Welcome home! Please contact lincoln@icrontic.com if you have any difficulty logging in or using the site. New registrations must be manually approved which may take several days. Can't log in? Try clearing your browser's cookies.
The Hindrances and Mental Illness
AllbuddhaBound
Veteran
What mechanism hinders the mind when we consider bipolar disorder? The pat answer is "chemical imbalance" but there is also more to it. It is more than a series of chemical reactions. There are attitudes, feelings and beliefs that aggravate illnesses such as this. How were people treated for illnesses such as bipolar disorder by the Buddha? Was he at all effective with these people?
In many ways, enlightenment is the exact opposite of mental illness. Can a mentally ill person become enlightened?
In many ways, enlightenment is the exact opposite of mental illness. Can a mentally ill person become enlightened?
0
Comments
unless the cause of the chemical imbalance is physical (birth defect or head trauma) then one can rewire his brain eventually and address the cause of the chemical imbalance.
(actually even with birth defects and head trauma, sometimes one can possibly make great progress as the brain is very flexible and adapt, modify itself in incredible ways.)
"Can a mentally ill person become enlightened?" That depends on what you call "mentally ill". I invite you to read this:
TRANSCENDENTAL<o> </o>EXPERIENCE IN<o> </o>RELATION TO RELIGION<o> </o>AND PSYCHOSIS
http://www.mindfire.ca/Transcendental%20Experience%20in%20Relation%20to%20Religion%20&%20Psychoses.htm
And finally, I think there is a mental health thread somewhere else on the site and this may be better to post over there.
Buddah abandoned his royal life and family to leave for monastery. That must seem like na insanity to people around. If one have taken a mental illness to be something very different from "ordinary" people, there would be no way for those mental sicks to get the enlightment. I do not thinl mentak ilness should be distinguished from "ordynary" states, therefore find no hinderance to bipolars as for Buddhist enlightment. I even like to say, without having suffered from mental ilness, one does not get the enlightment, as he does not knowv ture suffering.
my view. namaste.
There is no reason that I can see that someone who is successfully treated for mental illness should not achieve enlightenment.
In many respects I would suggest that all unenlightened people are 'mentally ill' being gripped as we are by delusion - whether we are Buddhist or not.
metta
However, I really do not think it is a condition that can easily be controlled through brunt force mental focus. It is caused by chemicals in the brain. The causes (in a karmic sense) of the chemical imbalance seem unskillful to contemplate.
The behaviors of the "up" persona I would classify as empathically unmindful. There is a lot of joy, and it leads into many exchanges of sense pleasures. Because there is so much internal, unfocused or uncontrolled energy, there is an ignoring of the connections in the external, and often there is a steamrolling effect to the phenomena in the outside. People, conversations, experiences are all "moved through" without really hearing, seeing, or being conscious that the other part of the experience is "real." I'm not fully doing it justice, but I also wish to be concise.
Then, when they go down, the experiences they are having all seem painful. Its as though the steamrolling effect of the up time collapses into a backlash of being steamrolled. They seem to have much less internal drive, and get a serious case of "I-dont-wannas." Instead of each experience being over saturated with a projected "beauty and sparkles" it is projected with an equally potent "needles and thorns". This isn't just that they are thinking about it poorly, but the actual experience of the stimuli seems to carry the energy of the pain... the first arrow of simple stimuli like a phone call carries the pain... not just the second.
There are also nearly uncontrollable, non-stop ruminating thoughts with both phases, which I am sure helps carry the imprints on and on.
In working with the bi-polar, medication has been the greatest help. Through sitting meditation (although one prays instead of stillness) it seems the projections can be lessened, so when an episode of downs comes up, there aren't as many thorns. The problem I've found is that being up seems to correlate to being down, and I have yet to see a bi-polar stop wanting to be up. It is claimed to be very fun, and because it happens without an external drug, isn't as easy to renunciate.
Just my 2 cents anyway.
With warmth,
Matt
With all due respect, according to the best science, this is just incorrect.
It is possible for chemical imbalance to be the result of "poor mental habits", but this is by no means the general rule. Lack of sunlight, lack of certain foods and vitamins, isolation, sensory deprivation, and other physical factors can also lead to this type of chemical imbalance. But, unless it is to be classified as a birth-brain defect, some people's brains just do not produce enough serotonin at certain times of their lives, as well as other chemicals that produce mental stability.
There are just some mental states that people can't meditate their way out of. Good "mental hygiene" can help some people who are prone to depression stave off the effects, but in many cases it's just a lack of chemicals or an imbalance of chemicals. That's what the best science says so far.
yes. but it is how one react to these factors based on their conditioned emotional reactions that can create problems or not.
yes i mentioned this. I did not address how to get out of this problem.
nor did i suggest that "people can meditate their way out of it."
yes, many cases... I do not deny this. I agreed to this.
but which one is difficult to determine.
There is also numerous cases of people with life long crippling depressions, and state diagnosed as bi-polar who found permanent liberation from their "mental illness"... and based on the new movement of research and implementation of meditation as a mean to modify how one see or define himself, all around the world, many more will find liberation or great improvements.
I don't think we follow the same news on science...
I guess you are referring to general population practice?
Yes. And I'm willing to let it go at that.
This is just my opinion, but only a person who has never really been depressed would doubt that it has a chemical basis. If there's something inherently wrong with the chemical substrate, then the person feels terrible. The best treatment, according to the best science having to do with the general population, is antidepressants coupled with cognitive therapy. If meditation can be considered a cognitive therapy, that is, a type of cognitive reframing, then there's that. But people can be born with a predisposition to having their brains not produce enough serotonin or improper amounts of dopamine, and this chemical imbalance has to be corrected before the person can progress. In less severe cases, only cognitive therapy can sometimes work. This is why I say that only someone who has never been really really depressed would believe that the chemical imbalance is secondary to the poor mental habits.
I guess I didn't "leave it at that", did I? I may be back later with more about neurochemical "rewiring", but for now I just want to leave the thought out there that although neurochemical rewiring based on meditative techniques and cognitive restructuring can help, this most often needs to be supplemented with medication, in the general population.
Parental bonding with a newborn is mediated by oxytocin, especially with mothers who choose to breastfeed.
Speaking as someone who has spent years struggling with depression, I completely agree with you. In my case the depression would hit in October and usually lift in April. With large amounts of vitamin D and a sun lamp I now cope reasonably well during the winter months. No amount of meditation would give me what my body needed.
The thing to understand my point of view is that you confuse when i say "chemical imbalance is the result of the problem, not it's source" with "chemical imbalance is secondary".
I guess i could say "chemical imbalance was not in many cases, the source of the original problem. It came as a result. But it became a part of the problem that need to be addressed with chemicals in many cases."
Unless the source of the problem was a birth defect (including genes, dna...) or body trauma.
how's that
I would not think that no matter what is the position of that person on this issue.
Leave a little window open for doubts.
As i've read you just discovered Buddhism, you may be surprise to find life long problems eventually just dissipate with practice.
But if you hold onto an idea that something is entirely impossible, it may very well remain impossible for you until you begin to loosen up that view.
Just keep a "maybe" or a "I'm pretty sure that this is true but..." in there perhaps?
We pretty much say the same thing and have the same position;
but even if it is entirely not your intention, i believe that phrasing it the way you do can often lead to so many people just strengthening their view of themselves and their situation to the point where their mind become entirely closed to the possibility that perhaps, just perhaps, there is a chance that they may overcome their illness... which technically is a very real possibility for many people suffering from these common illness (not all, we agree).
Their minds just use this information like a cane to lean on to... "well see? there's nothing i can do about it!" so perhaps delay or even undermine entirely their progress.
I have been diagnosed with Major Depression and Bipolar II (depressive). I have received extensive treatment for both (the treatments are different, and for the record treating Bipolar as you would treat Major Depression is a huge no-no). I have made several suicide attempts and exhibited classical symptoms for multiple years consecutively. I only mention all of this to establish my pedigree as someone who has a personal experience of depression.
I don't believe that the fundamental issue is chemical. We can all probably agree that it is the current predominant thinking in science and medicine, but I think it is important to ask some critical questions.
For instance, how is seratonin measured? What impact does an increase or decrease of 10% of seratonin have on diagnosis of depression (ignoring the more important question about impact on mood)? Why has the diagnoses of depression skyrocketed since the development of a myriad of pharmaceutical/medical solutions? What percentage of diagnosed patients fall out of the requirements for diagnosis with medical treatment?
Now substitute meditation where appropriate in the last paragraph.
I am no medical expert, but I have spent years allowing half-baked theories to have a devastating impact on my life (and the lives of my loved ones). This is a science in it's infancy...the brain/mood is still largely a black box to science and medicine. What is offered as treatment today is a transitory effort, but it does not (in my opinion) offer any real answers as to cause or clear answers as to treatment.
We should also remember that there is considerable commercial support for these chemical theories. I am not saying it is a conspiracy, but given the structure of American medicine, can we really trust the press releases and advertising? Even studies are regularly bought and sold.
When any person claims that depression is caused by x or y and should be treated by a or b, I question it. I have to reference my personal experience, and in that I see compelling evidence that the answer to this question is: unknown.
Hmm actually, it seems we've gotten a bit off topic... and maybe I don't want to contribute to that.
I don't really know much about bipolar disorder, but I've found Buddhist philosophy to be a good way to work with anxiety and depression. Sometimes, when I'm at my worst, I end up feeling more compassion than at any other time. I can take the pain and turn it into something good. And I really like what nescafe said, that someone who has not suffered mental illness cannot achieve enlightenment, for he has not known true suffering. It really can be used as powerful motivation to practice. I remember once, being in my apartment, terrified at one thing or another, just having puked due to a panic attack, and I said to myself, "nothing can possibly be worse than this." And I think I was right.
On the other hand, if you're talking about a mental illness like skitzophrenia, which I don't know much about, it may not be possible, no. I read once that we are luck to be born healthy, with a working mind and body. This implies that without a properly functioning brian, we cannot proceed.
Genes and DNA.
Just a story, really.. I happen to be Irish-American, and it is fairly well known that the Irish have a predisposition to depression and more so to anxiety disorders, as do some Scots.
I was talking with a psychotherapist the other day and telling him about how my brother jokes about having Attention Deficit Advantage. The therapist replied by pointing out that we are descended from hunter-gatherers, and some people are hunters and some people are gatherers. With a heavy genetic load of Viking Norse, and to a certain extent Celt and Gael, it makes perfect sense that those of us that are descended from "hunters", or conqueror-warring types, would tend to be more high-strung and therefore more susceptible to maladies like anxiety disorders and depression.
Genes and DNA is my point. For some reason, serotonin-reuptake inhibitor medication makes us feel better. It would follow that the level of serotonin in the brain is therefore elevated, although the level of serotonin cannot be directly measured. Nobody really knows.
There are theories that have come up in the past few years that it may not be a direct serotonin vs. less serotonin question, but the size of a structure in the brain known as the hippocampus. It's interesting to note that meditators can actually increase the size of their hippocampus, and theoretically therefore its functioning, but serotonin reuptake inhibitors also seem to help increase the size of the hippocampus. Both of these phenomena were discovered by Dr. Richard Davidson of the University of Wisconsin at Madison when he was studying the size of the hippocampus in meditators and also had to have some control groups.
But genes and DNA is my point. If those are to be considered birth defects or birth phenomena, that's an easy enough point to grant. If someone has a genetic predisposition to depression (as dictated by their DNA), then rewiring by way of meditation or cognitive therapy can only go so far, and sometimes the antidepressant medication must be taken first to help the person be able to participate in whatever adjunctive therapy is thought to help.
I would classify this as a different attribute, not a disfunctionnal one.
Many people with this attribute did not develop the reactive emotional conditionnings that lead to a depression or different mental illness.
it just mean that these said undesirable reactive conditionnings will have a greater negative effect.
having said that, it still doesn't mean that i disagree with this: because i do agree with this.
However, if someone is just acutely depressed because of situations or old pain they carry with them, cognitive and/or behavioral therapies have been quite successful.
I find the attitude of "I was depressed, and I am unconvinced that my depression was chemical, therefore all depression is not chemical" to be short sighted. Studies show about 10% of depression is clinical (biological).
much of theses studies are quite debatable (and did raise many debates in the past).
As far as i know about this, first you must consider that mostly these studies were intended for very serious depressions; not the % of diagnosed depressions.
Which might be perhaps only 5% of the total diagnosed depressions.
Then (again as i understand), you must consider what you called a chemical depression.
Many of the studies did not (could not) make a difference between a brain that was earlier healthy, but have evolved to become chemically imbalanced (the opposite of what meditation do) to those who have some kind of birth defect that prevent them from having a healthy brain, and the endless variences inbetween.
I believe that there are chemical depression, just not as many (as defined by me) as it is commonly believed.
with love
patb, Several points: 'Most studies for very serious depressions, not the % of diagnosed depression'. There are no established criteria that are used to quantify the severity of depression for either treatment or research purposes. What researchers may do is include those who have had depression for a set period of time or include only those who have had hospital admissions. Unfortunately both of these criteria are subjective in that they do not reflect the severity of depression, they reflect the decisions made by clinicians. As for your assertion that 5% of diagnosed depression is 'severe' I would be very interested to hear what you base that on - do you have any research that you could cite to support this?
In addition, I am very unclear as to what you mean in your final point. You seem keen to make a distinction between brains the develop depression as a result of experiences and brains that have a 'birth defect'. I am also unclear about what you mean by the term 'birth defect'. However, you then contradict yourself by referring - correctly as it happens - to the continuum existing between the position that depression is inherited and the position that it is learned; which is what I think you mean by 'endless variance inbetween'.
Finally patb, I've given some more thought to your assertion that a person with depression (or any mental illness) can 'rewire their brain' and overcome it. Something that we have discussed before. Your statement is similar to the following:
An engine does not work.
The engine is seized as a result of not working.
A seized engine cannot work.
Working the engine will overcome the seizure.
All you have to do is to work the engine.
But the engine cannot work with a seized engine.......
This can be applied to your belief about rewiring a brain:
The person is thinking 'depressed thoughts' and having faulty beliefs.
The neurochemistry is imbalanced as a result of these thoughts and beliefs.
Imbalanced neurochemistry produces depressed thoughts and faulty beliefs.
Balancing the neurochemisry will overcome these thoughs and beliefs.
All you have to do is think healthy thoughts and right beliefs.
But the person cannot think healthy thoughts and right beliefs with imbalanced neurochemistry.......
I hope you see the problem. As a psychologist and a person diagnosed with depressive disorder this issue is an important one.
metta
There are alternative approaches which have proven to demonstrate a lot of efficacy. A number of thinkers are of the opinion that the medical model is "one way" to treat mental illness but there are others and many of them suggest acceptance is a very important key.
I believe it is short-sighted to assume that anyone who has experienced a mental illness such as bipolar disorder knows that it has a chemical basis and must be treated as such.
The link contained here demonstrates that many who suffer from the disorder or treat the disorder, make no such assumptions.
http://mybipolarreadinglist.blogspot.com/
The person is thinking 'depressed thoughts' and having faulty beliefs.
The neurochemistry is imbalanced as a result of these thoughts and beliefs.
Imbalanced neurochemistry produces depressed thoughts and faulty beliefs.
Balancing the neurochemisry will overcome these thoughs and beliefs.
All you have to do is think healthy thoughts and right beliefs.
But the person cannot think healthy thoughts and right beliefs with imbalanced neurochemistry......."
This is what I have been trying to say, and only this. I guess it comes down to a matter of the individual and their choice to take antidepressant medication or not. I chose to take antidepressant medication and it worked for me, and now, to the extent that I can meditate and do other forms of practice, I do.
I just don't think anyone should be discouraged (by another person) from seeing antidepressant medication as a possible alternative. It's very much a life-and-death decision and anyone seeking advice about it should be offered a balanced perspective.
Depression involves great pain and the distraction that comes with it. A person must alleviate the great pain before they can practice, unless they are a truly advanced practitioner. Expecting feats that only a truly advanced practitioner can do is too much.
Its really only a general statistic, but I was saying about 10% of diagnosed major depressions are found to be related to biology. I read it in one of my textbooks for class, but looking around on the internet to substantiate the stat has proven unfruitful. I retract the number, but the assertion remains that there are definitely chemically related depressions, but most depression is based of situational experiences and perceptions.
With warmth,
Matt
If you clean them up, one of them can be fixed and work properly after.
The other cannot because one of the mechanical part is defective and cannot be repaired.
the "in between" that i was referring to is those whose every parts were fine in the beginning, but years of working improperly have damaged one of the parts beyond repair.
example would be an Atrophy of the hippocampus, like seen in life long drugs abusers.
I think it would be good to lay things down and agree on terms..
All depression are chemical.
of those you can divide in 3 sections,
a) some would experience normal levels of hormones etc... if only the reactive emotional conditioning would be removed.
b) some would not experience normal levels of hormones etc...even if the brain were "formatted" because the brain has evolved to produce abnormal levels of hormones.
c) some can now only experience abnormal levels of hormones because the brain is physically incapable of producing normal levels not matter what.
depending on the severity of the depression, many could potentially benefit from medication to get them in a state where they can work on themselves.
a) b) have the potential to be able to overcome their condition and eventually walk away from medication.
some of b) can eventually "evolve back" and not require medication anymore.
c) will require medication forever to be able to achieve reasonable levels of hormones.
a) b) are the very vast majority of diagnosed depression.
many in the b) category, with severe depressions that lasted for decades, managed to overcome their depression without any medication. I'm not saying this is possible for all of the b) category, or that it was the best method to do it, all i'm saying is that it can be possible in some of these case, possible but extremely (unnecessarily) difficult for many in this category.
If the meditation is successful and the person can change the way he sees himself and how he relate to the sensations and the feelings in his body ("I'm stressed out" become "there is a tension in the abdominal area")
Then all will benefit greatly from Buddhism.
This is where it all start for everyone. Many begin their journey from the bottom of the pit, they have barely any serotonin to work with, but learn to be at peace with the way they feel and the state of their body and mind right now.
c) is the only one where we can say that the source of the depression was the chemical imbalance. and even then this is debatable.
Abnormal levels of hormones does not necessarily mean depression.
A depression require suffering. There is no suffering if one can relate to the sensations/his reality in a detached way, there are only sensations.
now the main issue is about drugs.
The problem is how one react to drugs.
- Some get enormous benefits, the drugs allow them to get in a state of mind where they can work on themselves and greatly reduce the suffering in all category a)b)c).
- Some react differently, they can get in a state of mind where any work is almost impossible.
Zombie, extremely foggy type of mind.
But some do require medication, even if it puts them in a position where they cannot work on themselves because if they don't, they will be a danger to themselves.
I still don't know what you mean by 'birth defect' in relation to depression. Are you talking about inheritance? Or are you talking about a neurological deficit that is present prenatally or are you talking about an acquired brain injury either during or shortly after birth? If the former, then there is some (mixed) evidence regarding inheritance and certainly genes seem to play some part.
I'm glad that you made the point that all depression has a neurophysiological foundation as this is the point that I was going to make to aMatt regarding his distinction between 'chemically related' and 'situational' depression. I think he was referring to endogenous and reactive depression, but even so both have a neurophysiological basis - whatever their aetiology.
I'm afraid however, that you have contradicted yourself again, as you say at one point 'all depression is chemical' and then later 'only in (c) is .....the source the chemical imbalance'.
I think that the difference between us arises from your belief that people make themselves depressed by their own thoughts and beliefs and that this precedes neurotransmitter imbalance. I however think that although cognitive styles and beliefs may contribute to the development of depression; depression itself is a result of neurotransmitter imbalance. Hence your belief that the majority of depressed people can 'think themselves well' when ill. This is of course what your assertion means.
Whilst cognitive therapy can help some people with mild to moderate depression it has not been shown to be effective with severe depression, or in the longer term. Indeed, it has been extensively critiqued as superficial and ignoring important underpinning contributors to depression such as neurophysiological, developmental, intellectual, social, cultural and historical factors. It also ignores personality and unconscious factors. It has been likened to applying a bandaid to a broken leg.
If you expect people to walk, then they need the leg fixed. If you want the engine to run, you have to oil and repair it first. Of course, there will be further work to do, but you're not going anywhere until this is done!
You are right that some people need medication long term. What is important is that at the moment we lack the ability and evidence in order to identify those groups. It therefore seems a little harsh to say to large numbers of suffering people (the majority of depressed people, as you say in your post) - you don't need the drugs, you are responsible for your illness, you can get better through Buddhist practice alone - when we don't know whether that is true for that person.
This is why advice and decisions regarding the treatment of depression is best left to the clinicians treating the person, rather than being served up as 'one size fits all' on an internet forum. I think that a similar principle also applies to the question of whether a person either can achieve enlightenment or has achieved enlightenment. Mentally ill or not!
metta
Well put. I just think it does a disservice to people that really need medication, and to people that really should seek professional help to determine whether or not they need medication.
Not sure why you are questioning or making a point of this.
Perhaps you want me to use more sophisticated terms?
I admit that i suspect a bit of bad faith on your part.
Forgive me if there is none.
I don't believe that I contradicted myself. I believe that if you read carefully my last post, you will understand my position.
indeed this seems to be the case,
but what is the cause of the neurotransmitter imbalance?? this is me point.
also that the same neurotransmitter imbalance in another human will not necessarily lead to a depression.
Well if you want to reduce the entire Buddhist practice, the changes in the deepest level of the mind how a person perceive himself, how a person perceive and interact with his emotions, sensations in his body, how a person perceive and interract with his personnal reality from the deepest levels of the mind... changes and transformation of the structure of the mind in ways that classical psychology cannot even begin to consider or dream to achieve, if you want to reduce all this to "think themselves well", then yes this is what i mean.
well if it ignored personality and the unconscious mind, it wasn't a very good cognitive therapy now was it.
These are at the core of Buddhist teaching. Personality is the ego or false self.
Yes, i've made a point of stating exactly this... Why do you re-state this?
Again I must admit that i suspect a bit of bad faith on your part.
Arguing to try to make the other "look bad" as oppose to arguing on the content.
Forgive me if there is no bad faith on your part.
But i mentioned that it can be a wonderful tool for some.
But perhaps not so much for others who will experience negative effects of it.
It is phrased in this way to give hope, not to be harsh.
I find it much much harsher to say things that sound like: "your mind is messed up, you can try these little therapy and practice meditation a bit but don't expect too much... your mind is messed up and there is probably nothing you can do about it." of course. but one should choose his physician wisely and advices on an internet forums can certainly help much with this.
As a side note, I'm certain that you would agree that many physicians know nothing of the mind... and prescribe drugs.
with love and good faith
The cause of the neurotransmitter imbalance is often genetically based, and something over which the person experiencing the depression has no control whatever. This is why a person must wisely choose an appropriate physician or mental health professional to help determine whether or not they need medication in order to be amenable to non-medication-type therapies.
No bad faith on my part.
It would seem that you are expecting people who are ill, to engage in Buddhist practice that is beyond most of us when well and in living a non monastic life! Don't misunderstand me, I do not mean that it is not possible, but rather that it is very, very difficult even for those who are not mentally ill.
Are you aware that the long term neurological changes that I assume you are referring to when you say 'rewire your brain' have only been documented in advanced, long term meditators? Long term means over 10 years and in many cases 25 years of monastic practice. There are short term changes in, for example the activity of the frontal lobes, but whether this is maintained or linked to depression is debatable.
I am not disputing the usefulness of Buddhist practices for some depressed people. I am not disputing that some people can and do recover from depression without medication and with Buddhist practice.
What I am trying to say, but perhaps need to be more direct about, it is that the way you phrase your posts and write about this issue is simplistic at best and insulting to those with depression at worst.
Thank you for the opportunity to discuss this.
metta
While certainly anecdotal, please consider it one data point in contrast. I believe many others suffering depression could find benefit in lay Buddhist practice, and not requiring monastic dedication.
I'm not denying that Buddhist practice may be helpful for many and that some people do recover from depression using mindfulness and meditation; there is certainly plenty of literature supporting this. Nor am I suggesting that neurological changes only occur in monastics, I was simply pointing out that most of the studies use monastics and advanced practitioners, therefore it is unwise to generalise to the findings to other populations.
I'm very pleased that you have found practice helpful. I'm certain that many do, just as I have!
metta
http://www.amazon.com/Soteria-Loren-Mosher-Voyce-Hendrix/dp/1413465234/ref=sr_1_1?ie=UTF8&s=books&qid=1225654047&sr=8-1
The problem is, this form of treatment is not available and it did not get a chance to gather momentum because of the pharmaceutical lobby. It is not a good idea to go off prescribed medication and given the current environment, there are no viable treatment options that would permit it to happen safely.