Saturday, January 15, 2011

Depression Again


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.

58 comments:

Anonymous said...

Broken eyes never see more than they tell.

Anonymous said...

walking the tight rope over suicide,
a certain drug gives just enough
balance to take the next step

Anonymous said...

The next thing any of you know, a dark storm can silently seize upon your mind and if you're not very careful you might end up hanging from the rafters.

All are warned, suicide is not some rational thing with independent clauses that anybody could obviously see a mile away. Everybody tragically thinks they're untouchable and that chaos will never get them - they have it figured or they live in honest fear knowing what is out there.

Personally, part of the cruelty of this positive thinking or "I've bootstrapped myself why can't you" is the unexamined fault you place on the person you give such advice to.

Anonymous said...

And yes, sometimes being depressed is the proper response to existential chaos. The problem comes for many when the depression burns out of control and consumes you. Get help before then.

Anonymous said...

"Our society is generally pretty fucked up."

enabled by secrecy and counterfeit currency

KatyDid said...

It seems to me that there's a big difference between clinical depression and the blues, as you pointed out. I'm not sure we always recognize the difference, and there ARE a lot of folks wandering around zonked out on antidepressants who probably SHOULDN'T be, because it's a quick fix for doctors.

If someone close to me dies, or I lose my job or break up with a lover, I SHOULD be sad. It's a normal reaction that my psyche gets to work through as part of being human.

That's NOT a medical condition.

Anyway, I don't know that YOU should have to warn people not to do everything stupid that potentially could be done after reading your blog. I can think of a long laundry list of disclaimers - from looking both ways before you cross the street to not poking pencils in your eye - that could easily become mandatory every time we blog, otherwise.

I liked this one. Keep 'em coming! :-)

Rehn said...

I know the difference between clinical depression and the blues. The blues is when you sit in your room and listen to sad songs. Clinical depression is when you wake up crying and that's the best part of your day. I've been off medication and on medication, and all I know is that I'm still alive with medication. Yes, drugs are over prescribed. I think that people are now given antidepressants as they are walking out of sad movies. But for some people, thinking positive can't fix the horrible feelings that just won't go away. Unless you've actually experience such horrible pain, nothing you say about use of medication means anything. You don't know.

Rehn

Mysterion said...
This comment has been removed by the author.
Anonymous said...

The SG article was a good one, I thought. But it sounds like Brad and I only have bouts of fairly severe depression. This is nothing compared to the clinical depression that at its worst had my partner unable to get up off the sofa. For him drugs really were necessary at the time since they work more quickly--perhaps most importantly in re-establishing sleep patterns--than therapy can.
But in order to re-learn that life offers joys as well as sorrows, some sort of therapy (cognative-behavioral therapies focusing on the persent seem to be more useful than "digging up the past") and/or patient guidance from loved ones and friends is also necessary.
Experiments in Britain with teaching people who suffer from depression meditation (that seems to be based on viapssana) as a way of getting them to discover that thoughts are just thoughts (so not as cruchingly important as they seem to be when in the grips of depression) appear to be successful in helping people recover and learn a new, more adaptable way to view life that they can carry into the future.

RDeWald said...

I am a registered nurse with actual training in mental illness.

Clinical depression is not sadness. It is a neurochemical disease state. Sadness is a feeling.

It is unwise to take medications, prescribed or otherwise to deal with feelings. To borrow a Buddhist phrase, it is like quenching thirst with sea water.

Clinical depression is something else entirely. People suffering from clinical depression are often sad as well, but that's actually a sign their disease is not terribly serious, or not at a serious stage yet. This observation leads to confusion.

The disease we call clinical depression makes people sad like having a broken leg makes people sad...for a while. As the disease progresses they will lose the capacity to even feel sadness.

Just as if you lie still long enough on a green blanket a broken leg will eventually heal, it is certainly possible that after enough time passes doing zazen the disease state named clinical depression may improve. While no one believes the green blanket has anything to do with a fractured leg knitting up, some people persist in beliefs like zazen, or diet, or petitioning the flying spaghetti monster can help clinical depression.

Clinical depression is reflected at the neurochemical level as an imbalance in brain chemistry. Nature seeks balance. Given time, nature will compel a return to balance. Zazen, being a state of balance, promoting balance, is certainly a rational candidate for something that would help. That's certainly a reasonable assertion to make.

Reason, the realm of thought, is very seductive territory.

However, if we called clinical depression something else, say dopaminemia, perhaps the confusion with sadness wouldn't be so easy. No one would tell a diabetic to just live with high blood sugar, to just tough it out, until they lost enough weight to make it go away, yet people give the kind of advice that Brad gives here to people who are genuinely suffering from a readily treatable imbalance in their brain chemistry all the time. This is dangerous.

Clinical depression is actually discernable from profound sadness via an interview by a mental health professional. It is certainly true that lazy and uninformed doctors prescribe drugs to sad people all the time, and this is unwise, but that is something very distinct from the notion that anti-depressant therapy is of dubious value to a person genuinely afflicted with an imbalance in their brain chemistry. It is in fact a safe and effective treatment. When properly managed by a trained professional anti-depressants can reliably completely cure the disease.

Sadness is something else altogether. Taking drugs for sadness will likely hinder recovery from it.

Mysterion said...
This comment has been removed by the author.
Lone Wolf said...

There is a book called Spark: The Revolutionary New Science of Exercise and the Brain that introduces the science-based data on the benefits that exercise has on mental health, including depression.

http://www.amazon.com/Spark-Revolutionary-Science-Exercise-Brain/dp/0316113506

Soulagent79 said...

I'm on Effexor xr at the moment and I wonder how much it influences (or disturbs?) my zazen. Is zazen still zazen when you're doing it on antidpressants? Zazen probaly wouldn't be zazen anymore if you did it after smoking a joint or after a bottle of wine. So what about mind altering medication?

Mumon said...

But perhaps I shouldn't make such assumptions.

You shouldn't make such assumptions: there may be those that are looking for reasons not to be seeking help.

gniz said...

RDeWald,

I think you make some really valid points here but as far as I know, the studies and data on "curing" clinical depression through modern anti-depressants has not reached the kind of consensus you describe.

I work at a drug company and we run clinical trials. You make it sound like an interview with a medical professional to diagnose mental illness is akin to a blood test for diabetes. It most definitely is not the case.

There are a lot of moving parts with mental illness. As such, I've also worked at a residential treatment center and had access to patient files and I've seen the long list of varied diagnoses that every patient received. The same patient would be called schitzo, bipolar, depressed, etc etc over the years they would have differing labels and medications associated with those labels.

So although you said a lot of good points, you came across a little more certain of the entire thing than is warranted. My impression is that we still do not have a great grasp on mental illness and treatment, but for some the medications can still be lifesaving.

Anonymous said...

As someone who once suffered from ulcers and severe depression (i had the gun in my mouth) for many years Id like to mention that zazen actually did function to correct those "chemical imbalances" which at one point left me laid in bed in the dark for days. I was poor and unable to pay for either medicine or therapy. Zazen was my only recourse. It didn't work overnight, but im healthy and happy now going on 8 years.

It also led me to changing many of the things in my life which had contributed to severe depression. My wife was on effexor for years, when wanted to taper down her therapist informed her that she was supposed to remain on it for the rest of her life! As she did taper off the side effects were horrible and worse than her anxiety had been before starting the drug.

I'm afraid that I see drugs as a band-aid over a bullet wound when it comes to depression. Without really getting to the root of the problem you are simply trading a state of misery for a state of dopiness. I can see the use of a drug as a very short term prevention of suicide, but beyond that they are dangerous and unnecessary.

Anonymous said...

I don't understand why so many take so much of what you say as the last word on a situation. They want you to give them all the answers like you are the authority for all things. I don;t think everything you say is perfect or even profound, but why do so many feel the need to accuse you of being wrong about your OPINION?

Soulagent79 said...

I know - getting off Effexor is probably a real horrible experience. You get all kinds of feelings of fear, nausea and the much dreaded 'brain zaps'.
Every coin has two sides, you have to take the good with the bad. When I started taking Effexor it helped me a lot and I WAS fully aware of the side effects, I still decided to start taking it though.

Anonymous said...

In Episode 44 of the Brain Science Podcast talk with Daniel Siegel, MD about meditation and the brain. Dr. Siegel is the author of several books including The Mindful Brain: Reflection and Attunement in the Cultivation of Well-Being. In this interview they review the scientific evidence about how mindfulness meditation changes the brain, both in terms of short term activity and in terms of long-term structural changes. The evidence is convincing that a regular mindfulness practice can be an important element of brain health.

http://www.brainsciencepodcast.com/bsp/2008/8/22/meditation-and-the-brain-with-daniel-siegel-bsp-44.html

Anonymous said...

Can meditation really help with stress from the economy, upcoming holidays, work stress, and more? From THIS EMOTIONAL LIFE (January 4-6, 2010), Dr. Michael Baime talks about how meditation and mindfulness helps students, teachers, doctors, people with cancer, and others.

http://www.youtube.com/watch?v=DdyQ9y5IUck


______________

A survey and history of meditation practices, East and West. including Christian meditation, such as the Jesus Prayer, Jewish Kabbalah forms of meditation, medical studies of meditation, and practical instructions from a variety of traditions, featuring the Buddhist methods of "stopping and contemplating," which are the two branches of Chan/Zen meditation. Also includes meditating with vizualizations.

This is a 10-minute excerpt from the talk given by Buddhist Rev. Heng Sure, PhD, at the Healthy Lifestyle Expo 2007.

http://www.youtube.com/watch?v=FePeVvFb7Io

What is said...

In the 21st century, the biopsychiatric model was increasingly global in reach and pharmaceutical companies corruptly influenced and funded scientific studies, and surpassed the defense industry as the primary defrauder of the American federal government. Sixty-eight percent of the psychiatric members working on the 2013 edition of the psychiatric "bible" or Diagnostic and Statistical Manual of Mental Disorders (DSM-V) reported economic ties with drug companies. In 2008, antipsychotic drugs were the number one seller on the American medicine market and brought in 14.6 billions dollars in sales.

In the face of the biopsychiatric model's dangerous science and deep corruption, voices of dissent are marginalized and judged harshly. The reverberations of this unquestioned attitude towards psychiatry extend deep into the pockets of even the recovery movement, such as the National Alliance on Mental Illness, which received in recent years 75 percent of its funding from the pharmaceutical industry. Also, in spite of side effects such as, acathisia, tardive dyskenesia, neuroleptic malignant syndrome, birth defects and even the side effect of suicide, psychiatrists continue to envision a future where mental illness is eradicated.

patdolan said...

People should be mindful when they take insulin. They should be mindful when they take Paxil. It comes down to the same things.

True depression (or any mental illness) is a fact about the brain, not simply a mood. Exercise, rest and good diet may minimize the effects, just as exercise, rest and a good diet help with diabetes. And a comprehensive approach that uses lifestyle choices as well as a conservative approach to medications with side effects is best.

One of the things that Americans thinking about health get wrong, and zen gets right, is that we should get away from talking about a "cure." "Life is suffering," isn't a disease that gets cured, it's a fact that gets lived with. So depression, so illness, so a dysfunctional culture.

Try it this way: If you can live with your depression (diabetes) using diet, exercise and meditation, you should. If you can't live with your depression (diabetes) with those things, you should seek more help, ideally from someone who knows what she's talking about.

For example, RDeWald on this thread.

Mysterion said...
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Anonymous said...

no depression

Anonymous said...

don't try this at home, kids

anon said...

No Depression.

Mysterion said...
This comment has been removed by the author.
Manny Furious said...

I work in the "Mental Health" field and I think anyone who partakes in anything that resembles "objective" research into the subject should find that "Mental Illness" is really just a metaphor for undesirable behaviors. Mental Illness is not the same as Physical Illness. I'm sorry to anyone who disagrees, but, as Dr. Thomas Szasz says, most Mental Illnesses are not Brain Illnesses. This is a highly important but all-too-often overlooked point. Depression is not a "disease" in the same way that Parkinson's is a disease. Things like Parkinson's and Tourette's and other BRAIN diseases differ significantly than "Mental" or "Mind" diseases. Most importantly, a mind, being a non-material thing, cannot become "sick" in the truest meaning of the word. This is where Psychiatry has gone bonkers.

Psychiatry wants to remain relevant and empowered and so the profession as a whole spends a lot of time and money trying to convince the general population that these medications can fix or cure so-called mental illness. When, in reality, it's probably more like putting the proverbial band-aid on a tumor. If Mental Illness is truly a Brain disease as many like to purpose, well, then, treatment belongs to the neurologist and not the psychiatrist.

This is not to say that there aren't people who don't suffer in this life. Certainly there are those who are so badly depressed that they can't get out of bed or can't go two minutes without crying or really, really want to kill themselves. I am not denying this. And if they feel that drugs could help them make it through their life, then more power to them. However, I believe, then, that the person should have access to any drug of their choosing and not just what multi-billion "pharmaceutical" companies tell them and their physicians is ok to take.

anon said...

How can you laugh when you know
I'm down

no depression said...

Now, when the day goes to sleep and the full moon looks
The night is so black that the darkness cooks
Don't you come creepin' around - makin' me do things I don't want to

Anonymous said...

When there is a chemical test for depression you can equate it with diabetes. Til then its just another constructed problem drug companies invent to sell dangerous pills.

I'm sorry but the two things are NOT comparable.

Mysterion said...
This comment has been removed by the author.
Mysterion said...
This comment has been removed by the author.
JJ said...

I agree, Brad. I've known people with some severe emotional issues who were medicated early but never given the care and attention they needed to get to the cause of the problems and deal with them. Medications should be used as a tool in part of the therapy process to help provide relief from symptoms until the patient in question can handle the symptoms themselves. Depression is serious, but medications aren't the only answer and they are certainly the go to in our society.

Mysterion said...
This comment has been removed by the author.
Melt said...

I might be wrong but I don't see the issue. I mean for the most part I enjoy Brad's writing and he usually has some pretty good thoughts, which is one of the reasons I check his stuff out, but at the end of the day he's just some dude. One of the people that posted under Anonymous pretty much said the same thing and I agree. Thats....just like....your opinion man.

Shandra said...

I was on a couple of anti-depressants a few years ago. They may have helped initially, but after a while I got to feeling like the drugs put a glass wall between me and the world, or my emotions and the world. I felt stifled and trapped. I'm glad I got off the stuff, I read science journals for fun and the newer discoveries about the brain suggest doping people up on a feel good chemical cocktail may be more chancy than they used to think. Too much variation in brain chemistry from person to person to be really effective. One dose will work fine for one person, the next guy may have a suicidal reaction on the same dose. Scary. Doctor's do seem to hand them out like candy, though. I came out of a walk-in clinic with a prescription for two different kinds and enough repeats for a year.

Anonymous said...

Jealousy the opposite of compassion, when one wants to exchange their self-made misery for the perceived happiness of another.

Manny Furious said...

Something else I think is worth pointing out and highly overlooked is the dilemma one comes by when dealing with chemical/biological models of something like depression. I.E. am I depressed because I'm lacking in certain chemicals, or am I lacking in certain chemicals because I'm depressed? Psychiatry as a profession depends on the answer being the former, so how do you think they're going to present their findings?

Mysterion said...
This comment has been removed by the author.
Anonymous said...

"Has anyone on the planet Earth ever gone to war over a math problem?" David-Wynn:Miller asked. "No. There has never been a dispute over math. It is absolute science. Language is flawed."

john e mumbles said...

Meanwhile, waiting out the next seven years...

http://www.msnbc.msn.com/id/41117702/ns/world_news-africa/

Dr. Zenmonger said...

"Life is suffering," isn't a disease that gets cured, it's a fact that gets lived with. So depression, so illness, so a dysfunctional culture.

The 4 noble truths do not say 'life is suffering, therefore learn to live with it.'

The Four Noble Truths

1. Life means suffering.

2. The origin of suffering is attachment.

3. The cessation of suffering is attainable.

4. The path to the cessation of suffering.


The Buddha said there 'is' a cure for suffering and then outlined that cure as being the 8fold path.

Life "as it is usually lived" is indeed suffering. The cause of suffering is attachment (including aversion). The way out of suffering is following the 8 fold path. The idea that suffering should just be lived-with and accepted or medicated away is not buddhism.

anon #108 said...

Hi Dr Z,

Well, that's not quite what the Four Truths of Noble Ones says either. Here is what the Dhammacakkappavattana Sutta, considered to be a record of the first utterance of the Four Truths actually says. After the intro comes, in the Pali original:

Idaü kho pana bhikkhave, dukkhaü ariyasaccaü: jàtipi dukkhà jaràpi dukkhà vyàdhipi dukkho maraõampi dukkhaü appiyehi sampayogo dukkho piyehi vippayogo dukkho yampicchaü na labhati tampi dukkhaü saïkhittena pa¤cupàdànakkhandhà dukkhà".

Here's a translation by Thanissaro Bhikkhu:

"Now this, monks, is the noble truth of stress: Birth is stressful, aging is stressful, death is stressful; sorrow, lamentation, pain, distress, & despair are stressful; association with the unbeloved is stressful, separation from the loved is stressful, not getting what is wanted is stressful. In short, the five clinging-aggregates are stressful."

Here's another translation, by Peter Harvey (whose notes on the terms and the problems of translation are well-worth reading):

"Now this, bhikkhus, for the spiritually ennobled ones, is the true reality which is pain: birth is painful, aging is painful, illness is painful, death is painful; sorrow, lamentation, physical pain, unhappiness and distress are painful; union with what is disliked is painful; separation from what is liked is painful; not to get what one wants is painful; in brief, the five bundles of grasping-fuel are painful."

So nowhere does the sutta say "Life is suffering", or "Life means suffering". It says something a little more subtle and specific, I think.

All quotes from http://www.accesstoinsight.org (Search Dhammacakkappavattana Sutta).

Manny Furious said...

"How do you know that?

"How can you know that?"

Because the entire profession exists currently to simply diagnose certain behaviors and prescribe chemicals to deal with those behaviors. The vast majority of psychiatrists don't do psychotherapy. They meet with clients/patients, spend less than an hour talking to them, diagnose them and send them off with a prescription.

Now, if there are ways to deal with so-called mental illness without the need of introducing synthetic chemicals into the brain, what other role does the psychiatrist have? Diagnosis? All mental health professionals (counselors/clinical social workers/clinical psychologists)can diagnosis. The only thing left for the contemporary psychiatrist is prescribing. And if that is taken away from them, then what? Back to psychotherapy, perhaps, but consumers could get those services for much cheaper from someone who didn't go through med school to do it (psychotherapy).

Furthermore, if so-called mental illnesses are truly brain diseases, such as Tourette's or Alzheimer's, then treatment belongs with the neurologist, i.e. someone who can diagnose based on actual, measurable PHYSICAL attributes, not behavior, which is all a psychiatrist does.

Barbara O said...

"Dukkha" is Pali, a variation of Sanskrit, and it means a lot of things. For example, anything temporary is dukkha, including happiness. But some people can't get past that English word "suffering" and want to disagree with the Buddha because of it.

I've noticed that some translators are chucking out "suffering" and replacing it with "dissatisfaction" or "stress." I'm a bit dissatisfied with that approach, however. Sometimes translators bump into words that have no corresponding words meaning exactly the same thing in the other language. I believe "dukkha" is one of those words.

Understanding dukkha, however, is critical to understanding the Four Noble Truths. And the Four Noble Truths are the foundation of Buddhism.

Anonymous said...

Brilliant post. I think your insights on the topic are spot on.

Anonymous said...

"But for some people, thinking positive can't fix the horrible feelings that just won't go away. Unless you've actually experience such horrible pain, nothing you say about use of medication means anything. You don't know."

Sorry, but I don't think you've been there more than I. And I can tell you that the pills are a placebo.

Anonymous said...

"Clinical depression is actually discernable from profound sadness via an interview by a mental health professional."

It's a PLACEBO.

I "had" it for years and went from $165K/year to around $20K in the span of 4 years, spiraling downward each year. I went weeks without leaving my house, hell, without taking off my flannel pajama pants.

When sugar pills perform at the same rate as the reuptake inhibitors, you know your paradigm has problems.

I don't know of any nicer way to discuss this issue. The more you buy in to the "chemical imbalance" bullshit, the more it is able to influence you.

Shalom.

Seagal Rinpoche said...

Be kind. Everyone you meet is fighting a hard battle.

Tragick93 (Benjamin Cicelske) said...

Brad,

I am a person who takes Antidepressants as well as other psychiatric meds. I have also gone the street drug route a couple of times with speed and heroine and I really like the observation you made on psych meds being kinda like tuning a piano with a sledgehammer. I would go farther and say that self medicating mental illness with street drugs is more akin to tuning a piano with a jackhammer, although I know that this is probably outsifde the scope of this discussion. I agree that it woiuld be great for everyone to be able to use tecniques such as zazen to work on themselves but some of us do not have the luxury of not being F'ed up enough to do this without some sort of medication. This is a difficult subject and I applaud you for even speaking on it, I know I would not have the brass to do so if I was in such a position as yours. Keep up the great and very inspiring work.

anon #108 said...

BTW - for anyone who might have missed the point of my copy/paste of those translations of the "dukkha" part of the Dhammacakkappavattana Sutta above, it has nothing to do with translations of "dhukka".

The point was to offer an alternative to Dr Zenmonger's suggestion that the Buddha didn't say or mean "Life is suffering" but "Life means Suffering". This wasn't the Dr's main point (I agree with his/her main point: that the Buddha said there can be an end to suffering). But the passage shows that nowhere is the word "Life" (or any pali equivalent) used. To use the word "life" suggests that ALL experiences are included as characterised by suffering, and that's not what the Buddha says. That's all.

FWIW, I'm quite OK with 'suffering', 'stress', 'pain'. 'dissatisfaction', 'dis-ease' unhappiness' and a whole bunch of whatever elses as translations for duhkka. It's not so difficult for a human being to understand the meaning. Whether it derives from dus-kha - a bad wheel-hub hole (hence, a rough ride/hard going), or is a prakritized (vernacular) form of dus-shta (bad or ill standing/situated, hence uneasy, uncomfortable, unpleasant, difficult), or whether it helps to think of it as the opposite of sukkha (good going[?]; pleasant, agreeable, comfortable, happy), all of us, I think can relate to what's being said in that passage. If still confused, see the Buddha's list of things that are dukkha, above.

(Close readers might find it interesting to note that as used in this sutta, dukkha is not a noun, but, as indicated by the Pali grammar, an adjective - reflected in both translations above).

anon #108 said...
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anon #108 said...

Of course, understanding WHY we find these things 'duhkka' (to keep Barbara O'Brien sukkha) and what to do about it is something else.

Anonymous said...

I'm wary of the declarative statements here regarding the reality of mental illness or effectiveness of medication. None of these assertions would help the people I've known struggling with mental illlness.

Depression in particular becomes a habit in addition to whatever its primary cause within the brain may be. It digs a deep rut in your mind and makes it ever more difficult to get out. Even once 'recovered, it's very easy to slip back into self-defeating habits.

Meditation is indeed helpful, but most people experiencing a serious depression are not in a place where they are able to begin a dedicated meditation practice.

Some people say, "Medication is just as effective as exercise and diet changes," and research seems to support that, at least in part. Someone in the depths of a depression will not be starting an exercise regime or making sweeping changes to their diet.

Taking medication is often the only thing a suffering individual feels capable of doing. So unless the disparagers of medication are ready to devote themselves wholly to the pursuit of taking personal responsibility for someone on the verge of giving up, perhaps a small nod to the worthiness of medication is deserved.

Anonymous said...

"Taking medication is often the only thing a suffering individual feels capable of doing. So unless the disparagers of medication are ready to devote themselves wholly to the pursuit of taking personal responsibility for someone on the verge of giving up, perhaps a small nod to the worthiness of medication is deserved."

Well said. What wasn't said is that the medication provides a placebo that the sufferer believes in, which is what seems to be truly needed. Does it even need to be said? Perhaps not, but I sometimes tire of seeing the same old incorrect theoretical BS passed off as fact.

Either way, please everyone take it easy and have a great day.

O no Barbara O! said...

Although I've never heard her speak, I'm certain that she sounds just like Lily Tomlin as the operator.

http://snltranscripts.jt.org/76/76aphonecompany.phtml

Broken Yogi said...

I can understand the reluctance to use or endorse most pharmaceutical anti-depressants. They suck, they don't work much better than placebos, they have dangerous and toxic side effects, and they can even make depression worse.

However, I've also found out that a lot of the "illegal" drugs that get a very bad rap can actually do wonders for depression. And that's from scientific studies on the subject.

Ketamine, for example, which I had thought was a really bad heavy drug, turns out to be three times better than any anti-depressant in treating serious depression. I mean one single dose can knock depression on its ass for a week to ten days.

MDMA has profound effects on depression, when used occasionally rather than regularly. This is clinically proven in study after study.

Likewise, psilocin, the active ingredient in Psylocibin mushrooms, is also a fantastic anti-depressant, especially when used in micro-doses on a daily basis. Daily micro-doses of LSD also has proven anti-depressant benefits as well.

I know these things can be abused, and it can be hard to find pure sources, but they have the advantage of being very non-toxic, highly effective, and generally work on natural systems our body is already geared to deal with. And they actually fuck with your head a lot less than pharmaceuticals, especially when used in microdoses or only occasionally.

Also, of course, basic good nutrition, omega-3 oils, exercise, etc. All the simple good things to do to your body.

Now, that's just one side of the equation, the bio-neurological. But that's an important side. If your brain chemistry is fucked up, it's hard to make use of Buddhism or any other mind-oriented approach. It works both ways, but oftentimes we need to work with the brain before we can use the mind. Sometimes we need a chemical kick start.

yeah, call it the punk-Zen approach to depression.