Psychedelics, Bipolar Disorder, and the Risk of Psychosis

Psychedelics, Bipolar Disorder, and the Risk of Psychosis

On April 18, 2026, a White House executive order pushed psychedelic treatments for serious mental illness toward faster approval and access. In this episode I work through what that order actually does, why the research is genuinely promising for depression, PTSD, and addiction, and why I’m still uneasy about where this is heading. I live with bipolar disorder, and people like me are usually screened out of the trials that make these drugs look safe. So I dig into the part of the story that doesn’t make the headlines: the risk of mania, psychosis, and misdiagnosis when a powerful, perception-altering drug meets a brain that’s more vulnerable than anyone realized. In this episode: * What the 2026 executive order does — Breakthrough Therapy, Right to Try, ibogaine * How psilocybin, MDMA, ketamine, and ibogaine actually work * Why bipolar disorder gets excluded from most psychedelic trials * What the 2025 research says about psychedelic-induced mania and psychosis * How a depression diagnosis can hide bipolar disorder, and why that’s dangerous here * The ordinary, unglamorous tools that still carry the most weight My books: Still Here: A Bipolar Survival Manual — http://amazon.com/dp/B0GT3YGKH5 [http://amazon.com/dp/B0GT3YGKH5] The Brain Under Pressure — http://amazon.com/dp/B0H12QPGR1 [http://amazon.com/dp/B0H12QPGR1] Read more at thebipolarbro.substack.com [http://thebipolarbro.substack.com]. If this helped, follow the show and share it with someone who needs it. This episode discusses suicide, psychosis, and mental illness. If you’re struggling, in the US you can call or text 988 for the Suicide & Crisis Lifeline. Get full access to The Bipolar Bro at thebipolarbro.substack.com/subscribe [https://thebipolarbro.substack.com/subscribe?utm_medium=podcast&utm_campaign=CTA_4]

The Brain Under Pressure Is Free This Week — What the Book Is and Why I Wrote It

I just published a new book: The Brain Under Pressure: How Sleep, Stress, Exercise, Nutrition, and Modern Life Shape Mental and Cognitive Health [http://amazon.com/dp/B0H12QPGR1]. The Kindle version is free May 16–20, 2026. This is not a book about bipolar disorder. It covers the biology behind mental health for anyone — what chronic sleep disruption, stress, blood sugar instability, inflammation, and sedentary behavior actually do to the brain at a mechanistic level, and what the research supports for improving it. In this episode I cover what the book is, how it differs from Still Here [http://amazon.com/dp/B0GT3YGKH5], and why the biological conditions underneath mental health matter more than most conversations about mental health ever acknowledge. The free Kindle app works on any iPhone, Android, or computer — no Kindle device needed. Grab it free through May 20th: http://amazon.com/dp/B0H12QPGR1 [http://amazon.com/dp/B0H12QPGR1] Get full access to The Bipolar Bro at thebipolarbro.substack.com/subscribe [https://thebipolarbro.substack.com/subscribe?utm_medium=podcast&utm_campaign=CTA_4]

The Antidepressant That Almost Killed Me: What Every Depressed Person Needs to Know

Before I was correctly diagnosed with bipolar I disorder, I was put on eight different antidepressants. Every single one made me worse. In this episode I break down why that happens, why bipolar disorder takes an average of ten years to diagnose correctly, and what to ask your doctor if treatment isn’t working. Topics covered: antidepressant-induced mood switching, the misdiagnosis pipeline from depression to bipolar, why mania goes unreported, and the privilege gap in psychiatric care that most people won’t talk about. My book Still Here: A Bipolar Survival Manual is available on Amazon in paperback and Kindle. Search Still Here: A Bipolar Survival Manual [http://amazon.com/dp/B0GT3YGKH5] by Adam Flesner. If you are in crisis, call or text 988. Follow the show on Spotify [https://open.spotify.com/show/1oWU0BBx0R865ymRGdWKB9?si=c37036da1970428f] and Apple Podcasts [https://podcasts.apple.com/us/podcast/the-bipolar-bro/id1836622550]. Subscribe on Substack at thebipolarbro.substack.com [https://thebipolarbro.substack.com/]. Get full access to The Bipolar Bro at thebipolarbro.substack.com/subscribe [https://thebipolarbro.substack.com/subscribe?utm_medium=podcast&utm_campaign=CTA_4]

Still Here: A Bipolar Survival Manual — Book Announcement

I’ve been gone for a while. This episode is me explaining why — and announcing the book I spent the last year writing instead. Before I get into it — a word about who this is for. The obvious answer is people with bipolar disorder. But the honest answer is broader. If you love someone with a brain-based condition, if you’ve been trying to make sense of your own brain for years without a good answer, if you work alongside someone who’s struggling and you don’t know how to reach them — this book was written with you in mind too. Bipolar disorder is one of the most misunderstood conditions there is. People lose relationships, jobs, and loved ones not because of who they are, but because nobody around them had a framework for what was actually happening. This book builds that framework. Still Here: A Bipolar Survival Manual is available now on Amazon in paperback and ebook. Search the title or my name — Adam Flesner — or use the link below. http://amazon.com/dp/B0GT3YGKH5 [http://amazon.com/dp/B0GT3YGKH5] If it helps you, tell me. If it reaches someone who needed it, tell them where you found it. More episodes coming. Get full access to The Bipolar Bro at thebipolarbro.substack.com/subscribe [https://thebipolarbro.substack.com/subscribe?utm_medium=podcast&utm_campaign=CTA_4]

You Are Not a Burden: The Lies Depression Tells

Depression doesn’t shout. It whispers. It convinces you that your pain is too much, that your presence is a problem, that the people you love would be better off without you.None of that is true. In this episode, I talk about the most dangerous lie depression tells: “You’re a burden.” I share my own battles with that lie—from the night my dog saved my life to waking up in an ICU after a suicide attempt. I also break down what’s actually happening in the brain when depression takes over, why those thoughts feel real, and how to fight back with truth, faith, and practical tools. This isn’t toxic positivity. It’s real talk about pain, neuroscience, hope, and why your story still matters. In this episode:• The quiet way depression convinces you you’re a burden• The neuroscience behind why those thoughts feel so real• The role of shame in depression and why it isolates us• My story of surviving the lie—twice• Practical tools to ground yourself and reach out for help• A letter to anyone who feels like they’re “too much” If you’re struggling, you are not alone.You matter more than the lie in your head. If this episode helped you or someone you love, share it. Subscribe on Substack for my writing and follow The Bipolar Bro wherever you listen. If you’re in crisis:Call or text 988 in the U.S. or reach out to your local emergency number. You matter. Please stay. Get full access to The Bipolar Bro at thebipolarbro.substack.com/subscribe [https://thebipolarbro.substack.com/subscribe?utm_medium=podcast&utm_campaign=CTA_4]