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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Some capsules are tiny pumps. A coating of powder gives an early lift, then water seeps in and slowly pushes a gel of medicine out through a laser drilled hole, with a little more strength held back for later in the day.

Knowing this changes what you expect from it. The rise is gentle rather than sudden, the afternoon is deliberately given a slightly stronger push…

Five minutesMedication and how it worksMedical and treatmentQur’an 26:80One line of research

One of the amphetamine medicines arrives switched off. It is bound to a simple building block of protein and only wakes up once the body cuts the two apart, which is why crushing or snorting it gets you nowhere faster.

That was designed in on purpose. Because the gate is an enzyme rather than a coating, there is no way to get in front of it, and the medicine comes…

Five minutesMedication and how it worksMedical and treatmentQur’an 12:67One line of research

That locked design turned out to carry an unplanned kindness: a somewhat longer day, and for many teenagers and adults a softer start and a softer finish, with less jaw clenching and less of the ragged hour when it wears off.

The edges often matter more to the person taking the medicine than the peak does. If you dread the late afternoon drop, or notice your jaw aching by…

Five minutesMedication and how it worksMedical and treatmentQur’an 16:69One line of research

You may hear that staying on stimulant medication for years can shift the structure of the brain itself, not only the day. It is a real line of research and it is still an open question, so hold it lightly.

The work points at a handful of regions involved in attention and movement, and at a minority of people who stayed on treatment for several years.…

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

Practising under provocation

Food, caffeine and fuel

Making it stick

Structure and routine

Cool the body first

What worry does

Screens and attention

What you are actually defending

Treatment and medication

Growing empathy

Breathing

Fondness and admiration

Answering bids

Righteous anger and perfectionism

Being seen and judged

Shame and stigma

Feeling from the inside

Breaking the worry loop

When you use something to cope

Use your strengths

Gratitude

Shared spiritual life

Anger, alcohol and the body

Facing it a step at a time

Question the thought

When anger turns to harm

Posture and how you carry yourself

Notice the pattern and flex

Name what you feel

Rebuilding trust

Your worth is not conditional

Affection and touch

Ride the urge

Rest and pacing

Your window of tolerance

Work with your brain

Patience and trust

Obsessions and compulsions

Listen to the body

Reading, numbers and learning differences

Keep the bond

Hold a boundary

Get it out of your head

Find meaning

Face it gently

Care for yourself in loss

Rituals of connection

When you go numb

The cost of avoiding

Panic and the body

Validate yourself and others

Living with uncertainty

Listening and understanding

Five minutesMedication and how it worksMedical and treatmentQur’an 16:69One line of research

It is a fair question to ask of anybody telling you about a medicine: what is their interest in it. Good clinicians answer without flinching, and some have said the unwelcome thing to a room that paid for their flight.

You are not accusing anyone by asking. Talks, printed materials and study days are often funded by the company that makes the drug, and that funding…

Five minutesMedication and how it worksMedical and treatmentQur’an 17:35One line of research

There is an old joke among researchers that you should use a new treatment quickly, while it still appears to work. It is funny because early results really do tend to shrink.

First studies are usually small, run by people who believe in the thing, and more likely to reach print when they come out well. Replication brings…

Five minutesMedication and how it worksMedical and treatmentQur’an 20:114One line of research

A workable rule for anything new: do not be the first to use it, and do not be the last either. Both ends carry a cost.

Being first means carrying the risks nobody has found yet. Being last means somebody waits years for help that was already sitting there. Most…

Five minutesMedication and how it worksMedical and treatmentQur’an 55:8One line of research

The medicine can help you focus. It will not make you want to study. Those are two different jobs and only one of them comes in a tablet.

Expect the difference to show up as an odd hour or two where you can sit still and hold a page, and still do not fancy the page. That is the drug…

Five minutesMedication and how it worksMedical and treatmentQur’an 17:36One line of research

A nerve cell spends its life adding up. Signals arrive along its branches, the body of the cell totals them, and at one particular point it either fires or it does not.

That threshold is where the pushing and the holding back meet, and it is roughly the level at which these medicines work. None of them decides…

Five minutesMedication and how it worksMedical and treatmentQur’an 55:8One line of research

A synapse is three things rather than one: the end of the cell sending, the gap itself, and the surface of the cell receiving. Ask which of the three a drug acts on and most of its behaviour follows.

Drugs that block the clearing away work on the sending side. Drugs that imitate or block the message work on the receiving side. Drugs that stop the…

Five minutesMedication and how it worksMedical and treatmentQur’an 16:43One line of research

A single nerve cell can be in contact with hundreds of others. That fanning out is the plainest reason side effects exist at all.

A tablet goes into your bloodstream and reaches everywhere the chemical it acts on is used, and these chemicals are used in far more than the circuit…

Five minutesMedication and how it worksMedical and treatmentQur’an 4:28One line of research

The message is not made fresh each time it is needed. It sits ready in small sacs at the end of the cell, waiting to be tipped out into the gap.

That storeroom is itself a place drugs act. Some work by emptying the store rather than by slowing the clean up, and that is one real difference…

Five minutesMedication and how it worksMedical and treatmentQur’an 65:3One line of research

The message is a key rather than a parcel. It fits a lock on the receiving cell, turns it, and then comes away again instead of being swallowed.

This one detail makes the rest make sense. Because the message comes back off, it can be collected and used again, which is what a reuptake inhibitor…

Five minutesMedication and how it worksMedical and treatmentQur’an 10:59One line of research

There are really only two directions in the nervous system, go and stop. Almost everything a medicine does comes down to shifting the balance between them somewhere.

It is a crude picture and a useful one. Drugs pushing the stopping side tend to slow and settle you, drugs pushing the going side tend to lift and…

Five minutesMedication and how it worksMedical and treatmentQur’an 13:28One line of research

After a message has been delivered, the cell hoovers up what is left over and packs it away to use again. A reuptake inhibitor simply slows that hoovering down.

Once you have the image, the name explains itself, and so does the fact that nothing is being added to you. The message you made stays around longer…

Five minutesMedication and how it worksMedical and treatmentQur’an 7:31One line of research

There is a second way the body clears these messages, which breaks them down rather than filing them away for reuse. A handful of older medicines work by blocking that breaking down.

It matters to the person taking one because the same enzyme sits in the gut and deals with things that arrive with food. That is why a few of these…

Five minutesMedication and how it worksMedical and treatmentQur’an 20:81One line of research

Some substances go further than slowing the clean up. They get the pump to run backwards and empty the cell out all at once, which is most of what separates a prescribed stimulant from a drug taken for a high.

The same door can be opened gently or forced. Ecstasy is the extreme case, carried in by the very system meant to clear serotonin away and then…

Five minutesMedication and how it worksMedical and treatmentQur’an 53:28One line of research

Two products can hold the identical molecule and still behave differently in a person, because the difference lives in how fast the drug is released. A change of formulation is a real change, and it is a different thing from a change of drug.

The release pattern sets how high the level climbs, how quickly it gets there, and how long it holds. For stimulants that decides whether cover…

Five minutesMedication and how it worksMedical and treatmentQur’an 20:114One line of research

An immediate release dose gives you the whole thing at once: quick to start, strong at the top, gone within a few hours. If that is what you take, put the demanding things inside the hours it actually covers.

The edges are sharp with immediate release, so most people feel the wear off rather than wondering about it. That is useful information rather than a…

Five minutesMedication and how it worksMedical and treatmentQur’an 73:20One line of research

If you take a prescribed stimulant and your workplace tests, sort the paperwork before anyone asks. A labelled bottle and a short letter from your prescriber turn an alarming result into a filing matter.

Prescribed amphetamine shows up on a standard screen as amphetamine, because that is what it is. The test cannot tell the pharmacy from anything…

Twenty minutesMedication and how it worksMedical and treatmentQur’an 12:67One line of research