Attention-Deficit/Hyperactivity Disorder (ADHD), sleep, and substance-use medicines – explained simply

From the book – Chapter 15: Medicines and Medical Treatment

Attention-Deficit/Hyperactivity Disorder (ADHD), sleep, and substance-use medicines

ADHD

Stimulants: methylphenidate, amphetamine-based medicines. Improve attention, focus, and impulse control. Controlled substances; careful prescribing and monitoring. Non-stimulants: atomoxetine, guanfacine — alternatives when stimulants are not suitable. Used mainly with a clear ADHD diagnosis.

ADHD: The Mind Without Brakes

In modern psychology, Attention-Deficit/Hyperactivity Disorder (ADHD) is frequently misunderstood as simple laziness, a lack of discipline, or low intelligence. It is a neurodevelopmental condition where the brain regulates dopamine and attention differently.

Imagine a powerful sports car with a massive, high-speed engine, but bicycle brakes and a disconnected steering wheel. The person can generate incredible speed, passion, and creativity, but they struggle to stop, steer, or hold their focus on quiet, unstimulating tasks. Sometimes they are entirely distracted and forgetful; other times, they "hyper-focus" on a fascinating subject for twelve hours straight and cannot pull themselves away.

The Ancient Understanding Thousands of years before we had the clinical term "ADHD," classical texts clearly recognised this biological reality.

Rajas (Restless Energy): In classical philosophy, the mind is influenced by different energies. An ADHD mind is heavily rajasic filled with the energy of constant motion, passion, and an inability to find stillness.
Chanchala Manas (The Restless Mind): In the Bhagavad Gita (6.34), the warrior Arjuna complains that his own mind is Chanchala (restless), turbulent, obstinate, and as impossible to control as the wind. Crucially, the text does not insult him for this or call him lazy. It recognises the raw power of a restless mind and prescribes structured, patient practice to guide it.

A STORY FROM ORDINARY LIFE — Kabir Age 28

Kabir was highly intelligent, but his daily life was a chaotic storm. At work, his desk was buried under half-finished projects. He would constantly miss important deadlines, not because he didn't care, but because his brain simply could not initiate the task until the absolute last minute, when sheer panic finally provided enough adrenaline to force his brain to focus.

At home, he would obsess over a new hobby—like buying all the expensive equipment for photography and staying up all night researching it—only to lose interest and abandon it completely a week later. His managers and family were deeply frustrated. They constantly told him he just needed to "try harder," buy a daily planner, and stop being so careless.

After years of absorbing these daily criticisms, Kabir carried a heavy, invisible weight of shame. He secretly believed he was simply a lazy, broken adult who refused to grow up.

The turning point came when the exhaustion of constantly failing his own expectations became too much, and he visited a clinical psychologist. After a thorough assessment, the psychologist gave Kabir's lifelong chaos a medical name: Adult ADHD.

The doctor explained a life-changing truth: Kabir was not lazy, and his struggles were not a moral failure. His brain simply required a completely different operating manual.

The treatment plan was highly practical. Instead of just telling him to "focus," the psychologist helped Kabir build external scaffolding for his mind. They set up visual alarms, broke large projects into tiny, ten-minute steps, and introduced a mild medication that acted as a chemical brake pedal, helping his nervous system physically regulate its attention.

The Core Lesson

For Kabir, the most powerful medicine was not the alarms or the pills—it was the total removal of his shame. Once he understood that his struggles were a physical, neurological difference rather than a bad attitude, he stopped hating himself. He finally learned how to work with his unique, fast-moving brain, rather than constantly going to war with it.

Sleep

Sedative antidepressants in low dose (trazodone, mirtazapine). Z-drugs (zolpidem, zopiclone) — short-term; risk of dependence. Melatonin — sleep-wake regulation in certain cases under medical advice. Sleep medicines should generally be short-term while underlying causes are addressed.

Substance use

Alcohol: disulfiram, naltrexone, acamprosate. Opioid: methadone, buprenorphine (substitution therapy), naltrexone. Used as part of comprehensive treatment including counselling and social support.

Read the full chapter – Chapter 15: Medicines and Medical Treatment

Stories from real life

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.…
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…
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…
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…

Shloks

Bhagavad Gita 2.47 – Your claim is to action alone, never to its fruits. Do not make the fruit the motive, and do not cling to inaction.

More on this topic: Counselling, therapy and psychiatric medicines explained

Attention-Deficit/Hyperactivity Disorder (ADHD), sleep, and substance-use medicines – explained simply