Practices

Much of the progress in these medicines over the past twenty years has been in how the drug is delivered rather than in new molecules. So if one version did not suit you, another form of the same drug can still be worth a try.

People often conclude that a whole class has failed them when what failed was one release pattern: too sharp, too short, too much at once. That is a…

A pharmacy refusing a valid prescription is often working from a made-up rule or a plain mistake. It can usually be escalated, and it usually resolves fast.

People have been turned away for having a prescriber in the next county, or told the shop does not stock narcotics for a medicine that is not one.…

With many of these medicines the unpleasant part turns up on day one and the good part takes weeks. Knowing that in advance is most of what carries people across the gap.

The first fortnight can feel like a bad bargain, because it is one: you pay now for something that arrives later. Put a date in the diary two to four…

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…

Missing a day is not the end of the programme. You missed a day. Tomorrow you carry on.

The dangerous part is not the missed session, it is the story that follows it, the one where you have blown it so you may as well stop altogether.…

Moving first does not only help you concentrate. It takes some of the heat out of being stuck, which is often the thing that ends the task.

For a lot of people the problem is not the maths, it is what happens inside them when the maths does not come immediately. That surge of frustration…

Hours of nothing, then panic, then three hours locked onto the wrong task, then dread, then a promise that tomorrow will be different. If that is your day, it is a known pattern and not a character flaw.

People post this shape as a joke and clinicians recognise it as an accurate description. Seeing it written down is often the moment something…

When you are low, the thing most likely to help is the thing you have least appetite for. Make the first step small enough that appetite is not required.

Getting as far as the front door can be the whole task on a bad day. Standing up, putting your shoes on, then deciding, is a fair plan. Anyone…

A movement practice comes apart into pieces: the shapes, the breathing, the noticing. On a day when the whole thing is beyond you, take one piece.

Just the breathing, sitting where you already are, is a practice. So is one stretch held for a minute. Doing a fragment keeps the thread going, and…

Slow movement practices seem to help mood, sleep and the general hum of stress. Bringing that background level down often does more for your concentration than trying to concentrate harder.

Running on a constant stress signal wears down exactly the part of you that plans, waits and holds a thought. So lowering the load is not a soft…

Movement gives you back some willingness, not just some focus. The problem is often not that you cannot concentrate but that you cannot make yourself care enough to start.

Those are two different difficulties and the second one is usually the more disabling in adult life. After moving, the same task tends to feel…

Moving your body is not a pleasant extra alongside the proper treatment for low mood. It has been tested as a treatment in its own right and it holds up.

This matters most when you are already doing other things and still struggling. Walking, cycling, swimming, anything that lifts your heart rate for a…

You do not have to walk into a room full of strangers for this to work. The moving and the attention are the active parts, and both travel happily to your living room.

Group classes suit some people and cost others far more than they give. A video at home, a quiet corner, the same fifteen minutes, all of it counts.…

Some of what you are carrying has not finished happening. Movement that soothes rather than pushes tends to suit that better than anything strenuous.

Advice built around a danger that has passed does not fit a person still meeting it weekly, whether that is racism, an unsafe household or work that…

If talking about it has not shifted things, a body based practice is worth trying next. It is not a consolation prize.

Some of what trauma leaves behind sits underneath words: the flinch, the going blank, the pull towards hurting yourself. Practices that work through…

Ask what is happening in the body right now, in the moment it happens, rather than asking afterwards what the feeling was.

A shutdown is quickest to catch while it is switching on. The question that works is small and physical: what is happening in your chest, your…

When someone says they feel nothing, find out where the nothing reaches. All the time, or only towards good things, or only here, in this conversation, when criticism is in the air?

The three answers point in quite different directions. Numb everywhere, day and night, is worth taking to a doctor. Numb to good things while the bad…

If a medicine has taken the edge off everything, including the good things, that is worth raising with whoever prescribed it. Taking the sharpness out of pain is one thing. Feeling nothing at all is not a way to live.

It matters practically as well as personally. Anything you are trying to change, in a relationship or in yourself, needs some feeling to work with,…