Practices

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…

Let the breath go along with the movement rather than counting it out. If you are guiding someone, do not set the pace of their breathing for them.

Being told exactly when to breathe in and out is unpleasant for more people than you would expect, and for anyone whose breath was held tight through…

The old angry route does not get deleted. What you are building is a rival route beside it, and at the start the new one is small.

Expect the old path to show up when you are tired, ill or caught off guard, because it is still there and it is well worn. That is not proof the work…

This goes the way learning a bicycle went. You could not, then you could but only with all of your attention, then one day you rode without thinking about it. The middle bit is the ugly bit.

In that middle phase the skill works but it costs you everything to use, and it looks clumsy from the outside. That is where most people decide it is…

When a child keeps failing at a task, try reducing what it demands of attention and memory before you increase the practice. Shorter steps, one instruction at a time, the working written down where they can see it.

Attention, holding things in mind and switching between steps all set a ceiling on how much of a lesson gets through. You cannot easily raise that…

Pouring more in does not help while the lid is still on. A child who is exhausted, wound up or not yet settled will keep very little of the lesson, however good the lesson is.

Do the settling first, even when it costs ten minutes of the hour. Sleep, food, movement and a calm start look like the soft part of the day and they…

The word one does several jobs at once: a digit, a number, a single object, a whole set. A child who has not sorted those out will put figures in the wrong columns and later read a third as a number instead of a part of something.

When digits land in the wrong place, check whether the child knows what is being counted before calling it carelessness. Say the unit out loud: one…

A child who talks well, listens well and seems bright will have their reading failure read as laziness. The strengths are exactly what makes the blame stick.

Strong spoken language, decent attention and an easy manner give an impression of capability that nobody can square with work coming back unfinished.…

Some people get all the way to university before anything is named, then meet eighty pages of reading a night and cannot do it. Nothing broke that night. The volume simply outgrew a way of coping that had held for years.

The history reads the same way every time afterwards: always needed longer, avoided reading aloud, dreaded timed tests, stomach trouble in exam…

Stopping suddenly can bring lethargy, nausea, irritability and headache within a few days. That is discontinuation, not the illness coming back.

Timing is the giveaway. Withdrawal starts within days of the last dose and often has a particular feel to it: dizziness, odd electrical zaps, a…

Discontinuation gets mistaken for relapse constantly, by clients and by clinicians. The mistake runs in both directions and both directions cost something.

Read withdrawal as relapse and a person concludes they will need the tablet for life, when what they needed was a slower taper. Read a real relapse…

If the worst part of low mood is that your thinking has gone foggy, say so specifically. Concentration can be treated as a target of its own rather than as something that will tidy itself up later.

Depression and attention problems overlap enough that the fog often gets filed under whichever label arrived first. Naming it separately gives you…

Heaviness in the body, aching, and a tiredness that sleep does not touch are part of low mood. They are not a separate complaint to raise another time.

There is a group of antidepressants that add a second action aimed partly at these bodily symptoms, which is one reason a prescriber may lean that…

Before deciding a medicine did not work, check that it was taken at a dose and for a length of time that could have worked.

Venlafaxine is the standard example. At low doses it behaves much like a plain SSRI, and the second mechanism people choose it for only comes in…

If pain is part of what you are carrying, bring it into the same conversation as the low mood. They are not two separate appointments.

The pathways that dampen pain and the ones involved in mood overlap, and one of the antidepressants is licensed for nerve pain and long term…

Sometimes what is most missing is not mood but drive: the flat, cannot get started feeling. That can be named as the target in its own right.

Antidepressants lean in different directions, and one or two are weighted more towards the system carrying energy and alertness than towards…

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…

If the usual antidepressants have not reached you, there are treatments that work on an entirely different system in the brain. They are worth asking about.

Esketamine, given as a nasal spray in a clinic, acts on glutamate rather than on serotonin or noradrenaline, and the change it brings can arrive in…