Practices

Play therapy and insight based psychotherapy do not treat ADHD. There is no buried, unexpressed feeling driving it that talking will let out.

The difficulty sits in executive control and how it develops, not in hidden conflict. That said, a child with ADHD can also be anxious, grieving or…

A belief you have carried since childhood will not fall over because you asked it a good question this afternoon. You are planting something, not winning an argument.

The temptation, once a thought starts to look flimsy, is to press harder, and pressing usually makes the belief dig in. Leave the question where it…

Asked what all the scrolling had done to her most, one young woman did not say sad. She said angry, more or less all the time.

Constant irritability in a teenager usually gets worked up as depression or ADHD, and sometimes that is right. Saturation belongs on the list too,…

For some people the online part is not a side issue sitting next to the depression or the anxiety. It is one of the things holding them in place.

One young woman with a history of being bullied found her platform use feeding the depression, the social anxiety, the fear of leaving the house and…

Pick one series and watch it together on the same evening each week. The point is not the programme. It is that something puts the two of you in the same room on purpose.

With an older teenager or a young adult, a set night can carry a relationship through stretches when talking is hard. Some weeks you will pause it…

Nothing here does the job on its own. Medication if it suits you, a few practical systems, something for the low mood and shame that has built up, and the people you live with brought into it.

The practical layer is the easiest to describe and the first to fall over, because whether you use a system at all depends on how you feel about…

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…

With someone deep in shame, your steady presence is not the warm up before the useful part. It is the useful part.

That means resisting the urge to fix, to explain the psychology of it, or to hurry them along to a better feeling. Sit at their pace. Keep your tone…

Some people book their first assessment on the day they turn eighteen, because it is the first day they can consent without a parent. If you have been waiting like that, the waiting was not laziness.

Where a family or a community treats mental health care as shameful, a young person can spend a decade struggling with nobody's permission to ask for…

The parts of this that look like lifestyle, meaning sleep, driving, drinking, appointments that get missed, are the parts carrying the most risk across a lifetime. They are also the most changeable parts.

You may have met a striking figure quoted about untreated ADHD and years of life lost. Take the point underneath rather than the number: risk from…

No food in the house means eating out late, which means a late night, which means a late start, which means no time to shop. It is not a character flaw. It is a loop.

The parts that feel most like personal failure, the takeaways, the extra coffee, the money going nowhere, are mostly downstream of a plan that never…

Getting your ordinary life a bit calmer is worth doing for its own sake. More sleep, a little more structure, food that is not all improvised. Not perfect, just good enough to work with.

It will not give you more capacity than you have. What it does is let you use more of what you already have, more of the time, which is usually the…

Where you can, let the learning be something done rather than something sat through. Typing instead of writing, a calculator instead of longhand, a built model instead of an essay.

The knowledge is usually already there. What fails is showing it through a long, still, low feedback task, and that is the part worth redesigning.…

When a feeling is genuinely unbearable, escaping it is the only regulator you have, so the drinking or the shutting down is doing a job. Build up what you can bear and the job disappears.

It helps to stop asking why you keep reaching for the thing and start asking what state you were in just before you reached. Usually it is a…

Before you go anywhere near the hard memory, you need to be able to stay in your own body while something difficult is happening in it. That capacity is part of the work, not a delay before it starts.

Phase based approaches put this first for a plain reason: people who cannot bear the arousal either drop out or push through and come away worse. If…

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…

Think of it the way you would think about diabetes. Something to manage with several things at once, most days, for as long as it is there.

That frame does a lot of quiet work. It says the treatment is ongoing rather than a course you finish, it explains why things slide back when…

There is no single treatment that covers all of this. What works looks more like five things running alongside each other, and understanding the condition comes first.

Each piece reaches a different part of the day. Medication does something the environment cannot, changing what a room asks of someone does something…

The stack goes: understand it, medicate where that is right, change what the adults do, change what the day asks, and keep arguing the child's corner. Each layer does a job the others cannot.

None of them stands in for another, which is why swapping one out leaves a gap rather than a smaller plan. Medication does not reorganise a…