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To What Extent Can Buddhism Help With Depression?

After reading Daphne Merkin’s A Journey Through Darkness in today’s New York Times Magazine, I was left contemplating Buddhist viewpoints on treating depression. It’s no secret that many people are drawn to the dharma during difficult times- seeking relief from despair and anxiety. Each week there seems to be new headlines touting the benefits of meditation for various psychological ailments. But is the deep unrelenting depression that Merkin describes outside the realm of a contemplative cure?

I think for those suffering from a more mild or situation based depression, Buddhist ideas such as non-self and non-attachment can be incredibly helpful. To know that the “I” experiencing these feelings is not a solid entity can help shake loose some of the suffering. But what happens when the despair is so deep that this type of mindful investigation is impossible? Must one attain a certain level of functioning to apply Buddhist principles at all? And if you’re not at that level, is this indicative of a failing in your practice or the result of chemical imbalances in need of medication?

As I was doing some research online, I came across a 1993 article by psychiatrist Mark Epstein for Tricycle entitled, Awakening with Prozac: Pharmaceuticals and Practice that shed some light on the topic. In it, he discusses the tendency of some dharma students to rely solely on their practice for relief, to the exclusion of medications that have been proven clinically effective. Epstein links this type of suffering to asceticism, which the Buddha cautioned against. While medication might not be people’s first choice, Epstein attests to the enormous benefit it can have, even if just used temporarily.     

Working with suffering is what makes up the path, but I think acknowledging that some suffering might be beyond the bounds of a purely spiritual approach is important for practitioners to realize. While there’s great relief to be found in the idea that we can alter how we work with our emotions (i.e. non-attached observation vs. rumination), I think there’s a danger in the responsibility this places on individuals, perhaps leading some to feel responsible for a condition that’s beyond their control and preventing them from seeking the additional help they need. Ideally meditation and studying the dharma would be enough to alleviate suffering, but when it’s not, acceptance that it’s all part of the path seems key.   



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MU

posted May 11, 2009 at 11:28 am


Thanks for raising this important topic, Denise. Three very good books that I use in my practice, and often recommend to clients who are open to mindfulness are:
The Zen Path through Depression by Philip Martin;
The Mindful Way through Depression by Mark Williams, John Teasdale, Zindel Segal, and Jon Kabat-Zinn; and
Overcoming Depression by Paul Gilbert.
Gilbert is a clinical psychologist in Great Britain and a leading researcher on the issue of compassion, and has some excellent Buddhist-inspired work on on what he terms compassionate mind-training as a therapy for shame, an emotion that quite often lies near the heart of depression.
You are absolutely right about some suffering being beyond the salutary effects of meditation and spiritual practice. One dimension of the therapeutic effect, however, that is true whether one addresses an issue through, say, psychoanalysis, through medication, or through time in the zendo, is that, as I like to put it, following Barry Magid, problems do not disappear from our lives; they disappear into our lives.



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Bryce

posted May 11, 2009 at 11:29 am


Thanks for writing this.



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Lee

posted May 11, 2009 at 7:31 pm


I disagree entirely. Buddhism (really, literally) started with a written prescription, offering a cure to the condition of unhappiness.
In other words, it IS a cure for depression, was from the very beginning, and has a LOT more years of research behind it that western psychology, which arguably, for the most part, started with daft ideas about sex, and proceeded to tranquilise anyone who it couldn’t cure. By contrast, Buddhism teaches one quickly to find moments of peace, and use those to find lasting peace, which leads to profound joy and appreciation for life.
It is clearly superior, is largely in tune with more recent western psychology such as humanism, and western psychologists and psychotherapists quite rightly are beginning to see how much they can learn from this much more advanced approach to a fundamental problem of lifestyle and attitude and beliefs.



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Your Name

posted May 11, 2009 at 10:25 pm


Thanks MU for the reading suggestions- I will check them out.
Lee- Having witnessed people in extreme life-threatening despair, I wonder about your position. I think Buddhism can be part of the cure and I’m generally a medication as a last result kind of person, but I don’t think it should be discounted entirely.



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MU

posted May 12, 2009 at 12:39 am


Lee, your enthusiasm for Buddhism as a panacea and your caricature of Western psychology aside, we do well to remind ourselves that, while clinical depression may be considered a state of dukkha, dukkha is by no means reducible to (or translatable as) depression. The important question Denise put before us is not which practice–meditation or psychotherapy–is superior but rather whether some forms of mental suffering, including depression as some experience it, are beyond the curative power of contemplation. I can think of no writer who is both trained in psychology/psychotherapy and Buddhism who would endorse Buddhist practice as the sole cure for depression. Can it help? Sure it can (see, e.g., the authors mentioned above).



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JayhooRay

posted May 12, 2009 at 4:34 pm


As a Buddhist who often feels like Buddhism is the cure for everything…I’ve had to get over it. Most people just aren’t going to be able to work with it. So I have this fascination now with all the ways that I see Dharma dressed up for Americans and sneaking in the back door.
My Lamas, and others, occasionally comment about how Westerners seem to have really strong egos but actually don’t. And that practice alone is often not effective for people who really need therapy. Most Westerners are better prepared for therapy than they are for Buddhist practice.
Currently I see the effect of meditation and some introduction to Right View for many people in my life being “creating a stable vessel” so they can take on the therapy with some efficiency and courage. Once the ego is actually stabilized somewhat and known, it can then be worked with in practice…otherwise neurosis/ego just high-jacks practice.
We also have to be pretty technical in what kind of mindfulness/meditation practice we are talking about. Different traditions have different forms etc. And when you work with people who really benefit from meds it is hard not to see that as a stage of skillful means. What I find is that for some folks, meds and therapy get them to a place where practice and view can allow them to rest in stabilization and move past meds and therapy.



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Shawn

posted December 2, 2009 at 11:57 am


Lee, your comments seem to imply that you might not have ever had to deal with a true long term depression. I might give them a bit more credence if you spoke from actual experience, but I think that is not the case.



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Jesse

posted June 4, 2010 at 3:30 pm


I have suffered most of my life from bi-polar and it can lead to psychosis due to going extended periods without sleep. I have followed Buddhism as much as possible in seeking relief from this condition. In the end I wrote audiodharma.org asking what I should do. I felt strongly that I had failed to practice meditation effectively and wondered about its use in combating a chemical deficit within the brain. The answer I received was that tools like meditation that aid in the cessation of suffering are important but in the middle way medicines help for a variety of problems in life. The brain is a complex organ and responsible for a lot of how we feel but it is not self, nor mind. All experience is preceded by MIND. Buddha didn’t say ‘preceded by the brain.’ If there is a true problem with the way the neurons are firing it can be assisted through meditation and even alleviated to a great extent however; not always and not 100%. On another note there is documented proof that an epileptic was literally cured and no longer needed the anticonvulsant he was prescribed after several biofeedback sessions in the late 1960’s. Chemical models of treatment can be an important implement to help – a sort of foundation for better meditation. Consider the schizophrenic who is so far detached from reality that neither concept of either meditation OR medication could possibly be explained or used UNTIL pharmacological treatment is introduced. It’s kind of hard to meditate if you’re epileptic and having a seizure every 30 minutes. Believe me I held on to pure meditation as the only treatment until I was suicidal from lack of sleep and a kind of delusion that was inescapable. It was an imposition from a chemically imbalanced organ – not my mind. Meditation is a treatment not a cure. If it were a cure one meditation session would be sufficient for the rest of our lives. I take something now that allows sleep. I’ve accepted that without it, my reality will only be greatly distorted and my mind and body in discord. When it was like that for me, it led to the most dangerous of all hindrances – doubt. All I could think was ‘why isn’t this working?’ I do still meditate and it’s useful and important and needed. Using both medicine and meditation is a reliable complement in battling suffering. Many Buddhists take medications for hearts for brains and all kinds of disorders. I believe that if the Buddha’s that have passed were here today they would advise that sick people need medicine too and to take it. The middle path is emphasized here.



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Joseph Merkle

posted July 29, 2010 at 11:09 am


I really enjoyed reading your post and the well written comments as well. I break it down to one simple question. Can medicine coincide with meditation without altering the results?
I have been a student of homeopathy for 30 years and have seen “miraculous” results. Being an energy medicine, homeopathic remedies work in conjunction with and not opposed to the natural healing processes of the body, mind, and soul.
So I would recommend to all those that are on a spiritual path yet require medication to seek out a good homeopath.
The middle path is often found after one has tripped over it time and again. Turn your meditation into contemplation. Be active, not passive during your spiritual exercises.



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Saint Jude

posted August 18, 2010 at 1:10 pm


You might appreciate this short documentary about a buddhist artist and her struggle with depression:
http://www.youtube.com/watch?v=H8KMX7YL9J4



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Pharme542

posted September 26, 2010 at 8:14 am


Hello! adcdbag interesting adcdbag site!



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Adam

posted November 28, 2010 at 10:13 pm


Thanks for an insightful piece. I think this point is often overlooked, even though it can be very simple and straightforward. I often tell people, “if you broke your leg, you wouldn’t go meditate to be liberated from the suffering. You would go to a doctor, take care of your wound, and then keep practicing. Severe depression is exactly the same.” Treatments for depression are varied, and which to pursue a very personal choice, but its still an illness, and my personal experience with chronic depression has shown me that it can be a barrier to practice. Trying to “fix it with practice”, of which I was often guilty, is, I think, a confused form of spiritual pride; recall the lojong slogan “abandon all hope of fruition”. I also think its important to remember that no psychotropic drug can have the slightest effect on the nature of mind. We start from a place of confusion, and seek to discover the pure nature of mind. The idea that anti-depressants corrupt or distort our mind doesn’t really make sense in that context; our mundane mind is already distorted in myriad ways. A relative solution that keeps it clear and balanced is a good practical solution for the severe depressive; it allows for practice that could lead to seeing the true nature of mind, which those medications do not obscure in the slightest. Anyway, I guess that’s just a long-winded way of saying “I agree”. My tradition is Tibetan, so you’ll have to excuse my tendency to elaborate. :)



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mindfulness4u

posted April 16, 2012 at 7:38 pm


Part of the true understanding and practice of buddhism is to reach for enlightenment. Being enlightened is to be able to see past the ideas and thoughts that we are trained to believe are true. We have no understanding of why or how things are the way they are, we just except that “they are.” There is suffering just as there is happiness.
If a person has a chemical imbalance of serotonin or dopamine in their brain which leaves them struggling,then the buddha might have prescribed medications to help them stay on the right path. Just as morphine is used to ease the suffering and pain related to cancer. It would be ignorant not to use it, just as it would be to let an uncontrolled mind suffer due to a chemical imbalance that could possibly be treated with the correct meds.
I am a nurse and I have seen many patients refuse pain medications because of the negative associations of drug addiction. These patients didnt understand that while laying in bed trying not to move because of the fear of pain, this only impaired the healing process and left them to aquire even more complications such as pneumonia.
The Buddhas teachings are to point us in the correct direction and we need to use both technology and mindfulness to achieve a better more productive life. We are the ones to make the decisions of what will work best for us because only we ourselves know “us.” Common sense is the teacher. If it works without being abused then medications are needed.
Now on the otherside of the fence, if you are lying to yourself and others using the meds to run away from everyday stressors that you are fully capable of dealing with but choose to numb your brain to escape temporarily, then dont be surprised when you get to the end of the path you have chosen. Goodluck.
Now take a deep breath, smile and go tell your family and friends you love them and appreciate them :)

mindfulness4u@aol.com



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rmejfhika

posted June 7, 2013 at 6:37 am


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