Question: I’ve been practicing in the Theravada tradition for six years. About seven years ago I was diagnosed with dysthymia (chronic mild depression), which occasionally escalates into full-blown depression. About two and a half years ago I began taking antidepressant medication to control the deeper depressive episodes. The first medication I tried helped for a while and then seemed to quit. The one I’m using now keeps the deep depression at bay but I think it’s destroying my mind. I’m finding it difficult to concentrate, my memory is deteriorating, and I’m becoming somewhat apathetic.
My state of mind is interfering with my meditation practice. My doctor wants me to give the medication another three months but I’m afraid my mind will become mush and there will be no hope for my enlightenment in this life.
Since becoming a Buddhist, I’ve wanted to ordain in the Theravada tradition and devote the remainder of my life to intensive practice. But I’m married. I’m also concerned that my current state of mind would lead to failure as a monastic. Any ideas?
Narayan Liebenson Grady: As a meditation teacher who has worked with students facing depression, I know that the relationship between medication and meditation is complex. Medication can help people enormously, but its long-term effect is an area of ongoing investigation in the medical field. In speaking with both medical professionals and practitioners who are taking antidepressants, I understand that the correct dosage is critical.
Recently a practitioner who is a psychiatrist suggested a book to me called Mindfulness Based Cognitive Therapy for Depression, which seems to shed some light on the issue. In it author John Teasdale points out that an increasing number of studies are showing that mindfulness-based cognitive therapy, applied in conjunction with medication, can be far more effective in treating depression than medication alone.
You seem to be thinking in extremes and contradictions (destroying your mind/seeking enlightenment; being married/wanting to ordain; failing as a monastic when you are not a monastic) which points to being out of balance. So right now you might want to emphasize whatever brings you into balance. Specifically, you might direct your attention toward developing steadiness and contentment in your everyday life, rather than focusing on possible future ordination.
The monastic life is a calling, suitable for some and not for others. Thoughts about ordaining can be simply an escape if one is not exploring them for the right reasons. From what you say, it sounds like ordination is not possible now, nor is it necessarily advisable.
Rather than valuing “intensive” practice, what about a more relaxed and dedicated practice? The aspiration to devote the rest of your life to practice is wonderful. But instead of hoping for enlightenment, it may be wiser to commit yourself to the slow and difficult, yet utterly meaningful work of living your life where you are and being as mindful as you can be from moment to moment. This truly would be an intensive practice!
Finally, as you begin to build a dedicated practice, you might find it helpful to be part of a community of practitioners. Having contact with others can not only provide a great sense of support, it can also help bring about a greater sense of perspective. By practicing with others, for example, you will quickly realize that the difficulties you have concentrating are normal. It is not unique to face such difficulties after only six years of practice.
Remember, practice is a lifelong journey; by sitting in a community of supportive practitioners we strengthen our own resolve to keep practicing, no matter how difficult the challenges we face. May you know ease of mind and comfort of heart.
Tenzin Wangyal Rinpoche: As a Buddhist practitioner, it is important to consider the preciousness of this human birth and to develop trust in the three jewels. On the basis of that trust, you can feel the strength to meet life’s challenges and ever-changing circumstances. It is important not to let any situation take over to the point where you abandon regular dharma practice.
Do not expect your meditation always to be healthy and clear, or your environment to be perfectly conducive to contemplative practice. We must seek to bring our practice into the very situations in which we do not feel clear. Whether we are sick, sleeping, in a coma, or in the bardo after death, and whether we are having peaceful or wrathful visions, we try to discover realization in all situations. Every situation is an opportunity to grow and develop.
Our clarity and comfort in practice never stays the same. Instead of struggling with your circumstances, bring your practice into each situation. When experiencing depression, I recommend systematically organizing your life with a strong and clear intention. I suggest three ways in which you can do this:
First, list five places in your house, neighborhood or town where you feel comfortable, such as a porch, shrine room, a neighborhood park or a garden. Visit one of these places on a daily basis and sit there. When you experience a positive quality of peace or calm or safety, bring this feeling inside so that you connect with this as an internal quality.
Second, list five people with whom you have contact who make you feel uplifted or give you energy. They have to be close enough to you that you can spend time with one of these people each day, or every other day. Have tea together, take a walk, or engage socially in a simple way.
Third, list five activities that bring you pleasure, such as walking, listening to or making music, or cooking. Engage daily in one of these activities.
When using an external support such as a place, a person or an activity in order to spark joy and enthusiasm for life, consider this as a form of medicine that you take every day. Be organized and consistent in your efforts to engage in these activities, and seek to internalize the positive qualities that these supports engender. The goal is to maximize a sense of trust, inspiration and hope—attitudes that will support your dharma practice.
Regarding the use of medication, it is important to ask the question: is the use of medication supporting you to access and become familiar with an open presence? My recommendation is to create and follow the structure as outlined above. When you begin to feel the support of this structure and some stability within it, then you could address the possibility with your physician of reducing or perhaps eliminating the need for medication.
Historically, there have been individuals like Shakyamuni Buddha who cut their ties to ordinary life and family through a deep sense of the illusory nature of life, entered into the dharma fully, and attained realization. We have all experienced disillusionment and exhaustion with life’s struggles, but for most of us, the decision to enter a monastic situation is not the right one. Perhaps it is wiser to consider adopting the focus and discipline of a monk or nun without changing your outer circumstances radically. It may be difficult at times, but our everyday relationships are opportunities to love others and exercise patience, qualities which can deepen our spiritual practice. Sometimes it is enough just to be peaceful and quiet and to hold that sense of space within oneself.
Zenkei Blanche Hartman: Practice is to see clearly what actually is, as-it-is. Our effort is to stay with our actual present-moment experience, moment after moment, and not to be distracted by hating what is or wishing for an imagined fantasy of some experience other than just this one, as-it-is.
This is not what we want to hear. Most of us, at least in Western convert sanghas, have come to Buddhist practice because of some aspect of dukkha in our lives. I have not yet met anyone who diligently practices because they are too happy or content. (While dukkha is usually translated as “suffering,” it is derived from a word that signifies the off-centeredness of a hole in a wheel, thus producing a bumpy ride. So something feels “off” to us, is uncomfortable or needs attention.)
I wonder if, when you started to practice six years ago, you hoped that meditating would end your depressive tendencies. After some years of serious practice it seems that you have found that meditating can show your state of mind—how it changes, resolves and changes again to something else. This is exactly the Buddha’s teaching of impermanence and no self. You, and indeed all of us, have the painful state of wanting suffering to be gone. Meditation introduces us to our suffering time and again. Only the determination to accept what comes, exactly as it is in our bodies and minds, leads us to see that the wish for what is to be different is dukkha itself. Accepting our whole being as it is—its pain, physical and psychological elements—is the beginning of equanimity.
You seem to have an idealized notion of monastic life, as if leaving everything that is difficult about your present life and just devoting yourself to meditation would somehow relieve your difficulty. But as the saying goes, “Wherever I go, there I am.” The reality of monastic life includes strict inner and outer discipline, little sleep, simple food and much work on every level to benefit all beings, to help us realize no-self, interdependence and dependent co-arising. It does not preclude depression—we all come with our inherent tendencies. Poor memory, apathy and inability to concentrate are symptoms of depression. It’s hard to pay attention when you are depressed and worrying about your mind ending up as mush. On a strictly practical level, you might want to ask your doctor if the prescribed dose of antidepressant is adequate, or explore with your teacher or therapist whether there may be difficult emotions which need your kind attention and care underneath the depression.
Traditionally, in addition to becoming aware of the existence of such feelings, the Buddha taught the practice of meditating on the four immeasurables to help us with such feeling states—not so much to eliminate them as to show us we equally can have feelings of loving-kindness, compassion, pleasure in other people’s happiness and equanimity. We can learn that it is possible to work with our anger and fear rather than pushing them away or being ruled by them.
You and your life as it is need loving attention. If you sincerely ask for help it will come, though perhaps not as you expect. You don’t mention your teacher or a similar connection. Dharma friends can offer real direction and an opportunity for you to discuss your concerns, face-to-face.