Simply put, the Buddha’s message in the first turning of the Wheel of Dharma is that anyone with a dualistic frame of mind suffers. The dualistic mind entertains selfish emotions, creates karma, has worries, hope, fear and pain. Dualistic mind seems to have built-in suffering. There is an immense variety of suffering, but all of these can be included within three types: the suffering of change, the double suffering of unpleasantness piled on unpleasantness, and the all-pervasive suffering of being conditioned. This is not a matter of mere philosophy; it is very real. We can and do experience suffering, discomfort, distress, and worry throughout our lives. Dualistic mind is always ready to be upset, to feel uneasy. An input from the senses, a memory or anticipation that is either a little pleasant or a little unpleasant always has the power to disturb us. In addition, there is one suffering which we can never ultimately sidestep: death.

-- Chokyi Nyima Rinpoche