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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670 practices

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Put something in before you take something out. Removing the only way a person has of coping leaves them with nothing, which is not safer.

In practice this looks like smaller steps than a promise to stop: cutting the frequency, changing what is used, agreeing to wait ten minutes and do…

Five minutesWhen everything feels flatParts workQur’an 65:7One line of research

When something has helped a little and then stalled, adding a different kind of help often does more than pushing harder on the first one.

That is the thinking behind adding a second medicine with a different action rather than only raising the dose of the first, and it is the same…

Twenty minutesWhen everything feels flatMedical and treatmentQur’an 42:28One line of research

Six to eight weeks is what an antidepressant needs before it can be judged. The first fortnight will mostly tell you about side effects.

The transporter is blocked within hours, so the delay belongs to slower changes further down the line. In practice that means picking a date four to…

LongerWhen everything feels flatMedical and treatmentQur’an 12:110One line of research

A few treatments are only given in a clinic, with someone sitting with you afterwards. The chair and the hours are part of the treatment rather than paperwork.

Esketamine is the current example. It is a nasal spray, given on site, with a monitoring period of about two hours afterwards because blood pressure,…

LongerWhen everything feels flatMedical and treatmentQur’an 94:1One line of research

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

Shame

Obsessions and compulsions

Treatment and medication

Breathing

What worry does

Breaking the worry loop

When you use something to cope

Being seen and judged

Feeling from the inside

Emotions as signals

Treatment and medication

Practising under provocation

Remembering to do it

Growing empathy

Bringing the future closer

Structure and routine

Question the thought

Posture and how you carry yourself

Exercise, food and other supports

Making it stick

Letting it out safely

When you go numb

The cost of avoiding

Facing it a step at a time

Living with uncertainty

Self-compassion

What you are actually defending

When anger turns to harm

Rest and pacing

Anger, alcohol and the body

Use your strengths

Righteous anger and perfectionism

Panic and the body

Reading, numbers and learning differences

With the fast acting treatments, the plan for what happens afterwards matters as much as the treatment itself.

Electroconvulsive therapy can shift severe depression quickly, and without something in place afterwards the relapse rate is high, which is why…

LongerWhen everything feels flatMedical and treatmentQur’an 12:110One line of research

Sometimes the honest answer is that there is nothing in your surroundings to feel good about. Changing them counts as treatment, not as running away.

A life with no friends nearby, no work that means anything and a steady drip of criticism will produce low mood in most people, and skills practised…

LongerWhen everything feels flatParts workQur’an 8:24One line of research

If sleep has gone since starting, look at what time the dose is being taken before deciding the medicine is the problem. A long acting dose swallowed at one in the afternoon is still working at bedtime.

Extended release preparations are built to cover eight to twelve hours from whenever they are taken, so a late start pushes the whole thing into the…

A minuteMedication and how it worksMedical and treatmentQur’an 73:20One line of research

Count good days, not unbroken runs. Whatever yesterday was, brilliant or a write off, the only live question is what can be done with today.

Streaks make one slip cost everything, so the missed night turns into a missed week and then the whole effort gets quietly dropped. Aiming for more…

A minuteMedication and how it worksADHD skillsQur’an 39:53One line of research

Debt, impulsive spending, an account that never quite recovers: this belongs in the conversation about attention rather than in a separate drawer marked shame.

People hide this part longer than anything else, which means it is usually the last thing to get any help. If you are the one struggling, saying it…

Five minutesMedication and how it worksMedical and treatmentQur’an 33:5One line of research

Where anxiety sits alongside the attention difficulty, a non-stimulant is sometimes the better first choice. Stimulants sharpen anxiety in some people, and that is a hard trade to live with.

The same holds when blood pressure rises on a stimulant that is otherwise working, since adding an alpha-2 agent can make it possible to keep the…

Five minutesMedication and how it worksMedical and treatmentQur’an 21:83One line of research

The stimulant shortage is not your pharmacy being disorganised. Regulators set a fixed annual quota of the raw material, and the ceiling has been too low to cover the prescriptions being written.

Knowing that changes what you do with your energy. Ringing round twenty chemists is exhausting and it creates no supply, so spend the effort on…

Five minutesMedication and how it worksMedical and treatmentQur’an 9:91One line of research

When a prescription cannot be filled, you can report it to the medicines regulator's shortage inbox, naming the medication and the pharmacy. Nobody writes back, and people often find their prescription turns up soon afterwards.

The value of this is partly practical and partly in not being stuck. Being told no at a counter, month after month, is what makes people quietly…

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

Waking your child at six to give the tablet so it has taken hold by breakfast, then letting them fall back to sleep, is not a strange thing you invented because you are failing. It is a reasonable answer to a real gap in how the medicine works.

Families quietly carry a lot of these. The early alarm, the switch to a faster product, the parent who does the whole morning alone because it goes…

Five minutesMedication and how it worksMedical and treatmentQur’an 9:91One line of research

Doing badly on one long acting product does not mean the medicine inside it was wrong for you. The same molecule in a different capsule can behave differently enough to be worth trying before anyone gives up on it.

What gets described as the medicine not working is often the shape of the day being wrong: too slow to start, too abrupt at the end, strongest at the…

Five minutesMedication and how it worksMedical and treatmentQur’an 33:5One line of research

People usually stop for one of three reasons: the side effects are not worth it, the price is too high, or the dose was never raised far enough to do anything. The last one is the saddest, because it makes a workable medicine look useless.

If a trial ended with the words nothing happened, it is worth going back over what dose was actually reached and for how long it was held there. A…

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

Before anyone concludes that medication does not work for you, check what dose was actually reached. Doses in general practice often stay lower than a specialist would use, and a fair share of so called non responders respond once the dose goes up.

You are allowed to ask this, gently and without any accusation in it: what was the highest dose tried, and how long did it stay there? A trial that…

Five minutesMedication and how it worksMedical and treatmentQur’an 49:6One line of research

If one family of stimulant did nothing, or felt awful, that tells you very little about the other. Methylphenidate and amphetamine work in overlapping but different ways, and plenty of people who do badly on one do well on the other.

Stopping after a single class is one of the commonest routes to believing that nothing helps. Trying the second one is a normal next step rather than…

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

A medicine can give you back some energy. It cannot turn a bad situation into a good one, and it helps to be clear which of the two you are hoping for.

If home has been miserable for two years, feeling steadier may just mean you notice the misery more sharply. People often read that as the medicine…

Five minutesMedication and how it worksMedical and treatmentQur’an 21:83One line of research

For someone who cannot swallow tablets, or whose mornings fall apart long before the tablet gets taken, patches exist that release medicine slowly through the skin over hours.

Going through the skin skips the first pass through the liver and smooths out the peak, which changes the timing and sometimes how well it is…

Five minutesMedication and how it worksMedical and treatmentQur’an 5:6One line of research

Much of the progress in these medicines over the past twenty years has been in how the drug is delivered rather than in new molecules. So if one version did not suit you, another form of the same drug can still be worth a try.

People often conclude that a whole class has failed them when what failed was one release pattern: too sharp, too short, too much at once. That is a…

Five minutesMedication and how it worksMedical and treatmentQur’an 33:5One line of research