Practices

Going from talking online to talking in person is not one more step up the same ladder. It is a different ladder, and it deserves rungs of its own.

Those rungs might run from voice notes, to a phone call, to a video call with the camera on, to meeting one person you already know somewhere quiet,…

A group can help a great deal, and it is rarely the place to begin. Being in a room of people is a strong dose, and doses climb rather than start at the top.

Left too early it often ends with someone dropping out, and dropping out gets read as proof they were right about themselves all along. Once there is…

Write it up before you leave. One salesman, knowing full well he will not remember the visit an hour later, does his notes in the car with the engine still off.

The strength of it is that the trigger is fixed and physical. Sitting down in the car is the cue, and the notes happen before the key turns. No…

Whatever the record is, do it the same day, every time. The salesman writes his notes in the car outside the client's office. Not that evening, not on Friday.

No exceptions is the part doing the work. One skipped day teaches you that skipping is survivable, and 'it worked out fine that once' is the thought…

Guard sleep first, especially through any long stretch away from the usual routine. Once the nights slide, everything else you have set up starts giving way.

Holidays, illness and school closures are when bedtimes drift, and a fortnight of late nights undoes more than any homework plan can fix. Keep the…

This is not a milestone you pass. The two year old's version goes, then a version comes back at twenty two, and again at fifty two, wearing whatever clothes that stage of life provides.

So think maintenance rather than course completion. When conditions change, a new baby, a new manager, an illness in the family, expect the old…

If reminders, other people's deadlines and a bit of chivvying are what keep you moving, you are allowed to keep them. Inner drive arrives later for some of us, and taking the scaffolding away early does not hurry it along.

Families often pull the supports back on a birthday, as though a certain age should switch on self-direction. What tends to happen is that the only…

An ADHD diagnosis usually arrives with two extra words attached: which presentation it is, and how severe. Both are descriptions of what gets in your way, not a grade you were awarded.

Inattentive, hyperactive and impulsive, or the two together, and then mild, moderate or severe. Mild means you met the threshold and the effect on…

Home DNA tests turn up relatives nobody expected. If someone is thinking of taking one to fill in a blank family history, it is worth saying out loud that it may hand them more than they asked for.

People find half siblings. Sometimes they find that the story they were told about their birth was not the story. That is a great deal to receive by…

Never come off an antidepressant on your own. The taper belongs to the prescriber, and for some drugs it needs to be slower and longer than people expect.

The moment to raise this is before anybody acts, not afterwards. If a client is feeling better and starting to think about stopping, that thought is…

Some antidepressants take weeks to build up and weeks to clear, so both the improvement and the aftermath run on a slower clock than you would expect.

Fluoxetine is the usual example. It and the substance it turns into stay around a long time, which means a fair trial is counted in weeks and…

Raising a dose does not simply raise the benefit. It raises everything the drug does, including the parts nobody was asking for.

As the amount climbs, a medicine begins touching things it barely touched before, which is why new side effects can appear at a higher dose of…

Coming off an antidepressant is a piece of work in itself. Plan it slowly with the prescriber rather than stopping on the day you feel well.

Some, venlafaxine especially, leave the body fast enough that a missed dose is felt within a day: dizziness, strange electrical sensations, a mood…

Skipping weekends, holidays and summers is a common suggestion and mostly it is the wrong call. The difficulty does not take a holiday when school does.

Unstructured time asks more of planning and self-regulation rather than less: whole days to fill, everyone at home, no timetable holding the shape of…

Two products can hold the identical molecule and still behave differently in a person, because the difference lives in how fast the drug is released. A change of formulation is a real change, and it is a different thing from a change of drug.

The release pattern sets how high the level climbs, how quickly it gets there, and how long it holds. For stimulants that decides whether cover…

If you take a prescribed stimulant and your workplace tests, sort the paperwork before anyone asks. A labelled bottle and a short letter from your prescriber turn an alarming result into a filing matter.

Prescribed amphetamine shows up on a standard screen as amphetamine, because that is what it is. The test cannot tell the pharmacy from anything…

Some settings simply suit an attention difficulty better. Expectations set out minute by minute, consequences that arrive the same day, a visible ladder to climb: military life often fits for exactly those reasons.

The point carries well beyond the army. When you are helping someone choose work, ask what the day actually looks like rather than what the job is…

Stopping medication rises sharply in the early teenage years. If that is where you are, it helps to know this is the usual pattern rather than a sign that something has gone wrong with your child.

The pull is understandable: wanting to be in charge of your own body, hating being the one who is different, and a parent no longer standing over the…

Use a timer you can see rather than a warning you have to remember. A dial that shrinks, or a light that goes from green to red, does the work that five more minutes never quite does.

Time is not something everyone feels passing. Turning it into something you can look at moves the job from guessing to seeing, which is much easier.…

One minute of moving between tasks. Star jumps, a lap of the corridor, anything that gets the blood going before you sit down to the next thing.

Classrooms that do this report smoother changeovers and better recall of whatever was just taught. The same trick works at a desk: end one job, move…