Practices

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…

Being told you are too sensitive is usually someone else's comfort talking. Feeling things strongly is not the problem to solve; what to do once the feeling has arrived is.

Both halves have to be said together. Validation on its own leaves a person flooded with permission and no handles. Teaching control on its own joins…

Since 1994, supplements have not had to satisfy a regulator before going on sale. Nobody checked the bottle in your hand the way they check a prescription.

The gap is wider than most people expect. Drug factories get unannounced inspections and can be shut down on the spot; supplement makers do not face…

Natural is not a regulated word: anyone can print it next to a picture of a leaf, on anything at all. Organic in the USDA sense does have a legal definition sitting behind it.

The same goes for the reassuring line about following good manufacturing practices, which describes what a company aims at rather than what an…

Kava, valerian, St John's wort, ginkgo, ginseng and the proprietary blends have not shown benefit for ADHD in trials that matched the amount in every capsule and kept both the person handing them out and the person rating behaviour unaware of who got what.

Those two design details are most of the story. Ordinary use has dose wobble and expectation running through it, and expectation is powerful,…

If a stimulant that was working suddenly is not, ask what else the person has started taking before deciding the dose needs to go up.

One woman's Adderall went flat while she was on a herbal supplement and came back to its usual self once she stopped it. Herbs can shift stomach…

If a little helps then a lot must help more is not really a supplement thought. It is an addiction shaped thought that has wandered into the vitamin aisle.

Moderation tends not to be a natural strength with ADHD, and this is one place where that costs something. Name it early, before a safe dose has…

People with ADHD tend to have lower omega-3 in their blood, and bringing low levels up has been linked with some improvement in symptoms. No convincing difference has shown up between DHA and EPA for this.

Omega-3 comes mostly from oily fish and krill, and fish is exactly what many people with texture sensitivity will not eat. Whether the shortfall…

If you are trying omega supplements, give them four to six weeks and then decide. Imaging work has picked up changes in how neurons communicate after around four weeks, which is fast as these things go.

Fixing the end point at the start protects you twice over. It takes the sting out of nothing happening by Thursday, and it stops an open ended habit…

In one trial, children were given omegas with a multivitamin, omegas alone, or neither, and after fifteen weeks everybody got both. The omega groups gained on set shifting and attention, and the children who started with nothing caught up once they crossed over.

Two features of that design are worth understanding. Everyone receiving the treatment eventually shows that the improvement follows the treatment…

Sixty two children took methylphenidate with either vitamin D or a placebo, and both groups improved. The two ADHD rating scales showed no difference between them, which leaves the positive headline resting on the clinician's judgement rather than on what parents reported.

That shape repeats all over this literature, so it is worth learning to spot. When a study reports an effect on one measure and not another, the…

People with ADHD are reported to run low on both tryptophan and homocysteine. Low homocysteine is a good thing to have, since it is the high version that damages hearts.

The reflex to correct any number under the reference range is worth resisting. Levels can be tested where there is a reason to test them. Eating a…

More clinicians now raise supplements themselves, and more of them will suggest something like omegas. The shift matters less for what gets recommended and more for what it does to disclosure.

People hide what they expect to be laughed at. Someone braced for an eye roll simply does not mention the four bottles in the kitchen cupboard, and…

Omega supplementation for ADHD began with encouraging results, including a Swedish study where about a quarter of inattentive children seemed to improve. Blinded, placebo controlled work did not reproduce it, and a Cochrane meta-analysis found no effect.

The manufacturers themselves largely moved on to other conditions, which tells you something. None of this makes omegas worthless, and levels do run…

Cutting sugar does not improve ADHD, and nor does stripping out additives. Both have been tested repeatedly, including under conditions where nobody knew which child had eaten what.

The belief survives because parties are where children eat sweets, and parties are also loud, crowded and thrilling. The sugar takes the blame for…

Megavitamins, antioxidant products such as pycnogenol and assorted trace minerals have not beaten placebo for ADHD. They stay popular on the strength of a good story about how they ought to work.

The gap between a mechanism and an outcome is the thing worth teaching, because it will still be useful when the next product appears. Ask what…