Practices

Often the most useful thing a clinician does is not delivered by the clinician. It is delivered by the teacher, or the parent, after a conversation you had with them.

Taking that seriously changes how the hour gets spent, towards talking with the school, coaching the parents and designing the arrangement, and away…

The classroom is the strongest place to help and most clinicians cannot get into one. That is a reason to work well in the next best place, not a reason to give up.

ADHD sits in how a brain is built, and the work is on the executive skills themselves rather than on attitude or effort. Where the moment of…

Some foods are formulated to be hard to stop eating. That is a design brief rather than a flaw in you, and it goes some way to explaining why one particular snack is the one you think about at eleven at night.

Knowing this moves the fight somewhere you can win it. Willpower at the moment of craving is a poor bet, and a decision made in the shop is a much…

Own brand products from large retailers were among the worst performers in these tests. A big name on the packet is not a quality check, however much it feels like one.

Own label goods are usually made under contract on thin margins with no independent verification of what comes out the other end. So the reassurance…

Your gut is not just plumbing. It makes many of the same chemicals your brain runs on and it is in constant conversation with your nervous system, which is part of why a bad stretch of digestion and a low mood so often turn up together.

If your stomach has been unsettled for weeks and your mood has slid over the same weeks, you do not have to work out which one is the real problem.…

Most claims about food and behaviour rest on weak studies. The ones worth taking seriously give each person both the real thing and a dummy at different times, with nobody knowing which is which, so that hope and expectation cannot do the work.

The food colouring trials are the standard example. Around 150 children each received drinks containing a preservative plus one of two dye mixes, or…

The same brand of sweets is often made with plant based colours in one country and artificial ones in another. If a company can make it without the dyes elsewhere, the dyes are not essential to the food.

Nine artificial colours are approved in the US, and the volume approved for use rose roughly fivefold between 1950 and 2012. One of them, Red No. 3,…

A real food allergy shows itself on the body: a rash, a swollen or inflamed throat, something you can see. Behaviour on its own does not identify one, although behaviour often improves once a genuine allergy is dealt with.

One child's attention and mood went back to her usual level once berries came out of her diet, and what made that findable was the rash and the sore…

The studies linking pesticide levels to ADHD are tangled up with income, since families least able to buy organic differ in plenty of other ways too. If organic food is affordable for you, fine. If it is not, you are not failing your child.

In one study of 1,140 children, 94% had detectable pesticide in their urine, and ADHD was about twice as common among those with higher…

Most eating advice quietly assumes a budget. Fresh food is expensive and does not keep, so a household relying on food assistance ends up buying what lasts, and what lasts comes in tins and packets.

If money is the constraint, say it out loud rather than nodding along and then failing quietly at home. The advice can be rebuilt around what is…

A second study, this time of 44 products, found only about half were authentic. Roughly six in ten were mislabelled, three in ten contained a substituted ingredient, and one in five held contaminants or fillers.

One study of this kind is a story about some bad batches. Two independent studies finding the same thing is a description of how the market works.…

Several herbal products change how fast the liver processes medication, which can leave a prescribed drug either weaker or stronger without a single change to the dose.

This is often why a supplement looks like it caused a relapse or a sudden run of side effects. Nothing about the prescription changed, so the pattern…

Two to be careful with in particular. Yohimbe reliably ramps anxiety up, so much so that it has been used in research to bring panic on, and kava is a sedative that stacks with alcohol and with sedating medication and has damaged livers at higher doses.

Kava has been restricted or banned in several countries over liver harm, which tells you how seriously that risk is taken. Yohimbe is a poor choice…

You cannot patent a plant, so there is little commercial reason to fund expensive trials of one. When you read that a herb has no evidence, that often means nobody paid to look rather than that somebody looked and found nothing.

Both halves of that need saying. No evidence is not proof of no effect, and it is also not permission to assume one. It leaves you with an open…

Herbal products are rarely covered by insurance and they add up quickly. That cost belongs in the decision, particularly when you cannot be sure the capsule holds what it says.

Money spent here is money not spent elsewhere, and often the alternative is a treatment that is covered and has been tested. Nobody is telling you…

What you feel does not stay in your head. Emotional states register in the body's immune signalling too, which is one reason a long stretch of unspoken distress can leave you physically run down.

This is not a claim that you can think yourself well or ill. It is closer to saying the body keeps a tally. If you have been carrying something heavy…

A physical symptom is not a free floating fact. Read it next to what your life has actually held, the early parts included, and it often makes more sense than it does on its own.

This works in both directions. It stops you treating a body complaint as something random that landed on you, and it stops you treating it as a…

Saying a difficulty is in the past is not the same as saying it was never real. Sometimes a picture changes because something that was making it worse got taken away, and the honest words for that are neither cured nor imagining it.

People who have been disbelieved by doctors are very sensitive to this, and with reason. The choice usually gets offered as either it was all in your…

If your attention runs low on stimulation, salty and sweet food is the fastest legal source of a lift and it is available all day. Worth knowing about yourself, because it explains a pattern that willpower alone never seems to touch.

Rates of overweight and type 2 diabetes are higher in people with ADHD, and the reasons are not moral ones. A reward system that is under stimulated…

Caffeine buys about half an hour of sharper focus and takes the payment out of your sleep. It is a decent tool for a particular hour, and using it in place of treatment usually leaves you worse off across the day.

Four cups a day and upwards starts producing insomnia, irritability, tremor, an unsettled stomach and a racing heart, and a few people go sleepy on…