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Low mood and hard feelings
Feelings are information before they are problems. The practices here are about naming what you feel accurately, sitting with what will not move yet, and acting on what matters to you even on the days nothing feels like anything.
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When · Coming and going
If telling your doctor or midwife what you are using feels impossible, you can ask someone you already trust to pass it on for you, with your permission and in your words.
People often stay quiet with the very clinician who could help, because saying it out loud feels heavier than the problem does. Handing the message…
Four things carry most of the difference within the class: how much it sedates, how much it activates, what it does to weight, and what it does to sex.
Before anything is chosen, write down which of the four you cannot live with. Almost nobody is neutral about all four, and the one you will not…
Match the tablet to the person rather than to the diagnosis. For someone flattened and slowed who has said clearly that they will not accept sexual side effects, paroxetine is close to the worst choice available.
It is the most sedating in the class, the least activating, and carries a high risk of exactly the effect they ruled out, with weight gain and the…
If you are the therapist, hand the prescriber the profile and leave them the pick. What you hold that they do not is what this person is like across a week, and what they will absolutely not tolerate.
So write those two things down and send them: the presentation, in plain description rather than jargon, and the non-negotiables. Not a drug name.…
If a treatment reliably produces strange sensations, describe them beforehand. Expected strangeness is far easier to sit through than strangeness that arrives unannounced.
With esketamine, feeling oddly detached from your body or the room is the drug doing what it does, not a sign of harm, and it usually clears within a…
When a treatment is offered, it is fair to ask whether it is the licensed version or a use that sits outside the licence, and what monitoring comes with it.
Ketamine for depression is the live example. The doses used are far below anaesthetic ones, the nasal form has approval for treatment resistant…
A few treatments are only given in a clinic, with someone sitting with you afterwards. The chair and the hours are part of the treatment rather than paperwork.
Esketamine is the current example. It is a nasal spray, given on site, with a monitoring period of about two hours afterwards because blood pressure,…
When someone tells you they have failed, the most useful thing you can do is nothing clever. Let your face stay soft and keep looking at them.
Shame is braced for disgust, so it reads your face before it hears your words. A quick reassurance can even land as a rush to move on. Slower is…
A friend or a counsellor telling you that you are not a monster helps, and it only takes you so far. The shame usually sits with one particular person, and it eases most when that person hears the thing and stays.
So aim a disclosure carefully rather than widely. Choose the person the shame is actually about, pick a moment with room in it, and say the small…