The patient is a woman in her early 60s with a warm and kind appearance. She visited with her daughter, but she looked troubled and downcast. Over the past 2–3 years, she has experienced increasing low moods, feelings of fatigue, depression, and frequent forgetfulness. The patient expressed resentment toward her husband, with whom she shares a very different personality. She describes herself as outgoing, optimistic, and easygoing, while her husband is diligent, meticulous, and critical, often nagging about household tasks. She struggled with chronic illness when she was younger, including surgery for uterine cancer in her 30s.
About 2–3 years ago, her dental health worsened due to periodontal disease, leading to tooth loss. She is about to get dentures but feels self-conscious about looking older. This has affected her confidence, especially when others comment on her appearance. She feels increasingly disconnected socially, often feeling isolated and burdened by a sense of aging and worthlessness. Memory issues have also intensified, and she finds it hard to focus.
The results of an Autonomic Nervous System Test indicated an imbalance, with lower sympathetic activity and higher parasympathetic activity. Her pulse was weak, her tongue was somewhat red and dry with minimal coating, and her face appeared somewhat pale. The diagnosis was “Heart and Spleen Blood Deficiency” (심비혈허), which affects her emotions, resulting in depression. The treatment plan included herbal medicine, acupuncture, moxibustion, and oriental psychotherapy.
- After week 2, she didn’t notice major changes but felt that looking at a “gratitude” plaque she had hung up at home helped her calm down when she felt irritable.
- After week 4, she initially doubted whether the treatments would help, but now feels brighter, experiences less depression, and gets less annoyed with her husband’s nagging. Her usual sense of fatigue has lessened, and she is eager to resume volunteer and church activities.
- After week 8, with her schedule busy with social and church activities, she now has less time for treatment, so the focus moved to just herbal medicine.
- After week 10, Recently, she and her husband shared a good laugh over how they had both aged. She noticed her husband, typically reserved, also laughed, which was unusual for him. She feels less resentment toward him and notices he nags less, making her feel more at ease.
- After week 12, while she still occasionally feels down when reminded of her aging appearance or memory lapses, she’s now more accepting of these feelings.
Initially, she looked troubled and sad, but with each session, her expression brightened, and she smiled more. Her depression lessened, thanks to her naturally optimistic personality, helping her recover more quickly. She now feels at peace with the changes that come with age and has a much-improved relationship with her husband.
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Depression is a condition characterized by a general decline in physical and mental function without any organic cause, leading to a persistent depressive state. The symptoms of depression are broadly divided into psychological and physical symptoms.
Psychological Symptoms
- Depressed Mood: Feelings expressed as "I feel down," "I have no interest," "I feel heavy-hearted," or "I lack enthusiasm." In some cases, patients may simply complain of a sense of inhibition, saying, "I feel lethargic," "I lack persistence," or "My memory has worsened."
- Agitation: Often described as "I feel restless," and in severe cases, patients may pace around the room, unable to sit still. This agitation can lessen somewhat in the presence of a close companion, but it tends to worsen when the person is alone.
- Loss of Confidence: Patients may say things like, "I feel like I've become an idiot," or "I can’t understand what I read anymore," expressing a loss of self-esteem and confidence.
Physical Symptoms Physical symptoms are more common in unipolar depression than in the depressive phases of bipolar disorder. In the early stages, patients may experience vague physical discomfort or a sense of fatigue, with few clear physical symptoms. During the extreme depressive phase (depressive stupor), physical symptoms are rarely present. However, if depression becomes chronic or persistent, psychological symptoms tend to decrease while physical symptoms become more prominent.
Physical symptoms can be broadly divided into digestive symptoms, circulatory symptoms, and neurological symptoms. Digestive symptoms are more common in the early stages of depression, while circulatory and neurological symptoms become more prominent as the condition becomes chronic.
In traditional Korean medicine, depression is often seen as an "excess yang syndrome," and treatment is administered with herbal medicine and acupuncture, tailored to the patient's symptoms and constitution.
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