The Hurdle With Seeking Psychiatric Medicines

If you tell someone you are taking antibiotics for an infection, they nod and ask if you are feeling better. If you tell them you are taking psychiatric medication, the reaction is entirely different.

For most people, mental health medicine is viewed as the absolute last resort. There is a deeply ingrained belief that if you need a pill for your mind, you must be fundamentally broken, unfixable, or simply too weak to handle life independently. People fear the side effects. They assume psychiatric drugs are instantly addictive, that once you take that first dose, you are signing a lifelong contract, or that the medication will alter your personality beyond recognition. These fears don’t just appear out of nowhere. They are a direct result of how our medical system has functioned for decades.

Is the medical system actually failing us?

In India, patients traditionally only seek mental health support when things have gone catastrophically wrong. We are slowly seeing this change, but the cultural default is still to wait for a crisis.

When people do finally look for help, they bring their biases with them. Almost everyone has a story about a friend or a distant relative who has been "on psychiatric meds their whole life" and "never got better." They see these long-term patients and automatically assume the medication is a trap. What they completely miss is the underlying biology. Many of these individuals are managing chronic, lifelong conditions like schizophrenia, bipolar disorder, or severe developmental delays. Taking medication long-term isn't a characteristic of the drug; it is a characteristic of the condition itself. But we cannot put all the blame on the patients. The healthcare system itself feeds this confusion.\

I see it constantly: doctors who don't educate their patients on what their diagnosis actually is. To be fair, psychiatrists are working in a highly stressed environment. They are vastly overworked. They are dealing with an Indian diaspora that is often deeply suspicious of healthcare, assuming doctors are just out to make money. Explaining the nuances of a prognosis, the expected timeline, and the mechanism of a drug is a tedious, exhausting process when you have a waiting room full of patients.

What is the cost of an unanswered question?

Because of this rush, doctors sometimes skip the formal explanation. Diagnoses become rigid and are rarely allowed to evolve. On the other side of the desk, patients in India rarely ask questions. If they do, they are sometimes quickly dismissed due to a lack of time.

This creates a dangerous communication vacuum. Psychiatric medicine relies heavily on reported symptoms. There is no blood test for OCD. If a patient doesn't actively report a specific symptom because they feel intimidated, or because the symptom isn't overtly visible during a fast ten-minute consult, it doesn't get treated.

Furthermore, patients often don't report side effects. Instead of telling their doctor that a pill makes them feel lethargic, they just quietly drop the doctor and throw the medicine in the bin. Sometimes, a patient with a chronic condition will see a tiny bit of improvement and assume that’s the absolute maximum relief they can get. They don't give feedback, the doctor assumes the current dose is perfect, and the patient spends years living with suboptimal results. Medical treatment is a complex process of trial and error; without patient feedback, the whole machine grinds to a halt.

What happens when the quick label gets it wrong?

This fractured system is exactly why so many people end up on the wrong treatment path, and it highlights why a diagnosis shouldn't be a one-person job. Let me give you a few examples of what happens when the dots don't connect:

• The Missed Nuance: I recently worked with a patient who had been diagnosed with schizophrenia by a doctor. It was never fully explained to her. When we finally sat down in therapy and had the time to peel back the layers, we found she wasn't schizophrenic. She was dealing with severe depression, deeply embedded OCD symptoms, and depressive psychosis. The treatment protocol had to completely shift.

• The Camouflage: Doctors frequently write off OCD as generic anxiety. Or, they see the chaotic, up-and-down relationships caused by OCD traits and misdiagnose it as a borderline personality issue or a mood disorder. We also see doctors entirely miss high-functioning autism simply because the patient doesn't display the "classic," textbook symptoms.

• The Reverse Problem: The misunderstanding of treatments goes both ways. I had an MBBS resident seek me out for therapy as an alternative to medicine for active psychosis. Conversely, I’ve seen patients with late-stage dementia—who lack short-term memory and cognitive insight—being recommended for talk therapy. In both cases, the tool being used was completely wrong for the job.
  

So, how do we actually fix this?

This is where the role of the psychologist becomes a game-changer. We spend significantly more time with the patient—often an hour a week compared to fifteen minutes a month. We get a much deeper, clearer insight into why a symptom is happening, not just that it is happening.

We can act as the bridge. We gather the feedback about what is improving, what isn't, and what the side effects feel like, and we can translate that for both the patient and the psychiatrist. We can educate the patient on the timeline of their treatment, manage the intense anxiety of starting or stopping a medication, and advocate for lower maintenance doses when the patient hits remission.

There is no question that psychiatric medications work. But without the correct approach, the treatment derails, and the patient's trust in the system shatters. We need to start looking at medication simply as a tool in a toolbox. If you have a nail, you need a hammer, not a screwdriver. When a psychiatrist and a therapist actually collaborate, we figure out exactly which tool is needed, making the patient's path to recovery infinitely easier and faster.

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TL;DR

• People often view psychiatric meds as a scary "last resort" and fear they are addictive or lifelong. This usually comes from seeing people with chronic, lifelong conditions (like bipolar or schizophrenia) take meds long-term and mistakenly blaming the medication instead of the illness.

• Overworked doctors in India often don't have time to fully explain diagnoses, and patients are usually too intimidated to ask questions or report side effects. This leads to people quietly throwing their pills away or settling for treatments that barely work.

• Fast consults frequently lead to misdiagnoses—like writing off complex OCD as generic anxiety, missing high-functioning autism, or labeling severe depression with psychosis as schizophrenia.

• Psychologists spend significantly more time with patients and can act as a crucial bridge. By tracking the nuances of a patient's symptoms, managing their fears about side effects, and providing detailed feedback to the psychiatrist, therapists ensure the right "tool" is used for the job, making recovery much faster.

  
  

~ Omkar Naik

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  For a therapist or counsellors who can offer you both support & growth, reach out to CINQ.IN @ +91 8007566553 or visit our centre in Baner, Pune.