Discover the hidden “clinical secret” of mood temperaments that most psychiatrists overlook and how low‑dose mood stabilizers can transform treatment.

In this episode Dr. Nasiragami explains mood temperaments—hyperthymic, dysthymic and cyclothymic traits that are constant, genetically linked to bipolar illness, and absent from DSM. He shows why these subtle, lifelong mood patterns can drive misdiagnoses such as ADD, GAD or major depression, especially in outpatient practice.

The conversation turns to practical solutions: using the validated TEMPS scale (downloadable from psychiatryletter.com) to identify temperaments, then treating the underlying cause with low‑dose lithium (300‑600 mg) or valproate (250‑500 mg). Dr. Nasiragami reviews the modest risk profile of low‑dose lithium, the rapid improvement of anxiety, concentration and mood symptoms, and how to differentiate temperaments from personality disorders or pure anxiety states.

If you’re a clinician or anyone curious about why “mild” mood traits matter, this episode offers a clear framework for assessment and a simple, evidence‑informed treatment approach. Share the show with colleagues and subscribe for more insights into real‑world psychiatry.