Home Base with Jeff Warren
Home Base with Jeff Warren
Medication and Meditation
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Medication and Meditation

I thought I could wrestle my mind into any shape I wanted. But it doesn’t work like that.

I’m medicated. And I’m meditated.

As a meditation teacher, I get asked versions of these two questions all the time:

  1. Does meditation work if you’re on psychiatric medication? And

  2. Can meditation help me get off psychiatric medication?

Artwork by Home Base community member Candace Coakley

There’s no one-size-fits-all answer to either question. Below are some thoughts on the topic, with a focus on my own experience as a human with mental health challenges. Obviously I’m not a doctor. Everyone’s situation is vastly different – please keep that in mind.

Does meditation work if you’re on psychiatric medication?

Yes, meditation can still work if you’re on medication.1 In fact, meds can help create the stability necessary to meditate in the first place. Then, as the practice begins to create healthier habits, it can – in theory – lead to conditions in which you may no longer need medication. On the other hand, you may need the support of medication your whole life – if that’s what works, so be it and thank you. What matters is figuring out what’s going to help you live with less suffering and more fulfillment.

Here’s an analogy: Recently, my right foot started killing me. The issue stems from a bad habit of walking with my foot turned out, which over time has worn down the ligaments of my inner arch. Cue grumpy Jeff, hobbling around in a plastic boot.

A podiatrist recommended orthotics. In our analogy, orthotics are like medication. They are an external intervention that will hopefully alleviate my symptoms. Orthotics will not cure my foot, but they can offer the support I need to do the things I want to do. I may be on these orthotics for the next 20 years. If that gets me back to dancing around like a happy idiot, I’m down.

Meanwhile, I also spoke to a physiotherapist, who said orthotics are fine, and ... he prescribed a series of strengthening exercises to help with my overall alignment and to build up the weak muscles of my foot. In six months, I may be able to go off my orthotics without the pain coming back. Or, I may not.

The exercises and re-alignments we do in physiotherapy are a lot like the ones we do in meditation. One is physical and one is attentional. They create new healthy habits that can address specific imbalances. In this sense, meditation teachers are like physiotherapists of the mind.

So: both medication and meditation can help. I see meditation as the more fundamental intervention, because in the long game it aims to get to the root of what causes much of our chronic suffering in the first place: the sense of separation and alienation, the reactivity and fear, the need to control the changing conditions of life.2

What might the above actually look like in practice?

My Meditation/Medication Chronology

I’ve struggled with mental health issues my entire life, mostly ADHD-related blow-out and emotional intensity, and then issues related to an as-yet undiagnosed mood disorder. In my late twenties, I realized meditation could help. It was a big insight for me – that I could do something under my own steam, without depending on some external authority. Meditation helped take the edge off my suffering. It gave me more perspective and stability. It also gave me a hopeful direction in life: not only could I manage my symptoms, I could turn that management into a spiritual practice that directed me to the wonder and magic of being alive (to say nothing of the tantalizing promise that it might uproot a big chunk of my suffering altogether). I’ll take it!

Then life changed, thank you impermanence. After I published my first book, I entered a fierce period of dysregulation where meditation was no longer enough. I had to face my own biases here. I thought I could wrestle my mind into any shape I wanted. But it doesn’t work like that. Although I can improve certain habits of mind, I cannot change my mind’s basic character, any more than I can change my body’s basic character. Meditation eased my pain by helping me accept that. I began to see how medication might also ease my pain, by stabilizing me enough for that acceptance to land.

I tried ADHD meds. Ritalin didn’t work – it felt like I was partying all the time, which I was actually trying to do less of. Concerta, however, did the job. I felt more settled and clear and could prioritize better. Except then, a couple months into it, the meds themselves became a problem – they started to make me feel cut off and buffered from life. I went off Concerta, and life circumstances improved. I found more community support. All was mostly well, for a while.

Then, a few years later … another down, this one resulting, finally, in a bipolar diagnosis. I tried lithium, but it made me feel spaced out. I started trauma therapy and that provided the ballast I needed at that time.

Things changed again – kids, Covid, more mental health shitstorms. One afternoon, in a busy emergency room filled with very vocal and unhappy people, a kind psychiatrist recommended a low dose of lamotrigine for my bipolar. It helped, and it stayed helpful. Not long after, my family doctor recommended an antidepressant, and I’ve been on 50 mg of Zoloft every day since. The lamotrigine keeps me more balanced; the Zoloft keeps me less reactive. These pills make me a better parent, and I’m grateful for them.

I go into all this detail because real life is messy. For most of my existence I’ve managed my mental health challenges without medication. And then a few years ago, when life took me outside my window of tolerance, I found the support I needed in psychiatry.

I still meditate – in formal practice, and moment-to-moment, in life. Overall, my inner world is more gentle, my relationships are more intimate, and my creativity and service are easier and more fulfilling. The habits of mind and heart cultivated in meditation work for me. Perhaps more importantly, there’s also an ever-growing understanding that who I am has nothing to do with those habits, or indeed, with any of my ideals around how I’d like my life to go. This sense – call it the sacred-weird-cosmic-perfection-of-now – gets continually more charged, and I know that’s where I’m headed, medication or not.

For our guided practice this week, I encourage you to find the metaphorical orthotics you need to make the meditation more accessible. They may be indispensable — if so, embrace them! Then we’ll practice a few core habits of mind that support positive change, and finish with a mystical tease, because that part makes my happily medicated brain shine.

Much love,

Jeff

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Online Retreat: The Subtle Art of Not Doing Anything

March 20, 2025, 7:00pm - 8:30pm ET
New York Insight - Online

Join me for an online evening thingy in March hosted by the good people at New York Insight, who gave me this instruction: “Begin your program description by addressing a core challenge or problem that your target audience is facing.”

Allow me then, to begin this program description by addressing a core problem that my target audience is facing:

Life.

Life is hard! So much happening, so many people doing important things, running around helter-skelter in a flurry of productivity.

This 90 minutes will not be about any of that.

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THIS WEEK ON THE MIND BOD ADVENTURE POD

This week, we explore the spiritual heart of psychedelics with Celina de Leon, founder of the Circle of Sacred Nature Church, and adjunct faculty at the Graduate Theological Union. Celina has spent 20 years working with ayahuasca – or yagé, as it’s known in the Kamentsa indigenous community of Colombia, her root lineage. We talk about psychedelics as contemplative practice, and under Celina’s gentle guidance, experience a taste of the deliberateness, care, and mystery of ceremony.

Listen Here

1

Although medication itself isn’t a barrier to meditation, there are psychological conditions in which it’s helpful to consult an experienced mental health professional before starting a meditation practice. Sitting and noticing your thoughts is going to be challenging in any period of intense dysregulation, and that includes chronic anxiety and depression and symptoms associated with psychosis, schizophrenia, bipolar, PTSD and some ADHD. It can even make things worse. And, as with all mental health situations, it is always on a case-by-case basis. I know plenty of schizophrenic and bipolar and ADHD folks who benefit hugely from meditation. Some experimentation with different practices may be necessary (a self-compassion or a movement practice may be a better fit than a vipassana retreat, for example), ideally under the supervision of a qualified expert who knows the particulars of your situation. I write this knowing full well most people won’t have that supervision – I didn’t - so all this is very lurching and imperfect. It’s a complicated subject that’s hard to do justice in a footnote!

2

The meditation/physiotherapy analogy breaks down at the deeper end of practice. One long term goal of meditation as a spiritual practice is fulfillment and connection independent of conditions. Fulfillment even when your body is coming apart, even when your mind is coming apart. The physiotherapy equivalent of this would be a set of exercises that transcends the need to do exercises, but frees you up to continue to do them anyway, because … well, caring for your embodiment is a beautiful thing to do, and if you’re going to be in this life, why not learn to be here in a more loving and attentive way?

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