Updated: Sep 14, 2019
By Dr. Phang Cheng Kar (M.D.),
First published in Eastern Horizon (September 2011).
I am not crazy!
Should a person with mental illness meditate? This is one of the often asked questions that I face in my effort to promote mental health education in the Buddhist community. At a glance, you may think that this article has nothing to do with you, “I’m interested in Buddhist meditation, but I’m not crazy!” In the last Malaysian National Health & Morbidity Survey (2011), it was found that the prevalence of generalized anxiety disorder, major depressive disorder and suicidal ideation among adults was around 2%. As for children and adolescents, 1 in 5 had significant mental health problems. Not surprisingly, whenever I give sharing in Buddhist temples or centers, I often meet people with psychological distress. No, I definitely do not mean that you are crazy: this is such a derogatory and stigmatizing term. What I mean is many of us in the Buddhist community do have mental health or emotional problems, and a significant number would have been diagnosed with mental illness if we had sought help from mental health professionals. Of course, many people never do so due to lack of awareness on mental illness and social stigma. Hence, this article may be of relevance to you.
What is mental illness?
Other names for mental illness include mental disorder, psychological illness, emotional sickness, etc. It is basically a group of psychological conditions, e.g. major depressive disorder, generalized anxiety disorder, schizophrenia, bipolar disorder, etc., that negatively affects the way we think, feel and behave, to the extent that it seriously interferes with our daily functions in life. This includes our spiritual pursuit and meditation practice. As the mind is closely connected to the body, mental illnesses are also medical conditions that affect our brain functions and physical health.
For easy understanding, mental illnesses are divided into two big groups: psychotic disorders and neurotic disorders. Psychotic disorders, e.g. schizophrenia are characterized by bizarre signs and symptoms, e.g. auditory and visual hallucinations, paranoid ideas, feeling of being possessed, odd religious beliefs, talking non-sense, abnormal body movements or gestures, violence, etc. Neurotic disorders are less severe and include features such as excessive sadness, fears and worries, loss of interest in life, sleep difficulties, significant appetite and weight change, irritability, unexplained tiredness, poor concentration, feeling useless and hopeless, suicidal thoughts, etc. How do we know whether we may have a mental illness? If one has some of the symptoms, having them almost every day for two weeks or more, and they are disturbing your daily functions (e.g. difficulty at work, unable to study or cannot manage household), it is a good idea to consult a mental health professional for clarification and assessment. You may email me at email@example.com for information on where and how to do that.
As mental health awareness in Malaysia is still in its infancy stage, I have repeatedly seen people with mental illness who had sought help through a psycho-spiritual pathway, e.g. meditation practice, instead of consulting mental health professionals such as psychiatrist, clinical psychologist and counselor.
This is understandable, and it is probably a useful community-based mental health strategy in Malaysia whereby mental health services are relatively scarce.
However, when people meditate with wrong attitudes, they are bound to worsen their situation. It gets worse when there are unrealistic expectation, and ignorance as to how meditation can interfere or worsen the existing mental illness. One also may not know how to adjust their meditation practice in a way that is helpful for the mental illness.
What is meditation?
The word ‘meditation’ is now very popular and used with diverse meanings. From a Buddhist perspective, meditation is described as mental cultivation or bhavana. It is a mental training to develop spiritual wisdom and positive mental states such as composure, confidence, loving-kindness, compassion, and appreciative joy. Common Buddhist meditation methods that you may have come across include Vipassanā /Insight /Mindfulness Meditation, Loving-kindness (Mettā) Meditation, Breath Meditation (Anapanasati), Medicine Buddha Visualization, Tonglen Compassion Meditation, etc.
Recent scientific research by Dr. Herbert Benson (Relaxation Response), Dr. Jon Kabat-Zinn (Mindfulness-based Stress Reduction - MBSR), Dr. Mark Williams (Mindfulness-based Cognitive Therapy - MBCT), etc. has supported the effectiveness of the meditation-based program to overcome stress, anxiety, and depression. The local MINDFULGym program that I have developed has also been found to be beneficial for medical students in coping with stress in their studies.
So, Buddhist meditation can be a helpful option for overcoming stress, anxiety, depression and to complement the treatment of physical and mental illnesses. However, it should be done correctly for optimal benefit.
The following points are guidelines for those who have or may have mental illness and wish to try meditation for mental health and wellness.
Meditation & Mental Health Guidelines: