How does modern medicine explain the depletion of qi described in the Donguibogam? Recent studies indicate that burnout, or burnout syndrome, is more than simple fatigue; it is closely tied to neurochemical imbalances in the brain and dysfunction in the endocrine system governing stress. Just as Korean medicine regards qi as the commander-in-chief of the body, modern medicine views specific brain regions and hormones as fulfilling that role.
The brain relies on key neurotransmitters such as dopamine, serotonin, and norepinephrine. Dopamine is involved in reward, motivation, and pleasure; serotonin regulates mood and well-being; and norepinephrine influences focus and alertness. In burnout, the balance among these neurotransmitters is disrupted, leading to loss of drive, lethargy, and an inability to feel pleasure. Just as everything withers when qi is exhausted, the brain's neurochemical energy becomes deficient.
Chronic stress also overactivates the hypothalamic-pituitary-adrenal axis. This axis releases stress hormones such as cortisol in response to strain. While helpful for managing short-term crises, prolonged overactivation harms both physical and mental function. Persistently elevated cortisol levels negatively affect the hippocampus, which handles memory and emotional regulation, and the prefrontal cortex, which governs judgment and decision-making, leading to poorer memory, reduced focus, and emotional volatility. This parallels the Korean medicine concept of disordered qi destabilizing the mind.
Decreased energy production at the cellular level is another significant factor in burnout. Every cell contains power plants known as mitochondria. When mitochondria fail to produce energy efficiently, fatigue persists regardless of rest, and physical vitality declines across the entire system. Chronic stress and nutritional imbalance can impair this mitochondrial function.
Gut health also plays a substantial role, as the gut is often referred to as a second brain due to its close connection with central neural function. An imbalance in the gut microbiota triggers inflammatory responses and alters neurotransmitter synthesis, directly affecting mood and energy levels. Modern medicine therefore approaches burnout as a multifaceted condition involving neural circuits, the endocrine system, cellular energy metabolism, and gut health, demonstrating how organically interconnected all bodily systems are.
