Pills for Sleep, Pills for Nerves

Mrs Dorothy Pereira, sixty-eight, widowed in Goa, was given a sleeping tablet after her husband died. It helped at first. Over two years she kept asking for repeats, then asked a second doctor too. She noticed she needed…

Mrs Dorothy Pereira, sixty-eight, widowed in Goa, was given a sleeping tablet after her husband died. It helped at first. Over two years she kept asking for repeats, then asked a second doctor too. She noticed she needed more for the same sleep.

Her daughter Anita saw her unsteady on the stairs and confused in the afternoons. When Dorothy once ran out for two days, she became shaky, tearful and could not sleep at all. She was frightened and ashamed, and said she could not tell anyone because she was taking what a doctor gave her.

Anita took her to the family doctor and told the full story, including the second prescriber. The doctor said these medicines can lead to dependence, that stopping suddenly can be dangerous, and that a slow, supervised plan was needed. They also arranged grief counselling, because the sleeplessness had started with loss. Dorothy cried with relief at being understood.

The slow plan took months, guided by the doctor, and some nights were hard. Anita stayed close, and a neighbour began to walk with Dorothy in the evening. In the grief group Dorothy met other widows and found that talking tired her out in a good way. She now sleeps without fear of running out, and keeps one doctor in charge of her medicines.

How to recognise it

• Needing more of a sedative for the same effect, or running out early.

• Getting prescriptions from more than one doctor.

• Daytime drowsiness, confusion, unsteadiness or falls.

• Shaking, anxiety or insomnia when doses are missed.

• Shame about taking a medicine that was legitimately prescribed.

What this story explains

This story shows that prescription sedatives are among the substances in the chapter and can cause tolerance and withdrawal, and that stopping needs medical supervision while the cause is treated.

Probable root causes

• Untreated grief, anxiety or insomnia that the pills were covering.

• Long-term use without regular review.

• Tolerance, where the body needs more for the same effect.

• Loneliness, and shame that stops people asking for help.

What to do

1. Go with the person to the doctor and give the full picture, including all medicines and prescribers.

2. Never stop the medicine suddenly; ask the doctor for a supervised plan.

3. Treat the reason sleep or nerves went wrong, such as grief or anxiety.

4. Build sleep habits: fixed times, daylight, a quiet evening, no late screens.

5. Reduce fall risks at home while confusion and drowsiness continue.

6. If there is a seizure or severe confusion, call the local emergency number or go to the nearest hospital.

Whom to consult

• Family doctor to review all medicines and plan any change.

• A psychiatrist for dependence and for anxiety, depression or grief.

• A grief counsellor or psychologist for talking support.

• Emergency services or nearest hospital for seizures or severe confusion.

Do and don’t

How to behave and communicate

• Reassure first: "You did nothing wrong by taking what you were given."

• Be concrete: "Let us go to the doctor together and tell her everything."

• Listen to the grief behind the sleeplessness.

• Use slow, simple words and check understanding.