." The Lancet Psychiatry, 2020. (NCBI) Sheffler, Z. M., Patel, P., & Abdijadid, S. "Antidepressants." StatPearls. An overview of antidepressant medications, including their role in Persistent Depressive Disorder and newer treatment developments. (NCBI) Douglas Adams. The Hitchhiker's Guide to the Galaxy. Included because Marvin the Paranoid Android provides our slightly humorous illustration of what it might look like when gloom, boredom, and pessimism seem to become the permanent background setting. (Penguin Random House) Mentioned in This Episode #PersistentDepressiveDisorder #PDD #Dysthymia #Depression #MentalHealth #TheHitchhikersGuideToTheGalaxy #MarvinTheParanoidAndroid #DouglasAdams

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Off the Couch Psychology Podcast is your go-to source for understanding mental health, breaking the stigma around mental illness, and learning how to take control of your mind and your life. Hosted by Dr. Jerry Cunningham, psychologist, author, and podcast host, this show breaks down complex psychological topics into real, practical conversations you can actually use in your everyday life. Each episode explores mental health in a way that is clear, relatable, and grounded in real science. From anxiety, depression, ADHD, trauma, and burnout to cutting-edge psychological research and treatment approaches, you'll gain a deeper understanding of what's really going on in your mind—and what you can do about it. This isn't therapy—but it might be the closest thing you can get in your car, at the gym, or sitting on your couch. If you've ever struggled with stress, overthinking, emotional exhaustion, or just found yourself wondering, "What is going on in my mind?"—this podcast is for you. You'll learn: • How anxiety, depression, and other mental health disorders actually work • Evidence-based therapy approaches that professional use and coping strategies you can use • How to manage stress, overthinking, and emotional overwhelm • Information about mental health medications and treatment options • Practical tools to improve your mental health and daily life This podcast is designed to educate, motivate, and empower you to take action—because understanding your mind is the first step to changing your life.

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