Damcho Pamo, a British woman, experienced psychosis and mania, when she was 51, while attending an intensive meditation retreat. Prior to this chapter in her life she had no history of psychological problems and in fact was psychologically robust.

In 1997 I became involved with a Zen group. I adopted a daily meditation practice and attended three retreats a year, two weekends and one five day. The retreats were intensive as they were in silence, the only opportunity to talk was in individual interviews with the teacher, and there were around eight hours of meditation a day.

I was motivated to attend the retreats and to practise meditation daily to engage with an authentic practice enabling me to be more in touch with The Sacred and in particular to develop compassion.  In 2001 whilst attending one of these five day retreats I became manic and psychotic. It actually turned out that I was slightly psychotic when I arrived at the retreat, though at the time I wasn’t aware of that. The first night there I had very disturbed sleep. My mind was racing and I slept for only about three hours. I had a sense of my mind fizzing. I was concerned about this as I normally slept well and especially so when I attended retreats so I raised it with the teacher. She was dismissive just saying you don’t need to sleep when you meditate. So I continued with the retreat becoming increasingly psychotic and manic. Having no prior experience of such states I had not a clue what was going on. There were not many signs that I was in difficulties as I attended the whole of the programme. However I think my demeanour must have been odd and also I was eating very little at some of the communal meals but none of this was picked up on; no one approached me to ask how I was. After the retreat I was travelling for three or four days. During this time I became increasingly psychotic and manic but amazingly managed to negotiate train tickets and generally look after myself. The first two days at home my husband and I had visitors. I managed to cope with that. Much of my psychosis was just in my head and I was quite clever at hiding it from others but my husband and our guests could see that my behaviour was odd. It then took my husband a couple of days to persuade me to see the doctor. I was very wrapped up with what was going on in my head but had no sense that anything was wrong. I had no awareness in that way. When the doctor came he interviewed me for about two hours and easily established that I was psychotic and manic. I was then given medication that very quickly got me out of this state. However it turned out to be just the start of a three year illness. I went on to experience long periods of agitated depression and a further period of psychosis and mania. Eventually having had two courses of ECT and with the right balance of medication my condition became stable. From 2004 I was sufficiently well to work. My condition ever since, on the right balance of medication, has been stable. In 2002 I became involved with a Tibetan Buddhist group, adopting a daily meditation practice from 2008 and becoming a Buddhist in 2013. With my illness I had been in a cul-de-sac but now feel I am back on the Buddhist path.

I see the meditation retreats that I attended and the daily meditation practice I adopted, and actually practised in a rather forced way, prior to becoming ill, as contributory factors to me becoming psychotic and manic. The strongest indicator of this being so was that for the first four days after each retreat I would be aloof, distant and cold towards my family. I’d then snap out of it and revert to my usual warm and supportive self. However at that time there were also several strong stressors in my life. I had a perimenopausal physiology that was giving me psychological problems, a close relative had died, my work was stressful and I felt frustrated about my employment, and I practised Astanga Vinyasa Yoga, a very physically demanding and energising practice. In addition I had an underlying genetic vulnerability as relatives in my extended family had had similar problems.