Practices

If most of the difficulty is happening at home, most of the work needs to happen with the household in the room. Otherwise the hour of good conversation gets quietly undone by Tuesday.

In a settled stretch, seeing the young person on their own with occasional family time is fine. In a crisis, turn it round: everyone together,…

Sorting goes better fast than carefully. If every item stalls you, ask someone to sit in the room while you work, not to help but to keep the pace up.

A person nearby changes what the hour feels like, and they can be reading their own book the whole time. What they supply is momentum, which is…

The pull towards bread, pasta and biscuits when you are low is not simply greed. Carbohydrate makes it easier for the brain to get hold of the raw material it needs for serotonin, so it gives a real if short lived lift.

Calling it self medication instead of a failure of character changes what you do next. You stop trying to out-discipline the craving and start asking…

Put a rubber band round your water bottle for each refill you want to get through today, and slide one off each time you finish it. Nothing to remember, nothing to buy, and you can see where you are at a glance.

Tracking anything in your head is hard when your head is already full, and harder still when concentration is one of the things that has taken a hit.…

Where ADHD and disordered eating meet, the pattern is more often bingeing, or bingeing and purging, than strict restriction. Restriction tends to travel with over-control, while bingeing travels with impulse and reward seeking.

This matters because the questions asked at assessment are usually the restriction ones, so a binge pattern can sit unnoticed for years. If you…

Pick one small change and leave the rest alone. A full overhaul asks the most of you at the point when you have the least to give, and it usually collapses in the second week.

One change, small enough to be almost boring, kept for a month. Then another. It feels slow while you are in it, and it is the version that tends to…

Health advice usually assumes a kitchen, a fridge and money for the week. If you are working with less than that, the answer is not to try harder at the advice. It is to shrink the plan until it fits what you actually have.

A plan you cannot keep does more than fail. It quietly adds to the pile of evidence that nothing you do makes any difference, and that pile is heavy…

When digestion goes wrong there are usually two things to look at rather than one: something you are eating that does not suit you, and a body too braced to digest properly. Checking only one door tends to leave you stuck.

Digestion mostly happens when your body believes it is safe. If you eat every meal with your shoulders up round your ears, that alone can show up as…

Months of fog, where thinking feels like wading, is a real complaint and deserves looking into rather than waving away. It usually has more than one cause, which is part of why it gets dismissed.

Fog sits where several things overlap: dissociation, anxiety, poor sleep, thyroid and iron problems, infections, medication. Because it belongs…

Irritable bowel symptoms turn up more often in people with ADHD, and they tend to track stress. If your stomach is at its worst in the weeks when everything else is at its worst, that is information rather than coincidence.

Two things help more often than they get suggested. Cutting caffeine frequently settles symptoms on its own, since it speeds the gut up and raises…

If your mood drops reliably as the light goes, that is worth naming as a thing in its own right. Seasonal low is more common alongside ADHD, and a light box first thing in the morning helps a lot of people.

Use it early in the day and use it consistently, since the timing is part of how it works. It is also worth asking whoever prescribes for you about…

Very low vitamin D produces fatigue, low mood and a flatness that looks exactly like depression, and it is not part of routine bloods in most places. If you have never had it measured, it is a fair thing to ask for.

One clinician telling this story about himself had a level that was almost undetectable, and no antidepressant would have raised it, because what was…

Before settling on depression as the whole story, ask for thyroid function and vitamin D to be checked. Both are common, both are cheap to test, and an underactive thyroid produces a picture that looks like depression from the outside.

An untreated thyroid problem also blunts how well antidepressants work, so missing it can mean months on a treatment that was never going to do the…

Stress unsettles the gut and an unsettled gut drags on mood, so the two keep each other going. The good news buried in that is you can step in from either end.

You do not have to establish which came first. Easing the pressure on your nervous system helps digestion, steadying what you eat helps mood, and…

Before settling on a purely psychological account of months of anxiety or broken sleep, it is worth having the ordinary bloods done. Low iron, low vitamin D or low magnesium can produce symptoms that look exactly like a mental health problem.

This is not about swapping therapy for supplements. It is about not spending a year working on something a blood test could have partly explained. If…

If your body has something going on as well, try to get both looked after at the same time rather than in a queue. Therapy for what happened to you does not have to wait for your gut to settle, and it often goes better when the two run side by side.

Plenty of people park the physical thing while they do the psychological work, or the other way round, then wonder why progress keeps sliding back. A…