I got an interesting response to my Suicide Girls article about depression:
"Part of the problem is that you seem clearly to be talking about clinical depression and not 'the blues' but I think you give some of the mental illness part of it short shrift. I'm assuming we're talking about actual clinical depression.
I have a fundamental problem with the article. I believe that any article that attempts to discuss mental illness should definitely include statement saying, 'if you are suicidal or think you may cause harm to yourself or others, please seek medical attention. Call a suicide hotline. Talk to a trusted friend, relative or doctor.' Otherwise, we're just Scientologists who forbid you to seek medical help."
OK. Sure. Maybe I should have included that disclaimer. But I really think that's a given. I tend to assume that anyone who can read is at least intelligent enough to figure out they have other options if they're suicidal than taking me at my word on this blog. But perhaps I shouldn't make such assumptions.
The guy who wrote this then went on to say a lot about the use of anti-depressants and other such medication in the treatment of depression.
First off, there is no general Buddhist rule that says one must never use these kinds of medications. Some Buddhist teachers are OK with them. Others are not. Nishijima Roshi does not seem to be a fan of them. But, then again, this is one of the many things you had to ask him about in person when referring specifically to yourself in a particular situation. He did not go around making general pronouncements about it. I never once heard him address the subject publicly in the 15 years I followed him around. He talked about it with me in private a couple times though.
Dogen, in his list of pieces of advice he received from his teacher Tendo Nyojo, quotes Tendo as saying, "Do not take medications for mental illness." Who knows what sort of medications the Chinese of the 12th century had. But apparently they had some and Tendo Nyojo didn't think it was a good idea for monks to take them.
Contemporary Western Zen places tend to be OK with residents using prescription anti-depressants and the like. I recall it was one of the items on the Tassajara check list of things you'd better remember because you can't get them down in the valley. I also recall they wanted to know if you were on such meds and which ones you were taking when you applied to be admitted.
Personally I am not the world's biggest fan of such medications. But I understand they have some use and value. Still, I think they are terribly over-prescribed and often act to normalize conditions that maybe ought not to be normalized. By that I mean drugs can mask the effects of poor diet, poor living conditions, overwork, etc. etc. that ought to be addressed either before or at least during treatment. You overload a kid with sugar and 18 hrs a day of video games, he gets hyperactive, so you feed him downers AND sugar and video games, and then he seems more normal. But really you should have tried taking away the sugar and 18 hrs a day of video games first. Oversimplification, I know. But it happens.
On the other hand, there are people with far deeper problems for whom the drugs can be useful. But I really don't like them unless all other options have been checked out. I think we live in a culture that goes right for the pills.
On a larger scale, I think these kinds of medication can act to help mask deep rooted cultural problems that really must be addressed. Our society is generally pretty fucked up. And this is the cause of much of our mental illnesses and depression. Rather than finding a different way to live, though, we turn to medications that make our fucked up situation bearable. And so the root problem goes unaddressed.
I've never been on anti-depressants or any similar types of medication for mental illness. So you could accuse me of talking out my ass here. But I believe the only reason I was never on anything like that is that I went through my teenage years just before they became really popular and in my twenties I couldn't even afford to see a doctor for the mononucleosis I caught, let alone go to a psychiatrist each week to deal with the nearly unbearable bouts of depression I had to endure.
I found another way because I was forced to. I had to really address these things step by step in a very dynamic manner. I'm not trying to sound heroic here. It's just that I had no other choice. I saw what friends of mine in similar situations did, self-medicating with alcohol and other drugs, cutting themselves, killing themselves. I did not like those options. So I dove headfirst into the meditation thing.
I do not consider those who turn to prescribed psychiatric medications weak or stupid. You do what you have to do to get by in life. Some people have it way worse than I ever did in the depression area. I cannot judge so I do not judge.
I've talked to and held dokusan with lots of people who use these medications. I've spoken to some who have decided to stop doing the drugs and work on themselves through zazen instead. I try to be helpful in these cases. But I've had conversations with people who tried this and then decided they needed the medications after all. When that has happened, I've supported that as well. It is up to you, not me, what you do in your life. Gurus and "Masters" who give advice on matters like this should probably shut up.
I've also known people who really, really needed those medications and did not want to take them. I understand that too because those drugs all have unpleasant side-effects. It's seems to me like trying to tune a piano with a sledge hammer. If you're really skilled you might get the string you aim for to sound right, but you'll mess up the ones around it. The options have to be weighed carefully. Maybe you need medication to get to the point where other approaches are even possible.
I do not know if the stuff I have gone through qualifies as clinical depression or not. I've never had anyone examine me in any manner that might have determined that. I suspect I had enough symptoms to be prescribed medication had I gone to a doctor inclined to do so during my darkest years. But I'll never know for sure. I do know that whatever affected me then still comes on from time to time even now. But I know how to allow it to pass over. I know how to patiently wait for it to finish its business and go.
It's not as bad for me these days as it used to be. Maybe it was never as bad for me as it is for you, dear reader. I have no way of knowing.
I also changed my lifestyle and my diet. They're still not exemplary. But they're better. I stopped drinking. I was never a big drinker to begin with. But I started seeing that if I got drunk, I didn't really sober up completely after a good night's sleep. The alcohol lingered in my system for quite a while. Same with other drugs. This, I had not noticed before I started doing more zazen. I started seeing what large amounts of refined sugar did to my mental state. This, too, I had not noticed before. I saw what a lack of exercise did. All kinds of things I hadn't noticed because I had not been in touch with myself enough to notice them became clear.
I'm not a skeptic who says you ought to "pull yourself up by your bootstraps." I know things can be really bad. I'll say it again: Only you know how bad it is for you.