Can antidepressants help or hinder waking up?
In some ways the dispute over antidepressants recalls discussions about “talking therapy” in the fifties and sixties. The analysts, who then ruled psychiatric departments - and who were supposed to perform miracles - remained aloof from the dirty work of medication, considering drug prescribing a breach of the sacred analytic relationship. In the same way, in Buddhist circles ten or twenty years ago, practice alone was supposed to be the antidote for all ills. “I think today we’re more mature than we were in the love-is-all-you-need seventies,” says Boorstein. “We have a more realistic idea of what a practice can and can’t do. It doesn’t transform the personality. If you were shy, you’re still going to be shy. If you have a short fuse, well, it might get a little better. But you’re not going to fly.”
There is a taboo around antidepressants among Baby Boomer Buddhists. (Three people interviewed here, for instance, chose to remain anonymous.) Often, the taboo reflects a lack of sophistication about brain science. In contrast to the longstanding (and flamboyant) association between Buddhism and the arts in America, science has not been a traditional Buddhist stomping ground - though there are signs that this is no longer true.
Another entrenched Buddhist taboo concerns a certain type of emotional self-involvement, the promulgation of one’s “personal story.” “A lot of Zen teachers think you should never talk about your emotions,” says John Tarrant of Sonoma County, California, roshi of the California Diamond Sangha and author of a recent book, The Light Inside the Dark: Zen, Soul and the Spiritual Life (HarperCollins). “That’s very common, the idea that they are a distraction.” Traditionally, Tibetan lamas, too, have been oblivious to a personal interpretation of psychological pain, according to Gelek Rinpoche of the Jewel Heart Dharma Center in Ann Arbor, Michigan. He himself used to have reservations about antidepressants until he saw how much some of his friends were helped by them. “Mental suffering is real suffering, sometimes more powerful than physical suffering,” he says. “I am talking about the suffering that is mentally and psychologically experienced by the individual, rather than universal suffering. The older generation will ignore it, but one should not ignore it or deny it.
“Teachings and practice can help you,” he adds, “but using dharma to affect a chemical balance is the long way round; it can be too late for some people. When there is a chemical imbalance in the body, it is a good idea to work with that chemically.”
Psychopharmacology is still an inexact science, yet rather than obscuring the true nature of mind, Prozac (or Prozac consciousness) may do just the opposite. Like mindfulness meditation, neuropharmacology, which deals with the action of drugs in the nervous system, reveals to us a mind that is not a fixed entity but an ever-flowing succession of states. Author Paul Fleischman of Amherst, Massachusetts, who is a psychiatrist and vipassana teacher in the tradition of S. N. Goenka, tells me that, “Buddha used the term asava, meaning flow. Our mental life is based upon flow, he said, and he meant specifically the flow of particles. Our body is composed of particles, and our thoughts and feelings are based on changes in the flow of these particles. He [Buddha] was meditating and he figured that out.”
A few decades ago, neuroscientists were dealing with a brain that was primarily neuroanatomical/mechanical, with neat contour maps of “centers” for speech, vision, language, rage, and so on; it might have been complicated, but with time and effort, neuroscientists felt, we could deconstruct the wiring and figure out which switchboardlike connections went where. The mind/brain was a thing, composed of hard, solid parts. A brief glimpse of modern neuropharmacology, however, plunges us into a microworld that is always in flux.
Not so long ago, there was one known serotonin receptor; then there were three; now there are new ones being discovered practically every day. The receptor molecule - often depicted inaccurately as a “lock” opened by the perfectly shaped “key” of the neurotransmitter—is not a hard, solid thing but a fluid shape-shifter; every time you throw a molecule of a drug (like Prozac) at it, it is changed. Under the influence of the ceaseless ebb and flow of a hundred-plus chemical transmitters (most of which are still unidentified), the mind is much more like a river—Heraclitus’s river, which is never the same river twice—than, say, a computer. When we meditate and watch our thoughts arise and die away, we may be actually observing the higher-level “readout” of fluctuations in concentrations of serotonin or norepinephrine or glutamate in the synapse, the opening and closing of minute ion channels, and so on.