Practices

Anger sends people back to the thing they had stopped, and the thing they had stopped makes the anger worse. Any plan that treats these as two separate projects tends to come apart.

Write anger into the relapse plan by name, alongside the parties, the old friends and the difficult anniversary. Then when you look at the anger, ask…

The pull towards bread, pasta and biscuits when you are low is not simply greed. Carbohydrate makes it easier for the brain to get hold of the raw material it needs for serotonin, so it gives a real if short lived lift.

Calling it self medication instead of a failure of character changes what you do next. You stop trying to out-discipline the craving and start asking…

When you find yourself reaching for something sweet again, try asking what the reaching is doing for you instead of telling yourself off. Comfort, a small rebellion, a way to stay awake: the answer usually points somewhere useful.

Talk about being good or bad closes the conversation down. Curiosity keeps it open, and it tends to surface the actual job the food is doing, which…

When digestion goes wrong there are usually two things to look at rather than one: something you are eating that does not suit you, and a body too braced to digest properly. Checking only one door tends to leave you stuck.

Digestion mostly happens when your body believes it is safe. If you eat every meal with your shoulders up round your ears, that alone can show up as…

Irritable bowel symptoms turn up more often in people with ADHD, and they tend to track stress. If your stomach is at its worst in the weeks when everything else is at its worst, that is information rather than coincidence.

Two things help more often than they get suggested. Cutting caffeine frequently settles symptoms on its own, since it speeds the gut up and raises…

Stress unsettles the gut and an unsettled gut drags on mood, so the two keep each other going. The good news buried in that is you can step in from either end.

You do not have to establish which came first. Easing the pressure on your nervous system helps digestion, steadying what you eat helps mood, and…

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,…

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…

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…

A medicine that lifts drive is not the same as one that settles anxiety, and for some people the energising kind makes the worry louder.

Bupropion is the clearest example: often good for flatness and lack of motivation, often unhelpful on its own when anxiety and a racing, sleepless…

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…

If a question at the counter feels like judgement rather than care, you are allowed to ask which it is. Is this a medical question or a personal one?

Asked evenly it does not start a row, and it returns the conversation to where it belongs. Pharmacists have proper clinical questions to ask about…

The stimulant shortage is not your pharmacy being disorganised. Regulators set a fixed annual quota of the raw material, and the ceiling has been too low to cover the prescriptions being written.

Knowing that changes what you do with your energy. Ringing round twenty chemists is exhausting and it creates no supply, so spend the effort on…

When a prescription cannot be filled, you can report it to the medicines regulator's shortage inbox, naming the medication and the pharmacy. Nobody writes back, and people often find their prescription turns up soon afterwards.

The value of this is partly practical and partly in not being stuck. Being told no at a counter, month after month, is what makes people quietly…

Waking your child at six to give the tablet so it has taken hold by breakfast, then letting them fall back to sleep, is not a strange thing you invented because you are failing. It is a reasonable answer to a real gap in how the medicine works.

Families quietly carry a lot of these. The early alarm, the switch to a faster product, the parent who does the whole morning alone because it goes…

A medicine can give you back some energy. It cannot turn a bad situation into a good one, and it helps to be clear which of the two you are hoping for.

If home has been miserable for two years, feeling steadier may just mean you notice the misery more sharply. People often read that as the medicine…

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.…

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…

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…