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Dharma practice and mental health / bipolar disorder / schizophrenia Tom Tom 8/6/14 5:34 PM
RE: A dharma practice for those diagnosed with mental illness End in Sight 8/3/12 8:52 AM
RE: A dharma practice for those diagnosed with mental illness Tom Tom 1/11/13 9:56 PM
RE: A dharma practice for those diagnosed with mental illness End in Sight 8/11/12 2:20 PM
RE: A dharma practice for those diagnosed with mental illness Tom Tom 8/11/12 10:57 PM
RE: A dharma practice for those diagnosed with mental illness End in Sight 8/12/12 4:13 PM
RE: A dharma practice for those diagnosed with mental illness Tom Tom 8/20/13 12:18 AM
RE: A dharma practice for mental health Martin Sokolski 12/24/12 1:57 PM
RE: A dharma practice for mental health Tom Tom 12/25/12 2:16 PM
RE: A dharma practice for mental health Zoo Car 12/30/12 8:29 AM
RE: A dharma practice for mental health Tom Tom 8/27/13 4:16 PM
RE: A dharma practice for mental health R P 1/11/13 6:20 AM
RE: A dharma practice for mental health Tom Tom 1/11/13 2:59 PM
RE: A dharma practice for mental health R P 1/11/13 3:57 PM
RE: A dharma practice for mental health Tom Tom 1/11/13 9:58 PM
RE: A dharma practice for mental health Martin Sokolski 12/30/12 10:22 AM
RE: A dharma practice for mental health Tom Tom 8/15/13 3:14 AM
RE: A dharma practice for mental health Tom Tom 2/19/14 5:01 PM
RE: Dharma practice and mental health / bipolar disorder Clinton Tyler Patterson 4/3/14 9:22 PM
RE: Dharma practice and mental health / bipolar disorder Tom Tom 4/4/14 6:23 PM
RE: Dharma practice and mental health / bipolar disorder T DC 4/4/14 9:03 PM
RE: Dharma practice and mental health / bipolar disorder Tom Tom 4/5/14 5:59 AM
RE: Dharma practice and mental health / bipolar disorder Tom Tom 4/5/14 6:19 AM
RE: Dharma practice and mental health / bipolar disorder Robin Woods 4/5/14 7:10 AM
Some of the terminology in this thread may be confusing if you have not read the book "Mastering the Core Teachings of the Buddha" ( MCTB ) by Daniel Ingram.  A superficial knowledge of the terms used can be gained from reading parts of the book in the wiki or the acronym and terms thread: http://www.dharmaoverground.org/discussion/-/message_boards/message/3906614

The full text of the book MCTB can be found here: http://integrateddaniel.info/book/ 

A print version can also be purchased from the standard online stores.

A comprehensive table summary of the stages of insight can be found here.

**************************DISCLAIMER/WARNING:

This thread is provided for informational purposes regarding increased safety concerns and changes in practice to reduce danger. I took this thread down for 7 or 8 months or so due to the following reasons:

1. This isn't safe. The worse the illness is (or, at least, the worse the illness is when episodes are occurring) the less safe it is (particularly if psychosis/schizophrenia/psychotic features is/are involved). I have done as much as I can explaining methods to mitigate these safety problems, however, I cannot guarantee your safety even with these precautions. Please make sure to read the two links I have included as they represent the dangers very well.

2. I stated that the illness would be eliminated upon completion of all paths when in my case the mood disorder part disappeared but the psychosis part stayed and became more prominent (mild non-paranoid schizophrenia). On the other hand, I have been able to successfully treat the symptoms with vitamins/drugs. Since my manias were atypical to begin with, this is unlikely to occur to people without schizophrenic-like manias (people who experience "classical" bipolar manias or to people who just experience hypomania - bipolar II). In any case, any statement of "cure" is likely overly optimistic and changes to the mental illness post 4th path are unpredictable and unknown as this is frontier territory. There is likely to be a change in the presentation of the illness, but that change is, so far, unpredictable..I have found that most long-term meditation sittings have a significant danger of becoming psychotomimetic in individuals predisposed to psychosis and/or mania inciting in individuals pre-disposed to mania (particularly at the A&P stage). Risk of psychosis occurs at all meditative stages..I have put forth ways to mitigate this problem, below, by drastically reducing sitting times and significantly altering the meditative technique. However, this is not a guarantee of safety. The purpose of this post is to prevent people from practicing/meditating in the same way as a person would if they had no mental illness (since this, obviously, is even more dangerous). Please see the links for case history of dangers.

********************************************************************************************************************************

I am creating this thread to refer people to a source of information regarding the issue of mental illness (bipolar disorder and its variants) and HOW TO practice if that is the case/situation.

Searching through this forum there has been much discussion about the dangers of dharma practice for those diagnosed with certain forms of mental illness (as well as for those who are not) and was the impetus for the big WARNING at the top of this forum. Given that some people, such as my former self, might try to go for it anyways, they might as well have a source of information here about how to practice, and succeed.

See below quote:

"Froth, disregarding my issues with meditation for the moment, what should be done when someone comes in complaining of depression and depersonalization and gets diagnosed instead with dark night and a glimpse of 'no-self'? There's a huge amount of overlap in symptoms when you compare conditions such as bipolar, schizophrenia, borderline personality disorder, etc with effects of meditation practice. And what about when these people are told to 'keep meditating', and 'go on a retreat for a week', and they end up in a psychiatric ward or dead? Who's there to pick up the pieces? I realize I misrepresented Daniel at the start of the thread. Beo also pointed this out. Sorry Dan. To me the degree of risk seems very high to not have it plastered in big letters at the top of the home page. That's what I want."



As someone who is a practitioner that has done/completed the stages of insight to a fairly high degree (still between 3rd/4th path - still cautious about claiming 4th) and had been "diagnosed" before starting practices with "bipolar w/ psychotic features," has been in psychiatric wards before starting any practices, been in psychiatric wards due to practices, and despite these challenges/difficulties has concluded that practice is still MOST definitely worth doing.

I feel there are some very signficant differences in practice that need to be taken for someone in these situations, but it is still very possible to be brought to the highest degrees of realization/awakening as well as the EVENTUAL likely elimination or alleviation - whether medications needs/chooses to be continued or not) of the diagnosed illness (to which I will offer various theoretical reasons as well as my own personal experience). However, the degree to which the "illness" will be absent will depend on the degree of progress. (EDIT: While there may be changes to the illness post 4th path, they are unpredictable. See the new disclaimer at the top of the post).

However, the practice requires a significant deviation from what is done on retreats/at the dharmaoverground/in mctb/or any other intensive meditative practice center. FOR SOMEONE WITH MAJOR MENTAL ILLNESS: DO NOT DO EXACTLY WHAT IS WRITTEN IN MCTB/MAHASI SYADAW PROGRESS OF INSIGHT. DO NOT GO ON A RETREAT!
For a history of these issues see the following posts (which in and themselves contain more than enough descriptive information to show just how dangerous these practices can become if the advice in this article is not followed).

http://www.dharmaoverground.org/web/guest/discussion/-/message_boards/message/3142129

url=http://www.dharmaoverground.org/web/guest/discussion/-/message_boards/message/1032824

Also check out a relatively old discussion started by Daniel on Bipolar Disorder and the stages of insight: http://dharmaoverground.org/web/guest/discussion/-/message_boards/message/105357;jsessionid=FACEC1C4B8678147CC1F41742896E409?doAsUserId=U4FYRpmIICQ%3D

Admittedly these posts, despite their dramatic intensity, only contain a very small fraction of my experiences during several acute states of psychosis both as a result of too much intensive meditation after starting practices and before knowing what the dharma was.

The fact that I came out alive and thriving has to do with several factors: The ability to bounce back very very quickly (due to an understanding of dharma (or Buddhism) - whereas before knowing dharma I would never recover at all), products of my personality that involve a non-violent disposition, psychosis that retreats inward rather than outward (meaning it, for the most part, despite intensity, didn't involve interfering too much with other people and had little bleed-through). Little bleed-through both in temporal terms (I wasn't "traumatized" by any of it), and in interpersonal terms (I mostly kept to myself during these times).

The goal here isn't to get people to have these qualtiies, but to become awakened with no resultant manic/psychotic episodes at all - by approaching practice in an entirely different manner.

My working hypothesis for someone with bipolar disorder/schizoaffective is that mania/psychosis would be the only danger of practice, and clinical depression would not be a danger unless one STOPPED practice. Though passages through the dark nights may mimic some outward signs of depressed behavior, the internal experience would not be the same as clinical depression if one keeps practicing.

Therefore, clinical depression is not mentioned much in this article as I have not experienced clinical depresssion since starting a meditation practice and at this point can't imagine ever experiencing it again though my memory banks have in them some very severe instances of it before encountering the dharma. However, this does not mean that I never experienced moments of "depression/sorrow" (not clinical depression) during practice, just that these moments were very brief and passed quickly without lingering around and turning into a clinical syndrome.

I'm going to detail a practice starting from the beginning:

Before starting practice descriptions I will talk about an important philosophical point:

There are two extreme types of mentally ill individuals:

-The mentally ill individual that completely denies the psychiatric system to their detriment.
-The mentally ill individual that completely embraces the psychiatric system to their detriment.

I would recommend staying out of both of these extremes.

In the second category people say I AM A BIPOLAR TYPE II RAPID-CYCLING WITH DISASSOCIATIVE/DEREALIZATION TENDENCIES AND MELANCHOLIC FEATURES. Do not do this. Do not use phrases like this. This is the self/ego (no such inherent entity exists btw) looking for something to cling to, even if it is deviant/pathological/and very harmful. This is similar to the university student who proclaims to everyone: I AM AN INTERNATIONAL STUDIES MAJOR WITH AN EMPHASIS IN MIDDLE EASTERN AFFAIRS AND A MINOR IN MUSIC AND ANTHROPOLOGY. EDIT: While these types of psychological reasons do factor into illness severity, mental illness is still significantly a biological issue, and simply avoiding these types of behaviors will not cure anyone of their illness, though it may significantly reduce some symptoms and interpersonal problems.

People in the denial category range from someone with complete awareness of their problem, but is totally in love with their problems, to someone who completely denies all issues, keeps abruptly stopping their medications, and is totally out of control.

Don't be either of these extremes, nor is this article meant for someone in either of these extremes until they can let go of these behaviors. If you've already started down the path of medications and are significantly down that road, KEEP TAKING THE MEDICATIONS, but don't get too deeply involved in either of these extremes.

If you have a major mental illness AND YOU ARE NOT IN EITHER OF THE ABOVE TWO EXTREMES, then due to your experiences with lots of fleeting and constantly changing altered states you likely comprehend the statement in MCTB about the below:

In fact, not everyone is even willing to attempt to follow this advice, particularly those who buy into the dangerous paradigm that “whatever I feel right now is real” in the sense that their feelings at that moment must be the only possible valid perspective on their current situation and are thus completely justified along with their reactions to those feelings. There are those who simply don’t believe that such a wondrous and holy thing as insight practices could produce such profound difficulties. There are also those who do not believe in the maps or that the maps could possibly apply to their own very special and unique life. Lastly, there are a few whose pride and insecurity issues will not allow them to admit that they might be affected by the Dark Night in this way.

I would warn such people to STAY OUT OF THE DARK NIGHT until they come to a place where they might be able to approximate at least some aspects of the above-mentioned resolution or apply the basics of the theory behind it. That means that if you are not willing to at least try to make and live by some version of my recommended resolution, you should not do insight practices and should not cross the A&P Event.


Though, unfortunately, I'm pretty certain almost everyone with bipolar disorder has at some point crossed the A&P event. Though I have no specific research evidence for this, nor does anyone else for that matter.

If you have several suicide attempts, or have significant suicidal tendencies (many people do not have these and they are somewhat independent of seeming severity of illness), then insight practices for the forseeable future are definitely not for you and only the most basic and light forms of meditation should be done.

If you have had a "manic/hypomanic/depressive" episode, but have not yet started taking medications then read this article http://www.theroadback.org/nevertaken.aspx as well as all the writings about the stages and progression of insight. Research nutritional/vitamin approaches as supplements to medication if already started or as mono-therapy. See http://doctoryourself.com and information written further below.

Keep taking all prescribed medications as directed if you are already significantly involved in the psychiatric system and/or have had several psychiatric hospitalizations.


Training the Puppy stage:

The mind is likely a total mess, despite very likely already being involved in the first cycle of insight, someone with bipolar disorder should not do any insight practices before "training their puppy." The problem is the person is tangled up into a giant mess of insights occurring without any mindfulness/precision/practice coupled with obsessions/fixations/frustrated cravings (which I recommend some effort to pursue in daily life, but only if actually possible) and a mind that is generally far more of a mess than most "normal" people while at the same time likely crossed the A&P at some point in the past where they had a moment of "cosmic unity" or what-not and then it degenerated from there with future episodes and being somewhat misguided by worldly psychiatrists/psychotherapy/medication they are now "in the psychiatric system" and tangled into a mess of confusion.

The person may already be struggling with some delusions that may occur episodically. Generally, these delusions are related to the struggle with duality (take the ubiquitious "delusion of reference" or "voices talking to me" .

List of below symptoms of bipolar disorder/schizoaffective which in the past I have delineated as having experienced (with the exception of planning/attempting suicide - which I have not experienced):
-------------------------------------------------------------------------------------------------------------------
Symptoms of Bipolar Disorder.
Section II: Depression
i. DSM-IV definition
ii. Depressed Mood
iii. Lack of Interest or Pleasure
iv. Lack/Gain of Appetite
v. Insomnia/Hypersomnia
vi. Psychomotor Retardation/Agitation
vii. Fatigue and Loss of Energy
viii. Worthlessness/Guilt
ix. Inability to Think/Concentrate/Decide
x. Death and Dying/Suicidal Ideation/Planning and Attempting Suicide
xi. Lack of Bereavement
xii. Indulging in Depression
Section III: Mania
i. DSM-IV definition
ii. Grandiosity and Inflated Self-Esteem
iii. Decreased Need for Sleep
iv. Increased Talkativeness/Pressured Speech
v. Racing Thoughts/Flight of Ideas
vi. Distractibility/Attention Easily Drawn to Unimportant/Irrelevant Stimuli
vii. Goal-directed activity/Psychomotor agitation
viii. Pleasure seeking without thought of consequence
ix. Indulging in Mania
Additional Symptoms
i. Mixed States/Episodes (Mania + Depression)
ii. Hypomania
iii. Psychotic Features (Hallucinations/delusions) iv. Depersonalization and Derealization
v. Obsessive/Intrusive thoughts
----------------------------------------------------------------------------------------------------------------


These symptoms are exagerrations of the five hindrances. However, it is a specific variant/pattern that is related to cycling.

Hindrances
----------------
Sense Desire
Ill-will
Sloth and Torpor
Restlessness
Doubt
----------------

-Also note that all of the above bipolar symptoms are all symptoms that can occur during dark night/three characteristics and A&P cycles (which in and of themselves occur due to alteration in hindrance levels due to insight meditation). Alteration of hindrance levels is occurring due to the struggle with duality (having a false belief in an inherently existing self/observer/controller/"I").

This is why I say the mind of a "diagnosed" bipolar individual is a total mess and thus the person must start at the very basics with the faith/goal of reaching access concentration and staying there with every sit. Personally, this took me 1.5-2 years of sitting practice before reaching this level.

How to do this:

Put the attention on the breath. "Where" the breath is located is irrelevant, put it wherever you find the breath and when it wanders bring it back. I used the nostrils mostly during this period, but it can also be the belly. The mind will wander incessantly, but keep practicing and don't give up! Try counting breaths (1-8 and then restart). When you can keep attention on the breath for several minutes without attention wandering - then that is "access concentration."

From here the first and second jhana will eventually be reached. However, I caution such individuals with major mental illness from developing the third and fourth jhanas as this sort of practice is going to require a less developed level of concentration. Why? Because despite now being able to suppress your hindrances and a seeming "recovery," your "illness" is still latent and active.

Developing too much concentration now will lead to hallucinations/problems with psychosis after starting insight practices. People with bipolar disorder are people who are already prone to too much concentration without adequate development in mindfulness/non-duality/effort. However, this "concentration" has been habitually misdirected into some obsession/fixation or other.

Once access concrentration/jhana is attained, that concentration will remain just as strong, and thus prone to out of control hallucinatory states when starting insight practices. This is coupled with a propensity for strange desires for things as they are not and a desire to indulge in such things.

----------------------------------------------------------------------------------------------------------------
-At this point you've learned to access jhana, can sit at access concentration at a whim, have stopped all episodes by learning to suppress hindrances, are still taking meds, you've researched nutrition/vitaminsand put that into practice, and the doctor has reported that you are "very stable" and you've been strangely stable for the first time in quite some time. (certain vitamins can suppress symptoms far beyond what psychiatrists likely think is possible, but it is still a "suppression" and not a cure, as the symptoms will come back when vitamins are stopped). Though vitamins will likely have a regenerative effect that may lessen symptoms over time. Drugs do not have this effect.

Now you are ready to begin the progress of insight. If you're familiar with the three characteristics, you have been ignoring them in your practice right? You've just been doing basic mindfulness/meditation that the media talks about, not getting too heavily concentrated or getting too deep into jhana -Good, all is well.
------------------------------------------------------------------------------------------------------------

PROGRESS OF INSIGHT STAGE

-Whereas in the previous stage you were likely able to sit as long as you wanted, you no longer have that luxury. If you have major mental illness (bipolar/schizoaffective/psychotic features) then you should not sit "on cushion" for more than 3 hours a day or go on a retreat (despite the fact that you feel fine and are stable at this point).

Sit longer than this at your own risk. I have derived this number off my own experience varying sitting times, and feel it is a good number for still making progress/keeping up momentum without going overboard. In reality, after you have path, you won't even have to sit for this long and there will only be sporadic periods where you will feel "compelled" to sit for long periods of time to keep up momentum.

Resist all temptation to sit "on cushion" for longer than 3 hours / day during these periods (that doesn't mean you can't make progress off cushion).

People with bipolar disorder don't actually have to "sit on cushion" as long as everyone else to make just as much progress. Why? Because you have more "acceleration" that has already been building up over the years and that is the problem. It's the difference between pushing down the accelerator on a ferrari vs. a ford focus (don't let that go to ego, it's just an analogy). You're going to have to push the accelerator down much more carefully and slowly to avoid wiping out.

Get a feel for what is most comfortable in the range of 1-3 hours/insight practice per day.

-Practice "light noting" OUT LOUD. Do NOT note in your head! I can't emphasize this enough. It will create a mess of spaghetti that will become tangled and may lead to mania at certain later stages such as review. Don't note every second or you will become too concentrated and thus risk lapsing into mania/psychosis. Note every 30seconds - every few minutes out loud/whisper only. If you really feel it necessary to do mental noting or find yourself doing it anyways, then switch to noting with mental pictures instead of words. However, only do this if you're able to condition things so that this is not also causing auditory mental sensations that try to interpret or read the pictures.

Maintain awareness of the three characteristics of phenomena, starting with impermanence. Focus more on the characteristics of phenomena than on noting, but still note. Important point: The three characteristics are intrinsic to phenomena and are not observed from an observer observing them. To say: "I see a sensation, and that sensation is impermanent because I'm looking at it is wrong." This particular kind of wrong view can show up when looking at visual sensations or mental sensations, so avoid those in early paths to avoid manic/psychotic responses. Notice the sensations like the ones on your fingertips and notice how they come and go. That's all.

-When going about your day note in a whisper.

-Do lots of walking meditation and note in a whisper.

-Take up basic yoga and/or basic tai chi.

-Join a gym, lift weights, run, swim

Ground yourself in bodily sensations. De-emphasize the three characteristics of mental phenomena and focus on breath, tingles in body, etc. Same goes for visual sensations. Don't mess with mental/visual sensations until attaining higher paths.

*When in equinamity be weary of review phases. All my most acute psychotic episodes that required hospitalization happened during review phases after obtaining path. Though having over-done it before this, there were definite indicators of psychosis beforehand.

Do the same for 2nd path (as 2nd path is the same as 1st)
Sitting meditation (on cushion) really needs to be taken cautiously and carefully as over-doing it on cushion will lead to problems off cushion. The problem is that you might not know you over-did it until you get up and go about your day realizing that you actually did, then it is too late as the acceleration from that sitting may lead to mania!

-That is why you should not sit for more than 3 hours a day, and should BUILD UP to that number. Start with 30 minutes /day (or even 10 or 20 minutes) for a week, then move to an hour, etc. You will, in due course, having followed all the precautions get stream entry without too much fuss. I estimate in a manner of a few months (or perhaps a year or several years which would also be sufficient).
.
[Personal note: After pushing myself way too hard and developing too strong of concentration (much harder, and unnecessarily, than I'm advocating here), I actually began to "hear voices." If this happens, keep non-duality in mind, and remember they are NOT talking to "you" as there is no independent entity here to talk to. Keep an intellectual knowledge of this available and take it moment by moment. Try taking Niacin-immediate release nicotinic acid (see doctoryourself.com), as this seems to help mask them. If you are hearing them, then this, particularly, is what led to psychosis (states of confusion - like doing hallucinogenic drugs) when hitting reviews when the mind was too powerful for its own good and couldn't handle the dualism from the voices.

Eventually this untangled and I no longer consider myself to "hear" voices (EDIT: This actually isn't true, as they are still come and go and I have had to stop meditating, for the time being, since the risk of meditation becoming psychotomimetic is too high. I have been able to largely treat most of the schizophrenia symptoms with vitamins/niacin/prescribed tranquilizers).

------------------------------------------------------------------------------
After stream entry:

-Learn the "3 gears"

-Practice using the phrase "How am I experiencing this moment of being alive"

-Repeat this process until you have 2nd path

-Repeat the process again until you have 3rd path.

-Resist all urges to sit more than 3 HOURS / DAY. The urge will likely be very high at times, resist it or you will fall into the trap where you will not know you over-did it until it is too late!

-Chance of mania/psychosis is directly proportional to time spent "on the cushion" and to no other activity of being aware throughout the day. Use cushion time to hit the accelerator, then coast on that momentum throughout the day without actually "sitting on cushion."

-Be weary of review phases. Do NOT go into them with too much momentum or it may lead to mania/psychosis. Have in-person people available in case of emergency if you think you're about to hit review. The mind is much too powerful for its own good in review.

---------------------------------------------------------------------------------
Post 3rd path/4th path:

-You can now note in your head.

-Keep going until you are utterly happy and at peace 24/7!

-Keep to the sitting length limit!

When emptiness of phenomena is apparent in all activities (at 3rd path):

-Experiment with slowly lowering dosage of medications and notice how this affects practice/mental phenomena. Do not do this until you are at this stage, as you would not have the insight level necessary to notice such effects anyways.

-Keep practicing "How am I experiencing this moment of being alive."

-Let go of all subtle mental obsessions/fixations

-Work on eliminating all higher fetters by noticing three characteristics at chakra points.
--------------------------------------------------------------------------------
You did it!

As you can see this appraoch has several important elements:

-De-emphasis of "on cushion" sitting time. MAX 3 hours/day. All "on cushion time" should only be used to "hit the accelerator" and the rest of practice should be practicing "awareness" throughout the day based on that down-hill momentum.

-Lack of emphasis on samatha jhanas/strong concentration.

-If mania/psychotic features are a danger, all concentration must be kept light. [EDIT: Before insight practices concentration practices are generally mania preventive, after starting insight practices the background vipassana/struggle with duality causes situations that are potentially mania inciting if the person has a tendency towards hallucinatory states - hallucinatory states are caused by very "strong" concentration. People with bipolar II(hypomania only) may not be as prone to this problem and for them very strong concentration may be beneficial for reducing "hypomania" (mania/hypomania = increased mental proliferation]

-Noting must be kept light in the sense that it should not be forceful or done once every second, or done mentally until 3rd path (Personally, I prefer not to note verbally in the head at all ever at any path. Visual pictures of words to note is preferable)

-An emphasis on the three characteristics of bodily sensations over mental and visual sensations until at least 3rd path. Though getting involved in some amount of mental activity is likely unavoidable before then. Though try to condition yourself to do at least 80% body sensations.

Nutrition/Supplements/Vitamins - Vitamins are rather harmless, but read books by Dr. Abram Hoffer (also see www.doctoryourself.com) for more information. Talk to your doctor or see an orthomolecular physician.

Learn to recognize cerebral food allergies. Certain foods, unique to the individual, are often off-setters of symptoms. It can be difficult to recognize that it is the foods that are causing the problem, so practice elimination diets or be very conscious of what you're eating to identify problematic foods. Certain foods like milk are very common instigators.

Here is a vitamin regimen that can minimize the toxic effects of neuroleptic medications and/or reduce the risk of psychosis occurring (the most important being the niacin/b vitamins and vitamin c).

Nicotinic acid (niacin) - 1.5-9 grams/day (immediate release only ~ start in mg amounts and increase dose gradually)
Vitamin C - 3-10 grams/day
Folic Acid
Omega-3 fatty acids
B-complex
Vitamin D3
Zinc
Selenium

RE: A dharma practice for those diagnosed with mental illness
Answer
8/3/12 8:52 AM as a reply to Tom Tom.
How would you say that the various medications you may have taken during your practice affected or didn't affect the formal and informal components of that practice?

RE: A dharma practice for those diagnosed with mental illness
Answer
1/11/13 9:56 PM as a reply to End in Sight.
How would you say that the various medications you may have taken during your practice affected or didn't affect the formal and informal components of that practice?



My experience is that taking the medications did not significantly alter the progression of practice, though reducing the dosages too low/too fast did. During certain periods of "intensive practice" the body would automatically try to reduce the dosage, the extent of which was usually a massive acceleration in practice, though ultimately involved getting tangled up with more hallucinations/delusory activity rather than less. It's probably best and safest to keep the dosage as constant as possible until a high level of realization/stabilization is reached.

Though I had taken many different drugs before starting a meditation practice, during practice I took the following two: (I also took just these two during my two year "training the puppy" phase, before I discovered the word "jhana" which I typed in google which ultimately led me to the dharmaunderground.wetpaint.com which is now called the dharmaoverground.org).

Lithium - an "anti-manic" drug at about 900mg then dropped to 600mg (at start of 3rd path), then 300 (upon further stabilization), then 0 and have ceased taking it. However, previous attempts to drop the dosage at earlier paths (1st/2nd) often resulted in increased mental proliferation and some inability to keep up with it. Eventually the dosage was dropped with no change in experience, and ultimately dropped altogether with no change in experience for 3 or 4 months now.

Seroquel (quetiapine) - an "anti-psychotic" drug at about 100-150mg/day for the majority of the practice (EDIT: max I would take was 400mg shortly after hospitalizations, but would reduce quickly afterward). There were several attempts to drastically drop the dosage (particularly at early 3rd path), but as this was done too drastically and shortly after a hospitalization from the 3rd path review cycles, it ultimately resulted in nasty withdrawal symptoms and a a train of hallucinations/delusory sensations to which I started taking the above range dosage again and these symptoms promptly went away without any further issue. I was later hit with a train of "voices" upon going back to an area where an acute psychosis had occurred and the interdependence of memory sensations from the event (or, I think, an allergic reaction to a certain food that causes these sorts of symptoms) re-triggered many of the "hallucinatory" sensations and their resultant referencing sensations. In response I started taking 3,000mg/day of vitamin b-3 [increased gradually from 250-500mg] (I didn't know about this beforehand) and they promptly disappeared. I have experimented with not taking it and now take lower dosages as well as using these sensations as a basis for insight.

I began to slowly lower the dosage of seroquel again several months ago and then after a major stabilization in practice I am now mostly off all of it, and am currently taking about 10-15mg/day of seroquel/quetiapine as well as about 1,000mg/day of vitamin b-3 and seem to have stabilized on that (quite well), for now. The website http://www.theroadback.org/ has some very specific/exhaustive instructions on how to get off antipsychotic meds, to which I have not followed, exactly, nor feel the need to follow, exactly, at this point, as things seem to be stabilized on the very lowest possible dosage of seroquel/quetiapine.

RE: A dharma practice for those diagnosed with mental illness
Answer
8/11/12 2:20 PM as a reply to Tom Tom.
If a person with mental illnesses similar to yours wanted to begin meditating, would you suggest they start taking medication if they haven't started it already? In other words, did you find that

*medication helped your practice and that you simply needed less medication over time, or

*medication made no difference to your practice, when you were taking an appropriate amount; but you began practice while medicated and continued that way, or

* you needed medication in order to function, and so the question of whether it helped your practice is missing the point, or

* something else

?

Also, how did you judge that a certain amount of medication was enough, or too much?

RE: A dharma practice for those diagnosed with mental illness
Answer
8/11/12 10:57 PM as a reply to End in Sight.
If a person with mental illnesses similar to yours wanted to begin meditating, would you suggest they start taking medication if they haven't started it already?


As I wrote above, if a person has had a manic/hypomanic/depressive episode and they have not yet started taking them, then I would suggest that they pursue as many alternatives to medication (which I provided links to above) as possible before resorting to medication. Medication did not significantly alter the progression of practice, but that is not to say that it did not alter practice. To what extent they helped precipitate illness due to practice, rather than prevent it, is unknown. Though in emergency situations, they most certainly helped.

you needed medication in order to function, and so the question of whether it helped your practice is missing the point


This is probably the most accurate point, as I had been taking some form of medication or other since 2004 (as well as having been involved in several trips to ERs and two psychiatric hospitalizations of a week to two weeks duration before starting any meditation practice at all - I began sitting in January 2008, but didn't start doing insight practices until January 2010).

medication helped your practice and that you simply needed less medication over time, or


I wouldn't say that medication "helped" practice, but that practice seemed to eventually reduce/eliminate the need for the medications, as well as all the original symptoms of the illness which have faded over time as the result of practice (despite some very intense and potentially dangerous/deadly flare ups along the way). The extent to which these flare ups were caused by drastic reductions in medication dosage* and thus intense "physiological medication withdrawal" rather than inherent "illness" is somewhat significant and not all flare ups can be said to NOT be due to medication though I cannot say they were all completely because of the medication either. It is because of this that I recommend people not get involved in medications and pursue holistic/nutrition/natural/vitamin alternatives if at all possible.

*EDIT: Even if the dosage is kept constant, but the mind is pushed too far beyond to its limits through intensive meditation (by over-meditating in reverse chronological order- 5hours/day for 5 weeks, 14 hours a day for one week, and 10 hours/day for two weeks (no medications were taken during this particular phase, but had been previously stopped a week or so before starting) - these intensive phases all directly resulted in intense/very dangerous flare ups), then there was the sense that the medications can't "keep up" with what was going on and the dosage needed to be "increased" to curtail whatever "out-of-control" episode was going to happen. Usually such efforts temporarily alleviated an episode, but usually occurred shortly and inevitably after despite vain attempts to increase antipsychotic dosage. To what extent this is due to "illness" or the antipsychotic drug itself is somewhat unknown, though I hypothesize in some sense more weighted toward the "illness," though there is the physiological withdrawal factor as well. So it may be possible that pushing the mind beyond its limits somehow pushes the brain beyond the normal response of the antipsychotic and as such the brain/nervous system goes into physiological withdrawal in the same way as if the dosage were reduced too far too soon.

Also, how did you judge that a certain amount of medication was enough, or too much?


Generally, if the medications led to too much significant increase in one of the hindrances to the point where there was trouble penetrating and perceiving. Particularly grogginess/sloth and torpor in reference to high doses of the antipsychotic or restlessness if the lithium was reduced too low too soon.

RE: A dharma practice for those diagnosed with mental illness
Answer
8/12/12 4:13 PM as a reply to Tom Tom.
Tom A Vitale:
Also, how did you judge that a certain amount of medication was enough, or too much?


Generally, if the medications led to too much significant increase in one of the hindrances to the point where there was trouble penetrating and perceiving. Particularly grogginess/sloth and torpor in reference to high doses of the antipsychotic or restlessness if the lithium was reduced too low too soon.


Are you saying that antipsychotics caused more sloth as your practice progressed, and so you had to reduce the dosage to compensate, or that they always caused a fixed amount of sloth for a fixed dosage, but as your practiced progressed, you found you could reduce the dosage (and thus the hindrance) without negative repercussions?

RE: A dharma practice for those diagnosed with mental illness
Answer
8/20/13 12:18 AM as a reply to End in Sight.
Are you saying that antipsychotics caused more sloth as your practice progressed, and so you had to reduce the dosage to compensate, or that they always caused a fixed amount of sloth for a fixed dosage, but as your practiced progressed, you found you could reduce the dosage (and thus the hindrance) without negative repercussions?


I found that the sloth decreased as practice progressed, regardless of what the dosage was. Being largely off the drug now, there isn't any decrease/increase in sloth compared to when the dosage was 100-150mg. Meaning, the dosage was reduced without repercussions more when there were an overall absence of hindrances rather than a presence of hindrances. Although I stated above that changing the dosages to alter hindrances can help practice, this may have been more the mind (rightly or wrongly) blaming its hindrances on the drugs. UPDATE 8/19/2013: I have gone back on the original dose of seroquel/quetiapine as of about 4 months ago due to symptoms. I stopped lithium carbonate for 9 months with no problems or mood symptoms, though now I take 300 mg per day just in case.

RE: A dharma practice for mental health
Answer
12/24/12 1:57 PM as a reply to Tom Tom.
I am temporarily removing this post as there are some incompletions that need resolving. When they are resolved and fully resolved (for some significant period of time) the post will be returned and further explained.

Curious. Could you say more? I found that post very useful. Oh well, I shall continue to 'train the puppy' as you suggested, as it seems pretty sensible. Plus I've got a gut feeling I should avoid insight practice till I've got better concentration skills. Anyway, I'm enjoying exploring samatha more, even though I'm still far off mastery of access concentration.
All the best, Martin

RE: A dharma practice for mental health
Answer
12/25/12 2:16 PM as a reply to Martin Sokolski.
Curious. Could you say more? I found that post very useful. Oh well, I shall continue to 'train the puppy' as you suggested, as it seems pretty sensible. Plus I've got a gut feeling I should avoid insight practice till I've got better concentration skills. Anyway, I'm enjoying exploring samatha more, even though I'm still far off mastery of access concentration.
All the best, Martin


If you found it useful then I'll put it back up soon. I want to add some further important information.

RE: A dharma practice for mental health
Answer
12/30/12 8:29 AM as a reply to Tom Tom.
Tom A Vitale:
If you found it useful then I'll put it back up soon. I want to add some further important information.


I've made an account just to tell you, please do! And perhaps it can be added to the wiki at some point? I understand it might not have been complete but as someone with bipolar as well it was extremely reassuring reading what you had here!

At the time I was going through exactly what you described and until I stumbled upon your post I was convinced I was just going nuts and on the edge of psychosis. Suddenly it all made sense, I no longer feared what was happening and took the precautions you suggested. I can safely say I am back on track thanks to you emoticon

RE: A dharma practice for mental health
Answer
12/30/12 10:22 AM as a reply to Tom Tom.
Tom A Vitale:
If you found it useful then I'll put it back up soon. I want to add some further important information.
Yes, please do put it back. Or at least put back the stuff you're more certain of, and add the rest later. It's such a good resource, and really helped put my manic tendencies in perspective, and also helped me better understand the dangers of indulging my desire for insight too soon. I ditto Zoo Cars request that it be added to the wiki.

RE: A dharma practice for mental health
Answer
8/27/13 4:16 PM as a reply to Zoo Car.
I've made an account just to tell you, please do! And perhaps it can be added to the wiki at some point? I understand it might not have been complete but as someone with bipolar as well it was extremely reassuring reading what you had here!

At the time I was going through exactly what you described and until I stumbled upon your post I was convinced I was just going nuts and on the edge of psychosis. Suddenly it all made sense, I no longer feared what was happening and took the precautions you suggested. I can safely say I am back on track thanks to you


One of the reasons I removed it was because I thought it might be too dangerous to be encouraging this or to have this written up in a public space (even with the precautions, as everyone's results may not be the same as mine so I added a disclaimer). If someone is having problems they should lower the maximum of 3 hours a day to 30min- hour a day or less or stop sitting (on cushion) for a while (or for even quite a while). In addition, if momentum needs to be kept up during these periods, they could explore tai chi/yoga/supervised energy medicine/light walking meditation. I have gone relatively long periods without sitting (on cushion).

Though it's definitely far more dangerous for someone in these situations to read MCTB and to do exactly what is written in it, so it is better to have this available. .

There might be other more appropriate insight paths for people in these situations that I have not explored. Though what I have written is more body oriented (not strictly in accordance with MCT B / mahasi noting) and loosely based off what I've read from dharmaocean.org and the body practices of Reggie Ray which are similar to some Taoist energy practices. Also, I have no problem recommending cultivating the pce, since it does not require meditation and is safe*. *EDIT: Cultivating "pces" is said to lead to large increases in dopamine (though reduced amounts of adrenaline) and its effect on mental illness is unknown. See the post on Dr. Hoffer and orthomolecular medicine below. I am also not currently an active "AF" practitioner.

Since I had access to jhanas pre-path I could have hit those and then did pce cultivating practices from there (would have been impossible for me, personally, to do it without samatha/jhana or some meditation though - since "The more one enjoys and appreciates being just here right now – to the point of excellence being the norm – the greater the likelihood of a PCE happening ... a grim and/or glum person has no chance whatsoever of allowing the magical event, which indubitably shows where everyone has being going awry, to occur." ).

Another issue is that doing samatha incorrectly can inadvertently instigate the insight process. I cannot guarantee people are going to be able to properly train their puppy or do samatha without inadvertently activating the insight process. Though I can give the following tips if someone really wants to avoid doing insight.

How to do samatha without activating insight:

-Do single length sits of 1-4 hours duration (without getting up, or only getting up briefly) every other day. If meditation is done every other day (or every two days), then the likelihood of entering insight territory will be greatly diminished. Skip days where you do lengthier sits. A single length sit of 1-3 hours/day would likely not precipitate the insight process so long as the person has some sense/practice of staying squarely on the object of meditation and ignoring everything else.
-Stay on the object only, forget investigation, ignore all but the object ("breath", if it is chosen to be "breath"). (However, there actually is no breath, but instead a group of infinitely fascinating sensations that make up what we like to call breath), do not become fascinated or entranced by this. Pretend this is not true, assume there is only this single object called breath and it is the only thing you're going to pay attention to for the next several hours.
-Think peace, ease, no strain, no problems, like getting a massage
-It should always be pleasant.
-Experiment with candle flames
-Do no noting whatsoever.

After sitting the following should be reduced or absent from a fair to large to degree for a short to long period of time. After some period of time the following will subsequently re-arise. When they re-arise they should not be coming back stronger than when you sat down to meditate. If the hindrances re-arise stronger or are not diminished immediately (from a time period ranging from minutes to days) after sitting, then you're not doing it properly and the person should stop sitting for a while and meditate again after a few days to a week.

sense desire
ill will
sloth and torpor (mental or physical)
restlessness (mental or physical)
doubt

-Read the very relevant post I wrote here: http://www.dharmaoverground.org/web/guest/discussion/-/message_boards/message/3631675

A person with a messy mind wiill find it easier to do samatha without activating the insight process since the mind will stabilize only when sitting and then re-configure back into its original pattern when the hindrances re-arise. This will help prevent activating the insight process.

RE: A dharma practice for mental health
Answer
1/11/13 6:20 AM as a reply to Tom Tom.
Hello,

Thank you for this guide, it's very helpful to me. I have bipolar disorder type-II, and have been focusing exclusively on samatha practice. Currently, my aim is to master the jhanas as described in 'Practicing the Jhanas' by Snyder and Rasmussen (Pa Auk Sayadaw tradition), although I'm aware that I would really need to crank up my sitting time. Would that be a 'safe' thing to pursue? I only sit for 45 minutes max a day and I do take a break from meditation now and then. I feel I could easily overdo it.
Often I come out of meditation at peace and with a calm mind. But sometimes, I become anxious and have racing thoughts. I've been having some mood issues lately, although I doubt they have anything to do with meditation practice.

RE: A dharma practice for mental health
Answer
1/11/13 2:59 PM as a reply to R P.
Currently, my aim is to master the jhanas as described in 'Practicing the Jhanas' by Snyder and Rasmussen (Pa Auk Sayadaw tradition), although I'm aware that I would really need to crank up my sitting time. Would that be a 'safe' thing to pursue?


I meditated for two years without inadvertently activating the insight process. I spent about 5 months practicing the formed jhanas and was able to get the first 4 samatha jhanas before starting insight practices. Although I never inadvertently started the insight process, having access to the first 4 samatha jhanas may have definitely created a very strong "instinctual" pull toward doing insight practices and I sat down to "consciously/decidedly" do insight practices shortly after (5 months). If you would like to avoid doing insight practices then a strong formal vow to delay the insight process can help. Get some practice with staying on the object and when you feel you're really getting it, up the sitting time.

Also check out the below link:

http://www.doctoryourself.com/anxiety.html

Here is something I wrote from another post that might help:

What worked for me (when I first started) was to stay on the object of meditation, but to let the breath and body be wild Meaning if the breath needs to be wild, let it be wild, if you need to sway back and forth for a while, then sway back and forth (while keeping the attention on the wild breath). I found that eventually the breath would settle down and then become shallow (perhaps after 30 minutes or longer of doing this) and then I would enter access concentration and then even jhana. This is what worked for me, but you'll have to experiment and see what works for you. If things get too bad off cushion, then make sure to take a break from sitting for a while and then come back to it and alter your technique to what is reducing hindrances and not increasing them. So what I mean is if the following are increasing for some time after a period of sitting then you're not doing it right. Proper samatha practice is about reducing these off cushion, not increasing them off cushion

sense desire
ill will
sloth and torpor
restlessness (fear is a form of restlessness, doubt, and "ill will")
doubt

So immediately after sitting these should be reduced (even if you started out sitting in a somewhat wild and anxious state, as I stated above). They should be reduced for some period of time afterward (ranging from minutes, hours, days), and then re-arise at some point afterwards. When they re-arise they should not be coming back stronger than when you sat down. If they are coming back stronger then you should alter your technique/sitting time accordingly.

RE: A dharma practice for mental health
Answer
1/11/13 3:57 PM as a reply to Tom Tom.
Thanks, that's good advice about the hindrances.

I'm currently taking quite a few nutrition supplements. Vitamin B complex, vitamin D3, iodine, selenium and magnesium. I take quite a large dose of vitamin D3, 5000 IU per day. This was recommended to me by a friend, because it supposedly helps protect against things like depression.

One other thing I've been noticing: I regularly hear a ringing sound during meditation, but also when I'm not meditating. Whenever I'm at work and I hear the ringing sound, I can put my awareness on it and it will become louder. I also feel a slight sensation on the top of my head. When I focus on these sensations for a while, I calm down and become more concentrated while sitting at my desk. I feel this is a great benefit of the samatha practice.

RE: A dharma practice for mental health
Answer
1/11/13 9:58 PM as a reply to R P.
One other thing I've been noticing: I regularly hear a ringing sound during meditation, but also when I'm not meditating. Whenever I'm at work and I hear the ringing sound, I can put my awareness on it and it will become louder. I also feel a slight sensation on the top of my head. When I focus on these sensations for a while, I calm down and become more concentrated while sitting at my desk. I feel this is a great benefit of the samatha practice.


(If you wish to attain samatha jhanas) It would be better to avoid using anything other than the breath (at nostrils), belly, or candle flame as meditation objects (keeping the attention on one of these three things - solidly/solely/exclusively during meditation sitting and obviously not as strongy when "practicing off cushion"). Anything else might be prone to inadvertently making too much investigation.

RE: A dharma practice for mental health
Answer
8/15/13 3:14 AM as a reply to Tom Tom.
I was interested in your comment about how people prone to mania should not do noting practice. I was considering going to the Mahasi center this september for a month-long retreat, but you have advised me against it; can it really be so dangerous?


This is taken from another thread and is my answer to the above question

There is the potential for it to be very dangerous, but this is dependent on these factors.

1. Have you experienced any psychosis? (meaning a diagnosis of bipolar type 1 w/ psychotic features or schizoaffective disorder. Schizoaffective disorder is when psychotic features can occur during a normal mood, not manic or depressed, but the person also has experienced mania and/or depression).

2. Have you ever attempted suicide and/or made a plan for suicide? (If psychotic features are prominent, then suicide can also be a risk in the same way doing too much LSD might cause someone to jump off a roof thinking they are able to fly). It also can be a risk factor if someone gets deeply depressed and is prone to attempting suicide from a deep state of depression.

3. Do you experience hypomania (a diagnosis of bipolar type II) or do you also experience full-blown mania? (meaning it either involves psychotic features, or if it doesn't involve psychotic features, it involves behavior that is highly destructive to your life. Non-classical mania is psychosis-like states resembling schizophrenia or an acid trip. Classical mania is going on a 50,000 dollar shopping spree).

Keep in mind that bipolar type II, by definition, does not involve psychotic features as they only occur in schizophrenia/schizoaffective or bipolar w/ psychotic features (which is always bipolar type 1 or schizophrenia/schizoaffective..

If you only experience hypomania (bipolar II), then it is less risky though there is the potential for a depressive state. You, obviously, know your symptoms better than I do, so you would have to assess the risk based on the above three points.

Another important point: You may or may not have these problems when you're on the actual retreat. It is more likely that the problems will sneak up on you after the retreat has ended, but are causally related to the excessive amount of meditation and noting practice done while on the retreat. This could be very dangerous if there are no actual people around to tell you you're getting off track. Keep in mind that the only retreat I went on was 5 days, and I went into psychosis shortly after and was hospitalized twice in row.

On the other hand, I know several people who are bipolar who do not experience psychosis who have successfully completed retreats with little to no problems. These were all people who were practicing according to the instructions/tradition of Goenka, had no history of suicide attempts, and they were unfamiliar with mahasi noting, the dharmaoverground, or MCTB. This, in itself, doesn't mean anything as they may not have made any progress whatsoever, according to the maps in use here while they were on the retreat. Meaning they probably didn't pass the A&P event.

RE: A dharma practice for mental health
Answer
2/19/14 5:01 PM as a reply to Tom Tom.
Someone on another thread mentioned niacin as a treatment for anxiety and other mental health problems. Here is some information on mental health (depression/anxiety/bipolar/schizophrenia) and orthomolecular (megavitamin) medicine from that post. This is what they wrote and my response:

Take Niacin - the flush kind, not the slo kind, either with each meal or right as you fall asleep. I find it helps keep me from getting into excessive levels of anxiety and seems to somehow make sleep much more refreshing as well. It can make you a bit loopy during the day so beware. Also try a small dose in the evening a few times before trying more so you can get used to the flush and itching. I kind of think its refreshing but sometimes people can't stand it. I take ~1000mg before I fall asleep. Your liver needs extra water to deal with this so plan on drinking a bit extra with this or having more in your glass by the bed for the middle of the night.



My Response:



See this book: Anxiety Orthomolecular Diagnosis and Treatment

I will add to this that if someone wants to do this they should read the writings/books of the late Canadian physician Dr. Abram Hoffer. Dr. Abram Hoffer M.D. P.h.D was the discoverer that Niacin lowers cholesterol and a founder of "Orthomolecular Medicine." He was a practicing psychiatrist and biochemist that successfully treated mental health conditions with a combination of pharmaceutical medications and vitamins/niacin. He treated over 5,000 schizophrenic patients (many with resounding success - particularly if they were acute cases rather than chronic) using Niacin and pharmaceuticals. He treated many mental health conditions but was particularly an excelled expert in schizophrenia and megavitamins, There is a lot of material on this on the website doctoryourself.com. There are some reports that the slo release or extended release kind has damaged some people's livers, but there is no such evidence for the immediate release kind at any dosage. Hoffer himself took 4.5-6 grams of niacin (regular/flush immediate release) daily for over 50 years until his death at age 92.

Also note that standard medicine has not yet accepted orthomolecular treatment (for any condition) and it was dismissed as a treatment for schizophrenia by the APA (American Psychiatric Association) in a 1973 report titled "(1973). Task Force Report on Megavitamin and Orthomolecular Therapy in Psychiatry. American Psychiatric Association." (This report can be found in many university libraries). Dr. Hoffer felt the report was deeply flawed/biased and he wrote a lengthy response detailing all the methodological problems which can be found here:http://www.iahf.com/orthomolecular/reply_to_apa_tfr_7.pdf

Hoffer focused/specialized in schizophrenia, but you can find his views on niacin and bipolar disorder and its relationship to schizophrenia in this article. His definition of schizoaffective in the article would be what is now called bipolar with psychotic features. Schizoaffective would now mean psychosis symptoms when the mood is normal, but the person has experienced or experiences mania or depression: http://www.thefreelibrary.com/Bipolar+disorder+and+orthomolecular+treatment.-a0213722863

Also nicotinamide/niacinamide (not the same thing as niacin - nicotinic acid) can cause temporary symptoms of psychiatric depression (which goes away when the niacinamide is stopped) in a few select patients when it is taken in high doses.

Link List

www.doctoryourself.com
Anxiety: Orthomolecular Diagnosis and Treatment
Healing Schizophrenia
Orthomolecular Treatment for Schizophrenia

Hoffer believed schizophrenia was caused by a byproduct of adrenaline called adrenochrome and its derivatives adrenolutin and noradrenochrome. Similarly, he believed a product of L-dopa called dopachrome was psychotomimetic. Hoffer's experiments with adrenochrome and its derivatives can be found in great detail in a book titled "The Hallucinogens" which can be found online for free in the below link. Standard medicine has dismissed adrenochrome citing it as not being psychoactive/psychotomimetic (often citing a faulty experiment) but numerous experiments detailed in the books "The Hallucinogens" and "Healing Schizophrenia" clearly shows otherwise.

http://www.erowid.org/library/books_online/hallucinogens_hoffer_osmond.pdf

Also, I have noticed that Richard (of the actual freedom trust) has written:

Incidentally (in regards adrenaline injections): whenever I have a dental injection to anaesthetise the jaw, these days, I make sure the dentist uses a procaine mixture which does not contain adrenaline, which most such mixtures do, because its effect is to set-off a psychotropic episode (lasting up to 5-6 hours).
here http://www.actualfreedom.com.au/richard/listafcorrespondence/listaf78b.htm

This would actually confirm Dr. Hoffer's hypothesis. Richard's state of an "actual freedom" is a state where very little to no adrenaline is produced, thus if adrenaline is produced/injected, it is quickly oxidized into the hallucinogenic derivatives that Hoffer found. In a non-schizophrenic person Hoffer felt that adrenochrome would form primarily into a harmless compound called 5,6-Dihydroxy-N-methylindole which has some anti-anxiety effects. In people with schizophrenia the pathway becomes noradrenaline->adrenaline->adrenochrome->adrenolutin. Noradrenaline can also be formed from dopamine.


EDIT: More comprehensive link list taken from this thread (sidetrack of the thread): http://www.dharmaoverground.org/web/guest/discussion/-/message_boards/message/5126180

Lots of evidence in this comprehensive book (specifically chapter III) that adrenochrome and adrenolutin are psychoactive: http://www.erowid.org/library/books_online/hallucinogens_hoffer_osmond.pdf

Doctor Hoffer refutes 1973 American series of studies stating vitamins don't work: http://www.doctoryourself.com/APA_Reply_Hoffer.pdf

By Dr. Richard Kunin: Manganese and Niacin prevent and cure drug induced dyskinesias (particularly tardive dyskinesia though including akathisia).

http://orthomolecular.org/library/jom/1976/pdf/1976-v05n01-p004.pdf

Relationship between bipolar disorder ( manic-depressive illness) and schizophrenia:

http://www.thefreelibrary.com/Bipolar+disorder+and+orthomolecular+treatment.-a0213722863

Other important books:

http://www.hdfoster.com/sites/hdfoster.com/files/users/user10/WhatReallyCausesSchizophreniawithp54.pdf

http://www.amazon.com/Healing-Schizophrenia-Complementary-Vitamin-Treatments-ebook/dp/B001QOGJ4U/ref=sr_1_1?ie=UTF8&qid=1389917681&sr=8-1&keywords=healing+schizophrenia

http://www.amazon.com/Orthomolecular-Treatment-Schizophrenia-Health-Guides-ebook/dp/B000PY3EZY/ref=sr_1_1?ie=UTF8&qid=1389917703&sr=8-1&keywords=orthomolecular+treatment+for+schizophrenia

RE: Dharma practice and mental health / bipolar disorder
Answer
4/3/14 9:22 PM as a reply to Tom Tom.
Tom Tom:
**
You did it!

As you can see this appraoch has several important elements:

-De-emphasis of "on cushion" sitting time. MAX 3 hours/day. All "on cushion time" should only be used to "hit the accelerator" and the rest of practice should be practicing "awareness" throughout the day based on that down-hill momentum.

-Lack of emphasis on samatha jhanas/strong concentration.



Tom Tom,

This has been the best thread I've seen on the forum for such cases. I suffer from recently-medicated schizophrenia and have found 1-10 minutes of sitting practice per day (or per session with a few sessions, but generally morning) to be optimal, much better than no practice, which I had tried for a period due to symptom severity.

RE: Dharma practice and mental health / bipolar disorder
Answer
4/4/14 6:23 PM as a reply to Clinton Tyler Patterson.
I'm glad you found it helpful. Private message me or write a post here if you have any questions.

RE: Dharma practice and mental health / bipolar disorder
Answer
4/4/14 9:03 PM as a reply to Tom Tom.
Tom Tom:
I'm glad you found it helpful. Private message me or write a post here if you have any questions.


Hi Tom,

Given that this thread was started a year ago, and you wrote you were 3rd/4th path, I am curious if this has changed or if you feel you have moved to 4th path now. I am really curious, if this is the case, how this has affected your mental health.

I must say, as someone without a mental illness who has gone through the paths, while there were some times before 4th path where I felt 'crazy', or mentally out of control (the dark night), the most memorable time this occurred was some distance down the insight road post 4th path. Truly, I would say my mental stability always was felt to be somewhat patchy up until I was fully done with the path, and that was sometimes really a driving factor to continue practice.

I'm sorry if this is a ramble, I think you are really an inspiration and it's great you are so up front and descriptive about your experience. It is a truly interesting question as to how, or whether mental health issues can be solved by attainment. It seems like the further in attainment one would go, the more there would be to anchor one to genuine reality, so instability would gradually subside. At any rate, this is how I experienced insight, and I am curious how this would work for someone with a more significant mental instability, if schizophrenia could be called that.

Cheers,
Tim

RE: Dharma practice and mental health / bipolar disorder
Answer
4/5/14 5:59 AM as a reply to T DC.
Hi Tom,

Given that this thread was started a year ago, and you wrote you were 3rd/4th path, I am curious if this has changed or if you feel you have moved to 4th path now. I am really curious, if this is the case, how this has affected your mental health.

I must say, as someone without a mental illness who has gone through the paths, while there were some times before 4th path where I felt 'crazy', or mentally out of control (the dark night), the most memorable time this occurred was some distance down the insight road post 4th path. Truly, I would say my mental stability always was felt to be somewhat patchy up until I was fully done with the path, and that was sometimes really a driving factor to continue practice.

I'm sorry if this is a ramble, I think you are really an inspiration and it's great you are so up front and descriptive about your experience. It is a truly interesting question as to how, or whether mental health issues can be solved by attainment. It seems like the further in attainment one would go, the more there would be to anchor one to genuine reality, so instability would gradually subside. At any rate, this is how I experienced insight, and I am curious how this would work for someone with a more significant mental instability, if schizophrenia could be called that.

Cheers,
Tim


Hi Tim,

This thread was actually started August, 2012 so it has been almost two years. I've edited the main post many times with new information and have added a lot of new posts.

I feel that by many definitions I have reached 4th path. I experience very little internal emotion and this is even in circumstances where I previously would have become full of emotion. I was once a very emotional person and now I find myself to be just the opposite. Paradoxically, I had previously learned to bottle emotions and to also appear as if I had a blunt affect. In turn, I appeared externally very un-ordinary from time to time to certain people. Now I seem to present externally as very ordinary.

There are many people on this forum who have reached 4th path who still experience the full range of emotions. I have no doubt that they have reached 4th path, but I seem to have reached past stage 6 and stage 7 on one of Kenneth's models of enlightenment. See

http://jaytek.net/KFD/KFDForum/page/A%2B9%2BStage%2BMap%2Bof%2BDevelopmental%2BEnlightenmenthtml.html

Stage 6: Emotional transformation. Marked attenuation of feelings. (See Damasio’s Looking for Spinoza for the distinction between emotions and feelings. Feelings are the subjective component of emotions. Emotions can and do carry on without the corresponding feelings, as emotions and feelings happen in different parts of the brain.) Practitioner may still display full range of emotions as observed by others while reporting only contentment, well-being, acceptance, etc. This new emotional stability sets the stage for...


This description is pretty much spot on to my experience though I would not say that emotions are 100% absent (definitely over 99% ). I'm not entirely sure what range of emotions I'm displaying externally, though I doubt I seem abnormal in any way these days. I have experience appearing abnormal externally and also experience with blunted/flat affect due to mental illness symptoms and the lack of emotions I'm experiencing bears little resemblance, internally or externally, to those types of symptoms.

I would also say I match the description for the stage prior to stage 5, stage 4 (minus most of, but not all of, the "neurotic patterns" as well as most of the identifications with emotions) as well as stage 7:

Stage 5: The tipping point. Practitioner has a profound sense of completion, as though “done is what needs to be done.” (One interpretation of the 4th Path of Enlightenment. And here is my 2010 commentary on interpretation of the 4-Path model.) The longing to be enlightened seems to have melted away. With further ripening at this stage, it will be seen that there is more to be done; the practitioner still experiences many of the old neurotic patterns, but has some distance from them. “It’s still happening, but it doesn’t seem to be happening to me,” is a common report. How common is this stage? As a rough estimate, I’ve guided 20-25 or so folks to this stage over the last 5 years. I occasionally meet someone who has come to this through some other system. At this stage, the practitioner is identified with emotional feelings rather than a conceptual self. So he or she will resist and argue with more advanced practitioners about what comes next...


Stage 7: Proprioceptive selfing is seen clearly. From the platform of the emotionally stable mind, it becomes possible to see that certain sensations, especially around the face, eyes, and forehead, are sporadically signaling “this is I, me, mine.” See Metzinger’s comments about Ronald Melzac’s neuromatrix and “a kind of proprioception that is so subtle, it’s almost unconscious” (paraphrased from memory, but here is the video). When the moments of operation of this proprioceptive selfing are juxtaposed, moment by moment, with non-selfing moments, the selfing is seen as painful and the mind conditions itself to stop doing it. This proprioceptive selfing seems to operates at several layers, however, because it comes back at a subtler level, as do feelings of fear, irritation, and aversion. Here is a Youtube video in which I sketch out the first 7 stages. (At the time, I did not know there were more stages available.)


However, in other ways I feel I have not yet attained 4th path. Daniel states that 4th path is an experience of complete and utter agencylessness and centerlessness. I experience an entire full-field of sensations transiently appearing and disappearing, though this is not always at the forefront of my mind. I have no experiential sense that these sensations are occurring to any person or inherently existing "entity." Yet it somehow feels incomplete in that I do experience some small sense of agency though I have not been able to pinpoint exactly where or how this is. A sense of a center is gone yet in the same way that there is still this lingering sense of agency perhaps there is some sense of a center from time to time though I cannot pinpoint this either. A big problem is that I had to completely stop meditating so I cannot sit and try to identify these things on the cushion. This was due to my schizophrenia symptoms as any level of sitting was exacerbating the symptoms and I decided to just stop for a while. My vitamin regimen seems to be kicking in big time as within the last few months I have had virtually zero symptoms. The entire year previous I have had periodic but very mild symptoms. Some periodic voices so mild that they could not be noticed externally, only internally.

I did try to sit and meditate about a month ago for a couple hours and while I did not have any symptoms during the waking day, I ended up having a lot of schizophrenic symptoms during dreaming the night of the day that I meditated (hearing voices in sleep, vivid wild and crazy dreams). So, for now, I have quit meditation but perhaps will pick it up again if and when there is a time when meditating no longer exacerbates my symptoms. However, I would also say that the drive and strong desire to sit and meditate is gone. I also haven't read any books or looked up anything online about dharma and spirituality in quite some time whereas I was previously quite entranced with such things.

It is a truly interesting question as to how, or whether mental health issues can be solved by attainment.


In my experience, they were not completely resolved with attainment, and perhaps I would attribute about 50% of the recovery to enlightenment and emotional changes/attenuation and the other 50% to the vitamin regimen and the medication. In the earlier stages, enlightenment probably made me appear externally worse and meditation served to exacerbate some of the symptoms as can be read in the reports above. This was also due, partially, to my ignorance on this issue as I did not have the type of information that I've presented in this thread and was pretty much taking stabs in the dark until I succeeded.

In addition to all of this I experience absolutely no sense of time. There seems to be no change whatsoever to this realization for the past year or more. It is always now and this is unshakable and unwavering. Unlike the previous realizations there are no periods where suddenly time appears and then disappears, it is always completely absent. I don't feel comfortable saying "Full 4th path" until the agencylessness and centerlessness are as equally unwavering as this is the actual definition of 4th path used here on the dharmaoverground though definitions do vary and I do seem to be above and beyond the criteria of 4th path defined elsewhere.

RE: Dharma practice and mental health / bipolar disorder
Answer
4/5/14 6:19 AM as a reply to Tom Tom.
I would also add to this that Kenneth places the end of all agency (if that is what is meant by "curshing blow") as the very last stage on his list

Stage 8: A deepening of the insights from stages 6 and 7, plus a crushing blow to the ownership and agency aspects of selfing. (See Metzinger, The Ego Tunnel, for more on ownership and agency as components of selfing.) Practitioner feels very “enlightened” at this point, even somewhat alien as compared to “normal” people. Lots of disorientation. At times some sense of “divine retardation,” in which practitioner feels him or herself losing interest in some things that mattered previously, while simultaneously feeling profoundly OK with these changes. Life gets simpler as unnecessary ideas and attachments slough off. Friends can drift apart if some neurotic need no longer needs to be fulfilled. Conventions and concepts soften in favor of “this is happening now.” Disorientation becomes the norm and one adapts to it. Some motivations, e.g., need for social status, need to be right, need to please others, which began to lose steam at KF5, fade further. How common is this stage? I personally know at least seven people, five of whom are my students or former students. As of this writing (April, 2012), I also consider myself to be at this stage.)


I would definitely say the path of my progress matches Kenneths descriptions very well and in the order he has placed them. Though I wouldn't say that I experience any "divine retardation" though there is a loss of interest in certain things that I am no longer neurotic about. Though I don't sense this as a "retardation."

RE: Dharma practice and mental health / bipolar disorder
Answer
4/5/14 7:10 AM as a reply to Tom Tom.
Tom Tom:
I would also add to this that Kenneth places the end of all agency (if that is what is meant by "curshing blow") as the very last stage on his list



I was just about to ask a question about this very subject and as if by Magick, the answer appears in the very first post I look at!

Just wanted to add my own experience to this thread as another data point considering that so little is understood about this and thousands of people with serious mental health issues are currently being introduced to mindfulness by professionals who would probably laugh at the very idea of 'enlightenment'.

I second what Tom says about review cycles after path (especially First!) being points to watch out for if you've ever experienced psychosis. I didn't really even know if I was asleep or awake I was cycling through the stages of insight so vividly. Make sure you have plenty of atypical anti-psychotic to hand after stream-entry if there's any chance you're on the bipolar spectrum.

I think I may now be at Kenneth's fourth path and I consider my depression/bipolar disorder to be effectively cured. Peace and joy are starting to become my predominant mind-states and any unskilfull mental habits are so easy not to follow it's like a joke. However, I have to stress that I think the process nearly killed me last winter - but looking back there was a 'purifying' element to the breakdown I had that may have meant it was really a 'purging' of negativity. God knows.

I just want to thank Tom for helping to save my life with the advice he kindly gave me when I first turned up on this forum after the Kabat-Zinnians had got me in over my head.