Practices

Finding the dose is a search rather than a calculation. It goes up in small steps until either the effect you want turns up, or the side effects get annoying enough that you come back down a step and settle there.

There is no way to work the right dose out from body weight or from how bad things look, which surprises people who expect medicine to be more exact…

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…

One of the founding figures of biological psychiatry summed the whole business up as some medicine helping some people at some doses some of the time. Knowing that before you start makes the first disappointment much easier to survive.

Most people need more than one adjustment: the dose, then the timing, sometimes the drug itself. Go in expecting the first prescription to be the…

When medication works, its best effect is often on everything else you were already trying. Coaching, exercise, a routine: each of them needs enough attention to get started, and attention is the thing in short supply.

That is why setting medication against the other approaches usually misses the point. The plan you could not keep last year may be perfectly keepable…

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…