Low mood and hard feelings

There are medicines that make stopping smoking easier, and one of them can sometimes cover a mood or attention problem at the same time. That is a fair thing to ask a doctor about.

All of them carry side effects, so the conversation is a weighing up rather than a yes or no. Go in with what you already know about yourself: how…

When someone keeps doing the risky thing after every explanation, the missing piece is usually not information. The pull is simply louder than the knowledge.

Which means another lecture is mostly wasted breath, while changing what is within reach is not. Fewer bottles in the house, a route home that avoids…

If a young person is using regularly, waiting to see whether they grow out of it is a gamble. Help early is nearly always cheaper than help later.

Families often hold off because raising it feels like an accusation. You can raise it without one: say what you have noticed, say you are not going…

Sometimes the drinking or the smoking is not the first problem at all. It is somebody's own treatment for an attention difficulty or an anxiety nobody has looked at yet.

You can usually tell from what it is used for: to speak in a group, to sit still long enough to work, to sleep. Where that is the shape of it, work…

Draw your own chart of the moment you usually give in, with the questions you actually ask yourself, and put it where you will see it.

One woman smoking around ten bowls a day made hers as a set of branches: is it a working day, have I been to work, are the errands done, are the…

When all you can say is that something happened and you went off, take it apart in five pieces: what set it off, how you read it, what your body did, what you made it mean, and what you wanted to do next.

Written out on paper it usually stops being a blur. You often find the trigger was small and the meaning was enormous, or that your body was already…

Going deeper into a feeling only helps if it is being put in order at the same time. Depth without order is just flooding.

So as the feeling rises, keep laying it out: this is what happened, this is what my body did, this is what I was afraid it meant. If your chest is…

Emptying the feeling out at somebody does not shift it, and being told what to do instead skips over it. What changes things is feeling it with someone who stays.

You can tell the difference from the inside. Venting has a rehearsed quality, the same phrases coming round again with the heat kept up. Advice…

Take one episode from this week and give it five lines: what set it off, how you read it, what happened in your body, what you took it to mean, and what you wanted to do.

Doing this with an actual event, rather than in general, is what makes it useful. Keep the lines short and resist tidying them into something more…

You cannot taste food you are eating fast. Feeling works the same way, so slow the pace until there is something to actually notice.

In practice that means one sentence at a time, with a pause after it, and questions like what happened in you just then. Both of you will want to…

When you are trying to reach a feeling, stay with the actual sentence that caused it rather than paraphrasing it into something milder.

She said you are too difficult. Said again, gently, it keeps the moment alive in the room instead of turning it into a memory being reported.…

Give the anger a room rather than a target. Music up loud, walk fast, dance badly, shake your arms out until something in you settles.

Some children's grief centres keep a padded room where a child can go in and move however they need to, with nothing to hit and nothing to break.…

Write the exact thing you are furious about on a paper plate, tape it to the wall, and throw wet cotton balls at it. It sounds childish, and it does more than swinging at nothing.

Half the good of it is in the writing. Vague anger has to become a sentence before it can go on the plate, and reading that sentence back usually…

There are around twenty five antidepressants and nowhere near twenty five mechanisms. What comes next is decided mostly by side effects, other conditions, and what has already worked for you.

Which is why your own record is worth more than any comparison chart. Keep a plain list: what you took, at what dose, for how long, what it helped,…

The reason depression is mostly treated by GPs now is pharmacological. A drug you can start without an ECG, blood monitoring or a diet sheet is a drug that fits inside a ten minute appointment.

That has been good for access, and it puts a lot of weight on a very short conversation. Go in with the specifics written down: which symptoms, since…

When something has helped a little and then stalled, adding a different kind of help often does more than pushing harder on the first one.

That is the thinking behind adding a second medicine with a different action rather than only raising the dose of the first, and it is the same…

For some young people self-harm carries something besides relief: belonging, recognition, a name for who they are among friends who do the same.

That is uncomfortable to sit with and it changes what helps. If a behaviour is the reason someone feels understood, taking it away without touching…

Ask what the behaviour does for them, and then ask how they would like to feel instead. Both questions open more than telling them to stop ever does.

The first question maps what is being managed: numbness, rage, panic, a need to make something visible. The second gives you a goal in their words…

A belief about yourself comes with a feeling somewhere in the body, an emotion, and a set of things you then do or avoid. Argue only with the words and the rest of it carries on exactly as before.

This is the gap behind I know it is not true but I do not feel it. Next time you catch the belief, note where it sits physically, what emotion turned…

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…