Practices

Every practice in the library, in one list. Narrow it by how long you have, who it is written for, and where you are right now.

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For some young people self-harm carries something besides relief: belonging, recognition, a name for who they are among friends who do the same.

That is uncomfortable to sit with and it changes what helps. If a behaviour is the reason someone feels understood, taking it away without touching…

Twenty minutesWhen everything feels flatParts workQur’an 9:118One line of research

Six to eight weeks is what an antidepressant needs before it can be judged. The first fortnight will mostly tell you about side effects.

The transporter is blocked within hours, so the delay belongs to slower changes further down the line. In practice that means picking a date four to…

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

Coming off an antidepressant is a piece of work in itself. Plan it slowly with the prescriber rather than stopping on the day you feel well.

Some, venlafaxine especially, leave the body fast enough that a missed dose is felt within a day: dizziness, strange electrical sensations, a mood…

LongerWhen everything feels flatMedical and treatmentQur’an 16:127One line of research

A few treatments are only given in a clinic, with someone sitting with you afterwards. The chair and the hours are part of the treatment rather than paperwork.

Esketamine is the current example. It is a nasal spray, given on site, with a monitoring period of about two hours afterwards because blood pressure,…

LongerWhen everything feels flatMedical and treatmentQur’an 94:1One line of research

Looking for a whole subject rather than a single practice? Start from the nine areas.

Feelings and focus

Practising under provocation

Shame and stigma

Screens and attention

Making it stick

Breathing

What worry does

Treatment and medication

Feeling from the inside

Structure and routine

What you are actually defending

Being seen and judged

Growing empathy

Tolerate distress

When you use something to cope

Remembering to do it

Reading, numbers and learning differences

Breaking the worry loop

Righteous anger and perfectionism

Obsessions and compulsions

Emotions as signals

Self-compassion

Facing it a step at a time

Shame

Posture and how you carry yourself

Question the thought

Anger, alcohol and the body

Use your strengths

When anger turns to harm

Letting it out safely

When you go numb

Living with uncertainty

Rest and pacing

Panic and the body

The cost of avoiding

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

Sometimes the honest answer is that there is nothing in your surroundings to feel good about. Changing them counts as treatment, not as running away.

A life with no friends nearby, no work that means anything and a steady drip of criticism will produce low mood in most people, and skills practised…

LongerWhen everything feels flatParts workQur’an 8:24One line of research

More of the medicine is not automatically better. What you are looking for is a level that sits inside the working range, and going past it usually brings side effects rather than sharper thinking.

It is a natural thought that if some helps a little, double would help twice as much. In practice people describe the higher dose as flat, or wired,…

A minuteMedication and how it worksMedical and treatmentQur’an 55:8One line of research

If sleep has gone since starting, look at what time the dose is being taken before deciding the medicine is the problem. A long acting dose swallowed at one in the afternoon is still working at bedtime.

Extended release preparations are built to cover eight to twelve hours from whenever they are taken, so a late start pushes the whole thing into the…

A minuteMedication and how it worksMedical and treatmentQur’an 73:20One line of research

Do not compare your dose with anybody else's. Two milligrams of one medicine and a hundred milligrams of another can both be perfectly ordinary, because strength per milligram differs from molecule to molecule.

This comes up in waiting rooms and family group chats and it causes real alarm about being on a lot. The number on the box only means something…

A minuteMedication and how it worksMedical and treatmentQur’an 65:3One line of research

If you open atomoxetine capsules to mix the contents into food, keep it away from your eyes and wash your hands afterwards. The powder stings badly.

The molecule is acidic and cannot be softened without falling apart, so the fix is in the handling rather than the chemistry. Take it with something…

A minuteMedication and how it worksMedical and treatmentQur’an 5:6One line of research

Stand up slowly. Getting off the floor after an hour of gaming, or out of bed in the morning, is where the dizziness tends to catch people.

A drop in blood pressure on standing is common enough with these medicines and it frightens people, because a near faint feels like something serious…

A minuteMedication and how it worksMedical and treatmentQur’an 12:67One line of research

If a question at the counter feels like judgement rather than care, you are allowed to ask which it is. Is this a medical question or a personal one?

Asked evenly it does not start a row, and it returns the conversation to where it belongs. Pharmacists have proper clinical questions to ask about…

A minuteMedication and how it worksMedical and treatmentQur’an 7:32One line of research

The skin patch comes with two things worth knowing before you start. Take it off several hours before bedtime or it keeps delivering and sleep goes, and around one person in six gets a rash bad enough to stop.

The upside is real control over the length of the day. Because the medicine stops arriving soon after the patch comes off, the removal time is yours…

A minuteMedication and how it worksMedical and treatmentQur’an 20:81One line of research

With a bedtime dose, the clock is the dose. Give it too early and the medicine switches on in the small hours, which buys you a child awake at half past four and no appetite at breakfast.

The ordinary effects still apply: appetite tends to dip around the middle of the day and sleep can be harder to come by. What changes is that one…

A minuteMedication and how it worksMedical and treatmentQur’an 55:8One line of research

Notice which word somebody reaches for. Protection sounds like a shield against loss, while what the studies describe is closer to a little extra growth, and those are not the same promise.

The difference is small on the page and large in a consultation. A parent who hears protection may start treating the tablet as a wall they cannot…

A minuteMedication and how it worksMedical and treatmentQur’an 17:36One line of research

The same question has not been asked of the non-stimulants. They reach much of the same circuitry, so you can see why people expect a similar effect over years, but expecting is all it is.

This is a good place to notice the shape of your own reasoning. Going from these drugs touch the same regions to therefore they do the same thing…

A minuteMedication and how it worksMedical and treatmentQur’an 53:28One line of research

People expect to feel wired and often describe feeling settled instead. That surprise is common enough to be worth knowing about before you start.

What tends to quieten is the churn: the half started tasks, the jumping from one thing to another, the low hum of being behind. That can read as calm…

A minuteMedication and how it worksMedical and treatmentQur’an 13:28One line of research

Stimulants have been used for this since 1937. That is a long time for any treatment to survive, and very few do.

Longevity is a different argument from a trial result. It means decades of changing fashion, competing products, repeated safety scares and reviews,…

A minuteMedication and how it worksMedical and treatmentQur’an 7:32One line of research

These medicines do not pour a foreign chemical into you. Mostly they help you hold on to the serotonin your body already makes, so whatever follows is yours.

The worry underneath is usually about authenticity: that any lift will be counterfeit, or that it will not really be you feeling it. Knowing that the…

A minuteMedication and how it worksMedical and treatmentQur’an 16:69One line of research

The line about not cutting, crushing or chewing a long acting medicine is a safety instruction with a real mechanism behind it. Break the coating and the whole day's dose arrives in one go.

People sometimes crush a capsule because swallowing is genuinely hard, not because they are misusing it, so ask before assuming. There are usually…

A minuteMedication and how it worksMedical and treatmentQur’an 20:81One line of research