I would like to return to the practice of Buddhism. Where should I begin?

I have a serious mental illness. It has been well treated by medication.

When I was young, before I developed this illness I would practice meditation as best I could. But I had no mentor and so I don't know if my practice was correct. I do not come from a Buddhist culture so I know little about the subject other than what I have been able to read.

Will my medication interfere with meditation as it is obviously mind altering?

Should I start for example with meditation on impermanence, on mindfulness, or by attempting to reduce my desire?

  • Welcome. I wonder whether someone could answer this if you asked it on discourse.suttacentral.net – ChrisW Jul 6 at 9:48
  • Thank you @ChrisW I will try that. My main fear is not that I could make my condition worse, but more that I may be practising incorrectly and reaching states (of mind) that are unhelpful. It might even be that I cannot perform some meditation correctly because of my medication, but stopping the medicine is not really an option. – Huw Evans Jul 6 at 10:39
  • I feel I have some understanding of what you're saying, I was close to someone who maybe had similar experience, and for whom medication was effective (I won't be one telling you to stop medicine). Your question is a bit specialised (outside most people's experience). and IMO I haven't previously seen it answered really well on this site. Perhaps someone needs extensive or specialised experience as a teacher to answer it from experience, hence my suggestion you could try asking on SuttaCentral; and/or ask, "If you can't answer, do you know where/how/who else I could ask who might know better"? – ChrisW Jul 6 at 11:57

A while ago, i wrote this as an answer to a similar question. I suspect you are struggling with something a bit different than the poster from that previous question, but i hope that answer can shed some light regarding the mind-altering aspect.

I don't know how your particular medication is expected to work, but giving some thought on whether you'd have an easier/harder time meditating without your medication would probably give you a clue (I am not arguing for/against using medicine here).

Provided your healthcare givers aren't giving you the red light for meditation, the choice of meditation subject is likely no different than for anyone else starting up. You can never go wrong with anapanasati. If you have the time and energy, here is a good introduction text:


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  • Thank you for your answer. Yes it is very different, delusions and hallucinations are the main symptoms. It was not possible to calm the mind in this state. I have continued with meditation on breath throughout my illness though as a part of my martial arts training. – Huw Evans Jul 5 at 18:48
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    @HuwEvans Glad to read that you're able to keep your symptoms in check. It seems to me like you're already an experienced practitioner! – Erik Jul 5 at 18:51
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    I have some experience but only in the a few aspects... The martial art (japanese shorinji kempo) teaches a rather radical form of Buddhism. I feel that it's teachings would probably not be considered correct or helpful to the majority of Buddhists. Teaching yourself to not suffer when you are in pain is a big part of it. – Huw Evans Jul 5 at 18:57

Please check with your doctor on whether you could attempt any meditation while on treatment. Answers that you get from this site does not substitute or supersede professional medical advice.

Firstly, you should try to observe the five precepts. This is the foundation to virtue, and to all other practices.

Secondly, you can try "A Guided Meditation" by Thanissaro Bhikkhu.

It has basic meditation steps, where it starts with loving kindness (metta), then it goes to mindfulness of breathing, then body scanning and finally ends with loving kindness (metta) again.

It's relatively simple, and it's also useful for building your foundation in meditation, as he explained:

If you can keep the mind centered in this way, you'll have a standard against which you can measure its movements, its reactions to the events around it and within it. Only when you have a solid center like this can you gain insight into the movements of the mind.

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    Thanks, I understand your concern but western medicine does not have much to say about meditation. Mindfulness meditation is actually offered in some form by the medical service though. – Huw Evans Jul 6 at 8:44
  • @HuwEvans Please also see this answer. There's a lot of info there about medicine and meditation. The main ones are Mindfulness Based Stress Reduction (MBSR) and Mindfulness Based Cognitive Therapy (MBCT). There is a TEDx Talk video by Dr. Zindel Segal, which explains MBCT and provides research evidence. But I'm not sure if MBSR and MBCT are suited to your particular condition. – ruben2020 Jul 6 at 9:36
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    I had heard of that research, but so far as I know there just isn't any evidence either way other than that research. Those studies were very recent and my condition is very different to the ones studied. I have mentioned it to my doctor in any case. Her answer was basically 'I dont' know'. The impression I get is that psychiatry is still in it's infancy. The medication I am on was only discovered in my lifetime. – Huw Evans Jul 6 at 10:31
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    @Erik Yes, I'm not looking for a clinical application. I just want to practice (meditation and wholesome living) correctly. – Huw Evans Jul 6 at 10:49
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    @ChrisW Indeed, it's a very new science but credit where credit it due: they are good at getting people functioning in society. Functioning in society is a long way though from following the 8 fold path. – Huw Evans Jul 6 at 11:25

This doesn't answer your question ... but perhaps what you're asking might be independent of "mental illness", in which case advice for you -- about "following the 8 fold path" -- might be the same for you as for everyone.

I'm not sure whether (or which) "mental illness" is an issue at the moment, given that you say it is well treated by medication -- from your writing here you seem to me lucid and obviously not very disabled.

If you were anxious about meditation, possibly like this would be relevant -- Three Tips on Mindfulness from a Buddhist Psychiatrist:

For those with anxiety especially, the idea of being alone with one’s thoughts can be overwhelming at first. Epstein does not recommend that one buckle down and push through such moments. Rather, he relates a story of discussing meditation induced anxiety with the Dalai Lama’s physician to find that Buddhism was quite familiar with the phenomenon. For those who find meditation to be suffused with dread,

“Tibetan doctors have such afflicted patients do simple tasks like sweeping the temple halls or chopping vegetables in the kitchen rather than prescribing more meditation. They know that they treatment for meditation-induced anxiety disorders is less meditation, not more.”

If the idea of meditating just seems like too much, bring the same focused attention to bear on doing your household activities, and in the process you will find your mind settling down to rest.

I'm not saying you are anxious, only that this seems to me an example of the sort of adaptable advice -- adjusting to your specific condition -- that you might benefit from if you were able to find an experienced teacher.

As for "practising incorrectly and reaching states (of mind) that are unhelpful", again I don't know what to say, not that I'm an expert.

This might be a good question (that I still wouldn't know how to answer) even as a stand-alone question i.e. if it were asked decoupled/independent from any question of prior/preconceived mental illness.

Correct me if I'm wrong but I suspect that Buddhism doesn't even start with meditation.

So far I know I think it's said to start with "virtue" (see e.g. here or here) -- including being mindful of "the precepts" as perhaps a minimum or a good beginning, and a certain but not excessive "generosity" (or dana) too -- being harmless, moderate, self-restrained.

And perhaps Right View is maybe supposed to be primary, and I think that that might start not with meditation but by learning dhamma -- reading suttas, hearing dhamma talks.

In earlier times that would necessarily have meant meeting with people (Kalyāṇa-mittatā).

Should I start for example with meditation on impermanence, on mindfulness, or by attempting to reduce my desire?

For me it was a question like, "Why would I be suffering after a friend's death?" -- that kind of touches on those themes, e.g. "impermanence" and "desire" -- and "attachment", which is adjacent to desire, and the sense of "self" which is said to be another cause of suffering.

I haven't read that's one of the classic forms of meditation, but it (death) is one of the classic forms of suffering and incentive for many people.

Off the top of my head some of the classic forms of meditation are:

  • Learn to concentrate (on the focus of meditation)
  • Learn peace or to relax (by letting go)
  • Learn to observe (the senses are impermanent)
  • Learn not to lust (by concentrating on disadvantages and by not dwelling on the sign of what's attractive)
  • Learn to be kind and not angry or selfish (by rehearsing to view everyone as a friend)
  • And many more -- Dzogchen, maybe "just sitting, and this rather remarkable practice (all from different schools)

This is sometimes summarised as there being two forms, i.e. Tranquillity and Insight, of which you eventually need both

I really couldn't tell you how you should start.

Maybe the question is more how you should stop -- Brahmana Sutta -- perhaps that's not the right question either.

This might help -- Four stages of enlightenment -- a partial summary of doctrine of one of the major schools (Theravada). I mention it because you were asking about "reaching states (of mind) that are unhelpful", this article might give a hint or road-map about what states of mind are considered relatively enlightened. Even then I'm not sure, there's an aspect of this or risk that it might be a bit selfish or anti-social, solitary.

I think the unhelpful states of mind might be what are called Kleshas.

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  • When I meditate, I go through different states of mind that I can't easily describe. They dont' resemble the Klesha's or a stage of enlightenment as I have ever seen them described. They are more different levels of 'focus', 'awareness' and 'concentration'. I don't know if any of them are one's I should aim to prolong or if I should dismiss them all. – Huw Evans Jul 6 at 15:49
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    Perhaps I need to find a mentor? – Huw Evans Jul 6 at 15:49
  • Perhaps, eh? I (for example) studied a "martial art" too for a while: and that would be inconceivable without a mentor. I expect a lot of learning (skills?) needs a mentor (except technologies for which it may be enough to RTFM if you're inclined). I for one though don't know how to help with "different states of mind that I can't easily describe" -- I am not a meditation teacher. Different states are impermanent, perhaps it's their cessation that's unceasing -- though people do reason about states -- I suppose that ... – ChrisW Jul 6 at 16:59
  • ... "Abandon the unskillful, develop the skillful" depends on having some ability to recognise (or to learn) what's skilful. I wish I could explain it in a sentence, apparently "Hanc marginis exiguitas non caperet" though, a.k.a. "I wish I could have given him this beautiful moon." – ChrisW Jul 6 at 17:07

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