Within Madhyamaka thought, suffering is understood as empty of inherent existence, lacking any independent or unchanging essence. It arises only in dependence upon causes, conditions, and conceptual designation, and therefore cannot be found as a solid entity when subjected to careful analysis. This is the meaning of suffering as dependently originated: it appears and functions, yet it does not stand on its own. The ordinary tendency is to regard suffering as something fixed and substantial, but this very perception is already shaped by ignorance. Madhyamaka thus situates suffering within a dynamic web of relations rather than as a self-contained reality.

Ignorance of emptiness is regarded as the root from which suffering springs. When persons and phenomena are misperceived as inherently existent, there arises grasping at “I” and “mine,” along with attachment, aversion, and the various mental afflictions that sustain duḥkha. The reification of experience—treating what is fluid and contingent as if it were solid and self-established—intensifies the sense of being bound by suffering. In this way, suffering is not merely a set of unpleasant experiences, but a distorted way of relating to what appears.

Madhyamaka employs the framework of two truths to clarify this. On the level of conventional truth, suffering is fully acknowledged as experientially real, ethically significant, and in need of remedy. On the level of ultimate truth, however, suffering is seen as empty of inherent nature, without any findable core when analyzed. It is neither absolutely real nor utterly non-existent, but dependently arisen and conceptually imputed. This middle way avoids both the extreme of eternalism, which would treat suffering and the sufferer as ultimately real, and the extreme of nihilism, which would deny the meaningful reality of suffering altogether.

From this perspective, liberation does not consist in destroying some ultimately existent entity called “suffering,” but in recognizing its empty, dependently arisen character. When this recognition matures, the rigid conceptual and emotional grip on suffering loosens, and the proliferating thoughts that sustain bondage begin to subside. Seeing that suffering lacks inherent existence undercuts the ignorance that fuels attachment and aversion, making genuine transformation possible. In this sense, the very emptiness of suffering is what allows for its cessation and opens the path to freedom.