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…

If you smoked or drank during a pregnancy and have spent years holding yourself responsible for how your child turned out, you are allowed to put some of that down.

The picture is genuinely tangled. The same traits run in families, so a parent is both more likely to pass something on and more likely to have been…

If telling your doctor or midwife what you are using feels impossible, you can ask someone you already trust to pass it on for you, with your permission and in your words.

People often stay quiet with the very clinician who could help, because saying it out loud feels heavier than the problem does. Handing the message…

Difficult things come out more easily when your hands are occupied and you are not looking straight at the other person. Walk side by side, drive somewhere, wash up together, keep the sewing going.

If you are the one listening, offer it first. Most people assume that picking something up would look rude or half interested, so they sit still and…

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…

Put a rubber band round your water bottle for each refill you want to get through today, and slide one off each time you finish it. Nothing to remember, nothing to buy, and you can see where you are at a glance.

Tracking anything in your head is hard when your head is already full, and harder still when concentration is one of the things that has taken a hit.…

Health advice usually assumes a kitchen, a fridge and money for the week. If you are working with less than that, the answer is not to try harder at the advice. It is to shrink the plan until it fits what you actually have.

A plan you cannot keep does more than fail. It quietly adds to the pile of evidence that nothing you do makes any difference, and that pile is heavy…

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…

If your mood drops reliably as the light goes, that is worth naming as a thing in its own right. Seasonal low is more common alongside ADHD, and a light box first thing in the morning helps a lot of people.

Use it early in the day and use it consistently, since the timing is part of how it works. It is also worth asking whoever prescribes for you about…

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…

Before anyone concludes that nothing works, go back over the ordinary explanations: a dose that never went high enough, a trial that stopped after three weeks, doses missed on the hard days.

Treatment resistant has a technical meaning, which is that at least two proper trials at a proper dose and length have failed. A great deal of what…

With the fast acting treatments, the plan for what happens afterwards matters as much as the treatment itself.

Electroconvulsive therapy can shift severe depression quickly, and without something in place afterwards the relapse rate is high, which is why…

If sleep has gone since starting, look at what time the dose is being taken before deciding the medicine is the problem. A long acting dose swallowed at one in the afternoon is still working at bedtime.

Extended release preparations are built to cover eight to twelve hours from whenever they are taken, so a late start pushes the whole thing into the…

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…

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 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.…

Medication treats the attention difficulty. It does not teach reading, lift a depression, or repair a household that has been fighting for years.

Those things need treatment of their own, and they are often what the family actually came about. Treating the attention difficulty well can stop…

Smoking runs high in ADHD, and nicotine genuinely does something for attention. It helps to treat that as self-medication rather than as one more impulsive habit.

It changes what a conversation about stopping looks like. If a cigarette is doing a job, taking it away and leaving the job undone is a plan that…

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…

Treat the first fortnight as a stretch that needs contact rather than silence. Say plainly that things may feel worse before they feel better, and arrange to hear from the person during that window instead of after it.

This is when most people quietly stop. Somebody who has been warned experiences a rough two weeks as expected; somebody who has not experiences it as…