中醫對心理健康障礙的認識（一）

吳宇琛

Sum Wu

Registered Chinese Medicine Practitioner

Bachelor of Health Science in Traditional Chinese Medicine (UTS)

Bachelor of Science Majoring in Psychology (UOW)

Specialising in pain management and mental wellbeing through Tradition Chinese medicine in combination with modern science in mental health, dieting and nutrition.

吳宇琛，澳洲政府註冊中醫師、針灸師，五龍崗大學心理學學士、悉尼科技大學中醫系學士，擅長用傳統針灸理傷手法和中藥治療各種新舊損傷痛症，特別採用中醫中藥和現代心理學、營養學相結合調理治療各種慢性病和亞健康。

Mental health through the lens of Traditional Chinese Medicine

中醫對心理健康障礙的認識（一）

Mental health disorders is one of the most prevalent in Australia and yet it is also one that is most invisible. Each year approximately 1 in 5 adults will experience some form of mental illness and a staggering 50% of the population has experienced it in some form at some point in their lives.

心理健康障礙是澳大利亞最普遍的疾病之一，但也是最不易察覺的疾病之一。每年大約在5個成年人中，有1個就會經歷某種形式的精神疾病，令人震驚的是，有 50% 的人在生命中的某個時刻經歷過某種形式的精神疾病。

What makes mental health disorder so insidious is that for a long time it was a subject that was rarely touched upon or only in hushed tones and was marred by preconceptions and shame but luckily a lot of these notions has changed over time and while there still a lot of unknowns on how certain mental health disorders develop, the definitions is constantly evolving and diagnostic standards are updated, luckily there is plenty of resources and support for mental health in Australia.

心理健康障礙之所以很隱秘不易被察覺，是因為在很長一段時間裏，它是一個很少被提及或只是大家以低調的方式談論的話題，並且受到先入為主的觀念和羞恥感破壞。但幸運的是，隨著時間的推移，其中很多觀念已經發生了變化，盡管仍然存在關於某些精神健康疾病如何發展，存在很多未知數，定義在不斷演變，診斷標準也在更新，但幸運的是，澳大利亞有充足的資源來支持精神健康的治療和發展。

Let’s start off by trying to define what constitutes to a mental health disorder or illness. It is a health issue that affect your mood, thoughts and behaviour. It can create debilitating effects on how someone perceives their environment and can negatively impact relationships and interactions with others. Some mental illness are transient or temporary while some can be lifelong. Whether the illness is permanent or not, they can also range from little or mild symptoms to severely debilitation.

讓我們首先看看是什麽構成了精神健康障礙或疾病，它是一個影響人情緒、想法和行為的健康問題。它會對人們如何看待他們的環境產生破壞性影響，並對與他人的關系和互動產生負面影響。有些精神疾病是短暫的或暫時的，而有些則可能是終生的。無論這種疾病是否是永久性的，其範圍也可以從輕微或有輕微症狀到嚴重症狀。

These illnesses can range from personality disorders, eating disorders, substance abuse, anxiety and mood disorders such as depression just to name a few.

這些疾病包括人格障礙、飲食失調、藥物濫用、焦慮和抑郁等情緒障礙。

While doctors and psychologist have a pretty good understanding on identifying and treating a lot of these disorders by their presenting symptoms, scientifically, there is still some uncertainty on the exact causes for them. Let’s take for example depressive disorders.

雖然醫生和心理學家對通過癥狀來識別和治療許多這些疾病已經有了很好的研究，但從科學上講，它們的確切原因仍然存在一些不確定性，我們以抑郁症為例。

The DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) requires the following criteria to be diagnosed depression. The individual must be experiencing five or more symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure.

1. Depressed mood most of the day, nearly every day.
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
3. Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
4. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
5. Fatigue or loss of energy nearly every day.
6. Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
7. Diminished ability to think or concentrate, or indecisiveness, nearly every day.
8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

DSM-5 （精神障礙診斷與統計手冊第五版） 要求滿足以下標準才能診斷為抑郁症，個人必須在連續兩周內經歷五種或更多症狀，並且至少一種症狀應該是 (1) 情緒低落或 (2) 失去興趣或快樂。

1. 幾乎每天，大部分時間情緒低落。

2. 一天中大部分時間（幾乎每天）對所有或幾乎所有活動的興趣或樂趣明顯減少。

3. 不節食時體重明顯減輕或體重增加，或幾乎每天食欲減少或增加。

4. 思維減慢和身體運動減少（其他人可以觀察到，而不僅僅是不安或放慢的主觀感覺）。

5. 幾乎每天都會感到疲勞或精神不振。

6. 幾乎每天都會感到無價值或過度或不適當的內疚感。

7. 幾乎每天都思考或集中注意力的能力下降，或優柔寡斷。

8. 反復出現死亡念頭、反復出現沒有具體計劃的自殺意念、自殺未遂或有具體的自殺計劃。

While we can define what is depression there is still debate on the cause or possibly multiple factors contributing to the illness. It could be due to a genetic risk, traumatic life events, substances use and changes in brain chemistry are some of the key factors to consider.

雖然我們可以定義什麽是抑郁症，但對於抑郁癥的病因或可能的多種因素仍存在爭議。這可能是由於遺傳、創傷性生活事件、大腦化學物質的變化等都是需要考慮的關鍵因素。

One commonly taught theory says there may be a deficiency in brain neurotransmitters such as serotonin, norepinephrine or dopamine. A common treatment is to prescribe SSRI （Selective serotonin reuptake inhibitors such as Prozac to increase serotonin levels which has the effect of reducing depressive symptoms. It’s widely used and effective but there is also a host of side effects as well but usually the benefits outweigh the risks. Unfortunately there are those that don’t respond well the anti-depressants or want to look for alternatives and that brings me to our topic today – how TCM views and treats mental health issues.

一種常見的理論認為，大腦神經遞質（如血清素、去甲腎上腺素或多巴胺）可能缺乏，一種常見的治療方法是服用 SSRI（選擇性血清素再攝取抑製劑） 來增加血清素水平，從而減輕抑郁症狀。它被廣泛使用且有效，但也存在許多副作用，但這種藥物通常好處大於風險。不幸的是，有些人對抗抑郁藥物反應不佳，或者想要尋找替代藥物，這讓我想到了今天的主題——中醫如何看待和治療心理健康問題。

As with all TCM theories they are all based on the fundamentals of the Yin and Yang and the 5 Elements. From this we have the 5 Zang organs and the 5 tastes and the 5 shen, of which I briefly touched on recently, and today I will like to introduce the 7 emotions of TCM Joy, Anger, Grief and Melancholy, Worry, Fear and Fright. You may have noticed a pattern where everything is based on the number 5 then why is there 7 emotions?

與所有中醫理論一樣，它們都基於陰陽和五行的基本原理。由此就有了五臟、五味、五神，這是我最近都有提到的，今天我給大家介紹一下中醫的喜、怒、悲、憂、思、恐、驚七情。 大家可能已經注意到中醫的基本模式一切都基於數字五，那麽為什麽會有七種情緒呢？

For each of the 5 Zang organs there is their associated emotion. Heart – Joy, Liver – Anger, , Lung – Grief and Melancholy, Spleen – Worry, Kidney – Fear and Fright. And through the 5 element theory we can see how imbalances in the Zang can affect your physical and mental health but also how these symptoms can injure the Zang as well.

五臟各有相應的情緒。心—喜，肝—怒，脾—思，肺—悲憂，腎—恐驚。通過五行理論，我們可以看到臟的失衡如何影響您的身心健康，以及這些症狀如何傷害內臟。

如有疑問想咨詢小吳醫師，可以在微信或whatsapp搜索0404836368，加小吳醫師微信或whatsapp，也可以發短信或致電0404836368作語音留言，小吳醫師有空就會回復。

（吳宇琛中醫師，澳洲政府註冊中醫師、針灸師，五龍崗大學心理學學士、悉尼科技大學中醫系學士，悉尼好思维松轩药行主治中医师，本文僅供參考，具體診療應諮詢專業人士。）