Padmasana on Prozac?

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With my instructor Patricia Walden, I've been teaching workshops on yoga for depression for several years. Some of our students have used the yogic tools we teach--like asana, breathing techniques, and chanting--to avoid taking antidepressants or to reduce their dependency on the drugs.

But we don't offer the workshops as a method of persuading people not to find pharmaceutical support in difficult times. There are situations when drugs truly are just what the doctor ordered. I view them as powerful means--along with yoga, aerobic exercise, and psychotherapy--to help address what can be a life-threatening condition.

Not only can clinical depression lead to suicide, but it can suppress the immune system and heighten the risk of dying of a heart attack or suffering a recurrence of cancer. In the right circumstances, antidepressants can offer amazing life support.

Mind you, these medications--such as Prozac and Zoloft--are far from perfect. They can take weeks to become effective and, unfortunately, are not guaranteed to work for everyone. Sometimes it takes a painful process of trial and error to find the right antidepressant. And even when a particular drug does offer relief, it can trigger various side effects--from insomnia to sexual difficulties to a blunting of all emotions.

Yet antidepressants can help some people overcome depression, and can also give them the strength to tackle psychotherapy, bring themselves to their yoga mats, and make other life changes that may make the drugs ultimately unnecessary. Other people, particularly those with repeated episodes of major clinical depression, may need antidepressants for longer periods to stay out of the abyss.

Despite the proven benefits of these drugs, some people cling to the outmoded belief that they (or others) should be able to "snap out of it" without relying on the "crutch" of medication. Clearly, the persistence of this belief in our culture has little to do with its value and much to do with our fears about mental illness.

What's wrong with seeking help when you need it? No
one would dare to guilt-trip a diabetic about needing
insulin or think a person who takes an antibiotic to
get over pneumonia is spiritually weak. But our society has yet to completely accept mental illness and its treatments as just another entry on a medical chart.

Antidepressants themselves are neither good nor bad. What matters is whether they are an appropriate choice for you in light of your overall condition and the other methods at your disposal. Far from being a sign of weakness, recognizing when you need medication is a matter of seeing clearly--which is what yoga is all about. It can take a lot of strength to recognize the painful reality that you need help.

The question is not just whether to take an antidepressant but what you do with the resulting lift in mood and energy. Are you using it to begin the hard work of figuring out what your dark emotions may be signaling? In my experience, depression is often--although not always--a sign that something needs to change: an unfulfilling job, a dysfunctional relationship, an attachment to past resentments or disappointments.

If you take the medication to feel good but don't face what needs to be faced, you not only miss the opportunity to transcend the depression, you may be inviting its return.

Timothy McCall is Yoga Journal's medical editor. His Web site is www.drmccall.com.