We can see that often people with schizophrenia, clinical depression, and other problems are treated with psychotropic drugs and show improvement in their symptoms. Sometimes they become almost completely cured by these drugs.
However, this can be quite difficult to explain from a philosophical perspective, since the mind is supposed to be a subtle entity, intrinsically different from the body.
Different from the brain, which is an organ, The mind is a subtle entity that can’t be affected by chemical substances. Drugs can surely affect the workings of the brain, but how can they influence the workings of the subtle mind? This question applies both to pharmaceutical drugs and recreational drugs since both classes have similar effects on one’s consciousness. So, how does it work?
The point is that although the brain and the mind are different entities, they are deeply connected. The brain is a kind of interface between the subtle mind and the gross body. The mind receives the signals from the brain, and based on these signals creates our understanding of reality.
If the brain sends a message of constant pain to the mind, for example, the mind will be affected by it, and because we (the soul) are identifying with the mind, we will feel unhappy.
How can the soul feel pain, if the soul is by nature different from the mind and the body? Srila Prabhupada explains this concept in his purport to SB 5.10.22: “It can be said that a person sitting in his car is certainly different from his car, but if there is damage to the car, the owner of the car, being overly attached to the car, feels pain. Actually, the damage done to the car has nothing to do with the car’s proprietor, but because the proprietor has identified himself with the interest of the car, he feels pleasure and pain connected with it. This conditional state can be avoided if attachment is withdrawn from the car. Then the proprietor would not feel pleasure or pain if the car is damaged or whatever.”
In this way, the soul identifies with the pain and pleasures of the mind, and the mind in turn receives the signals from the physical senses through the brain. In other words, the brain does not only serve as an interface between the mind and the gross senses, but it also works as a medium for the expression of the mind and intelligence. We can practically see that when the brain is damaged, one’s intelligence or memory can be impaired, and if the damage is serious enough, one can be reduced to a vegetative state, unable to act at all.
One example we can give is that our computer is connected to our webcam, keyboard, monitor, and so on by a mesh of cables. If these cables are damaged, different peripherals may stop working, although the computer itself is fine. The brain is thus like the mesh of cables that transport information from the senses to the subtle mind and vice-versa. As long we are in the body, damage to the brain can affect our consciousness and our understanding of reality.
Psychotropic drugs don’t have a direct effect on the subtle mind, but they affect it indirectly by affecting the workings of the brain. A drug can make the brain start sending signals to the mind that everything is wonderful, and this will make the mind experience pleasure, a feeling that is thus shared by the identified soul. Illicit drugs like cocaine or heroin make the brain work in erratic ways, and their use can be quite damaging to one’s spiritual practice, but when we speak about legal drugs used to treat schizophrenia, depression, and other diseases, the situation is not so black and white.
A pure devotee may not be affected by such conditions because he may have reached a level where he is not identifying with the mind. At this point, the state of the mind may not interfere in his devotional practice. However, one not on such an elevated platform will still be affected by the state of the mind, and in this case, be affected by diseases of the brain.
Just like someone who has a broken arm or leg may have to go to a hospital to fix it and be able to continue his or her services, someone with a broken brain may benefit from psychiatric drugs correctly prescribed. The opposite may also the true: too many desires in the subtle mind may make it too disturbed and it may manifest in the form of disease in the gross body. In such cases, psychological treatment may actually cure physical diseases.
It’s true that the holy names can cure all maladies, including disturbances created by the brain or the mind, but this happens only at a very high level. A devotee who is mentally sick and doesn’t receive the proper medical treatment may not have an opportunity to properly practice and associate with devotees, and thus not be able to ascend to such a platform in this life.
Some problems, like regular depression, can be treated with just psychological assistance (that should be ministered by devotees who have the proper competence in this regard) but serious mental conditions may demand the use of psychiatric drugs to be controlled, and there is nothing wrong in using such facility if it’s necessary. The main principle is that we should accept what is favorable to our devotional service and reject what is unfavorable.