Practices

Every adjustment should arrive with the date you will start reducing it. Written down at the beginning, while everyone is still reasonable.

Supports meant as a bridge have a way of becoming the new normal, and by the spring nobody remembers they were temporary. Decide at the outset what…

Write it up before you leave. One salesman, knowing full well he will not remember the visit an hour later, does his notes in the car with the engine still off.

The strength of it is that the trigger is fixed and physical. Sitting down in the car is the cue, and the notes happen before the key turns. No…

Whatever the record is, do it the same day, every time. The salesman writes his notes in the car outside the client's office. Not that evening, not on Friday.

No exceptions is the part doing the work. One skipped day teaches you that skipping is survivable, and 'it worked out fine that once' is the thought…

An ADHD diagnosis usually arrives with two extra words attached: which presentation it is, and how severe. Both are descriptions of what gets in your way, not a grade you were awarded.

Inattentive, hyperactive and impulsive, or the two together, and then mild, moderate or severe. Mild means you met the threshold and the effect on…

Home DNA tests turn up relatives nobody expected. If someone is thinking of taking one to fill in a blank family history, it is worth saying out loud that it may hand them more than they asked for.

People find half siblings. Sometimes they find that the story they were told about their birth was not the story. That is a great deal to receive by…

Never come off an antidepressant on your own. The taper belongs to the prescriber, and for some drugs it needs to be slower and longer than people expect.

The moment to raise this is before anybody acts, not afterwards. If a client is feeling better and starting to think about stopping, that thought is…

Some antidepressants take weeks to build up and weeks to clear, so both the improvement and the aftermath run on a slower clock than you would expect.

Fluoxetine is the usual example. It and the substance it turns into stay around a long time, which means a fair trial is counted in weeks and…

Raising a dose does not simply raise the benefit. It raises everything the drug does, including the parts nobody was asking for.

As the amount climbs, a medicine begins touching things it barely touched before, which is why new side effects can appear at a higher dose of…

When you are weighing up whether a teenager is ready for something, it helps to think in two thirds. A fifteen year old may be handling responsibility more like a twelve or thirteen year old.

This is not an insult and it should never be delivered as one. It is a way of explaining why a privilege arrives later here than for their friends,…

Skipping weekends, holidays and summers is a common suggestion and mostly it is the wrong call. The difficulty does not take a holiday when school does.

Unstructured time asks more of planning and self-regulation rather than less: whole days to fill, everyone at home, no timetable holding the shape of…

Two products can hold the identical molecule and still behave differently in a person, because the difference lives in how fast the drug is released. A change of formulation is a real change, and it is a different thing from a change of drug.

The release pattern sets how high the level climbs, how quickly it gets there, and how long it holds. For stimulants that decides whether cover…

Do not stop dead. Give the end of anything energetic a few minutes of winding down, so the change of gear is a routine rather than a demand.

Stopping is a transition, and transitions are where things fall apart for a lot of people. A short unwinding phase, the same one every time, takes…

Move just before the difficult task, not after it as a reward. Five minutes of skipping, stairs or running on the spot, then sit down to the thing.

The window straight after moving is when focus is at its best, so that is the bit worth spending on whatever you have been dreading. For a child,…

Most children with ADHD grow into adults with ADHD. Some of it settles as the brain finishes developing into your late twenties, and adult life gives you more say over how your days are arranged, but the underlying difficulty tends to stay.

This is worth knowing because much of the improvement people do get comes from arranging things to suit themselves: the job that fits, the hours that…

Moving between lessons is where things fall apart, so plan the move out loud before it happens. What to bring, where to go, and who will be waiting.

Before the child leaves maths, walk them through what comes with them and tell them to check in with the next teacher on arrival. That teacher greets…

ADHD does not usually vanish at eighteen. The visible fidgeting often settles while the inattention stays, and the restlessness moves inwards where nobody can see it.

A teenager who has stopped bouncing off the walls can look much improved at exactly the point their workload has quadrupled, which is a poor moment…

If a young person says they do not feel ready to drive, take that as information rather than something to talk them out of. Plenty of them know their own attention better than the adults around them do.

Waiting a year is not a failure, and there are other ways to get about. Do ask what sits behind it, because there is a difference between a sober…

If you swallow it all day at work and it comes out at home, home is not where the problem is. It is just the safest place to put it down.

Anger lands where retaliation costs least, which usually means on the people who will forgive you. Two things help more than trying to be calmer at…

A skill that lives in your own body and your own phone stays with you after the appointments stop. That is worth choosing for.

Plenty of what helps during treatment ends when the relationship does. This does not. People often say afterwards that the breathing thing was the…

Getting ill the week after the exams, the deadline or the funeral is not bad luck. It is the pattern.

You hold together through the push, and the moment it stops you are in bed with something. Often it was already brewing while you were still going.…