Practices

Unmanaged ADHD wrecks sleep, food and movement, and wrecked sleep, food and movement make the attention worse the next day. The loop feeds itself, which is also the hopeful part: a small repair anywhere in it pays back more than it should.

Short sleep hits the same front part of the brain that is already struggling, so a late night costs you more than it costs other people. Pick the one…

There are two jobs here, not one. Free up the time, and then be able to sit in it without feeling like a fraud.

Working more efficiently buys hours back, and that is the easier half. The harder half is the belief that rest is only for people who have finished…

There is a rough ladder for tech overuse. Build a schedule together with some outside control at first, add substitutes once the person can stop for a while, then more intensive care, and residential only when someone is entirely taken over by it.

The order matters more than the rungs. You cannot install a better alternative in someone who has no capacity yet to put the thing down, so a bit of…

Nothing here does the job on its own. Medication if it suits you, a few practical systems, something for the low mood and shame that has built up, and the people you live with brought into it.

The practical layer is the easiest to describe and the first to fall over, because whether you use a system at all depends on how you feel about…

Walking away from a course or a job that was never going to fit can be the sensible move rather than a failure of nerve. It is also frightening, particularly when other people are paying for it.

Fit does more work here than effort does. The person who cannot survive a rigid nine to five in an open plan office may be excellent somewhere with…

Some people book their first assessment on the day they turn eighteen, because it is the first day they can consent without a parent. If you have been waiting like that, the waiting was not laziness.

Where a family or a community treats mental health care as shameful, a young person can spend a decade struggling with nobody's permission to ask for…

The parts of this that look like lifestyle, meaning sleep, driving, drinking, appointments that get missed, are the parts carrying the most risk across a lifetime. They are also the most changeable parts.

You may have met a striking figure quoted about untreated ADHD and years of life lost. Take the point underneath rather than the number: risk from…

No food in the house means eating out late, which means a late night, which means a late start, which means no time to shop. It is not a character flaw. It is a loop.

The parts that feel most like personal failure, the takeaways, the extra coffee, the money going nowhere, are mostly downstream of a plan that never…

Getting your ordinary life a bit calmer is worth doing for its own sake. More sleep, a little more structure, food that is not all improvised. Not perfect, just good enough to work with.

It will not give you more capacity than you have. What it does is let you use more of what you already have, more of the time, which is usually the…

Where you can, let the learning be something done rather than something sat through. Typing instead of writing, a calculator instead of longhand, a built model instead of an essay.

The knowledge is usually already there. What fails is showing it through a long, still, low feedback task, and that is the part worth redesigning.…

Think of it the way you would think about diabetes. Something to manage with several things at once, most days, for as long as it is there.

That frame does a lot of quiet work. It says the treatment is ongoing rather than a course you finish, it explains why things slide back when…

There is no single treatment that covers all of this. What works looks more like five things running alongside each other, and understanding the condition comes first.

Each piece reaches a different part of the day. Medication does something the environment cannot, changing what a room asks of someone does something…

The stack goes: understand it, medicate where that is right, change what the adults do, change what the day asks, and keep arguing the child's corner. Each layer does a job the others cannot.

None of them stands in for another, which is why swapping one out leaves a gap rather than a smaller plan. Medication does not reorganise a…

Behaviour work for ADHD is mostly about changing what the adults do. The child's behaviour shifts afterwards, as a consequence.

Consequences live in other people's responses, and a child who cannot yet hold a reward in mind across three days cannot supply them for themselves.…

The trouble now is not that nothing works. It is that the things which work are spread unevenly, and whether a family gets any of them depends heavily on where they happen to live.

Medication travels reasonably well, since a prescriber can be found in most places. The psychological and behavioural work travels badly, because it…

Look for something genuinely hard that sits on top of something you are already good at. Too easy and your attention wanders off. Too far beyond you and it just becomes another thing you failed at.

The narrow band in between is where you stay engaged without noticing you are trying. It is usually a bit further up than feels comfortable when you…