So, you're thinking of starting a Substack?

Reflections from one year of writing

If you want to know how to start a Substack…I might not be the best person to ask. Unlike the 2000 subscribers in six months from Erik Hoel, I’m slowly approaching 500 after one year. Many others have built up large enough audiences to make a living and leave their regular jobs, or in the case of Hoel, career pivot out of academia.

Instead, consider these reflections from a lower league Substacker. I think it offers a fantastic platform for sharing writing and I believe many (like me) would suit this form of communication.

Maybe if you’re on the fence, it might even persuade you to take the plunge.

Why start a Substack?

When I came out of psychiatry clinical training to do a PhD, I was afforded the time and headspace to launch a Substack. For much longer, I’ve been a fan of science blogs. The best, often written by academics themselves, can influence a research field - communicating complex ideas in straightforward language.

Blogs can be more to-the-point and honest than many editorials or opinion pieces published in academic journals. A great early example of this was Neuroskeptic, another is Wiring the Brain.

The blog that inspired me most is, unsurprisingly, Slate Star Codex / Astral Codex Ten. This is by the Bay Area psychiatrist Scott Alexander, who famously de-anonymised himself and shut down his original blog, before the New York Times revealed his identity.

(I assume that most of my subscribers will be familiar with Scott – but for me the quintessential SSC post explains candidate gene studies in a more accessible way than traditional academic sources.)

Scott is one of the poster boys for Substack, relaunching as Astral Codex Ten in 2021. His post about an allopregnanolone-based medication for postpartum depression pushed me over the line – after commenting on it, I wrote my first post about a related hormone-mediated mental disorder, Premenstrual Dysphoric Disorder.

I won’t be the only person to have been inspired by Scott, but I am really grateful for his indirect support (getting a shoutout in his posts results in a big spike in traffic to my page).

So, why should I write when there are already lots of people doing a fantastic job? For me, it serves various purposes:

1. Clarifying scientific ideas. Putting my thoughts down on the page can crystallise what I understand about a topic and demonstrate what I don’t understand enough. Writing posts has changed my mind on a few different questions, such as the use of antidepressants during the menopause or the oestrogen protection hypothesis for schizophrenia.

2. Creating an online presence. I like the fact that if someone looks for me online they might come across my Substack page. I am generally proud of the content I’ve produced and hope it shows capacity for communication and critical thinking. In a way, it acts as an advert for my scientific writing.

3. Making connections. In academia, it is important to get to know other people in your field. Writing a Substack has helped me get in touch with some interesting people - particularly if I’m doing a post about a particular paper, such as this one about cognitive trajectories in schizophrenia.

4. Improving writing. Like strengthening a muscle, good writing is developed with practice. I’m sure the commitment of regularly producing a post about varied research topics is helping me to develop as a writer.

How to write?

Some advice says to put out as much content as possible. I’ve slightly gone against this principle, deciding early on to produce one post per month, ideally on the first day of the month (this anniversary post is an exception).

This is a good balance between regularity and balancing the workload with my other commitments. It allows me to be (relatively) rigorous – I try to write to a similar standard of a journal editorial (providing references/links to any claims), albeit with a more informal tone.

One of my motivators is to write about topics that I want to learn about. This is not difficult – psychiatry provides an almost limitless supply of interesting subjects. Sometimes I write about questions that are relevant to my research. This gives me a feel of the literature and can be useful in collecting relevant references.

One of the biggest influences on how I think about complex questions comes from the Scout Mindset, by Julia Galef. This advocates a rationalist approach – trying to stay curious and open-minded, while avoiding the pitfalls of motivated reasoning. It aims to view the world as it is, rather than as we want it to be. It is also where the name Rational Psychiatry came from.

I favour ‘cold takes’ rather than ‘hot takes’. I try to make contributions that I haven’t seen others cover. Some topics I feel are oversaturated include ‘do antidepressants work’ or ‘is psychiatric diagnosis valid’. These questions have been covered by people who’ve done a better job than I can. Similarly, I have nothing to add to political issues especially ‘culture war’ topics (of which a few do overlap with psychiatry).

It’s not just a blog

It’s a no brainer, if you are thinking of starting a blog – do it on Substack, there are so many advantages. As a reader, I find the Substack aesthetic better than almost all self-made blogs.

The writer-interface is simple and functional. Substack gives you much better opportunity for harnessing network effects – i.e. getting people who are reading other Substacks to read your post. I don’t have a citation to back this one up but my guess is that a typical Substack gets far more views than a typical blog.

I see my Substack as more than a blog – it’s a newsletter. This might not sound very different, but a piece arriving in your inbox makes it that little bit more personal.

Growing an audience

If you ever hear me say that I’m writing for its own sake, I’m lying. I want others to read my work. I want to introduce you to new ideas or concepts. I want to change your mind and influence your view of the world. Writing for a small audience is better than none but ultimately I am trying to grow my subscriber list.

I started out with a handicap in that I didn’t have any online profile or Twitter following. This meant I didn’t have a ready-made audience to be transported. The biggest boosts to my subscribers have come from shout-outs, from people like Scott, or Freddie deBoer.

One thing I have taken from the best Substacks is visual consistency / branding. Luckily, one of my friends is a graphic designer and helped me out. I try to include some images in my post, usually making use of Stable Diffusion for these.

Thank you!

Finally, thank you everyone who has supported this newsletter. For most of the last year, I have been writing for a very small audience (under 200). This hasn’t felt like a chore because throughout I’ve had nice feedback from you all. It means a lot, whether it is commenting, sharing a post, or telling me IRL. It amazes me that people are subscribing from across the world.

Shout out to those who have shared/promoted my work – you guys are the real ones. Most of all, thanks to my wife Mads for reading every post and telling me when I’m talking nonsense.

If you have any feedback or questions, please comment on this post and I’ll do my best to answer.