Practices

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…

Put something in before you take something out. Removing the only way a person has of coping leaves them with nothing, which is not safer.

In practice this looks like smaller steps than a promise to stop: cutting the frequency, changing what is used, agreeing to wait ten minutes and do…

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.…

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…

For a small number of children the question was never about school reports. A toddler who runs into a road and keeps running, a child who climbs the pool fence: what is being weighed there is whether they stay alive.

Most decisions about treating a very young child are finely balanced and deserve to be taken slowly. Where the behaviour itself is life threatening,…

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…

When you are low, the thing most likely to help is the thing you have least appetite for. Make the first step small enough that appetite is not required.

Getting as far as the front door can be the whole task on a bad day. Standing up, putting your shoes on, then deciding, is a fair plan. Anyone…

A movement practice comes apart into pieces: the shapes, the breathing, the noticing. On a day when the whole thing is beyond you, take one piece.

Just the breathing, sitting where you already are, is a practice. So is one stretch held for a minute. Doing a fragment keeps the thread going, and…

If a child is climbing the walls, green space helps most, a walk down a busy street helps a bit, and staying in the room helps least. Any of the three beats none.

The research on this puts them in that order rather than saying only a forest will do. A park, a scruffy playing field, the bit of grass behind the…

Slow movement practices seem to help mood, sleep and the general hum of stress. Bringing that background level down often does more for your concentration than trying to concentrate harder.

Running on a constant stress signal wears down exactly the part of you that plans, waits and holds a thought. So lowering the load is not a soft…

Some of what you are carrying has not finished happening. Movement that soothes rather than pushes tends to suit that better than anything strenuous.

Advice built around a danger that has passed does not fit a person still meeting it weekly, whether that is racism, an unsafe household or work that…

If talking about it has not shifted things, a body based practice is worth trying next. It is not a consolation prize.

Some of what trauma leaves behind sits underneath words: the flinch, the going blank, the pull towards hurting yourself. Practices that work through…

You can take someone's fear entirely seriously without walking through the frightening story with them. Say you can see how frightening it feels, and leave the plot alone.

It reads colder written down than it lands in the room. What the person needs is to feel believed. What they do not need is a second person weighing…

Keep something to eat and drink within reach for hard conversations. Handing someone a biscuit and a glass of water often settles a room faster than any instruction does.

Part of why it works is that nobody has to be told how. A person too wound up to follow a breathing exercise can still take a sip and chew. Sharing…

Being told you are too sensitive is usually someone else's comfort talking. Feeling things strongly is not the problem to solve; what to do once the feeling has arrived is.

Both halves have to be said together. Validation on its own leaves a person flooded with permission and no handles. Teaching control on its own joins…

Peripheral biofeedback, the sort that tracks skin conductance and heart rate rather than brainwaves, has more behind it than neurofeedback does. You practise letting the body drop into a calmer state while a monitor shows you it happening.

Once that state is familiar, pair it with a distinctive scent used only for this. After enough repetitions the smell starts pulling the state along…

There is a point where a to do list stops being a tool and becomes something you flinch away from. If you have not opened yours in a fortnight, it has passed that point.

The usual advice is to work through it, which is precisely what nobody does with a list that long. It is kinder and quicker to start a fresh page…