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AreasLow mood and hard feelings

Low mood and hard feelings

Feelings are information before they are problems. The practices here are about naming what you feel accurately, sitting with what will not move yet, and acting on what matters to you even on the days nothing feels like anything.

What works for this

Behavioural activation

The strongest self help evidence in this whole field says the way out of a flat heavy state is through what you do, not through what you think. You act first and the feeling follows, which is the opposite of what the state tells you.

One move, today

Choose one small thing you used to do and do it today without waiting to feel like it. Ten minutes is enough. Waiting to feel like it is the trap.

What matches

10 practices

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If you smoked or drank during a pregnancy and have spent years holding yourself responsible for how your child turned out, you are allowed to put some of that down.

The picture is genuinely tangled. The same traits run in families, so a parent is both more likely to pass something on and more likely to have been…

Five minutesWhen you use something to copeMedical and treatmentQur’an 6:54One line of research

If telling your doctor or midwife what you are using feels impossible, you can ask someone you already trust to pass it on for you, with your permission and in your words.

People often stay quiet with the very clinician who could help, because saying it out loud feels heavier than the problem does. Handing the message…

Five minutesWhen you use something to copeMedical and treatmentQur’an 9:104One line of research

Serotonin syndrome comes from stacking, and the second agent is usually something nobody thought to mention: a migraine tablet, a cough medicine, a herbal remedy for low mood.

Triptans, tramadol, dextromethorphan, linezolid and St John's wort all count, as do other antidepressants. Someone who mentions in passing that they…

A minuteWhen everything feels flatMedical and treatmentQur’an 12:87One line of research

When someone says they react badly to normal doses of almost everything, take it as information about their body rather than as a personality trait.

Bodies differ in how fast they break a medicine down. Give two people the same dose and one of them may be holding far more of it for far longer,…

A minuteWhen everything feels flatMedical and treatmentQur’an 65:7One line of research

Never come off an antidepressant on your own. The taper belongs to the prescriber, and for some drugs it needs to be slower and longer than people expect.

The moment to raise this is before anybody acts, not afterwards. If a client is feeling better and starting to think about stopping, that thought is…

Five minutesWhen everything feels flatMedical and treatmentQur’an 9:118One line of research

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…

Five minutesWhen everything feels flatMedical and treatmentQur’an 8:24One line of research

If you know something about a person's history that the prescriber may not, say it. A past eating disorder or a single seizure can change what is safe to prescribe.

Bupropion lowers the seizure threshold, and in someone who is purging, restricting or very underweight that risk climbs meaningfully. The therapist…

Five minutesWhen everything feels flatMedical and treatmentQur’an 15:88One line of research

If a treatment reliably produces strange sensations, describe them beforehand. Expected strangeness is far easier to sit through than strangeness that arrives unannounced.

With esketamine, feeling oddly detached from your body or the room is the drug doing what it does, not a sign of harm, and it usually clears within a…

Five minutesWhen everything feels flatMedical and treatmentQur’an 6:125One line of research

Before anyone concludes that nothing works, go back over the ordinary explanations: a dose that never went high enough, a trial that stopped after three weeks, doses missed on the hard days.

Treatment resistant has a technical meaning, which is that at least two proper trials at a proper dose and length have failed. A great deal of what…

Five minutesWhen everything feels flatMedical and treatmentQur’an 15:56One line of research

With the fast acting treatments, the plan for what happens afterwards matters as much as the treatment itself.

Electroconvulsive therapy can shift severe depression quickly, and without something in place afterwards the relapse rate is high, which is why…

LongerWhen everything feels flatMedical and treatmentQur’an 12:110One line of research

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