Now, how does the wisdom of the ancient Donguibogam translate into modern science? The statement that 'labor consumes qi, while worry damages the spirit' is an insight that accurately reflects modern burnout syndrome and chronic fatigue syndrome. When our body faces stress, it activates the fight-or-flight response. At the center of this response lies the hypothalamic-pituitary-adrenal axis. The hypothalamic-pituitary-adrenal axis secretes stress hormones such as cortisol to supply the energy needed to cope with threats.
However, under persistent stress—such as relentless workloads, psychological pressure, and sleep deprivation—this hypothalamic-pituitary-adrenal axis becomes hyperactivated, eventually leading to a state of exhaustion. In the beginning, cortisol secretion rises. Yet if chronic stress continues, the adrenal gland becomes exhausted, leading to a state of adrenal fatigue where cortisol secretion declines or becomes irregular. This goes beyond simple tiredness, leading to an overall physical and mental hypofunction: struggling to open your eyes in the morning, feeling lethargic all day, having difficulty regulating emotions, and becoming irritated by small matters.
Simultaneously, neurotransmitter imbalances worsen. When essential brain chemicals—such as serotonin, dopamine, and norepinephrine—are depleted or disrupted by stress, symptoms such as depression, anxiety, impaired concentration, and memory impairment appear. Taeyangin individuals, who naturally lean toward outward expression and exterior release, are especially likely to expend these neurotransmitters and hormones more rapidly as they pour their energy outward. It is similar to a high-performance car running constantly at top speed, which burns fuel rapidly and wears down its components quickly.
Furthermore, chronic fatigue is closely linked to mitochondrial dysfunction, affecting the energy powerhouses of our cells. Mitochondria produce energy called adenosine triphosphate within cells, but chronic stress, poor nutrition, and sleep deprivation degrade mitochondrial efficiency, hindering energy production. As energy becomes scarce at the cellular level, the entire body naturally turns lethargic. In addition, chronic stress induces chronic inflammation and triggers an autonomic nervous system imbalance. With sympathetic nerve hyperactivation, the body remains in a constant state of tension; when parasympathetic nerve function—responsible for rest and recovery—declines, resting no longer feels like true rest. This explains why you might experience heart palpitations or poor digestion even while lying down to sleep.
Ultimately, the depletion of qi and spirit described in Donguibogam can be explained in modern medicine through complex physiological changes: overload of the hypothalamic-pituitary-adrenal axis, hormonal imbalance, neurotransmitter disruption, mitochondrial dysfunction, chronic inflammation, and autonomic nervous system imbalance. What matters most is that these changes are the cumulative result of a gradual process over a long period. It is not something to dismiss as simply being tired. We must listen to the signals our bodies send and respond proactively.
