Practices

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…

If sleep has gone since starting, look at what time the dose is being taken before deciding the medicine is the problem. A long acting dose swallowed at one in the afternoon is still working at bedtime.

Extended release preparations are built to cover eight to twelve hours from whenever they are taken, so a late start pushes the whole thing into the…

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.…

Medication treats the attention difficulty. It does not teach reading, lift a depression, or repair a household that has been fighting for years.

Those things need treatment of their own, and they are often what the family actually came about. Treating the attention difficulty well can stop…

Smoking runs high in ADHD, and nicotine genuinely does something for attention. It helps to treat that as self-medication rather than as one more impulsive habit.

It changes what a conversation about stopping looks like. If a cigarette is doing a job, taking it away and leaving the job undone is a plan that…

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…

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,…

If the first medicine disappoints, that is information about the first medicine. Plenty of people who get nothing from one class do well on another.

Methylphenidate and amphetamine are not the same drug at different strengths. They work by partly different routes, so a poor result on one says…

Missing a day is not the end of the programme. You missed a day. Tomorrow you carry on.

The dangerous part is not the missed session, it is the story that follows it, the one where you have blown it so you may as well stop altogether.…

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…

Movement gives you back some willingness, not just some focus. The problem is often not that you cannot concentrate but that you cannot make yourself care enough to start.

Those are two different difficulties and the second one is usually the more disabling in adult life. After moving, the same task tends to feel…