Practices

If cutting down has failed over and over, that is information rather than a verdict on you. For some people the workable goal turns out to be none rather than less.

Starting young makes this more likely, and the earlier the heavy use began the harder the road back to casual use tends to be. Nobody enjoys hearing…

With attention difficulties the organising side often runs a few years behind the birthday. A nineteen year old may be running life more like a sixteen year old, and that is a lag rather than a verdict.

Set expectations against where someone actually is instead of what year they were born in. That way the support that felt normal at school does not…

If everything came apart the moment school ended, it may be that the structure was never yours. It belonged to the timetable, and the timetable stopped.

School decides when you get up, what happens next and when the work is due, so nobody ever finds out whether the person can build a week from…

A bridge year can be a deferred place, a course at the local college, a job, or a stretch of genuinely doing very little. That last one is a real option and not a refusal to choose.

For someone who has just come apart, a fresh demand can restart the same collapse, so a few months with nothing scheduled is sometimes the…

The next step has to be theirs. A job that looks like nothing to you might be the first thing in two years they chose without being pushed, and that is exactly why it holds.

Parents tend to want the step that recovers the lost ground. The young person needs the step they can actually take on Monday. Shifts in a shop, one…

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…

Sometimes the answer is not a better system. It is doing less, including giving up something you love, because what it costs you has stopped being affordable.

Scouts on a Tuesday, the second job, the committee. Losing one of these is a real loss and it is worth grieving rather than pretending you never…

There is a difference between low mood you have carried all your life and low mood that grew out of years of working twice as hard for half the result. Both are real, and they need treating in a different order.

If the second describes you, the picture often lifts a fair way once the attention difficulties are being managed and the daily experience of falling…

This goes the way learning a bicycle went. You could not, then you could but only with all of your attention, then one day you rode without thinking about it. The middle bit is the ugly bit.

In that middle phase the skill works but it costs you everything to use, and it looks clumsy from the outside. That is where most people decide it is…

Some people get all the way to university before anything is named, then meet eighty pages of reading a night and cannot do it. Nothing broke that night. The volume simply outgrew a way of coping that had held for years.

The history reads the same way every time afterwards: always needed longer, avoided reading aloud, dreaded timed tests, stomach trouble in exam…

Stopping suddenly can bring lethargy, nausea, irritability and headache within a few days. That is discontinuation, not the illness coming back.

Timing is the giveaway. Withdrawal starts within days of the last dose and often has a particular feel to it: dizziness, odd electrical zaps, a…

Discontinuation gets mistaken for relapse constantly, by clients and by clinicians. The mistake runs in both directions and both directions cost something.

Read withdrawal as relapse and a person concludes they will need the tablet for life, when what they needed was a slower taper. Read a real relapse…

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…

Sometimes the honest answer is that there is nothing in your surroundings to feel good about. Changing them counts as treatment, not as running away.

A life with no friends nearby, no work that means anything and a steady drip of criticism will produce low mood in most people, and skills practised…

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…

If every step you try keeps not working, however small you make it, that is information rather than failure. A more intensive programme is the next thing to look at, and it should be put to you as an option.

The whole point of shrinking the steps is to find one that moves. When nothing moves at any size, staying in the same weekly arrangement out of…

For most of childhood somebody else held the diary. Parents remember the dentist, the kit, the letter that needs signing, and then one day nobody is doing that for you and the whole job is yours.

This is often why someone who managed well enough at school comes apart in their twenties. Nothing got worse. The scaffolding came down, and the…

Look back over your own history for the times you were knocked down and started something anyway. That pattern is common with ADHD, and it is easy to miss while you are busy counting the failures.

It may be a side effect of not weighting the future heavily. The past does not press down quite as hard either. People who have been sacked, dropped…

Walking away from a course or a job that was never going to fit can be the sensible move rather than a failure of nerve. It is also frightening, particularly when other people are paying for it.

Fit does more work here than effort does. The person who cannot survive a rigid nine to five in an open plan office may be excellent somewhere with…