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 traditional 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。

Seasonal Affective Disorder (SAD) 2

季節性情緒失調之二

Last week we started to talk about seasonal affective disorder or SAD and we covered most of the key points of what this disease is from a western medical perspective and briefly touched on the TCM side of the topic. So today I would like to elaborate on some of these points from the previous episode.

上周我們開始談論季節性情緒失調（SAD），我們從西醫的角度介紹了這種疾病的大部分要點，並簡要介紹了該主題的中醫方面。所以今天我想詳細闡述一下上一集的一些觀點。

Let’s refresh on what is SAD. It is a category of depression that generally affects people during the winter months and is more common in women than men and also more prevalent in countries further away from the equator which may explain why it is not a very commonly talked about illness in parts of the world such as Australia and southern parts of China.

讓我們回顧一下什麼是季節性情緒失調。這是一類抑鬱症，通常在冬季影響人們，女性比男性更常見，在遠離赤道的國家更常見，這可能解釋了為什麼在部分地區它不是一種很常見的疾病。如澳大利亞和中國南部地區等世界各地。

One of the main causes of SAD is believed to be due to the reduction of sunlight per day as well as the drop in temperature. An interesting fact, countries that are on or near the equator have almost equal amounts of daylight and darkness throughout the year so it would make sense the further away you move away from the middle the sunlight also decreases. Despite being commonly known as “winter blues” it is also possible to develop SAD during summer.

據信，SAD 的主要原因之一是每天陽光的減少以及氣溫的下降。一個有趣的事實是，赤道上或赤道附近的國家全年的日光和黑暗幾乎相同，因此，距離赤道越遠，陽光也會減少，這是有道理的。盡管通常被稱為“冬季憂鬱症”，但在夏季也有可能患上季節性情緒失調。

Sufferers may experience symptoms similar to major depression such as feeling listlessness and feeling sad most of the day, nearly every day. Losing interest and motivation, low energy, a constant state of sleepiness, difficulty concentrating, feelings of hopeless and worthlessness, suicidal thoughts. On top of that SAD can also cause constant fatigue, weight gain, and increased cravings for carbohydrates. Generally, this is treated with anti-depressants, Vitamin D supplements, and light therapy.

患者可能會經歷類似於重度抑鬱症的症狀，例如幾乎每天大部分時間都感到無精打采和悲傷、失去興趣和動力、精力不足、持續昏昏欲睡、難以集中注意力、感到絕望和無價值、有自殺念頭。除此之外，季節性情緒失調還會導致持續疲勞、體重增加和對碳水化合物的渴望增加。一般來說，可以通過抗抑鬱藥、維生素 D 補充劑和光療法來治療。

With these key points in mind let us move onto the next part of today’s topic, what is SAD in Chinese medicine?

記住這些要點讓我們進入今天主題的下一部分，中醫中的SAD是什麼？

In TCM there are many diagnostic frameworks such as the 5 elements theory, the Zang Fu organs and 12 channel systems etc. Each of these systems are interconnected but to me the most fundamental aspect of TCM, and by extension everything in life, is the Yin and Yang balance. Everything in the world has both a Yin and Yang aspect. In our body we have a delicate balance of Yin and Yang. There is fire and water, hot and cold, bright and dark etc. To maintain good health we must try to keep a balanced amount of Yin energy and Yang energy at all times.

中醫有很多診斷框架，如五行理論、臟腑和十二經絡系統等。每個系統都是相互關聯的，但對我來說，中醫最基本的方面，以及生活中的一切，都是陰與陽平衡。世界上的一切事物都有陰陽兩面。在我們的身體里，陰陽有著微妙的平衡。有火和水、冷和熱、明和暗等。為了保持身體健康，我們必須時刻保持陰陽能量的平衡。

Things that are Yang in nature are very active and warm and bright. They are also lifting and dispersing in movement. Conversely, things that are Yin in nature are more slow and cold and dark. They are also descending and contracting in movement.

陽的東西非常活躍，溫暖而明亮。它們在運動中呈現抬起（升舉）和分散。相反，陰的事物則更加緩慢、寒冷和黑暗。它們也在運動中呈現下降和收縮。

The movement of the seasons also follow a yin yang cycle. The yin cycle begins in autumn where the summer daylight fades and gradually decreases in intensity and duration. Autumn is of the metal element and corresponds to the metal organ, the Lung. And if you recall the emotion of the Lung is sadness and grief. We are more susceptible to respiratory diseases during this season as the air becomes more dry and cool which damages our lungs.

季節的變化也遵循陰陽循環。陰周期從秋季開始，夏季日光逐漸減弱，強度和持續時間逐漸減少。秋屬金，金對應臟肺。如果你還記得肺的情緒是悲傷和悲痛。在這個季節，我們更容易患呼吸道疾病，因為空氣變得更加乾燥和涼爽，這會損害我們的肺部。

The temperature also begins to get colder as it transitions into winter. Winter is associated with water and the Kidneys, it’s emotion is fear. So you can imagine for someone who is suffering from SAD, they will be going through the stages of depression worsening in winter.

随着进入冬季，气温也开始变冷。冬天与水和肾有关，它的情绪是恐惧。所以你可以想象，对于患有季节性情绪失调的人来说，他们将经历抑郁症在冬季恶化的阶段。

As the Yin cycle ends the Yang cycle begins with the start of spring. It is the season for growth and energy and as it transitions into summer our yang Qi increases, warming our body and mood. We see this up and down cycle like the tide in those that are affected by SAD where they will notice a gradual reduction in depressive symptoms and most of the time be completely depression free by summer.

隨著陰周期的結束，陽周期隨著春天的開始而開始。這是生長和精力充沛的季節，進入夏季，我們的陽氣增強，溫暖了我們的身體和情緒。我們看到這種上下循環就像那些受季節性情緒失調影響的人的潮汐一樣，他們會注意到抑鬱症狀逐漸減輕，並且大多數時候到夏天就完全擺脫了抑鬱症。

We can also use TCM to explain some of the symptoms that occur. During the winter months it is important to boost the Kidney Qi. The Kidney is associated with winter and water and its emotions is fear. The Kidneys Shen is the Zhi or Will. Poor Kidney Qi can affect our mental functions and memory. When the Kidney Qi is weak it will also affect the Lungs and this can lead to feelings of grief and sadness. During the winter months it is common to crave foods that are high in nutrient and energy as the extra calories can help the body stay warm – hence the craving for carbohydrates （tan sui fa he wu）. Our body expends energy and vital Qi to keep warm and expel the cold so there tends to be a feeling of lethargy and sluggishness as the Qi retreats inwards and the movement contracts. The lack of Yang Qi will also impair circulation as well as imbalances of Kidney and Lung function can result in emotional distress which combined with symptoms such as poor sleep and lack of vitamin D can result in depressive feelings.

我們還可以用中醫來解釋出現的一些症狀。冬季補腎氣很重要。腎主冬、水，其情志為畏。腎神是志或意志。腎氣不好會影響我們的精神功能和記憶力。當腎氣虛弱時，肺也會受到影響，從而導致悲傷、悲痛的情緒。在冬季，人們通常會渴望富含營養和能量的食物，因為額外的熱量可以幫助身體保持溫暖，因此渴望碳水化合物。我們的身體需要消耗精氣和正氣來保暖、驅寒，所以氣內退、運動收縮時，就會出現昏睡、呆滯的感覺。陽氣不足也會損害血液循環，腎和肺功能失衡會導致情緒困擾，再加上睡眠不佳和缺乏維生素 D 等症狀，會導致抑鬱情緒。

Interestingly not much can really be said for summer SAD from both Western medicine and TCM other than the shift in seasons affecting the body in some way. It is possible that the change in the day night cycle affects the circadian rhythm just like in winter. The heat and humidity can also irritate the emotions. In TCM we may say that the Heart Qi is too exuberant causing the Heart Shen to become overactive which results in irritability and manic symptoms. Over time this imbalance can turn into lack of enthusiasm and vitality, insomnia and depressive moods.

有趣的是，除了季節變化以某種方式影響身體之外，西醫和中醫對於夏季季節性情緒失調確實沒有什麼可說的。晝夜周期的變化可能會影響晝夜節律，就像冬天一樣。炎熱和潮濕也會刺激情緒。中醫認為，心氣太旺，心神過度活躍，就會出現煩躁、狂躁的症狀。隨著時間的推移，這種不平衡會變成缺乏熱情和活力、失眠和抑鬱情緒。

如有疑問想咨詢吳宇琛中醫師，可以在微信或whatsapp搜索0404836368，加吳宇琛中醫師微信或whatsapp，也可以發簡訊或致電0404836368作語音留言，吳宇琛中醫師有空就會回復。

（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，悉尼好思維松軒藥行主治中醫師，本文僅供參考，具體診療應諮詢專業人士。）