Practices

Going from talking online to talking in person is not one more step up the same ladder. It is a different ladder, and it deserves rungs of its own.

Those rungs might run from voice notes, to a phone call, to a video call with the camera on, to meeting one person you already know somewhere quiet,…

If cutting down has failed over and over, that is information rather than a verdict on you. For some people the workable goal turns out to be none rather than less.

Starting young makes this more likely, and the earlier the heavy use began the harder the road back to casual use tends to be. Nobody enjoys hearing…

This is not a milestone you pass. The two year old's version goes, then a version comes back at twenty two, and again at fifty two, wearing whatever clothes that stage of life provides.

So think maintenance rather than course completion. When conditions change, a new baby, a new manager, an illness in the family, expect the old…

Assessing a child's thinking used to mean a referral, a waiting list and a report some months later. Brief cognitive tools an ordinary clinician can run have changed that, and the gap between noticing something and having a plan can now be a session rather than a season.

Learn one of them properly instead of dabbling in three. Know what it measures, what it does not, and how to talk about a score without turning it…

Coming off an antidepressant is a piece of work in itself. Plan it slowly with the prescriber rather than stopping on the day you feel well.

Some, venlafaxine especially, leave the body fast enough that a missed dose is felt within a day: dizziness, strange electrical sensations, a mood…

With the fast acting treatments, the plan for what happens afterwards matters as much as the treatment itself.

Electroconvulsive therapy can shift severe depression quickly, and without something in place afterwards the relapse rate is high, which is why…

Sometimes the honest answer is that there is nothing in your surroundings to feel good about. Changing them counts as treatment, not as running away.

A life with no friends nearby, no work that means anything and a steady drip of criticism will produce low mood in most people, and skills practised…

Walking away from a course or a job that was never going to fit can be the sensible move rather than a failure of nerve. It is also frightening, particularly when other people are paying for it.

Fit does more work here than effort does. The person who cannot survive a rigid nine to five in an open plan office may be excellent somewhere with…

Some people book their first assessment on the day they turn eighteen, because it is the first day they can consent without a parent. If you have been waiting like that, the waiting was not laziness.

Where a family or a community treats mental health care as shameful, a young person can spend a decade struggling with nobody's permission to ask for…

You cannot work out in advance what will light you up. The only reliable method is a wide and slightly undignified search: many activities, many people, plenty of reading and watching, until something catches.

This means giving yourself permission to try things badly and drop them, which is hard if you have been told all your life that you never finish…

Far more people have ADHD than are ever assessed for it. If you have wondered about yourself for years, the odds that an assessment would be worth your time are better than you think.

The usual fear is being told you are making it up, or wasting a professional's morning. In practice adults are missed far more often than they are…

There is no age at which finding out stops being worth it. People have been diagnosed in their eighties and described it as the first explanation that ever fitted.

A late diagnosis will not give back the jobs or the years, and it is fair to grieve those. What it does is rewrite the story: not a person who kept…

The years you spent angry are not written off. The drive that wrecked things is the same drive available now for putting things right.

This is not a way of saying the damage was worth it. It is about what is still in your hands. People who have hurt others through their temper often…