Inside Mental Health

Medication nonadherence in schizophrenia is often framed as defiance — but that narrative misses the truth and harms the very people it claims to help.

Guest host Rachel Star Withers (who lives with schizophrenia) unpacks why up to 70% of people with schizophrenia have trouble taking medication as prescribed — and why the reasons are far more complex than “noncompliance.” From severe side effects and cognitive symptoms to stigma, trauma, access issues, and being dismissed by providers, this conversation exposes the real barriers standing in the way of effective treatment.

Rachel shares deeply personal experiences of both intentional and unintentional nonadherence, including how side effects like extreme fatigue and tardive dyskinesia shaped her decisions — and how lack of education nearly cost her years of quality of life. The episode also explores how medication refusal can be weaponized, stripping people with schizophrenia of autonomy under the guise of “lack of insight.”

Later, Rachel sits down with board certified toxicologist and psychopharmacologist Dr. Alberto Augsten, who brings clarity, hope, and science to the discussion. Together, they explore long-acting injectable antipsychotics (LAIs), new treatment advances, realistic expectations, and how education — not force — improves outcomes.

If you’ve ever wondered why medication adherence is so difficult in schizophrenia — and what actually helps — this episode delivers answers rooted in empathy, evidence, and lived experience.



Our guest, Dr. Alberto Augsten, is a board certified toxicologist and psychopharmacologist. He is a consultant and expert witness specializing in psychopharmacology and clinical toxicology. Offering professional, impactful, and strategic consulting services, Dr. Augsten caters to legal, healthcare, and clinical practice development. His expertise encompasses many areas, ensuring clients receive top-notch guidance and insights.

Dr. Augsten specializes in providing tailored consulting services to assist in the development and optimization of clinical practice standards. His expertise covers many areas crucial for clinic development, allowing for standard of care reviews concerning those matters.

Dr. Augsten's influence extends beyond his clinical practice. He offers consultation and education services to pharmaceutical companies, contributing to the advancement of pharmaceutical knowledge and practices. Through his contributions, he is helping to improve patient outcomes and ensure the highest quality of care.



Our guest host, Rachel Star Withers, creates videos documenting her schizophrenia, ways to manage, and let others like her know they’re not alone and can still live an amazing life. She has written “Lil Broken Star: Understanding Schizophrenia for Kids” and a tool for schizophrenics, “To See in the Dark: Hallucination and Delusion Journal.” Learn more at RachelStarLive.com.

Fun Fact: She has wrestled alligators.

Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. Gabe is also the host of the "Inside Bipolar" podcast with Dr. Nicole Washington.

Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com.
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Most people imagine schizophrenia beginning with dramatic hallucinations or sudden breaks from reality—but the truth is far more subtle, far more complicated, and far easier to miss. In this special featured episode from Inside Schizophrenia, host Rachel Star Withers, who lives openly with schizophrenia, joins co-host Gabe Howard to unpack the quiet red flags that often go unnoticed for months—or even years.

You’ll hear how early symptoms differ across children, teens, and adults, why up to 80% of people with schizophrenia don’t realize they’re experiencing warning signs, and how everyday stressors can mask the earliest hallucinations, delusions, and disorganized thinking. Psychiatric mental health nurse practitioner Carlos Larrauri, who also lives with schizophrenia, joins the conversation to explain what current research is uncovering about prodromal stages and early detection efforts.

Listener Takeaways


Why early schizophrenia symptoms are so subtle that most people overlook them


Key differences in warning signs across children, teens, and adults


Why families often miss early red flags—and why that’s understandable


What researchers are doing to identify schizophrenia sooner


From shadow people to slipping grades, from forgotten appointments to unexplained sensory sensitivity, this episode pulls back the curtain on the earliest—and most misunderstood—phase of schizophrenia.

Whether you’re a parent, partner, friend, clinician, or simply curious, this episode offers the clarity, compassion, and insight needed to recognize when something deeper may be happening long before a crisis appears.



Our guest, Carlos A. Larrauri, MSN, is co-chair of the Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ) and has formerly served on the National Alliance on Mental Illness (NAMI) and NAMI Miami-Dade County Board of Directors. Diagnosed with schizophrenia at 23 years old, access to quality mental health care, community-based treatment, and early intervention afforded him the best opportunity for recovery.

Mr. Larrauri is pursuing a law degree at the University of Michigan Law School and a concurrent master in public administration at the Harvard Kennedy School, where he was Zuckerman Fellow at Harvard’s Center for Public Leadership. He’s board certified as a family nurse practitioner and psychiatric mental health nurse practitioner and formerly lectured at the University of Miami and Miami Dade College.

Mr. Larrauri aspires to interface advocacy and research to reduce health inequities for people living with mental illness. To learn more about Carlos and his work, visit his website or his LinkedIn.





Our guest host, Rachel Star Withers, creates videos documenting her schizophrenia, ways to manage, and let others like her know they’re not alone and can still live an amazing life. She has written “Lil Broken Star: Understanding Schizophrenia for Kids” and a tool for schizophrenics, “To See in the Dark: Hallucination and Delusion Journal.” Learn more at RachelStarLive.com.




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Hallucinations are the most recognized—and most misunderstood—symptom of schizophrenia. Movies depict them as dramatic, terrifying commands or cinematic visions, but the lived reality is far more complex. In this episode we unravel what hallucinations actually are, why they happen, and how people learn to live with them.

This episode is a special feature from our sister show Inside Schizophrenia. Hosted by Rachel Star Withers (who lives with schizophrenia), with Gabe Howard as co-host. (Don’t worry, new Inside Mental Health episodes return in 2026.)

In this episode, Rachel shares her own experiences, from everyday “simple” hallucinations like sounds or shifting faces, to more intense, emotion-laden complex hallucinations. She challenges the assumption that hallucinations are always violent or dangerous—and breaks down the critical differences between hallucinations and sensory disturbances.

Expert guest Dr. Paul Fitzgerald joins the conversation to explain how the brain creates these perceptual misfires, why hallucinations in schizophrenia differ from those caused by grief, sleep deprivation, or drugs, and what current research reveals about how universal these experiences are across different cultures and countries.

Listener Takeaways


The difference between simple vs. complex hallucinations



Why hallucinations in schizophrenia feel different from drug- or grief-based ones



Why reducing—not eliminating—hallucinations is often the realistic recovery goal



How CBT and coping strategies help reduce fear and regain control


Whether you live with schizophrenia, love someone who does, or are simply curious about how the brain works, this episode offers clarity, compassion, and surprising insights you won’t forget.



Guest, Professor Paul Fitzgerald, completed his medical degree at Monash University and subsequently a Master of Psychological Medicine whilst completing psychiatric training. He then undertook a Clinical and Research Fellowship at the University of Toronto and The Clarke Institute of Psychiatry, Toronto, Ontario, Canada. On returning to Melbourne, he worked as a psychiatrist and completed a PhD in transcranial magnetic stimulation in schizophrenia. Since completing this PhD, he has developed a substantial research program including a team of over 25 psychiatrists, registrars, postdoctoral researchers, research assistants, research nurses, and students.

Professor Fitzgerald runs a research program across both MAPrc and Epworth Clinic using brain stimulation and neuroimaging techniques including transcranial magnetic stimulation, functional and structural MRI, EEG, and near infrared spectroscopy.  The primary focus of this program is on the development of new brain stimulation-based treatments for psychiatric disorders.



Guest host, Rachel Star Withers, creates videos documenting her schizophrenia, ways to manage, and let others like her know they’re not alone and can still live an amazing life. She has written “Lil Broken Star: Understanding Schizophrenia for Kids” and a tool for schizophrenics, “To See in the Dark: Hallucination and Delusion Journal.” Learn more at RachelStarLive.com.





Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. Gabe is also the host of the "Inside Bipolar" podcast with Dr. Nicole Washington.

Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com.
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Why does happiness always feel one step away? In this episode, we welcome back positive psychology expert Jodi Wellman to explore why so many of us keep “moving the goalposts” on our own success, and learn why accomplishments that once thrilled us eventually feel ordinary.

Jodi breaks down why we convince ourselves that one more thing — a new job, a relationship, a move, a big purchase — will finally deliver lasting happiness. Using Gabe’s own podcasting journey as a case study, the conversation exposes a mental trap familiar to anyone who’s ever felt like their wins “don’t count” for long.

But this episode isn’t just about naming the problem — it’s about fixing it. Jodi offers practical, research-backed strategies to help you savor your accomplishments, find a healthier balance between ambition and contentment, and stop letting your inner critic erase your progress.

Listener takeaways


why humans believe they’re always “one thing away” from feeling fulfilled



what the hedonic treadmill is and how it sabotages our happiness



how to balance ambition with genuine joy so you can grow without feeling miserable


If you’ve ever wondered, “Why don’t I feel successful?” this is the episode that can finally help you understand.



“We like to dupe ourselves. It's just one of the features of our psychology. It all comes down to this idea called the hedonic treadmill. We think, and we go for it. We'll buy the pill, we'll make the move, we'll take the job, we'll buy the car, we'll do a thing. And usually it's external stuff, but sometimes it's internal, like, I will become the person that I've been meant to be and that will make me happy. But then, because we adapt so well, this is this hedonic adaptation, hedonic treadmill, we adapt so reliably, damn it. And we end up, over time, some of us shorter than others. Naturally, meh. Okay, well, how come it's not doing it for me anymore?” ~Jodi Wellman, MAPP





Our guest, Jodi Wellman, MAPP is a speaker, author, and facilitator on living lives worth living. She founded Four Thousand Mondays to help people make the most of the time they are lucky to be above ground. 

With 25 years of corporate leadership experience (most recently as Senior Vice President of Operations at a leading health and lifestyle organization), Jodi has led private CEO advisory boards and coaches teams to work well and live even better.

Jodi has a Master’s of Applied Positive Psychology from the University of Pennsylvania, where she is also an Assistant Instructor and facilitator in the Penn Resilience Program. She is an ICF Professional Certified Coach. Her book, "You Only Die Once: How to Make It to the End with No Regrets," made Adam Grant’s Summer Reading List and was a “Top 3 Psychology Book of 2024” by the Next Big Idea Club (curated by Malcolm Gladwell, Susan Cain, Adam Grant, and Dan Pink). Jodi has been featured in The New York Times, Oprah Daily, Fast Company, CNBC, Forbes, Psychology Today, The Los Angeles Times, and more. Jodi’s TEDx talk is called How Death Can Bring You Back to Life; with over 1.3 million views, it is the 14th most-watched TEDx talk released in 2022, out of 15,900!



Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. Gabe is also the host of the "Inside Bipolar" podcast with Dr. Nicole Washington.

Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com.
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Can a single conversation help rewrite centuries of racial trauma? In this episode, host Gabe Howard sits down with award-winning podcaster Dominic Lawson to explore how America’s racial wounds continue to shape our collective mental health — and what it takes to begin healing. From the generational echoes of slavery to the modern-day silencing of diversity and inclusion, Dominic breaks down why talking about race isn’t “divisive” — it’s essential.

This candid, often uncomfortable, deeply human conversation shows that connection begins when we listen, show up, and see each other fully — no assumptions, no defensiveness, just honesty. Using vivid analogies (like concert tickets and cookouts), they discuss racism and racial trauma in approachable ways.



Listeners will learn:


why racial trauma still impacts communities today

how privilege is better understood through access, not advantage

how personal conversations can bridge racial divides

practical ways to “do the work” without causing harm or overstepping


If you’ve ever wondered how to talk about race — or where to even start — this episode is your invitation.



Our guest, Dominic Lawson, is a 24x award-winning podcast host, producer, and editor based in Memphis, Tennessee. A U.S. Army veteran, he studied business administration at National American University before discovering his passion for podcasting in 2016. That year, he launched "The Startup Life Podcast,” providing listeners with insights into building businesses and advancing in their careers. Throughout the show's run, Lawson interviewed notable figures such as Marc Randolph, co-founder and first CEO of Netflix, and Tom Golisano, founder and chairman of Paychex.

In 2021, Lawson joined Meadows Behavioral Healthcare as a podcast producer, editor, and host. He took the helm of the "Beyond Theory" podcast, facilitating in-depth conversations with experts in mental health and addiction recovery. His innovative approach led to the launch of "Recovery Replay" in April 2022, a groundbreaking podcast that chronicles personal recovery stories from three distinct perspectives.

Demonstrating his versatility, Lawson introduced the "Black Is America" podcast on February 1, 2022, shedding light on lesser-known African American figures and narratives. The podcast garnered significant acclaim, earning multiple awards, including the 2023 Webby Award for Best Podcast-Individual Episode.

Lawson's work has been recognized with numerous accolades and in recognition of his contributions to the industry, Lawson became a member of the Academy of Interactive & Visual Arts in November 2022. He has shared his expertise at events such as SXSW, Podcast Movement, and the University of Memphis.

Beyond his professional endeavors, Lawson is dedicated to mentoring emerging podcasters, offering guidance on content creation and storytelling. He emphasizes the importance of meticulous attention to detail, advocating for the "2/3 minute" rule to maintain listener engagement.

Outside of podcasting, Lawson enjoys spending time with his family, playing video games, watching movies — particularly Marvel and Hindi films — and exploring new podcast concepts. His commitment to storytelling and excellence continues to inspire and inform audiences, solidifying his reputation as a leading figure in the podcasting community.



Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. Gabe is also the host of the "Inside Bipolar" podcast with Dr. Nicole Washington.

Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com.
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