Practices

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…

When a medicine seems to be underperforming, look at what else is in the room before reaching for a higher dose. Anxiety, low mood and a wrecked sleep pattern can each blunt a good response or imitate a poor one.

Otherwise the dose climbs while the real driver goes untreated, and the side effects arrive without the benefit. Ask what a bad night actually looks…

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…

Most people who try do find something that helps, but often not the first thing they try. Not responding to one class of stimulant says surprisingly little about the other.

The high response figures you may have read come from people who worked through more than one option, not from one prescription going well. Response…

Unmanaged ADHD wrecks sleep, food and movement, and wrecked sleep, food and movement make the attention worse the next day. The loop feeds itself, which is also the hopeful part: a small repair anywhere in it pays back more than it should.

Short sleep hits the same front part of the brain that is already struggling, so a late night costs you more than it costs other people. Pick the one…

Weight across the body settles a lot of people and sends some of them to sleep quickly. It is a preference though, not a remedy, and for others it feels like being closed in.

If you try it, watch what actually happens rather than what is supposed to happen. Some people have wanted pressure, small dark spaces and being…

Keep something to eat and drink within reach for hard conversations. Handing someone a biscuit and a glass of water often settles a room faster than any instruction does.

Part of why it works is that nobody has to be told how. A person too wound up to follow a breathing exercise can still take a sip and chew. Sharing…

Being told you are too sensitive is usually someone else's comfort talking. Feeling things strongly is not the problem to solve; what to do once the feeling has arrived is.

Both halves have to be said together. Validation on its own leaves a person flooded with permission and no handles. Teaching control on its own joins…

Peripheral biofeedback, the sort that tracks skin conductance and heart rate rather than brainwaves, has more behind it than neurofeedback does. You practise letting the body drop into a calmer state while a monitor shows you it happening.

Once that state is familiar, pair it with a distinctive scent used only for this. After enough repetitions the smell starts pulling the state along…

When omega levels are low, everything about ADHD tends to get louder: attention, mood swings, holding things in mind. Low omega does not cause ADHD, but it can be sitting on top of it.

Think of it as one more layer to lift off rather than the thing underneath. Specialist labs can measure levels if it seems worth checking, and…

One woman's ADHD symptoms climbed and her thinking slowed as each B12 injection wore off, then settled again after the next one. The deficiency came down one side of her family and the ADHD down the other.

The two lived in the same person without either causing the other. What made it findable was the timing, because difficulties that follow a cycle are…

When a task is missed it is usually not sitting somewhere being refused. It has gone off the radar altogether, the way a name goes when somebody asks you for it.

The refusal reading is the expensive one, because it turns a lapse into an insult and starts the argument in the one place where nothing can be…

For most of childhood somebody else held the diary. Parents remember the dentist, the kit, the letter that needs signing, and then one day nobody is doing that for you and the whole job is yours.

This is often why someone who managed well enough at school comes apart in their twenties. Nothing got worse. The scaffolding came down, and the…

You can mean something completely, drive most of the way there with it in your head, and still turn left instead of right. Meaning it and doing it are two separate events, and only one of them is visible to anyone else.

To a partner, the missed errand looks like a verdict on where they come in your order of things. It helps to say out loud, at a calm moment rather…

It tends to go in a sequence: unreliable first, said kindly, then irresponsible, said less kindly. After that it stops being about the tasks at all and turns into a description of who you are.

By the third stage shame has arrived, and shame makes people avoid the very systems that would help, because setting up a calendar means admitting…