Practices

How well something works in the moment and whether it is right for the long run are two separate questions. Fast relief is extremely convincing, which is exactly why it is worth pausing over.

When something reliably ends the worst feeling within twenty minutes, what your body learns is to reach for it sooner next time. That is not…

There is an older antihistamine used for anxiety that works by making you drowsy and carries no risk of dependence. It suits a rough stretch, and it is a bridge rather than somewhere to settle.

The costs are the ordinary antihistamine ones: dry mouth, constipation, and for older people a genuine risk of confusion and falls, with effects on…

Most people are a mixture rather than a clean example of one thing. If treatment has taken the edge off one part and left another standing, that is usually two problems, not one failure.

Someone whose panic has settled but who still spends every evening rehearsing tomorrow has had the fear part treated and the worry part left alone.…

When what is keeping you awake or on edge is your situation, a tablet can only do so much. That is not a failure of the medicine and it is certainly not a failure of you.

Noise, an unsafe home, night shifts, someone you are frightened of: none of these are altered by anything you swallow. The medicine may still be…

ADHD is managed rather than cured, across a whole life. Anything advertising a cure is telling you it is not working from the evidence.

Managed sounds like a disappointment until you look at what it means in practice: treatment that fits your life now, adjusted when the life changes,…

Listen for the sentence that says the child could manage all of this perfectly well if they only decided to. However kindly it is meant, that is the belief to take apart.

It sounds like encouragement and it works like a verdict, because it says the ability was always there and only the willingness was missing. In a…

After a working lifetime in this field, Barkley names the change in how a family sees the child as the most important step of all. Not the medication, not the charts.

The reason is practical rather than sentimental. Every other part of treatment asks parents to keep going for weeks with very little to show for it,…

Being told ADHD is largely inherited can sound like being told nothing can be done. It does not follow, and the two questions are separate ones.

How much of something a person shows, day to day, moves a good deal with what is around them, even when the underlying trait is strongly heritable.…

If therapy for ADHD did little for your thirteen year old, that is not a sign they were not trying. The self monitoring it leans on is still being built at that age, and it builds later in ADHD than in most.

The practical reading is about timing rather than willingness. Younger teenagers usually do better when the adults around them change the setup at…

Massage may well leave you calmer, and calmer is worth having. It is not a treatment for ADHD, and the two are worth keeping in separate boxes.

Living with ADHD is stressful in a measurable way, so anything that genuinely lowers that load is doing real good and deserves a place. The error is…

A great many people are diagnosed and then left with a starting dose nobody ever revisited, no reading, no group, nothing else at all. If things have stalled, the first thing to check is whether the treatment was ever actually finished.

Optimising is unglamorous and often the quickest thing available. Was the dose ever adjusted upwards, and on what basis. Does the cover reach the…

If the prescriber, coach or therapist is not delivering much, say so and ask for someone else. Working around poor care quietly is the thing that convinces a couple this is simply as good as it gets.

A dose never revisited, or a therapist who has never worked with ADHD, sets a low ceiling. The trouble is that the ceiling gets read as the person:…

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…

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…

A no is usually information about fit rather than a report on your worth. Some of them have to happen before you can tell which places are right for you.

This is a real reframe rather than a comforting one, because a rejection does carry usable information: about what they were after, about what you…

When something feels unbearable to risk, follow it downwards. If that did happen, what would it mean, and what would happen after that?

Keep asking gently, and stop when you reach something that is a statement about the person rather than about the situation, such as it would prove I…

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…

Some of the low, grey stretches are not depression. They are what happens when there has been nothing on the go for a while, and the colour comes back when a project starts.

It is a quieter thing than depression and it does not look like much from outside. Sleep is fine, you are still working, but the zest has gone out of…

There is a real difference between a person who will not start and a person who cannot get started, and with ADHD it is nearly always the second.

This matters most in how you speak to yourself, and in how the people near you speak to you. Refusal invites pressure and punishment, which reliably…

With ADHD the one dependable thing is that you are not dependable in the same way each day. A day when everything works and a day when nothing does can arrive with no reason you can find.

Say this out loud to the people who need to know, because the good days get held against you later, by them and by you. Plan around your average…