中醫對心理健康障礙的認識(二)
吳宇琛
SUM WU
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 2
中醫對心理健康障礙的認識(二)
In the previous article we just began to briefly touch on a common mental health issue, depression, and even more broadly the struggles modern society has with mental health and wellbeing. Today I would like to continue where we left off, the seven emotions – Joy, Anger, Sadness and Grief, Worry, Fear and Fright
在上一篇文章中,我們剛剛開始簡要討論一個常見的心理健康問題:抑鬱症,以及更廣泛的現代社會在心理健康和福祉方面的鬥爭。今天我想繼續我們上次停下來的地方,即七情 – 喜、怒、悲、憂、思、恐、驚。
Let’s look at what some of the symptoms that may occur when there is an imbalance in these emotions.
The emotion of the Heart is Joy and when there is an imbalance such as excessive Joy it can injure Heart and lead to manic symptoms while too little Joy can cause lack of enthusiasm and vitality, mental restlessness, depression, insomnia, despair and affect long term memory.
現在讓我們看看當這些情緒不平衡時可能會出現哪些症狀。
心的情緒是喜,當不平衡時,如喜過多,會傷心,出現躁狂症狀;喜過少,會導致缺乏熱情和活力,精神煩躁,抑鬱,失眠,絕望,影響長期記憶。
The emotions of the Liver is Anger. Resentment, frustration, irritability and bitterness can impair the Liver which is responsible for the smooth flow of Qi and blood to the body. If the Liver is impaired then it may manifest as chest distension, menstrual pain, headache, irritability, and aggressiveness, and dizziness, dry and red eyes.
肝的情緒是憤怒。怨恨、沮喪、易怒 和苦澀會損害負責氣血順暢運行的肝臟。如果肝臟受損,則可能會出現胸悶、痛經、頭痛、煩躁、攻擊性強、頭暈目眩、眼睛乾澀、紅腫等症狀。
The emotions associated with the Lungs is Grief and Melancholy. Prolonged sadness can impair the Lungs function and can cause shortness of breath and shallow breathing, sweating, fatigue, coughing, depressive moods, and excessive crying.
與肺相關的情緒是悲傷和憂鬱。長時間悲傷會損害肺功能,導致呼吸短促、呼吸淺、出汗、疲勞、咳嗽、情緒抑鬱和過度哭泣。
The Spleen’s emotion is Worry and excessive worrying can impact the Spleens transforming and transporting of Qi resulting in tiredness, loss of appetite, mucus discharge, poor digestion, abdominal distension, loose stools, diarrhoea, weak muscles, pale lips, bruising, excess menstrual blood flow, and other bleeding disorders
脾的情志為思,思慮過度,會影響脾的運化,出現倦怠、食欲不振、痰多、消化不良、腹脹、稀便、腹瀉、肌肉無力、口唇淡白、瘀斑、經血過多等症狀和其他出血性疾病。
Excessive Fear and Fright, can injure the Kidneys and heart and can cause frequent urination, urinary incontinence, night sweats, dry mouth, poor short-term memory, low back pain, ringing in the ears, hearing loss. As the Kidney’s Shen is the Zhi excess Fear and Fright can make one feel insecure and loss willpower as well as affect decision making.
過度的恐懼和驚嚇,會損傷腎臟,導致尿頻、尿失禁、盜汗、口乾、短期記憶力差、腰痛、耳鳴、聽力下降。由於腎之神為志,過度的恐懼和驚嚇會使人缺乏安全感,喪失意志力,影響決策能力。
Like all things related to the 5 Elements theory, there must be a delicate balance between the organ, the function and the emotions etc. If there is too much or too little of something (emotion or levels of Qi) it will inherently affect the function of the Zang and the inverse is also true.
就像所有與五行理論相關的事物一樣,器官、功能和情緒等之間必須存在微妙的平衡。如果某種東西(情緒或氣)太多或太少,它本身就會影響功能,對於內臟來說亦是如此。
For example, excessive irritability and anger can affect the liver and result in multiple symptoms such as menstrual pain, headache, redness of the face and eyes, dizziness, and dry mouth. Conversely, imbalance in the liver which causes Liver Qi stagnation or Liver Qi rising can result in mood swings and irritability.
例如,過度煩躁、憤怒會影響肝臟,導致經痛、頭痛、面目發紅、頭暈、口乾等多種症狀。反之,肝氣失衡,導致肝氣鬱結或肝氣上升,就會導致情緒波動和煩躁。
So how does this tie back to using TCM as an alternative or complementary treatment?
Lets have a quick review of the definition of depression based on the DSM5
那麼,這與使用中醫作為替代或補充治療有何關系呢?讓我們回顧一下基於 DSM5 的抑鬱症定義。
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鬱症,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。
If you noticed that the DSM-5 criteria’s for depression have symptoms that overlap with the symptoms 5 Element theory and the 7 emotions. From a TCM perspective the depressive moods is due to Liver Qi stagnation as a manifestation of Anger, the change in appetite and fatigue is a symptom of an injured Spleen Qi and impaired Kidney function manifests as feeling of worthlessness and difficulties in concentration etc.
那麼,這與使用中醫作為替代或補充治療有何關系呢?
如果大家注意到 DSM-5 精神障礙診斷與統計手冊的症狀與五行和七情症狀重疊,從中醫角度看,情緒低落是肝氣鬱結,肝氣鬱結,食欲改變,疲乏無力,是脾氣損傷的表現,腎功能受損,表現為精神不振,注意力不集中等。
Of course this is just 1 example of depressive disorder as there are actually different categories of depression based on cause. We have the classical clinic depression where depressive moods last for more than 2 weeks, a prolonged depression this is depression that lasts for more than 2 years. Postpartum Depression, this affects both men and women. In women it is more common to feel extreme levels of sadness and anxiety and fatigue may be due to hormonal changes or loss of Essence while men usually feels more anger and irritability due to hormonal and stress changes. Seasonal affective disorder季节性情绪失调 which tends to be more common in winter months.
當然,這只是抑鬱症的一個例子,因為實際上根據原因有不同類別的抑鬱症。我們有典型的臨床抑鬱症,即抑鬱情緒持續兩周以上。長期抑鬱症是指持續兩年以上的抑鬱症。產後抑鬱症這會影響男性和女性。在女性中,更常見的是感到極度悲傷、焦慮和疲勞,可能是由於荷爾蒙變化或精氣流失所致,而男性通常由於荷爾蒙和壓力變化而感到更多憤怒和煩躁。季節性情緒失調在冬季更為常見。
So by using TCM theory we can identify the symptoms and link them to which organ system is in disharmony thus identifying the root causes and come up with a treatment protocol.
因此,通過運用中醫理論,我們可以識別症狀並將其與哪個器官系統不和諧聯繫起來,從而找到根本原因並提出治療方案。
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(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。)