Dear Abbey Dharma Winter 2010

Dear Abbey Dharma,
My doctor has suggested that I try a certain psychiatric medicine, but I want to meditate and I am wavering because I wonder if people can “wake up” or even get enlightened using these medicines.
—Wavering

Dear Wavering,
I’ve interviewed many students on meditation retreats whose practice is insightful, and therefore more personally liberating, who take a psychiatric drug that has been prescribed by their physician. Since there are many medicines that fit into the category of “psychiatric drugs,” there isn’t a simple answer to your question. Here are a few ideas that may help you in making your decision:

Please do not confuse the Buddha’s injunction against “intoxicants that cloud the mind and lead to heedlessness,” the fifth Buddhist precept, with the use of legitimately healing drugs that address medical problems. The Buddha certainly supported taking medicines to alleviate illness.

You and your physician can discuss whether the medicine she is prescribing for you addresses a serious psychiatric illness that might include the inability to function reasonably well in life— to work, form relationships, or perceive reality appropriately. The specific medicines for such illnesses are often effective, but meditation, especially intense meditation on a retreat, can be upsetting and destabilizing. I would, if this were the case, take the prescribed medicine and use life itself as the arena for developing inner awareness. If your physician feels that you do not have a serious psychiatric illness, but rather are suffering from a neurologically based disability such as obsessive-compulsive disorder, attention-deficit disorder, or chronic depression, you might consider one of the recently developed medicines that specifically address these conditions. The test for the efficacy of these medicines is empirical: people feel either that they think and process material in a more stable, focused way or that they don’t. Psychoactive drugs need to be prescribed and monitored by skilled psychopharmacologists. They have few, and seldom serious, side effects. One friend of mine, my age and a meditation practitioner for decades, says, “Before my medicine, my mindfulness helped me cope better with my cyclical depressive episodes. Since the medicine, I feel as if I have taken a heavy backpack off and my progress in insight has actually begun.”