Teen Depression: Easy-to-Miss Signs | Incheon Korean Medicine Clinic for Depression

Children Who Express Themselves with Irritability and Lethargy Instead of Saying "I'm Sad"

Hello, this is Choi Yeon-seung, a Korean medicine doctor at Baengnokdam Korean Medicine Clinic.

These are common things I hear in the clinic:

• "This child doesn't talk much lately and is always irritable."
• "They don't do anything; they just lie down."
• "They don't eat well and say they don't want to go to school..."

However, these children rarely say, "I'm depressed." Adolescents' emotional language is still immature. And the moment they say they're depressed, they fear they might seem like someone with a serious problem. So, these emotions manifest as:

• Irritability,
• Expressionless remarks like "I don't know" or "It's bothersome,"
• Or through the body, such as headaches, abdominal pain, or irregular menstruation.

Adults often mistake this for typical adolescent rebellion. But the problem is that these emotions drift, unable to find a safe place to settle. From then on, the child begins to live outside their emotions. Depression is not a mood problem; it is the suffocation of unexpressed feelings. Adolescents communicate this through signals of irritability, lethargy, and physical discomfort instead of saying, "I'm depressed."

The Point When "Let's Just Observe" Becomes Ineffective

When discussing adolescent depression, one of the most frequently heard phrases is, "Let's just observe for now." Of course, the approach of prioritizing observation over immediate medication is understandable. Adolescence itself is a period of intense emotional fluctuations, and their perception of life changes daily.

However, the problem is that often nothing is done during that "observation period." Parents become cautious, and the child blocks everything with phrases like, "I'm just tired," "It's bothersome," or "I'm fine." Meanwhile, the child finds it increasingly difficult to wake up in the morning, their appetite declines, and they toss and turn every night, eventually feeling more and more like a bother to themselves.

Even if this state continues for just a few weeks, the body's rhythm can completely break down, and emotions can become even more stagnant. In such cases, saying "let's observe a bit longer" can become a way of neglecting your child's deteriorating rhythm. Depression doesn't always manifest as severe crying or sadness. Most adolescent depression appears as a silent breakdown in the body's and emotions' flow. And the moment that flow is disrupted, it becomes much harder for the child to return to their previous state.

Understanding Adolescent Depression Through the 'Body'

Adolescent depression is not merely a problem of the mind. Depression during this period simultaneously disrupts the body's rhythm. And when this rhythm breaks down, the child's emotions can no longer flow freely and become stagnant.

Many adolescents who come to the clinic say:

• "I can't sleep at night."
• "My stomach is constantly uncomfortable."
• "I don't want to eat anything."
• "I get a headache whenever I go to school."

These are not simply stress-induced gastrointestinal or sleep disorders. In a state where emotions, the autonomic nervous system, and visceral functions are interconnected, depression manifests as a disruption of this overall flow.

In Korean medicine, this is explained using concepts like 'Qi Ul' (Qi stagnation), 'Qi Che' (Qi blockage), and 'Dam Ul' (Phlegm stagnation). Vital energy (Qi) becomes congested and cannot flow, the mind feels stifled, and the body becomes unnecessarily heavy.

If left untreated, the child falls into a state of "I don't know what I'm feeling." In such cases, saying "just try to cheer up" is entirely unhelpful. For emotions to flow, the body's rhythm must first be restored. Therefore, adolescent depression should not be addressed solely through psychological means but must also be understood through the body. Body patterns, gastrointestinal function, sleep-wake cycles, and even menstrual cycles are all maps and clues to emotional states.

Herbal Medicine and Acupuncture: Non-Psychotropic Therapies – The Flow of Qi Facilitates the Flow of Emotions

The most cautious aspect of adolescent depression is medication. Many parents hesitate regarding psychotropic drugs. "Is it okay to start medication at this age?" "Will it become a habit?" "Will my child become even more lethargic?" While these concerns persist, depression slowly but surely depletes the body's vitality.

It is at this juncture that non-psychotropic treatments, primarily centered on herbal medicine and acupuncture, become a realistic alternative. Korean medicine is a system specialized in harmonizing the flow of both emotions and the body.

For adolescents experiencing deep depression, Gami-Soyosan helps alleviate stagnant emotions, Gwibi-tang addresses fatigue and poor concentration, and Ondam-tang calms 'lingering heat' in the mind and intrusive thoughts.

These are not merely medications to improve mood. They are designed to restore the digestive, sleep, menstrual, and energy flows that have become tangled due to depression. Herbal medicine is not just a tonic; it's like a foundational construction project, paving the way for emotions to flow again.

And acupuncture acts as a catalyst, regulating the tense autonomic nervous system and re-initiating overall bodily circulation. It relaxes tense areas in the back, neck, and abdomen, and promotes circulation in the abdomen and head, where nerves and emotions converge.

It's not a treatment that 'blocks' something, but one that 'facilitates flow.' Adolescent depression is not a condition that can be halted with a single prescription; it's a process of restoring stagnant emotions and flows. In this process, herbal medicine and acupuncture work with gentle yet deep-rooted power.

Depression Doesn't Arise in Isolation – The Emotional Structure of Family and Environment

Adolescent depression is by no means a condition solely created by the child. Their emotions are thoroughly shaped within the emotional structure of their environment.

I often ask, "What emotions do you think your child is feeling lately?" Many parents pause for a moment and then reply, "Well... I don't really know. They don't talk... they're just expressionless."

However, with a bit more conversation, it becomes clear how strongly the parents' tone and atmosphere, and the emotional currents within the household, have been influencing the child.

Emotions are like air. They are conveyed even without being spoken, simply by breathing. And especially for emotionally sensitive children, they react much more profoundly to suppressed emotions, unresolved conflicts, and oppressive atmospheres within the family.

For example, if one parent is constantly anxious and excessively worried about the child's grades or future, that emotion directly impacts the child's autonomic nervous system and emotional rhythm.

Or, if unspoken losses, suppressed anger, or resentment towards each other accumulate within the family, the flow of those emotions acts as an 'emotional weight that is felt but cannot be expressed' for the child.

At this point, the child closes themselves off in confusion, not even knowing if the feelings are their own or someone else's. As a result, depression becomes not just 'an internal problem,' but the condensed outcome of unspoken emotional patterns within the entire family.

Therefore, recovery from adolescent depression must begin not just with medication or counseling, but with the family collectively confronting its own emotional structure.

The Sequence of Recovery

I often receive requests in the clinic like, "I'm depressed, please give me some restorative tonic." The thought is that if the body is 'taken care of' a bit, they might get better, since they lack energy, motivation, and keep lying down.

However, adolescent depression is not simply caused by a lack of vital energy. Nor does depression reside in the 'empty space' left by depleted energy. More accurately, it is a state where the flow of emotions and energy is distorted.

Therefore, a recovery plan that re-establishes flow takes precedence over a simple tonic. For instance, how to restore the circadian rhythm to enable waking in the morning, how to alleviate autonomic nervous system tension that simultaneously disrupts digestion and sleep, and how to transform patterns of emotional suppression into physical relaxation.

If these issues are not addressed with a structured plan, and the approach is merely 'take a tonic because you're tired,' or 'take a tonic because you lack energy,' depression might become even more firmly entrenched.

Recovery has a sequence. More important than boosting vital energy is opening the pathways for energy to flow again. The process of opening those pathways involves herbal medicine, acupuncture, sleep rhythm regulation, emotional recovery routines, and a safe space for expressing emotions.

Adolescent depression is not inherently wrong. It's simply a state where the flow has lost its way. Guiding that flow back onto its path—that is treatment, and that is the most fundamental help adults can provide.

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Baengnokdam Korean Medicine Clinic, 3rd Floor, Songdo Dream City, 81 Convention-daero, Yeonsu-gu, Incheon