The Off-Label Podcast - Mental Health, Therapy, and Psychiatry Explained

Amanda Smith MA, MSW, LCSW and Amanda Mitchell DNP, APRN, PMHNP-BC
  • 5.0 (7)
  • Mental Health
  • Updated Weekly

The Off-Label Podcast is a mental health podcast about psychiatry, medication, and therapy—explained clearly, honestly, and without judgment. Hosted by two clinicians with different perspectives, the show breaks down how mental health decisions are actually made: why treatment is rarely one-size-fits-all, what happens behind the scenes in psychiatry and therapy, and the second-order effects people don’t usually hear about. Episodes explore psychiatric medications, therapy approaches, and the real-world complexities of mental health care, with warmth, humor, and nuance.

  1. May 12

    The Anxiety Series Part 2: Understanding Anxiety (Physiology, Symptoms & Treatment)

    In Part 2 of our anxiety series, we’re going deeper, breaking down what anxiety actually is, what’s happening in your brain and body, and how medications fit into the picture. If you’ve ever wondered why anxiety feels so physical (racing heart, nausea, chest tightness, dizziness), this episode explains the physiology behind it in a way that actually makes sense. We walk through the anxiety response, including the role of the nervous system, fight-or-flight, and why your brain sometimes sounds the alarm when nothing is actually wrong. We also talk about anxiety medications—what they do, how they work, and common misconceptions people have about them. As mental health providers, we share real-world insight into when medications can be helpful and what to expect if you’re considering them. Whether you deal with generalized anxiety, panic attacks, or chronic overthinking, this episode will help you understand your symptoms in a way that feels less confusing and a lot less scary. Because once you understand what your anxiety is doing, it becomes a lot easier to work with it instead of against it.

    35 min

  2. Apr 28

    The Anxiety Series Part 1: Rating Our Most Unhinged Anxious Thoughts

    Welcome to Part 1 of our anxiety series where we’re making anxiety a little less scary and a lot more relatable. In this episode, we introduce the Catastrophe Scale, a funny but insightful way to understand how anxiety turns small moments into full-blown spirals. From unread texts to awkward social interactions, we rate everyday situations from mild concern to complete mental chaos. Along the way, we break down why anxious thoughts escalate so quickly and how to start catching yourself before you hit a level 10 spiral. If you struggle with overthinking, social anxiety, or constantly expecting the worst-case scenario, this episode will help you feel seen (and maybe laugh at your brain a little too). Because sometimes your brain is dramatic… and it’s okay to call it out.

    29 min

  3. Apr 21

    Spring Cleaning Pt. 4: Check It, Challenge It, Change It | How to Reframe Negative Thoughts (CBT)

    Hosted by Amanda Smith, MA, MSW, LCSW and Amanda Mitchell, DNP, APRN, PMHNP-BC with special guest Amber Herpfer, BA, MSWi We’re wrapping up our Mental Health Spring Cleaning series with the step that actually creates change. In Spring Cleaning Pt. 4, we break down the final piece of CBT: changing your thoughts. Using our simple framework, check it, challenge it, change it, we show you how to reframe negative thinking patterns and shift your mindset in a realistic, sustainable way. We’re also joined by our intern Amber, who helps us tie together everything we’ve covered in this series. From identifying thought patterns to challenging them and finally learning how to replace them, we work through the CBT process giving you some real tools to take home with you. In this episode, you’ll learn: How to reframe negative or distorted thoughtsWhat “changing your thoughts” actually looks like in real lifeWhy reframing isn’t toxic positivity (and what to do instead)How to start building healthier thinking patternsIf you struggle with overthinking, anxiety, or self-doubt, this episode gives you practical tools you can start using immediately.

    29 min

  4. Apr 14

    Spring Cleaning Pt. 3: Cognitive Distortions (Why Your Brain Lies to You) - CBT for Anxiety & Overthinking

    Hosted by Amanda Smith, MA, MSW, LCSW and Amanda Mitchell, DNP, APRN, PMHNP-BC Your thoughts feel true—but what if they’re not? In Spring Cleaning Pt. 3 of our Mental Health series, we’re breaking down cognitive distortions - the automatic thinking patterns that can fuel anxiety, overthinking, and self-doubt. As mental health providers, we see these patterns all the time and, chances are, you’re experiencing them too without even realizing it. From mind reading to catastrophizing, we explain how these thoughts show up in real life and why your brain is so quick to believe them. This episode will help you: Identify common cognitive distortionsUnderstand why your brain jumps to worst-case scenariosStart separating thoughts from factsWe also address overthinking, anxiety spirals, and how to tell if a thought is actually true. ✨ Not every thought deserves your trust—and this episode will show you why.

    38 min

  5. Mar 30

    Spring Cleaning Your Mind Pt. 2: Catch the Clutter (CBT Thought Awareness)

    In this episode of The Off-Label Podcast, we’re continuing our Mental Health Spring Cleaning series by diving deeper into Cognitive Behavioral Therapy (CBT) and the first step to changing your thoughts: awareness. If you’ve ever struggled with overthinking, anxiety, or negative thought spirals, this episode is for you. Most of the thoughts that drive stress and self-doubt happen automatically, and if you don’t notice them, you can’t change them. We break down how to identify automatic thoughts, why your brain jumps to worst-case scenarios, and how to start catching the mental “clutter” that’s been running in the background. Using real-life examples (and a little humor), we make CBT practical, relatable, and actually doable in your day-to-day life. In this episode, we cover: What automatic thoughts are and why they matterWhy overthinking feels uncontrollableHow to start noticing negative thought patternsSimple CBT techniques to build awarenessHow your thoughts impact anxiety, mood, and behaviorWhether you’re new to therapy concepts or already working on your mental health, this episode will help you take the first step toward a clearer, calmer mind. Don’t forget to follow, rate, and share with a friend who could use a little mental spring cleaning.

    32 min

  6. Mar 26

    Psychotherapy Networker Symposium Recap: DBT, Trauma, ACEs & High-Functioning Codependency Insights

    Hosted by Amanda Smith, MA, MSW, LCSW and Amanda Mitchell, DNP, APRN, PMHNP-BC In this bonus episode, we’re coming to you hot off the heels of the Psychotherapy Networker Symposium in Washington, DC! We’re breaking down our biggest takeaways, favorite moments, and the sessions that left a lasting impact on how we think about therapy, trauma, and real-world mental health work. We dive into powerful presentations from Britt Rathbone, LCSW-C, ACSW, BCD, CGP on Dialectical Behavior Therapy (DBT), Nadine Burke Harris, MD, MPH, FAAP on Adverse Childhood Experiences (ACEs), and Bessel van der Kolk, MD, author of The Body Keeps the Score, who led an engaging and thought-provoking discussion on trauma and healing. We also highlight insights from Terri Cole, MSW, LCSW on high-functioning codependency and boundaries. Beyond the sessions, we reflect on how attending a major mental health conference reignited our passion, challenged us to grow, and inspired us to show up more fully in our own community and clinical work. And of course, we share some of our funniest and most chaotic moments navigating DC along the way. If you’re a therapist, mental health professional, or just someone interested in trauma, therapy techniques, and personal growth, this episode is packed with insight, inspiration, and real talk.

    40 min

  7. Mar 10

    Mental Health Spring Cleaning: Your Brain Is a Junk Drawer

    Hosted by Amanda Smith, MA, MSW, LCSW and Amanda Mitchell, DNP, APRN, PMHNP-BC Spring cleaning isn’t just for your house — sometimes your brain needs it too. In this episode of the Off-Label Podcast, we’re talking about mental health spring cleaning and the thoughts we keep holding onto that might need to go. You know the ones: “I should be further along by now,” “Everyone is judging me,” “If I rest I’m being lazy,” and the classic mental junk drawer of overthinking, guilt, and negative self-talk. As a psychiatric nurse practitioner and a licensed clinical social worker, we break down the common thought patterns that contribute to anxiety, burnout, people-pleasing, and perfectionism, and talk about how to start letting some of that mental clutter go. We also explore why our brains hang onto unhelpful beliefs, how cognitive distortions show up in everyday life, and a few practical ways to challenge the thoughts that keep us stuck. If you’ve ever felt overwhelmed by overthinking, comparison, or the pressure to have everything figured out, this episode is your reminder that sometimes the healthiest thing you can do is clean out the mental junk drawer.

    30 min

  8. Mar 3

    Horrible Therapist? How to Spot Red Flags and Know If Therapy Is Working

    Hosted by Amanda Smith, MA, MSW, LCSW and Amanda Mitchell, DNP, APRN, PMHNP-BC We played a game called “Horrible Therapist”… and it sparked a deeper conversation about something a lot of people quietly wonder: How do you know if your therapist is actually good? In this episode of The Off-Label Podcast, we break down:• Red flags in therapy• Green flags in therapy• What good therapy should feel like• How to know if therapy is working• How to tell if your therapist is the right fit Therapy should feel collaborative, safe, and grounded in real clinical skill — not awkward, dismissive, or performative. We talk about the difference between discomfort that leads to growth and discomfort that signals something isn’t right. If you’ve ever wondered, “Is this normal in therapy?” this episode is for you. As always, this podcast is for educational purposes only and is not a substitute for individualized therapy or medical advice.

    46 min
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Ratings & Reviews

5
out of 5
7 Ratings

About

The Off-Label Podcast is a mental health podcast about psychiatry, medication, and therapy—explained clearly, honestly, and without judgment. Hosted by two clinicians with different perspectives, the show breaks down how mental health decisions are actually made: why treatment is rarely one-size-fits-all, what happens behind the scenes in psychiatry and therapy, and the second-order effects people don’t usually hear about. Episodes explore psychiatric medications, therapy approaches, and the real-world complexities of mental health care, with warmth, humor, and nuance.

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