Practices

Several herbal products change how fast the liver processes medication, which can leave a prescribed drug either weaker or stronger without a single change to the dose.

This is often why a supplement looks like it caused a relapse or a sudden run of side effects. Nothing about the prescription changed, so the pattern…

Two to be careful with in particular. Yohimbe reliably ramps anxiety up, so much so that it has been used in research to bring panic on, and kava is a sedative that stacks with alcohol and with sedating medication and has damaged livers at higher doses.

Kava has been restricted or banned in several countries over liver harm, which tells you how seriously that risk is taken. Yohimbe is a poor choice…

You cannot patent a plant, so there is little commercial reason to fund expensive trials of one. When you read that a herb has no evidence, that often means nobody paid to look rather than that somebody looked and found nothing.

Both halves of that need saying. No evidence is not proof of no effect, and it is also not permission to assume one. It leaves you with an open…

Some of these do have real evidence behind them. St John's wort has repeated support in mild to moderate depression, SAMe and methylfolate have reasonable backing as additions to treatment, and omega-3 has looked weaker in the larger and better run trials.

That last part is worth sitting with, because it is what usually happens. An early promising effect shrinks as trials get bigger and better…

If you want to use herbal remedies, two things carry most of the risk. Make sure whoever prescribes for you knows what you are taking, and buy from a source that has been independently tested.

That is a short list on purpose. Nearly all the harm in this area comes from an interaction nobody knew about or a product that was not what it…

Herbal products are rarely covered by insurance and they add up quickly. That cost belongs in the decision, particularly when you cannot be sure the capsule holds what it says.

Money spent here is money not spent elsewhere, and often the alternative is a treatment that is covered and has been tested. Nobody is telling you…

What you feel does not stay in your head. Emotional states register in the body's immune signalling too, which is one reason a long stretch of unspoken distress can leave you physically run down.

This is not a claim that you can think yourself well or ill. It is closer to saying the body keeps a tally. If you have been carrying something heavy…

Water, sleep, food and digestion are not the boring preamble to the real work. When those are running badly, everything else you try has less to work with.

It can feel almost insulting to be asked about breakfast when what you carry is so much bigger than breakfast. But a body short of sleep and short of…

A physical symptom is not a free floating fact. Read it next to what your life has actually held, the early parts included, and it often makes more sense than it does on its own.

This works in both directions. It stops you treating a body complaint as something random that landed on you, and it stops you treating it as a…

Saying a difficulty is in the past is not the same as saying it was never real. Sometimes a picture changes because something that was making it worse got taken away, and the honest words for that are neither cured nor imagining it.

People who have been disbelieved by doctors are very sensitive to this, and with reason. The choice usually gets offered as either it was all in your…

Months of fog, where thinking feels like wading, is a real complaint and deserves looking into rather than waving away. It usually has more than one cause, which is part of why it gets dismissed.

Fog sits where several things overlap: dissociation, anxiety, poor sleep, thyroid and iron problems, infections, medication. Because it belongs…

If your attention runs low on stimulation, salty and sweet food is the fastest legal source of a lift and it is available all day. Worth knowing about yourself, because it explains a pattern that willpower alone never seems to touch.

Rates of overweight and type 2 diabetes are higher in people with ADHD, and the reasons are not moral ones. A reward system that is under stimulated…

Caffeine buys about half an hour of sharper focus and takes the payment out of your sleep. It is a decent tool for a particular hour, and using it in place of treatment usually leaves you worse off across the day.

Four cups a day and upwards starts producing insomnia, irritability, tremor, an unsettled stomach and a racing heart, and a few people go sleepy on…

Very low vitamin D produces fatigue, low mood and a flatness that looks exactly like depression, and it is not part of routine bloods in most places. If you have never had it measured, it is a fair thing to ask for.

One clinician telling this story about himself had a level that was almost undetectable, and no antidepressant would have raised it, because what was…

The vitamin D in a general multivitamin is a maintenance amount, nowhere near what is used to correct a real deficiency. If your level is genuinely low, that is a prescribing conversation with blood tests behind it, not a shelf in the chemist.

Correcting a deficiency usually means a high dose for a defined period and then a steady daily amount, with the level rechecked to see where you have…

Before settling on depression as the whole story, ask for thyroid function and vitamin D to be checked. Both are common, both are cheap to test, and an underactive thyroid produces a picture that looks like depression from the outside.

An untreated thyroid problem also blunts how well antidepressants work, so missing it can mean months on a treatment that was never going to do the…

If a health habit keeps sliding, attach something immediate to it. The apps where you put real money on hitting a step target work for a reason: the payoff arrives now instead of in twenty years.

The natural reward for walking more is invisible and decades away, which is no use to a brain running on what happens next. A small stake, a streak,…

Before settling on a purely psychological account of months of anxiety or broken sleep, it is worth having the ordinary bloods done. Low iron, low vitamin D or low magnesium can produce symptoms that look exactly like a mental health problem.

This is not about swapping therapy for supplements. It is about not spending a year working on something a blood test could have partly explained. If…

If your body has something going on as well, try to get both looked after at the same time rather than in a queue. Therapy for what happened to you does not have to wait for your gut to settle, and it often goes better when the two run side by side.

Plenty of people park the physical thing while they do the psychological work, or the other way round, then wonder why progress keeps sliding back. A…

Low mood that arrives with bloating, fatigue and a foggy head is worth looking at from the food side too. An immune reaction to something you eat regularly can produce all three, and it gets labelled depression far more often than it gets tested.

The point is not to start cutting foods out on a hunch. It is to say the possibility out loud to a doctor, particularly if the gut symptoms and the…