Focus, starting, and ADHD

Someone who will tell you the part that was not good is someone whose 'that was fine' you can believe. That is what settles the doubt, not reassurance.

Blanket praise carries no information, so it slides off and the doubt is back within the hour. If you tend to worry about how you came across, ask…

With attention difficulties the organising side often runs a few years behind the birthday. A nineteen year old may be running life more like a sixteen year old, and that is a lag rather than a verdict.

Set expectations against where someone actually is instead of what year they were born in. That way the support that felt normal at school does not…

A young person hears the fear in a house even when nobody says anything. If the adults are frightened about their future, they usually take that fear as a verdict on themselves.

If you are the worried parent, you do not have to perform calm. It works better to say the true version out loud: I am anxious about this, the…

Not knowing how to do an ordinary thing, a bank transfer, a form, a phone call to book something, says nothing about your intelligence. It says nobody ever sat down and showed you.

These gaps hide well, because they embarrass people in a way that larger problems somehow do not. Someone can talk fluently about difficult ideas and…

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…

A wave across the road, a joke with the man in the shop, asking someone how they are and meaning it. These unplanned seconds count for more than they look like they should.

They are also the easiest place to start when arranging a proper meet up feels like too much. Almost nothing is at stake in a greeting, so a fear of…

If rating a feeling out of ten means nothing to you, use something that does. Colour in bubbles, point at a picture, hold your hands apart to show how big it is today.

This began as an adaptation for children, swapping the numbered anxiety ladder for bubbles to colour in, and it is just as useful for anyone who goes…

When someone has gone flat, the question is not what they ought to be doing. It is what still has any life in it for them, however small or unimpressive, and then how to get more of that.

Activities handed out from the outside do not lift much. Someone who brightens talking about their car, or a cousin, or a game has just given you the…

When somebody looks like they have stopped caring, it is often that they have stopped expecting it to go well. Giving up on yourself tends to come after a long run of trying and being told it was not enough.

That changes what helps. Another plan, another chart, another talk about wasted potential all land on the wrong problem. What shifts things is a…

Some of what looks like muddle is the system's fault. Our tenth month is named for eight, because two months were added later and nobody renamed the rest.

Worth saying to anyone who feels stupid about dates and forms. A calendar whose numbers are out of step, a tax year starting in April, forms asking…

When a child truly does not mind losing the privilege, taking more away will not get you anywhere. That is the moment to change approach rather than raise the stakes, usually to a structured parent programme that works on the pattern between parent and child.

Star charts fail with these children because the reward was never the point of the behaviour. What helps is a proper course of parent management…

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…

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.…

If a parent has been saying since the first year of school that something is wrong with their child's reading, start from the assumption that they are right. They have watched more of it than anyone else has.

The usual story is years of being told the child is fine, a little behind, will catch up, and then a diagnosis at nine or ten when the easiest years…

Waking your child at six to give the tablet so it has taken hold by breakfast, then letting them fall back to sleep, is not a strange thing you invented because you are failing. It is a reasonable answer to a real gap in how the medicine works.

Families quietly carry a lot of these. The early alarm, the switch to a faster product, the parent who does the whole morning alone because it goes…

Doing badly on one long acting product does not mean the medicine inside it was wrong for you. The same molecule in a different capsule can behave differently enough to be worth trying before anyone gives up on it.

What gets described as the medicine not working is often the shape of the day being wrong: too slow to start, too abrupt at the end, strongest at the…

People usually stop for one of three reasons: the side effects are not worth it, the price is too high, or the dose was never raised far enough to do anything. The last one is the saddest, because it makes a workable medicine look useless.

If a trial ended with the words nothing happened, it is worth going back over what dose was actually reached and for how long it was held there. A…

Before anyone concludes that medication does not work for you, check what dose was actually reached. Doses in general practice often stay lower than a specialist would use, and a fair share of so called non responders respond once the dose goes up.

You are allowed to ask this, gently and without any accusation in it: what was the highest dose tried, and how long did it stay there? A trial that…

If one family of stimulant did nothing, or felt awful, that tells you very little about the other. Methylphenidate and amphetamine work in overlapping but different ways, and plenty of people who do badly on one do well on the other.

Stopping after a single class is one of the commonest routes to believing that nothing helps. Trying the second one is a normal next step rather than…

For someone who cannot swallow tablets, or whose mornings fall apart long before the tablet gets taken, patches exist that release medicine slowly through the skin over hours.

Going through the skin skips the first pass through the liver and smooths out the peak, which changes the timing and sometimes how well it is…

Treat the first fortnight as a stretch that needs contact rather than silence. Say plainly that things may feel worse before they feel better, and arrange to hear from the person during that window instead of after it.

This is when most people quietly stop. Somebody who has been warned experiences a rough two weeks as expected; somebody who has not experiences it as…

Most people who try do find something that helps, but often not the first thing they try. Not responding to one class of stimulant says surprisingly little about the other.

The high response figures you may have read come from people who worked through more than one option, not from one prescription going well. Response…

Keep something to eat and drink within reach for hard conversations. Handing someone a biscuit and a glass of water often settles a room faster than any instruction does.

Part of why it works is that nobody has to be told how. A person too wound up to follow a breathing exercise can still take a sip and chew. Sharing…

You can mean something completely, drive most of the way there with it in your head, and still turn left instead of right. Meaning it and doing it are two separate events, and only one of them is visible to anyone else.

To a partner, the missed errand looks like a verdict on where they come in your order of things. It helps to say out loud, at a calm moment rather…

Saying it is done when it is not is a common next step, and it makes more sense than it looks. The lie is rarely about the parcel, it is a way out of the look on somebody's face.

It also makes everything worse, because being found out turns a forgotten task into a trust problem, and that is a much longer repair. If this is…

You will still forget things. What decides how much damage a missed task does is usually the ten minutes after you notice, not the miss itself.

Two moves reliably make it worse: sinking into shame until you cannot look at the person, and defending yourself as though nothing had been dropped.…

For a child who finds face to face conversation frightening, a game where they talk to friends while doing something else may be the only place they socialise at all. Worth noticing before you count the hours.

Talking through a headset takes out most of what makes conversation hard: no eye contact to hold, no faces to read in real time, no silence to fill.…

It is a genuine relief to hear that what someone did online may not reflect who they are. Say that gently, and say the other half in the same breath: the people who saw it will judge it as though it does.

Both halves are true and they need each other. Offer only the first and you have handed over a reason for nothing to change. Offer only the second…

Some of what circulates makes being unwell look good. Drugs filmed like a party, low mood styled into something delicate and photogenic, until the illness starts to feel like a personality.

This is worth spotting because of what it does to recovery. If sadness has become part of how someone is known, getting better means losing something…

Real footage of people dying circulates without any warning, sometimes buried inside a video that starts off looking harmless. Young people rarely raise this themselves, so it is worth asking.

Ask plainly what they have come across that they wish they had not seen, and how often it happens. There is no preparation before it and nothing…

The quietest damage comes from a young person deciding that feeling like this is simply how it is, because everyone around them feels it too.

Once distress counts as ordinary it stops being reported. Nobody mentions it at home, nobody brings it to an appointment, and years can pass with…

When someone misuses a device, sending explicit messages or piling on to someone or going where they should not, the useful read is that they were not ready for that much freedom yet. Not that they are a bad person.

Readiness gives you somewhere to go. You can name the skill that was missing, hand back a smaller amount of access, and set out what would show they…

When someone says they did not really mean it, that it was not really them, the temptation is to hear an excuse. It is usually better information than that.

Take the disowning seriously and ask what state it came out of. What time was it, how long had they been online, what had happened that day, had they…

Among teenagers, saying they want to die has become something you say when the bus is late. You can no longer read intent off the phrase, in either direction.

So the words neither prove there is danger nor prove there is not. What tells you is everything the words leave out: whether there is a plan, whether…

When a death is filmed and passed around, some of the people who watch it are not all right afterwards, and a few are put in real danger by it. Ask what has been going round.

The question is simple enough. Has anything about someone dying gone round your school or your feed lately, and did you see it. Then ask how it left…

Nobody gets far taking the drink away without asking what the drinking was for. It is the same here. Find out what the scrolling is doing for someone before you start subtracting hours.

It is doing something, or it would not have lasted this long. Company at one in the morning. A way to stop thinking. Somewhere they are good at…

Asked what all the scrolling had done to her most, one young woman did not say sad. She said angry, more or less all the time.

Constant irritability in a teenager usually gets worked up as depression or ADHD, and sometimes that is right. Saturation belongs on the list too,…

For some people the online part is not a side issue sitting next to the depression or the anxiety. It is one of the things holding them in place.

One young woman with a history of being bullied found her platform use feeding the depression, the social anxiety, the fear of leaving the house and…