Buddhist-derived “mindfulness” practices are currently enjoying popularity amongst both the lay population and health professionals in the West, especially in the treatment of psychiatric conditions such as depression. This popularity leads to questions regarding how people in diverse Buddhist communities might conceptualise psychiatric illness and healing. This paper explores perspectives on psychiatric illness within a Tibetan Buddhist community in North India, focusing on the role of “emotions” in causation and treatment which was frequently discussed by informants. Comparisons between biomedical perspectives on emotional “disturbance” as a symptom of psychiatric illness and Tibetan conceptions of emotions as causal or contributory factors in a number of psychiatric illnesses are discussed. Three case studies are described to illustrate some of these common perspectives, examine how they are reflected in health-seeking behavior, and consider comparisons between the two systems.