Lethargy, Fatigue, and Insomnia | Songdo Depression

Hello, this is Baekrokdam Korean Medicine Clinic.

Today, I'd like to talk about the term "depression" in a slightly different way. Many consultations begin with expressions like "feeling down," "not wanting to do anything," or "not wanting to meet people"... However, beneath these expressions lies a much more complex language of the body.

1. The morning feels heavy and the day feels long – Lethargy and Fatigue

“I don't feel refreshed even after waking up.”

“Waking up in the morning is a battle.”

Many people start with these words. A heavy body isn't just a matter of 'lacking strength'; it's a state where qi (vital energy) doesn't circulate. In Korean medicine, such cases are interpreted by distinguishing between 'Qi deficiency' (기허) and 'Qi stagnation' (기울).

• Qi deficiency (기허): A state where energy is depleted, and the entire body feels sluggish.
• Qi stagnation (기울): A state where qi is circulating but is blocked and stagnant somewhere.

Herbal medicines like Bojungikgitang (Buzhong Yiqi Tang) and Hyangsaryukgunjatang (Xiangsha Liujunzi Tang) don't just eliminate fatigue; they help clear these blocked flows and restore qi circulation. Acupuncture treatment re-establishes the energy center at points like Zusanli (ST36) and Jungwan (CV12).

2. Difficulty falling asleep and frequently waking up at night – Insomnia and Autonomic Nervous System Imbalance

“I feel sleepy, but I keep waking up.”

“Even after waking up, I feel groggy and lethargic.”

In such cases, it's not simply a lack of sleep; it's that the body cannot transition into a state of rest. The mind wants to rest, but the nervous system is still awake. This is what we call persistent tension of the autonomic nervous system.

In these situations, herbal prescriptions like Sanjoin-tang (Suanzaoren Tang), Gwibi-tang (Guipi Tang), and Cheonwangbosim-dan (Tianwang Buxin Dan) help calm the mind and body. Acupuncture points such as Naegwan (PC6), Shinmun (HT7), and Samumgyo (SP6) help reduce sympathetic nervous system activity. While herbal medicine and acupuncture work differently, they complement each other to help restore the night's rhythm.

3. My chest feels tight and my heart races – Anxiety and Shortness of Breath

“I'm not stressed. But my heart keeps racing, and I feel tight in my chest.”

When we hear such expressions, it often means the patient doesn't consciously perceive stress. It indicates that the body is reacting first. In Korean medicine, there are concepts like 'Phlegm Stagnation (담울)', 'Heart and Gallbladder Deficiency with Fear (심담허겁)', and 'Rebellious Qi (기역)'.

It's a state where thoughts aren't settled, and emotions cannot escape, remaining trapped somewhere in the chest, throat, or diaphragm. Representative prescriptions include Banha-hubak-tang (Banxia Houpo Tang) and Ondam-tang (Wendan Tang), and acupuncture treatment focuses on 'releasing' at points like In-dang (EX-HN3), Danjung (CV17), and Taechung (LR3). Breathing must accompany this treatment. For those who find it difficult to breathe deeply, the treatment cannot penetrate deeply.

4. Loss of Appetite and Frequent Indigestion – Anorexia and Digestive Issues

Feelings of depression often begin in the stomach. Rather than just feeling down, it's often expressed as 'my stomach feels completely blocked,' 'I feel more uncomfortable after eating,' or even 'I don't feel hungry at all'.

Concepts like Qi deficiency (기허), Liver-Qi invading the Stomach (간기범위), and Phlegm accumulation (담체) are involved here. For instance, Hyangsaryukgunjatang (Xiangsha Liujunzi Tang) is beneficial for strengthening stomach function, and Soyosan (Xiaoyao San) is a prescription that relieves the digestive system from emotional oppression. Banha-sasim-tang (Banxia Xiexin Tang) re-establishes the stomach's rhythm disrupted by reflux and tension. Such issues cannot be resolved solely with medication. True improvement requires adjusting meal times, breathing, and stress responses.

5. The Relationship Between Female Hormones and Emotions – Depression During Menopause and Pre/Post-Menstruation

A woman's emotional state is sensitively linked to hormonal changes. Menopause, pre/post-menstruation, postpartum depression... During these periods, emotions fluctuate wildly, and tears can fall over minor things. In Korean medicine, Kidney deficiency (신허), Liver Blood deficiency (간혈허), and Liver Qi stagnation (간울기체) are key pathologies.

Prescriptions like Jwaguieum (Zuogui Yin), Ongyeong-tang (Wenjing Tang), and Boganshinje (Liver-Kidney Nourishing Formulas) are specialized in regulating these rhythms. Acupuncture points such as Shinyu (BL23), Taegye (KI3), and Gwanwon (CV4) become core to treatments that manage the body's roots.

6. Depression is not an emotional problem; it's a problem of flow.

Now, we should be able to say this: "The problem isn't feeling depressed; it's a state where emotions aren't flowing." Korean medicine is a method for resolving these blocked flows. Headaches, insomnia, indigestion, fatigue... rather than viewing all these as separate issues, we see them as interconnected problems within a single flow and focus on restoring that flow.

If psychotropic medications have limitations in addressing the body's overall rhythm, then herbal medicine and acupuncture possess unique languages and methods to restore this rhythm.

Depression isn't caused by a weak will. The body breaks down first, and emotions follow suit. Therefore, there are many times when treatments that restore the body and its flow are more needed than medications that merely lift emotions. This is precisely the approach of Korean medicine, which has dealt with human emotions in a language older than the term "depression."

#Depression #Anxiety #Insomnia