Practices

There are two kinds of work on anger, and the order matters. Plain skills for the moment come first, and the larger questions about what your life is for can wait.

Going deep too early tends to backfire. If someone still cannot interrupt a flare, an honest conversation about meaning or forgiveness becomes one…

Someone running just ahead of the avalanche has nowhere to stand and think. Reflection needs a bit of room, and a life with no room in it cannot make any.

This is why so much sensible advice slides straight off. Before asking what the wisest option is, something usually has to come off the pile: fewer…

Nobody decides well mid-panic. So cutting the number of panics is itself a way of making better decisions, even if nothing about your judgement changes at all.

It is slow work and it is usually the real work: fewer things said yes to, earlier starts, deadlines negotiated before they are sitting on top of…

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…

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…

Nobody arrives with restraint already fitted. If holding your tongue feels like unnatural work, that is what it is for everyone, and it says nothing about what you are underneath.

This matters because the story you tell about a flare decides what you do next. Broken means give up quietly. Unbuilt means pick one situation, the…

The old reaction does not get erased. You lay a new one over the top of it, and on a tired or unfamiliar day the old one can still come through.

So a flare after months of doing well is not everything undone. That is what relearning looks like, and it tends to turn up alongside broken sleep,…

Sleeping until the middle of the afternoon, day after day, is usually not rest. It is closer to the body shutting down, and it tends to leave you flatter rather than restored.

The tell is how you feel on waking: real rest gives something back, while shutdown leaves the day already gone and you no better for it. Nudging the…

Connection does not have to be human. A dog will not judge how your week went, and it will get you out of the door twice a day whether you feel like it or not.

If people currently feel exhausting or risky, an animal is often the easiest place to begin. Part of the good is the company and part of it is the…

If you are permanently behind, short of sleep and scrambling, that is not the backdrop to your short fuse. A good deal of the time it is the cause of it.

This is what makes the dull organisational work worth doing, because it buys you something you actually want. A morning that is not a panic leaves…

If not knowing makes you itch, the work is learning to sit with the itch rather than making it go away. The plan can stay unfinished while you get on with today.

For some of us an unresolved question hums in the background until it is settled, and settling it becomes urgent even when nothing depends on it.…

Attention problems often travel with anxiety or low mood, and those two eat working memory as well. Settling that layer can make everything else look quite different.

If you are anxious most of the day you will lose track of things, forget what you came into the room for and struggle to hold a plan, whether or not…

Six to eight weeks is what an antidepressant needs before it can be judged. The first fortnight will mostly tell you about side effects.

The transporter is blocked within hours, so the delay belongs to slower changes further down the line. In practice that means picking a date four to…

A few treatments are only given in a clinic, with someone sitting with you afterwards. The chair and the hours are part of the treatment rather than paperwork.

Esketamine is the current example. It is a nasal spray, given on site, with a monitoring period of about two hours afterwards because blood pressure,…

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…

Being in recovery is not a reason to leave an attention difficulty untreated. The restlessness that made a substance useful is still there once the substance goes.

Clinicians often hold back here, uneasy about a stimulant for someone with a history, and that caution is understandable. The other choice carries a…

For a small number of children the question was never about school reports. A toddler who runs into a road and keeps running, a child who climbs the pool fence: what is being weighed there is whether they stay alive.

Most decisions about treating a very young child are finely balanced and deserve to be taken slowly. Where the behaviour itself is life threatening,…

Unmanaged ADHD wrecks sleep, food and movement, and wrecked sleep, food and movement make the attention worse the next day. The loop feeds itself, which is also the hopeful part: a small repair anywhere in it pays back more than it should.

Short sleep hits the same front part of the brain that is already struggling, so a late night costs you more than it costs other people. Pick the one…