Practices

Before you hand it over, read the original request again. Not your memory of it. The actual words.

Almost nobody enjoys this, which is why almost nobody does it. But work that is good except for the two things nobody remembered is the commonest…

Take ten quiet minutes to decompress before you walk in the door.

Arriving already softened means the day's stress is not spent on the person you love.

Nobody tolerates something unpleasant for no reason. Before starting anything difficult, get clear about what you want on the other side of it, in your own words.

Something like: I want to sit an exam without being sick, so I am willing to practise feeling uncomfortable. The sentence has to be yours. A goal…

The age by which symptoms have to have shown up is a number people agreed on, not a line in nature. It moved from seven to twelve when the manual was revised.

That matters if you are an adult wondering whether you would even qualify. The old cut-off was itself a compromise between studies pointing in…

You do not need clinical language at an assessment. Some of the wording in the manual came straight from how families described it in the first place.

Phrases about being permanently on the go are in there because people kept saying them. So use yours: that your head is like a browser with forty…

Not all distraction comes from outside. Some of it is a thought that will not leave, circling while you read the same paragraph four times.

That difference matters at an assessment. Being pulled away by everything in the room, and being held in place by an intrusive thought you cannot put…

Eating that runs away from you, and eating you cannot stop once it has started, turn up alongside ADHD more than people expect. Usually it is doing a job rather than proving a weakness.

The pattern leans towards bingeing rather than restricting, which fits: it belongs with the difficulty of stopping something already in motion. Often…

Trouble with eating, and with how your body looks, gets missed far more often in men. The questionnaires and the expectations behind them were built around women.

In men it runs more towards size and muscle than towards thinness, and towards fixing on one part of the body that everybody else says looks…

Two referrals turn up again and again. A young child being asked to leave a school for behaviour, with no developmental or cognitive information anywhere in the file. And a parent saying something is wrong while the school says everything is fine. Both are describing adult frustration rather than a formulation.

In each case the first job is the same: get some data. Not another opinion, not another meeting, but something measured about how this child thinks…

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…

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…

Before committing to a course that runs into thousands, set the same money next to the other things it could buy. Tutoring, a proper assessment, a medication review and a well tested psychosocial programme all sit in the same envelope.

Neurofeedback courses often run for a month or more, insurers rarely pay, and the training of whoever delivers it varies a great deal. The cost is…

Regulators let devices through by several different routes, and only some of them mean what a family assumes. A game cleared for further investigation has not passed the bar a medicine passes.

The word approval carries an authority that advertising borrows freely, and device pathways are shorter and lighter than the ones drugs travel. It is…

Almost everyone says the same thing afterwards, that the waiting was worse than the thing itself. Say it out loud in your own words, because your own words land differently from anyone else's reassurance.

Before a difficult conversation, write one line about how bad you expect it to be. Afterwards, write one line about how it actually went. Over a few…

When a treatment is described as approved, ask what it is approved for. Magnetic brain stimulation is licensed for depression, and using it for attention problems is off label.

Off label is not the same as forbidden or useless, and it does change three things: how much evidence stands behind it for your situation, what the…

The same treatment in two different clinics can go two different ways, and the difference is often the people. Kind, unhurried staff who explain things get better results.

So when you refer someone, or choose somewhere yourself, ask about that as well as the equipment. Do they remember your name, do they answer…

Three things are worth noticing before you buy any treatment: whether the only research on it is their own, whether they will say plainly what it is meant to change, and whether you have to sign something.

Each one covers a different way of being caught out. Research a company funded and ran itself has never been checked by anyone with nothing to lose.…

Part of why so many adults are coming forward now is that well known people have said out loud that they have this. Seeing someone capable say it makes the asking cost less.

The old picture of ADHD was a careless child and a lazy adult, and that picture kept a great many people from ever mentioning it. An athlete at the…

Some situations genuinely run on how you are seen. A job interview, a court hearing, a first meeting with in-laws: the image matters there, and it is honest to say so.

The claim is only that most of life is not one of those, and that the fear of disrespect is far larger than its actual cost. Keeping the exceptions…

Before you go towards the thing you are afraid of, it helps to have two things to hand: a way to settle your body, and a fairer account of what is likely to happen.

Neither of them is meant to take the fear away. They are there so you can stay in the situation long enough for it to teach you something, and that…