Practices

The next step has to be theirs. A job that looks like nothing to you might be the first thing in two years they chose without being pushed, and that is exactly why it holds.

Parents tend to want the step that recovers the lost ground. The young person needs the step they can actually take on Monday. Shifts in a shop, one…

When someone has shut down, pressure to get moving usually pushes them further in. Safety first and activity afterwards, even when the whole household is desperate for a sign of life.

Safety here is ordinary and physical. Food that turns up without being asked for. A room nobody is inspecting. Conversation that is not a progress…

If most of the difficulty is happening at home, most of the work needs to happen with the household in the room. Otherwise the hour of good conversation gets quietly undone by Tuesday.

In a settled stretch, seeing the young person on their own with occasional family time is fine. In a crisis, turn it round: everyone together,…

Sorting goes better fast than carefully. If every item stalls you, ask someone to sit in the room while you work, not to help but to keep the pace up.

A person nearby changes what the hour feels like, and they can be reading their own book the whole time. What they supply is momentum, which is…

Often the most useful thing a clinician does is not delivered by the clinician. It is delivered by the teacher, or the parent, after a conversation you had with them.

Taking that seriously changes how the hour gets spent, towards talking with the school, coaching the parents and designing the arrangement, and away…

The classroom is the strongest place to help and most clinicians cannot get into one. That is a reason to work well in the next best place, not a reason to give up.

ADHD sits in how a brain is built, and the work is on the executive skills themselves rather than on attitude or effort. Where the moment of…

The pull towards bread, pasta and biscuits when you are low is not simply greed. Carbohydrate makes it easier for the brain to get hold of the raw material it needs for serotonin, so it gives a real if short lived lift.

Calling it self medication instead of a failure of character changes what you do next. You stop trying to out-discipline the craving and start asking…

Allergies turn up more often alongside ADHD than chance would predict. Worth mentioning your allergy history at an assessment even when nobody asks, since the two seem to travel together.

The likeliest explanation is not that one causes the other. It is that some of the same underlying wiring makes both more likely in the same person.…

Some foods are formulated to be hard to stop eating. That is a design brief rather than a flaw in you, and it goes some way to explaining why one particular snack is the one you think about at eleven at night.

Knowing this moves the fight somewhere you can win it. Willpower at the moment of craving is a poor bet, and a decision made in the shop is a much…

Here is a question that costs nothing: has anyone in your family been told their vitamin D was low? It runs in families through genes, skin tone, where you live and how much time anyone spends outside.

The clinician telling this story found out only afterwards that his mother, father and brother had all been low. Nobody had mentioned it, because it…

Even where a herb has good evidence behind it, that evidence belongs to the plant and not to the bottle in your hand. Testing keeps turning up products that do not contain what the label says.

This part of the argument does not depend on whether herbal remedies work. You could accept every claim made for a plant and still be left with the…

Own brand products from large retailers were among the worst performers in these tests. A big name on the packet is not a quality check, however much it feels like one.

Own label goods are usually made under contract on thin margins with no independent verification of what comes out the other end. So the reassurance…

People often turn to herbal remedies hoping to avoid side effects. Plants are chemistry too, and some of them interact with prescribed medication in ways that matter.

A plant extract is not one substance, it is a mixture of many, which gives it more places to interact rather than fewer. Origin has nothing to do…

Around seven in ten people who use herbal products never mention it to their doctor. Not out of secrecy, mostly because a tea or a gummy does not feel like it belongs on a list of medications.

The useful move is to answer a wider question than the one you were asked. When someone asks what medication you take, tell them what else you take…

Your gut is not just plumbing. It makes many of the same chemicals your brain runs on and it is in constant conversation with your nervous system, which is part of why a bad stretch of digestion and a low mood so often turn up together.

If your stomach has been unsettled for weeks and your mood has slid over the same weeks, you do not have to work out which one is the real problem.…

When you find yourself reaching for something sweet again, try asking what the reaching is doing for you instead of telling yourself off. Comfort, a small rebellion, a way to stay awake: the answer usually points somewhere useful.

Talk about being good or bad closes the conversation down. Curiosity keeps it open, and it tends to surface the actual job the food is doing, which…

Put a rubber band round your water bottle for each refill you want to get through today, and slide one off each time you finish it. Nothing to remember, nothing to buy, and you can see where you are at a glance.

Tracking anything in your head is hard when your head is already full, and harder still when concentration is one of the things that has taken a hit.…

Where ADHD and disordered eating meet, the pattern is more often bingeing, or bingeing and purging, than strict restriction. Restriction tends to travel with over-control, while bingeing travels with impulse and reward seeking.

This matters because the questions asked at assessment are usually the restriction ones, so a binge pattern can sit unnoticed for years. If you…

Most claims about food and behaviour rest on weak studies. The ones worth taking seriously give each person both the real thing and a dummy at different times, with nobody knowing which is which, so that hope and expectation cannot do the work.

The food colouring trials are the standard example. Around 150 children each received drinks containing a preservative plus one of two dye mixes, or…

The same brand of sweets is often made with plant based colours in one country and artificial ones in another. If a company can make it without the dyes elsewhere, the dyes are not essential to the food.

Nine artificial colours are approved in the US, and the volume approved for use rose roughly fivefold between 1950 and 2012. One of them, Red No. 3,…