Medicines and Medical Treatment

Stories, signs to notice and what to do

Day Ten of the Little White Tablet

Sunita, 38, a teacher in Jaipur, began a prescribed medicine for depression ten days ago. She feels slightly nauseous and sleepy, and nothing seems better yet. Her neighbour tells her these tablets are habit-forming and that she should stop. Sunita is tempted to throw the strip away.

Instead, she tells her husband. He suggests calling the doctor's clinic. The doctor explains that this kind of medicine usually takes a few weeks to show benefit, and that early side effects often ease. She reminds Sunita that these medicines are not the same as addictive drugs, and that decisions to change anything should be made together with her.

The doctor adjusts the timing of the tablet and advises eating something with it, and sets a review after two weeks. Sunita keeps a short note of her sleep, appetite and mood each day, which makes the review clearer.

After six weeks she notices she is sleeping and concentrating better, and laughing with her students again. The doctor says to keep taking the medicine for the planned period, and when the time comes to stop, to reduce slowly under supervision rather than suddenly. She also learns that feeling a little better does not mean the treatment is finished, so she keeps going until the doctor says otherwise. Her husband says he is proud of her patience.

How to recognise it

• Early side effects such as nausea, sleepiness or restlessness in the first days.
• No obvious benefit at the start, which is expected to take weeks.
• Worry or myths from neighbours about addiction or damage.
• Temptation to stop without telling the doctor.
• Mood, sleep and appetite continue to need monitoring.

What this story explains

Medicines for depression often need weeks to work, early side effects are common and usually ease, and decisions about changing them belong with the doctor.

Probable root causes

• Biological changes in brain chemistry linked to depression.
• Stress and life events.
• Myths and fear of medicine.
• Lack of information on how long treatment takes.

What to do

1. Take the medicine exactly as prescribed.
2. Note side effects and benefits in a daily diary.
3. Call the doctor if side effects are troubling instead of stopping.
4. Attend follow-up visits.
5. Ask the doctor questions about duration and stopping.
6. Add sleep, movement and talk therapy to support treatment.

Whom to consult

• Psychiatrist or prescribing doctor for review and any changes.
• Family doctor for general health and interactions with other medicines.
• Emergency service or nearest hospital if there are thoughts of self-harm, or a sudden severe change.

Do and don’t

How to behave and communicate

• Support gently: "It is early days. Let us tell the doctor how you feel."
• Do not mock or pressurise.
• Listen to her worries about side effects.
• Praise her for sticking with treatment.

Neha Asks About the Baby

Neha, 31, has lived with bipolar disorder for eight years, steadied by a regular medicine and her doctor's plan. She and her husband Rishi are hoping to have a baby. She is torn: she is afraid of the medicine affecting the baby, and afraid of becoming unwell again if she stops.

A friend warns, "Just stop it before you conceive." Neha almost does. Rishi insists they speak to the doctor first. The psychiatrist praises her for asking early, and explains that decisions during pregnancy balance the risks of the medicine against the risks of an untreated illness. She says some treatments carry more risk than others, and that changes should be planned with a team including the gynaecologist, not made suddenly.

They agree on a joint plan: regular reviews, blood tests where needed, careful monitoring of mood and sleep, and a support person for early warning signs. Neha's sister is told the plan so she can help.

Neha does not find it easy, but she feels in control. She says, "I had thought I must choose between being a mother and staying well. Now I know there is a way to plan for both." Her sister now knows which signs to watch for, such as sleeping far less than usual, and promises to call the doctor with Neha rather than wait. The plan gives the whole family a little more calm.

How to recognise it

• Fear of medicine in pregnancy leading to thoughts of stopping suddenly.
• A long-term condition that needs ongoing treatment.
• Advice from friends that conflicts with the doctor.
• Mood or sleep changes may signal relapse.
• Need for planning before pregnancy.

What this story explains

Mood stabilisers and other medicines need careful planning for special groups such as pregnant women. Stopping suddenly can be risky, so decisions are made with the doctor.

Probable root causes

• Bipolar disorder, which often needs long-term treatment.
• Hormone and sleep changes in pregnancy.
• Anxiety about medicine safety.
• Myths from friends and social media.

What to do

1. Speak to the psychiatrist and gynaecologist before trying to conceive.
2. Do not stop or change medicine without medical advice.
3. Make a written plan for check-ups and early warning signs.
4. Keep sleep regular and avoid alcohol.
5. Share the plan with a trusted family member.
6. Contact the doctor early if mood changes.

Whom to consult

• Psychiatrist for planning medicine around pregnancy.
• Gynaecologist for pregnancy care.
• Family doctor for general health, and emergency service if there are severe mood changes or risk to safety.

Do and don’t

How to behave and communicate

• Partner: "We will decide with the doctor, together."
• Listen to fears before reassuring.
• Avoid pushing opinions.
• Use calm, supportive tone.

The Boy Who Could Finally Finish His Homework

Aarav, 9, in Bengaluru, cannot sit still. He loses his books, interrupts, and his homework takes three hours of tears. His teacher says he is bright but distracted. After a careful assessment, a child specialist diagnoses ADHD and suggests a medicine as part of a larger plan.

His father, Rohan, is scared. Relatives say, "Medicine will turn him into a zombie" or "It will become an addiction." Rohan asks the doctor directly. She explains how the medicine works, what side effects to watch for, such as reduced appetite or trouble sleeping, and that the child will be reviewed often, with height, weight and sleep checked.

The plan includes routines at home, a timetable at school, and praise for effort. After a few weeks, Aarav's teacher says he is finishing work. Aarav says, "My brain is not so loud now." He is still lively and funny, not subdued.

Rohan is honest about his own mixed feelings. He keeps the medicine in a safe place, attends reviews, and shares the observations of Aarav's teacher with the doctor. Together they learn that medicine is a tool, not a verdict on the child's character. On weekends he plays football for hours, eats a proper dinner and falls asleep easily. His father tells his own parents, with some pride, that asking questions was the best thing he did.

How to recognise it

• Long-standing inattention, restlessness and impulsiveness in more than one setting.
• Struggles with homework, routines and friendships.
• Parents hearing frightening myths about medicines.
• Concerns about appetite, sleep and growth.
• Need for assessment by a qualified doctor, not a guess.

What this story explains

Medicines for ADHD can help when carefully prescribed and monitored, alongside routines and support. The chapter reminds us to separate myths from facts.

Probable root causes

• Differences in brain development and attention control.
• Family history and genetics.
• Sleep, screen use and stress affecting symptoms.
• Myths that delay treatment.

What to do

1. Get a full assessment from a paediatrician or child psychiatrist.
2. Ask the doctor about benefits, side effects and monitoring.
3. Give medicine as prescribed and keep it safely stored.
4. Build routines, short tasks and rewards.
5. Share teacher and parent observations with the doctor.
6. Review regularly and discuss any worries.

Whom to consult

• Paediatrician or child psychiatrist for diagnosis and medicine decisions.
• School counsellor or teacher for classroom support.
• Clinical psychologist for behaviour strategies and parent guidance.

Do and don’t

How to behave and communicate

• Say to the child: "Your brain works differently, not badly."
• Give short, clear instructions.
• Listen to his own description of how he feels.
• Stay calm and encouraging.

Mr Fernandes and the Sleeping Strip

Mr Fernandes, 74, a retired clerk in Goa, has taken a sleeping tablet every night for years, first prescribed after his wife died. Lately he has been dizzy and forgetful, and fell in the bathroom last month. He also has a drink in the evening 'to relax', and sometimes takes an extra tablet when he cannot sleep.

His daughter, visiting from Mumbai, finds several strips in different drawers. She is alarmed but does not scold. She sits with him and says, "Papa, I am not taking anything away. I want your doctor to look at all of this."

At the clinic, the doctor reviews all his medicines and explains that sleeping tablets can cause dizziness, memory trouble and dependence, especially in older people, and that mixing them with alcohol is dangerous. He does not tell him to stop at once; he plans a slow, supervised reduction along with better sleep habits and treatment of the loneliness underneath.

Mr Fernandes joins a morning walking group and drinks less. It takes weeks, but he sleeps more naturally. His daughter keeps a list of all his medicines, and the doctor makes sure only one clinician prescribes them. He admits he had been afraid of lying awake with his thoughts, and that saying so aloud was a relief. His daughter calls him every evening for the first few weeks.

How to recognise it

• Long-term use of sleeping tablets with dizziness, falls or forgetfulness.
• Taking extra tablets or combining with alcohol.
• Medicines kept in several places and unclear what is taken.
• Loneliness, grief or poor sleep behind the tablet use.
• Fear of sleeping without medicine.

What this story explains

Sleeping medicines can cause dependence and side effects, especially in older adults, and should only be reduced under a doctor's guidance. Alcohol and extra tablets add to the risk.

Probable root causes

• Grief and loneliness.
• Age-related changes in sleep.
• Long-term habit and dependence.
• Alcohol use.
• Several medicines used without a single overview.

What to do

1. Gather all medicines and take them to the doctor.
2. Ask the doctor about a slow, supervised plan; do not stop abruptly.
3. Keep alcohol out of the picture.
4. Improve sleep habits: daylight, activity, regular times.
5. Address grief and loneliness through company and counselling.
6. Store medicines safely and keep a list.

Whom to consult

• Family doctor or geriatric physician for a full medicine review.
• Psychiatrist if sleep or mood problems continue.
• Counsellor for grief and loneliness; emergency service or nearest hospital if someone takes too many tablets or cannot be woken.

Do and don’t

How to behave and communicate

• Speak respectfully: "Papa, I want you safe and sleeping well."
• Avoid blame or lectures.
• Listen to his loneliness.
• Offer to go with him to the doctor.

When the House Cannot Hold the Storm

Joseph, 27, a delivery rider in Kochi, has barely slept for five days. He talks fast, says he has been chosen for a special mission, and has spent his savings on gifts. At night he walks the streets, and he told his brother that voices warn him about enemies.

His family tries to calm him. He refuses medicine and says nothing is wrong. His mother begs him to see a doctor, but he shouts and storms out. His brother, frightened, calls the family doctor, who advises that this sounds like a serious illness that may need hospital care, especially if Joseph cannot keep himself safe.

The family waits until Joseph is calmer and then goes together to a psychiatric hospital, with his brother and uncle speaking gently. The doctor explains the options, and that hospital treatment can give rest, safety and close monitoring while medicines begin to work.

Joseph stays for ten days. At first he is angry, but gradually he sleeps and the voices quiet. At discharge, the team plans follow-up, regular medicine and warning signs. His mother says, "I thought hospital meant shame. It was the safest place for him that week." The family also learns that the first days after leaving hospital are delicate, so they keep evenings quiet and make sure someone is always with him.

How to recognise it

• Several nights with very little sleep and unusual energy.
• Grand or frightening beliefs and hearing voices.
• Refusing help and saying nothing is wrong.
• Risky spending or behaviour and possible danger to self or others.
• Family unable to manage safely at home.

What this story explains

Some conditions need hospital treatment for safety and close care. Hospital is a medical support, not a punishment, and recovery continues with medicine and follow-up.

Probable root causes

• Severe mental illness such as mania or psychosis.
• Lack of sleep making symptoms worse.
• Stress or substance use.
• Delay in seeking help because of stigma.

What to do

1. Stay calm and do not argue with his beliefs.
2. Keep him and others safe; remove risky items.
3. Contact a doctor or psychiatrist early.
4. If there is danger, call the local emergency service.
5. Go to hospital together if advised.
6. Plan follow-up and medicine after discharge.

Whom to consult

• Psychiatrist or hospital for severe symptoms.
• Family doctor for guidance on next steps.
• Emergency service or nearest hospital if he is violent, unsafe or cannot care for himself.

Do and don’t

How to behave and communicate

• Speak slowly and softly: "I can see you are not sleeping. I am here."
• Do not shout or threaten.
• Offer simple choices.
• Listen and keep sentences short.

This book is for education and general awareness. It does not replace diagnosis or treatment by a qualified professional. If anyone is in danger, contact your local emergency services.