Practices

Do not write off simply sitting with someone. When researchers looked into why dummy treatments helped, one of the things they kept finding was half an hour of a person's full attention.

Thirty minutes of someone listening properly to your difficulties is not filler around the real treatment. Across the talking therapies, who the…

Paediatric and psychiatric bodies have moved towards treating earlier than used to be usual. The reasoning is that the damage builds on itself.

A year of falling behind makes the next year harder, a reputation among classmates is quick to form and slow to shift, and a household that has been…

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:…

Sleep, food and movement will not cure anything, but they lengthen the fuse. Bad moments still arrive, and you handle them differently when your body is not already running on empty.

This matters more here than it sounds, because ADHD tends to wreck exactly these three and then the wreckage feeds back into the flare ups. Late…

The diet evidence has drifted away from cutting particular things out and towards eating decently overall. That is easier on everyone at the table.

Removing additives or colourings helps a small number of children, and the trouble is that you cannot tell in advance who they are, so most families…

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…

The most convincing programme for teenagers does the obvious thing. It runs at school, twice a week, so nobody has to be driven anywhere: homework systems, organisation, some social practice and sport, in the place where the trouble actually happens.

By the teenage years the leverage parents had is thinning, and a clinic appointment is the first thing to fall off the week. Putting the help inside…

Paying someone to help sort the house will not mend the marriage. It will remove one of the things you fight about most weeks, and that counts for more than it sounds.

Nobody should pretend this reaches anything deep. The point is arithmetic. A couple has a certain number of rows in them, and if the living room is…

People who are sleeping properly, eating properly and moving a bit tend to want each other more. The unglamorous parts of life management run closer to the bedroom than either of you might expect.

It is worth saying out loud when desire has quietly gone from a marriage, because the usual explanations reach for something heavier: he has lost…

A useful picture: the parts of your brain are sections of an orchestra. In dysregulation they are playing different tunes at different speeds. The aim is timing, not repair.

This is a kinder frame than damage, and a more accurate one. Nothing is broken or missing. What has gone is the coordination between parts that used…

Neurofeedback usually starts with an assessment, then a block of sessions, then a review, and it is mostly paid for privately. Ask about all of that before you begin.

It is a referral rather than something your therapist adds to a session, so you are taking on a second appointment, a second bill and a second…

Neurofeedback has its strongest support in attention difficulties, decent support in depression and anxiety, and for trauma it is promising rather than proven.

Reported gains include better sleep and attention, less irritability and fewer trauma symptoms. The honest caveats are cost, wide variation in how…

Long stress does not have one look. Some people end up permanently switched on. Others end up flat, heavy and hopeless. The two need opposite things.

If you are the switched on kind, the work is coming down: a longer breath out, less caffeine, a real end to the working day. If you are the flattened…

The stress hormone that carries you through a hard month also quietens your immune system while it is high. When it drops, the immune side comes back up.

That is the plain version of a relationship usually summed up as stress making you ill, which is too blunt to be much use. Running high and running…

Getting ill the week after the exams, the deadline or the funeral is not bad luck. It is the pattern.

You hold together through the push, and the moment it stops you are in bed with something. Often it was already brewing while you were still going.…

Wanting sugar, salt and something sharp at the end of a punishing week is physiology talking, not a defect in your character.

Long stretches of high stress come with real bodily consequences, and a shifted appetite is one of the visible ones. Fighting the craving head on…

Long histories of unresolved stress show up in bodies: inflammation, gut trouble, broken sleep, conditions that end up labelled unexplained. Being told it is all in your head is both wrong and useless.

There is a well known overlap between hard early lives and diagnoses such as fibromyalgia, chronic fatigue and several autoimmune conditions. Overlap…

An immune system that stays switched on with nothing to fight can begin turning on healthy tissue. It is doing its job with the wrong target.

That is a kinder account than the ones people are usually handed, which tend to imply they brought it on themselves by not coping. None of this is…