Practices

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…

The parts of this that look like lifestyle, meaning sleep, driving, drinking, appointments that get missed, are the parts carrying the most risk across a lifetime. They are also the most changeable parts.

You may have met a striking figure quoted about untreated ADHD and years of life lost. Take the point underneath rather than the number: risk from…

No food in the house means eating out late, which means a late night, which means a late start, which means no time to shop. It is not a character flaw. It is a loop.

The parts that feel most like personal failure, the takeaways, the extra coffee, the money going nowhere, are mostly downstream of a plan that never…

Getting your ordinary life a bit calmer is worth doing for its own sake. More sleep, a little more structure, food that is not all improvised. Not perfect, just good enough to work with.

It will not give you more capacity than you have. What it does is let you use more of what you already have, more of the time, which is usually the…

The alarm stores as well as reacts. Every flare that ends badly teaches it a little, and so does every one you handle gently.

That is why triggers pile up over a lifetime, and why one calm response never feels like it changed anything. It is doing work you cannot see yet.…

This started as a way to stop yourself snapping, and it will do that. It also happens to be a way of noticing your whole life while you are in it.

The same watching works on wanting, on worrying, on the hour you lose to your phone. Anger is just the doorway you came in through, usually because…

When a feeling is genuinely unbearable, escaping it is the only regulator you have, so the drinking or the shutting down is doing a job. Build up what you can bear and the job disappears.

It helps to stop asking why you keep reaching for the thing and start asking what state you were in just before you reached. Usually it is a…

Before you go anywhere near the hard memory, you need to be able to stay in your own body while something difficult is happening in it. That capacity is part of the work, not a delay before it starts.

Phase based approaches put this first for a plain reason: people who cannot bear the arousal either drop out or push through and come away worse. If…

People who are sure they could never lie still for an hour tend to be asleep within ten minutes of getting on the table. Being unable to fidget seems to do it.

Worth saying in advance to anyone who is putting off booking. It is the same effect as a car journey knocking out a child who has not stopped moving…

The diet evidence has drifted away from cutting particular things out and towards eating decently overall. That is easier on everyone at the table.

Removing additives or colourings helps a small number of children, and the trouble is that you cannot tell in advance who they are, so most families…

Think of ADHD as sitting at the centre of an onion. Poor sleep, sleep apnoea, low vitamin levels, allergy, ongoing pain, untreated anxiety or low mood all sit in layers around it, and each one makes the centre look worse than it is.

This explains something that otherwise looks strange: treatments that do nothing whatever for ADHD can still make a real difference, because they…

Think of it the way you would think about diabetes. Something to manage with several things at once, most days, for as long as it is there.

That frame does a lot of quiet work. It says the treatment is ongoing rather than a course you finish, it explains why things slide back when…

There is no single treatment that covers all of this. What works looks more like five things running alongside each other, and understanding the condition comes first.

Each piece reaches a different part of the day. Medication does something the environment cannot, changing what a room asks of someone does something…

The stack goes: understand it, medicate where that is right, change what the adults do, change what the day asks, and keep arguing the child's corner. Each layer does a job the others cannot.

None of them stands in for another, which is why swapping one out leaves a gap rather than a smaller plan. Medication does not reorganise a…

When a child with ADHD and a parent get stuck in daily rows, the rows themselves start doing damage. Getting the ADHD properly managed early takes some heat out of those exchanges before defiance settles in as a habit.

The chain people worry about runs from constant friction at home to entrenched defiance, and from there to difficulties in the teenage years that are…

The therapy that helps adult ADHD is not really about arguing with your thoughts. It is practical work on how your week is built, and it works because you are the one who can go and rebuild it.

Sessions tend to circle the same handful of things. Where the list lives, what the calendar actually does when you are not looking at it, how a large…

The trouble now is not that nothing works. It is that the things which work are spread unevenly, and whether a family gets any of them depends heavily on where they happen to live.

Medication travels reasonably well, since a prescriber can be found in most places. The psychological and behavioural work travels badly, because it…

An exam is a task with requirements. It is not a ruling on whether you are capable, however much it feels like one while you are sitting inside it.

Saying that once changes very little. The person this comes from took a long time to arrive at it, and that is worth knowing so you do not expect it…

Look for something genuinely hard that sits on top of something you are already good at. Too easy and your attention wanders off. Too far beyond you and it just becomes another thing you failed at.

The narrow band in between is where you stay engaged without noticing you are trying. It is usually a bit further up than feels comfortable when you…

For a lot of people with ADHD, making things is not a hobby but closer to an appetite. The itch to start something is always there, and when nothing is being made it does not go quietly.

Read that way, the restlessness that arrives when you have no project on is information rather than a character flaw. The same drive that gets called…