Practices

When the usual route into reading or arithmetic does not form, children build another one, and it nearly always runs through memory. It works for years, and it costs far more effort than anyone watching realises.

This is the bright child who is somehow always tired, always slow with written work, quietly memorising what everyone else is working out. The route…

When grief rises like a wave, let it come and let it pass. Do not brace against it or push it down.

Grief arrives in waves, not a straight line. A wave allowed to rise will also fall. Fighting it is what makes it last.

Let yourself weep. Tears over someone you love are not a failure of faith or of strength.

Crying is not the opposite of patience. It is the body grieving honestly, and it passes more cleanly when it is not shamed.

Take the sorrow you cannot say to anyone else and pour it out to God, in your own plain words.

You do not have to hold it alone or find the right phrase. Say the raw thing to the One who already knows it.

Notice where the fear sits in your body, the chest, the throat, the gut, and breathe gently toward it.

The body remembers what words forget. Meeting the sensation with breath, not judgement, begins to loosen it.

Move the body gently, a walk, a stretch, to discharge what fear leaves stored in it.

Fear is physical energy. Letting the body move helps it complete and settle what it could not before.

Take your love needs to your partner, not outside the relationship. Going outside almost always makes it worse.

When something is missing, ask for it at home. Seeking it elsewhere deepens the wound.

The blockade is partial. Serotonin is not trapped in there forever: enzymes still break it down and the transporters that are not blocked carry on working.

That matters for accuracy and it matters for reassurance, because people do picture something flooding and stuck. It also explains why serotonin…

When someone says they react badly to normal doses of almost everything, take it as information about their body rather than as a personality trait.

Bodies differ in how fast they break a medicine down. Give two people the same dose and one of them may be holding far more of it for far longer,…

Whether a medicine works can turn on something as ordinary as taking it with food or moving it to bedtime.

Vilazodone is the clear case. On an empty stomach a good deal less of it is absorbed, and the nausea it can cause is easier to sit with overnight…

If a medicine leaves you wired, restless or with a pulse that will not settle, report it rather than tolerating it quietly.

The antidepressants that act on noradrenaline as well as serotonin can raise blood pressure and put nerves on edge, and with some of them that grows…

The same medicine can be dangerous given one way and safe given another. Slow release is not a marketing word.

Bupropion was pulled from the market over seizures and came back once a slow release form existed, because what drove the risk was the sharp peak…

The chemistry story runs backwards from how it is usually told. Nobody found a low chemical and then built a drug. They noticed what certain drugs did to mood and reasoned back to what must have been missing.

Reserpine emptied out the monoamines and people became depressed. Iproniazid and imipramine raised them and mood lifted. Out of that came the account…

Depression is not one thing with one address. Fatigue, blank concentration, lost libido and the loss of pleasure do not all come from the same place, so it helps to name which one you most want moved.

This is why two people with the same diagnosis get offered different tablets. A flat, pleasureless presentation points one way, a fatigued and achey…

Ask why the tablets take weeks. That one question sorts the honest accounts of how they work from the tidy story about a chemical being low.

Four competing versions sit under the same umbrella: too little released, reuptake running too hard, too much broken down, or receptors that need an…

Nearly all of them do the one thing: keep a monoamine hanging about in the synapse for longer. So when you hear that some other tablet is stronger, be a little sceptical.

Head to head, the differences in how much they lift mood are modest. Where they really differ is in everything else they do to you, and in how well…

SSRIs became the default for four reasons, and being more effective is not among them. They are easier to tolerate, taken once a day, far safer in overdose, and cheap as generics.

Tricyclics match them for lifting mood and are dangerous in overdose because of what they do to the heart. MAOIs carry food and drug interactions…

Never come off an antidepressant on your own. The taper belongs to the prescriber, and for some drugs it needs to be slower and longer than people expect.

The moment to raise this is before anybody acts, not afterwards. If a client is feeling better and starting to think about stopping, that thought is…

One person's side effect is another person's treatment. Sedation is a burden for someone who cannot get out of bed and a gift for someone who cannot get to sleep.

Read the comparison charts that way and they stop being lists of harms. They turn into a set of levers: this one settles, this one gets you moving,…

Two rough shapes of low mood are worth telling apart: the irritable, restless, crabby kind, and the flattened, heavy, nothing matters kind.

They ask for different things. The agitated version often tolerates and even welcomes something sedating, while the flattened version needs whatever…