Practices

When you are wound up and when you are flat, you need opposite things. Sweet tastes, soft light, slow rocking and steady weight bring you down; sharp smells, crunchy food, bright images and quick movement bring you up.

Before reaching for anything, work out which way you actually need to go. Racing, jaw tight, heart going: choose from the settling side. Foggy,…

Sound that repeats slowly, waves, rain, steady recitation, brings you down. Fast, loud, unpredictable music, or whistling, brings you up.

Have both ready before you need them, one playlist for each direction. Whistling is worth knowing about because it does two jobs at once, lifting you…

Steady pressure suits both directions. A weighted blanket, a firm squeeze of your own hands, lotion rubbed in with real pressure, bare feet pressed into the floor.

This is the one thing on the list that works whether you are wound up or gone flat, which makes it a good default when you cannot tell which you are.…

To come down, move slowly and rhythmically: rock, sway, walk at half speed. To come up, move properly: jog on the spot, jump, dance fast, or carry something heavy.

Heavy work is the interesting one, because it settles as well as it lifts. Carrying the shopping in one trip, shifting furniture, pushing hard…

The aim is not to stop feeling angry. It is to stretch the time between the feeling arriving and you doing anything about it, from no seconds to a few.

That target has the advantage of being honest and checkable. You can ask whether you got a moment this time that you did not get last time. The anger…

One move to interrupt, one to settle. Open your hand, then take the slow breaths: the first buys you the gap and the second gives you something to do with it.

An interrupt on its own leaves you standing there, aware and still flooded. A settling practice on its own never gets going, because the moment goes…

If a parent has been saying since the first year of school that something is wrong with their child's reading, start from the assumption that they are right. They have watched more of it than anyone else has.

The usual story is years of being told the child is fine, a little behind, will catch up, and then a diagnosis at nine or ten when the easiest years…

A child who cannot bear the noise, the lights and the scratchy jumper all day will be hard to be around by the afternoon. That child usually gets described as badly behaved rather than as overwhelmed.

Once a child is understood to be choosing it, everything that follows is punishment, the arousal climbs, and the sensory difficulty gets worse. That…

Try putting a sentence between you and the mood: this is what my brain is doing right now. It does not make me a bad person, and it does not mean I cannot cope. It just feels that way today.

Low mood does not arrive labelled as a mood. It arrives as facts about you, that you are useless, that nobody wants you around, and it is very hard…

A medicine that lifts drive is not the same as one that settles anxiety, and for some people the energising kind makes the worry louder.

Bupropion is the clearest example: often good for flatness and lack of motivation, often unhelpful on its own when anxiety and a racing, sleepless…

Put something in before you take something out. Removing the only way a person has of coping leaves them with nothing, which is not safer.

In practice this looks like smaller steps than a promise to stop: cutting the frequency, changing what is used, agreeing to wait ten minutes and do…

Six to eight weeks is what an antidepressant needs before it can be judged. The first fortnight will mostly tell you about side effects.

The transporter is blocked within hours, so the delay belongs to slower changes further down the line. In practice that means picking a date four to…

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…

When a prescription cannot be filled, you can report it to the medicines regulator's shortage inbox, naming the medication and the pharmacy. Nobody writes back, and people often find their prescription turns up soon afterwards.

The value of this is partly practical and partly in not being stuck. Being told no at a counter, month after month, is what makes people quietly…

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 medicine can give you back some energy. It cannot turn a bad situation into a good one, and it helps to be clear which of the two you are hoping for.

If home has been miserable for two years, feeling steadier may just mean you notice the misery more sharply. People often read that as the medicine…

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.…

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,…

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…