Practices

One of the founding figures of biological psychiatry summed the whole business up as some medicine helping some people at some doses some of the time. Knowing that before you start makes the first disappointment much easier to survive.

Most people need more than one adjustment: the dose, then the timing, sometimes the drug itself. Go in expecting the first prescription to be the…

When medication works, its best effect is often on everything else you were already trying. Coaching, exercise, a routine: each of them needs enough attention to get started, and attention is the thing in short supply.

That is why setting medication against the other approaches usually misses the point. The plan you could not keep last year may be perfectly keepable…

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…

Give a new habit two months rather than two weeks, and change one thing at a time. The old line about thirty days sets you up to feel like a failure on day thirty one.

Routines that wobble make repetition harder, and repetition is the whole mechanism, so it simply takes longer for some of us. Pick one change, keep…

Unstructured play in a big open space settles a child. A structured class teaches them how to be with other children. You want some of each, for different reasons.

If you only ever book the class, you take away the roaming that calms them down. If you only ever send them out to roam, they miss the taking turns…

Whatever gets you outside and quiet for a stretch of time counts. Fishing, sitting in a hide, weeding, waiting in the car park with the window down.

Nobody has to call it mindfulness for it to work like mindfulness. Hours of low demand attention outdoors, with nothing much required of you, is the…

Martial arts happen to bundle four useful things at once: hard physical work, a fixed structure, feedback in the moment, and a teacher who stays. That is why they suit restless minds so well.

Any one of those on its own helps a little. Together they cover the arousal, the shapelessness of time, the need for a reward that arrives today…

Long goals need markers you can reach this month. Belts work because you get a visible, earned step every so often instead of one distant summit.

Build the same thing into anything you are trying to keep up: a distance, a number of sessions, a move you could not do in January. Make it something…

For a child having a hard time, one adult who plainly thinks well of them makes more difference than almost anything else. A coach or a teacher can be that person.

Studies of children growing up through poverty, hunger and worse keep landing on the same finding: those who did well usually had somebody who…

A practice kept up for years stops being something you do and becomes part of who you are. That is when it no longer needs willpower.

People who started something physical as children and carried on often point to it as where their steadiness came from. The early years are the…

Keep a movement practice going long enough and your body starts doing it without you. People who have practised for decades describe the form running itself while their mind is elsewhere.

In the early months it takes all your concentration, which is why it feels expensive. Later it stops asking for that, and you get the calm without…

A few sessions give you an effect that fades. A few months of it starts to change your baseline. Plan for the longer version if you can.

One class leaves you calmer for an afternoon, which is real and also temporary. Fifteen weeks of the same practice is where people start reporting…

With a small child who is struggling with both movement and speech, start with the body. Balance and steadiness come before a child can take in much language or learning.

A child who is using most of what they have simply to stay upright in a chair has little left for the words on the page. Sorting out the physical…

An hour a day of moving enough to warm you and shorten your breath. Keep a record of it, on a watch or on a scrap of paper, because meeting a number you can see turns out to be quietly satisfying.

It does not have to arrive in one block and it does not have to look like exercise. Walking to the shop, taking the stairs, standing at the desk for…

If talking about it has not shifted things, a body based practice is worth trying next. It is not a consolation prize.

Some of what trauma leaves behind sits underneath words: the flinch, the going blank, the pull towards hurting yourself. Practices that work through…

If this has been going on for years, medication is often part of what helps, and it usually needs a longer run at it than people expect. Starting low and building up slowly is the normal way of doing it.

The slow build is there to keep side effects bearable through the first few weeks, which is where most people quietly give up. It helps to agree with…

If every step you try keeps not working, however small you make it, that is information rather than failure. A more intensive programme is the next thing to look at, and it should be put to you as an option.

The whole point of shrinking the steps is to find one that moves. When nothing moves at any size, staying in the same weekly arrangement out of…

Food colouring is the one narrow exception in this area. Large studies suggest it may mildly wind up some very young children, so a trial removal in a preschooler is a reasonable thing to do.

Keep it in proportion though. This is a minor irritant in a subset of little children, nowhere near the sweeping dietary cause that was claimed…

The restrictive elimination diet has real methodological problems, and it is expensive and exhausting to run. If a family still wants to try it, they can, because unproven and dangerous are different words.

There is usually more to lose by forbidding it. A family who feels blocked either does it anyway without telling you or spends another year…

Play therapy and insight based psychotherapy do not treat ADHD. There is no buried, unexpressed feeling driving it that talking will let out.

The difficulty sits in executive control and how it develops, not in hidden conflict. That said, a child with ADHD can also be anxious, grieving or…