Practices

Put today next to the night before it, out loud and often. How did today go after seven hours of sleep, next to the day that followed staying up until three?

ADHD makes it hard to link a consequence back to a choice made hours or days earlier, so the link has to be supplied from outside until it starts…

The same loss of appetite means very different things in different children. A slight child who was already struggling to gain weight may need a different formulation or a different medicine altogether.

For a sturdy child a smaller lunch is a nuisance. For one with nothing spare it is a reason to change the plan. Non-stimulant options exist and are…

Every workplace runs on a map nobody prints: who really decides, who to ask, what the polite route is. Picking that up by osmosis is exactly the channel that struggles here.

So you follow the written process, do it correctly, and it goes wrong anyway, and nobody can tell you why. The repair is to have it taught rather…

If you carry a firm dislike of medication from childhood, it is worth asking what you actually remember. Often what is remembered is a row between two adults rather than anything the medicine did.

Where parents disagreed about it, the disagreement was frequently about control and about each other. A child in the middle of that absorbs a…

Plenty of children on a stimulant are taking something else as well, most often an antidepressant. That second medicine is usually there for a second problem rather than for the attention itself.

It is a useful lens when a regimen has grown complicated. Ask what each item is for, and the list generally resolves into a treatment for the…

To find out whether treatment is helping, ask the people who live with the person. One parent who stopped her medication for a family holiday remembered a lovely trip, while her children remembered running it.

Two teenagers had packed for her, fetched what she forgot, and kept an eye on the airport clock. She had no idea any of it happened. There is no…

The old argument about medication against behaviour therapy was set down years ago. The useful question now is what each one covers.

They work by different routes and they reach different hours of the day, so putting them in a single contest was never going to tell anyone much.…

Adding psychosocial work to medication buys something extra, and less than people hope. The extra tends to arrive in the places medication was never going to reach.

Homework routines, the temperature of arguments at home, how a teacher speaks to a child, the hours after a dose has worn off: that is where the…

Doing the behavioural work alongside a medicine can mean managing on less of it. That matters most for the side effects that follow the size of the dose.

Appetite, sleep and irritability all tend to scale with how much is being taken. Where part of the load is carried by routines, by support at school,…

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…

One question is worth asking before choosing between products: which part of the day actually goes wrong? Bead type capsules tend to give more early on, while the pump type keeps more back for the afternoon.

Two products can hold the same molecule and cover the same number of hours, and still fit one person and not another, because of where the strongest…

When appetite disappears at lunchtime, work with the child's rhythm instead of against it. Feed them properly at the hours they are actually hungry, which is usually breakfast and then the late afternoon and evening.

What counts over a week is the total, not whether it arrived at the socially correct hour. A decent breakfast before the medicine takes hold, a light…

If the medication question is the one burning a hole in your pocket, try holding it until last on purpose. Heard after everything else, the answer lands differently.

Most people arrive wanting to know about tablets and nothing else, and the risk in that is a plan made only of tablets. Sleep, movement, the shape of…

Non-stimulants are usually tried after the stimulants rather than instead of them, mostly because they are harder to tolerate. That is about order, not about the drug being second rate.

There are people for whom one is the right first choice: tics, real anxiety alongside, a history that makes a stimulant a poor idea, or a body that…

If you learn one thing about how these medicines work, learn the junction between two nerve cells. Nearly every drug in this field acts at one of a handful of points in that small space.

It saves a great deal of memorising. Once you can picture a message being released, landing, and then being cleared away, most explanations turn out…

Mechanism is a moving thing, so it is easier to watch than to read. A university made animation of what happens at the junction will teach you more in ten minutes than a page of description.

Prefer something made by a university or a public body over whatever a search puts at the top, since much of what is written about these drugs is…

Once you can follow the sequence, release, landing, clearing away and breaking down, most new drugs turn out to be recombinations of those four. That is a fair claim to competence and a good place to stop.

Learning drug by drug never ends and never transfers. Learning the sequence means you can place something you have never heard of and ask a sensible…

Learn the family rather than the members. If you know roughly how one drug in a class behaves, you already know most of what the others will do.

The medicines people are most often on collapse into a handful of families. A new arrival is usually a variation inside one of them, and occasionally…

If you are not the one prescribing, you can still take an active part in the medication conversation. You see the person weekly and hold the ordinary detail their prescriber never gets to see.

Ask what they notice and write it down in their own words. With their permission, send the prescriber a short note that can be read in a minute: when…