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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Thanks for writing this.
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.
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.
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).
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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