Low mood and hard feelings

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…

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…

Most people can tell you exactly why the thing is a bad idea. The trouble arrives later, when feeling is running high and all that reasoning is nowhere to be found.

So treat it as a doing problem rather than a knowing problem. Decisions made calmly and in advance travel into hard moments much better than…

Repetition is what makes anything stick, and it does not check whether the thing is good for you. That is most of what addiction is.

It is the same machinery that lets somebody pick up a language or a trade, running in the part of the brain built for wanting rather than the part…

Drink can make talking easy and still leave you with friendships that feel like nothing. Worth noticing which of those two you actually came for.

One young woman put it plainly: drinking took away the worry about what she was saying, and the people she grew close to were mostly the ones she…

Distant health warnings move almost nobody. The cost that lands is the one showing up this month: your memory, your marks, the work you know you could be doing.

So keep it specific and keep it near. Heavy drinking in the teens and early twenties shows up in memory and in school work, which is the exact ground…

What you tried at that age is a poor guide to what is in front of your child now. Cannabis today is far stronger than the same word used to mean.

The sentence that closes most of these conversations is I turned out fine. Try a different one: ask what it does for them, when they reach for it,…

The fog after cannabis is not gone by morning. In younger users learning can stay dulled for several days, so Saturday night is still in the room on Wednesday.

That changes what to look at. Rather than arguing about the night itself, keep a rough note of the days that follow: what got read, what stayed in,…

Nicotine looks like the small problem next to everything else going on, and it is the one most likely to still be here in thirty years.

Most adults who smoke started as teenagers, and the earlier the start the harder the eventual stopping tends to be. So it earns a place on the list…

When someone pours out a lot at once, catch the two or three words carrying the weight and give those back to them, in order.

You said you felt cold in your own house, and like a nuisance. Nothing added, nothing solved. It sounds almost too simple, and it does the thing a…

Let what they say land in you before you answer. The word that catches somewhere in your own chest is usually the live one.

Cold. Empty. A nuisance. Take each one for a second rather than sailing past it to the reply. Then give back the one that carried the charge, and you…

When somebody says they just get on with it, take the getting on with it seriously. That is the door, and arguing with the nothing is a wall.

This happens a lot, I just roll with it, I forget about it: there is a whole strategy in that sentence and it is visible, unlike the feeling…

When someone finally gets one true word out about how they feel, resist explaining it to them. Ask what that word is like from the inside and let them find the rest.

The temptation is to say the clever thing: of course you felt rejected, anyone would. It is often accurate and it usually ends the moment, because…

If a conversation has wandered off and you have lost the thread, go back to the last thing that had real feeling in it, and go back using the words they used.

Not a summary of those words. The actual phrase: 'you said she has her standards and you will never meet them, and your eyes went red when you said…

You do not have to reflect back everything a person just told you. Pick up the part that carries the weight and say that much.

A long, careful summary can flatten what someone has just risked saying. If the heart of it is that he feels defeated and frightened of never being…

Punching something to get the anger out is the piece of grief advice that gets argued over most, and the honest answer is that hitting rarely leaves a person calmer.

Plenty of good people will tell you a bag is better than a wall or a face, and there is something in that. What has not held up is the older idea…

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…

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 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…

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…

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…

Put something in before you take something out. Removing the only way a person has of coping leaves them with nothing, which is not safer.

In practice this looks like smaller steps than a promise to stop: cutting the frequency, changing what is used, agreeing to wait ten minutes and do…

Picture somebody you love saying this exact thought about themselves. What would you say back, and why is none of that available to you?

Most of us are far kinder outward than inward, and the kind version is usually the more accurate one as well as the warmer one. Say your answer to…

Shame speaks in one flat sentence: I am bad. Notice that it never offers evidence, it just announces a verdict.

Because the claim covers all of you, no good day can disprove it. That is what makes it different from ordinary regret, which points at one thing you…

If you can see shame arriving in someone, say so gently and make it welcome. Something like: it looks like there is some shame here, and it is alright that it came.

Naming it does the opposite of exposing it. Left unnamed it works away in private, and the person assumes you have noticed and are judging. Said out…

You were the child. They were the adults. Say it as often as you need to, because shame will keep quietly filing it the other way round.

It is not an argument to win, more a fact to keep returning to. When a memory arrives with you cast as the guilty one, try describing the same scene…

A calming skill handed over at the wrong moment reads as your anger is not welcome here. For someone taught as a child that their anger was unacceptable, that is the old prohibition arriving again in kinder clothes.

Let the anger be seen first. Say that it makes sense, that there is a reason for it, and only then offer anything that settles the body. The order…

Accepting reality as it is means dropping the fight with what has already happened. It does not mean staying somewhere that is still harming you.

The two get confused often, usually by people who were told to be patient by whoever benefited from their patience. A rough test: acceptance is for…

Before going towards a hard feeling, decide what will hold you while you are inside it: a way of breathing, a way of standing, a sentence, a person you can picture or ring.

Going in with nothing is not brave, it is flooding, and it teaches your system that feelings really are dangerous. Pick two or three supports in…

Anger wants the body to do something, so let it. Breathe deeper and higher into the chest, stand up, press both palms hard into a wall, walk on the spot, push down through your feet.

Pressing against something solid gives the mobilisation an outlet with nothing broken and nobody hurt. Keep going until the charge drops a little,…