The Soul in Sleep Mode

靈魂的當機

We often see children who were once quick-witted and high-achieving gradually become expressionless, experience dropping grades, and lose interest in the world. Such changes are frequently misunderstood as rebellion, avoidance, or even intellectual decline. In reality, they represent a “total retreat” of the brain and spirit under extreme high pressure. This is not a lack of willpower; it is a protective response triggered by a system overload of the mind and body.

我們常看見原本反應敏捷、學習能力良好的孩子，逐漸變得表情木訥、成績下滑、對世界失去興趣。這樣的改變，常被誤解為叛逆、逃避，甚至能力退化；但實際上，它更接近一種大腦與心神在長期高壓下的全面撤退狀態。這並非意志薄弱，而是一種身心系統在過載後所啟動的保護性反應。

1. Modern Psychiatry: The “Inhibited” Brain Under Emotional Suppression

During the developmental stages when an adolescent’s nervous system is still highly plastic, the impact of depression on the brain is often deeper and more easily overlooked than in adults. One common but frequently misdiagnosed phenomenon is what we call “pseudodementia-like” manifestations.

在青少年神經系統仍高度可塑的發育階段，憂鬱症對大腦功能的影響，往往比成人更為深層，也更容易被忽略。其中一個常見卻容易被誤判的現象，是所謂的「假性失智」樣表現。

Although “dementia” is typically associated with the elderly, in states of severe depression, an adolescent’s prefrontal lobe function can undergo significant functional inhibition. This manifests as scattered attention, decreased short-term memory, and difficulty in complex thinking or decision-making. This shift is not a structural degeneration but a reversible neurological dysfunction, yet it is often misconstrued as a poor learning attitude or a loss of capability.

雖然「失智」一詞多用於老年族群，但在重度憂鬱狀態下，青少年的前額葉功能可能出現明顯的功能性抑制，表現為注意力渙散、短期記憶下降，以及難以進行複雜思考與決策。這種變化並非結構性退化，而是可逆的神經功能失調，卻常被誤解為學習態度不佳，甚至能力下降。

Another critical dimension is “negative-symptom-style” apathy. Unlike overt sadness or anxiety, some children present with a flattening of emotional responses and a significant drop in motivation. This “anhedonia”—the inability to feel pleasure—is linked to long-term low activity in dopamine and stress-regulation systems.

另一個同樣重要、卻更容易被忽視的面向，是情感淡漠。不同於外顯的悲傷或焦慮，有些孩子呈現的是情感反應變平、動機顯著降低，對原本感興趣的事物失去回應。這種「快樂能力下降（anhedonia）」，與多巴胺系統與壓力調節機制長期低活性有關，是青少年憂鬱中相當關鍵、卻經常被誤讀的表現。

2. Understanding “Shen-Zhi” Diseases in TCM: Veiled Spirit and Disordered Qi

TCM understands adolescent depression not just as an emotional issue, but as a holistic imbalance of “Qi” flow and the state of the “Shen” (Spirit). Clinically, these manifestations are often classified under “Dian Disease” (Depressive Disorder). Its characteristics are not agitation, but silence, apathy, pessimism, and withdrawal, reflecting a state where energy can no longer expand outward, causing mental activity to contract inward.

中醫對青少年憂鬱的理解，並不僅止於情緒層面，而是放在氣機運行與神志狀態的整體失衡之中。在臨床上，這類表現常被歸入中醫所稱的「癲病」，其特徵並非躁動或激烈行為，而是沉默、淡漠、悲觀與退縮。這反映的是身體能量無法向外舒展開來，精神活動逐漸內縮的狀態。

From a pathological perspective, prolonged academic pressure and emotional suppression lead to “Liver Qi Stagnation.” When the flow of Qi is obstructed, fluid metabolism becomes dysfunctional, gradually forming “Invisibile Phlegm.” When these pathological byproducts cloud the “Heart-Spirit,” symptoms such as dull reactions and decreased concentration appear—a state known as “Phlegm Misting the Mind.”

從病機來看，長期的學業壓力、人際緊繃與情緒壓抑，容易造成肝氣鬱結。氣機不暢，水液代謝隨之失調，逐漸形成中醫所說的「無形之痰」。當這類病理狀態影響心神的清明功能，便會出現反應遲鈍、思緒混濁、專注力下降等「痰蒙心神」的表現。

3. The Role of Acupuncture: Enhancing Regulation

In integrated care, acupuncture is a supportive physical intervention particularly suitable for individuals with low motivation or those resistant to psychological talk therapy. By stimulating specific acupoints, one can influence the regulation of the autonomic and central nervous systems. The goal is to improve the “adjustability” of the brain and body.

在青少年憂鬱的整合照護中，針灸常被視為一種輔助性的身體介入方式，特別適合用於動機低落、語言表達困難，或對心理介入高度抗拒的個案。透過頭部與四肢相關穴位的刺激，可影響自律神經與中樞神經的調節狀態。這類介入的目標，並非立即「改變情緒」，而是提升大腦與身體的可調節性。

For instance, head acupoints promote alertness and cognitive integration. Points on the limbs regulate Liver Qi and the Heart-Spirit to reduce defensive stress reactions. Furthermore, points related to digestion and sleep improve nutrient absorption and cellular energy efficiency, creating better conditions for neurological repair.

例如：頭部相關穴位常用於促進清醒度與認知整合；調節肝氣與心神的穴位有助於降低身體防禦反應；與安神、睡眠及腸胃吸收相關的取穴，則可協助營養吸收與細胞能量運作效率的恢復，為神經修復創造有利條件。這些介入與現代醫學並行，作為促進功能恢復的支持方式。

4. The Intersection: When “Crashing” is Actually a Survival Strategy

Whether from the perspective of modern neuroscience or TCM, this apathy is not laziness but a “low-energy mode” chosen by the system under chronic high stress. When the brain is highly inhibited, demanding that a child immediately “cheer up” often yields limited results. Instead, by starting with physiological regulation, neurological recovery, and the rebuilding of security, it becomes possible to gradually restart psychological and cognitive functions.

無論從現代神經科學或中醫理論來看，這類淡漠與退縮，都不是懶散或放棄，而是一種在長期高壓下，系統選擇最低能耗模式的結果。當大腦處於高度抑制狀態時，要求孩子立即反思、振作，或做出重大改變，往往效果有限。相反地，從身體調節、神經恢復與安全感重建著手，才可能逐步重啟心理與認知功能。

Conclusion

The indifference found in adolescent depression is often life’s way of temporarily retreating into a protective shell when it can no longer bear the burden. Do not rush to apply labels. Take time to slow down, understand, and accompany them. Patiently wait for the overloaded brain and the stress-veiled spirit to slowly recover. When Chinese and Western perspectives complement each other, those seemingly “crashed” souls have the chance to restart within a cocoon of support.

青少年憂鬱中的冷漠與遲鈍，往往是生命在無法承受時，選擇暫時縮回保護殼中的方式。別急著貼上任何標籤。也許我們能放慢節奏，試著理解與陪伴，溫柔地等待——等待一個正在承受過載的大腦，一顆被壓力遮蔽的心神，慢慢從防禦狀態中恢復。當身心被同時納入理解的範圍，那些看似「當機」的靈魂，才有機會在安全之中重新啟動。