Practices

Feeling close to your own people does not automatically make you kinder to everybody else. Sometimes it does the opposite and sharpens the line between us and them.

This is worth watching in yourself, particularly if you are the sort who gets angry on behalf of a group. The same warmth that makes you loyal can…

The advice to touch, to eat together, to move your body, to say the true thing out loud stands up perfectly well without the hormone story attached.

Explanations that hang on a single chemical are memorable and usually too tidy, and the studies behind the popular version are often small. None of…

Time alone can be a good idea or a dangerous one, and the difference is what sits underneath it. If you are already low, already dodging people, or drinking on your own, a plan to see fewer people is the wrong plan.

Ask honestly which one this is. Stepping back from a crowded, quarrelsome week is one thing. Disappearing because you cannot face anybody is another,…

Telling somebody one thing you are quietly embarrassed about will bring you closer than a month of pleasant conversation.

It does not have to be dramatic. The worry you have never said out loud, the mistake you still think about at night, the thing you are no good at.…

The thing worth admitting is not that you were angry. It is what you were frightened of underneath it: being made a fool of, being left, being counted as useless.

Anger is the easy half to say and it rarely lands well. The fear underneath is harder to say and it is the part that gets you heard. One sentence…

You cannot decide to feel closer to people. You can decide to eat with them, walk with them, sit near them and say one true thing, and the closeness tends to follow.

The chemistry gets talked about a great deal and it is the least useful part. What you can act on is the diary: a standing meal with someone, a hand…

Go long enough without company and almost anyone will do. That is worth knowing about yourself, and worth watching for in someone who lives alone.

Loneliness does not make you a poor judge of character on purpose. It just lowers the bar until whoever turns up seems fine. The steadier answer is…

Four ordinary things take the edge off a hot temper: being touched by someone you trust, eating with people, moving your body hard enough to breathe, and sitting still for a few minutes a day.

None of them are about anger directly, which is the point. Exercise lowers what you are already carrying before the argument starts. A shared meal…

If eating together helps, it is the together that is helping. Being full is not a route to feeling close, and treating it as one goes wrong quickly for some people.

Sit down with somebody once a week and eat whatever you were going to eat anyway. That is the whole practice. If you notice yourself reaching for…

If you are around people constantly and falling out with them constantly, a quiet weekend on your own may do more for your temper than any conversation will.

Company loses its flavour when there is never a break in it, and irritation fills the gap. A deliberate stretch alone, a day or a weekend, lets you…

Closeness arrives much faster in a small group that keeps meeting than in a wide circle you see now and then. If you want to feel less alone, pick the small thing that repeats.

Six people who show up every Tuesday and say something real will know each other within a couple of months. Sixty acquaintances will not. It does not…

There is a particular relief in hearing a room of strangers admit the same frightened thing you have never said aloud. It is why groups reach people that advice does not.

You go in expecting contempt. What comes back is usually recognition, along with a few nods from people who have been ruder to their families than…

You can say what an SSRI does in one sentence. It blocks the doorway that carries serotonin back out of the gap between two nerve cells, so more of it stays there for longer and is likelier to be picked up.

Worth being able to say plainly, because most people are carrying something vaguer and more frightening than that. It also sets a fair expectation.…

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…

Serotonin syndrome comes from stacking, and the second agent is usually something nobody thought to mention: a migraine tablet, a cough medicine, a herbal remedy for low mood.

Triptans, tramadol, dextromethorphan, linezolid and St John's wort all count, as do other antidepressants. Someone who mentions in passing that they…

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…