Lots of people come into the clinic saying that their main complaint is that they’re tired. Since holistic health care has largely become a do-it-yourself trip to the health food store, or the miracle remedy your friend involved in some multi-leveled marketing scheme your neighbor is now involved in, you’ve likely been there and done that. Often times hooked on this same idea they are looking askance at the medicine cabinet wondering if the answer to their needs is not poised beyond the glass. The answer is of course, perhaps, but not always in the form you expected it to be.

Most people would think of their lack of energy as a deficiency or there just not be enough of it. Certainly, there are enough people out there for which this is true, but a lot more of them have energy, but it is just tied up.

Deficiency Types

The first type of person is called “deficient .” They can be heavy set or thin, but most notable is a sort of lack of firm density to their bodies. They are always fearful that they are going to be called on to do something that is too taxing, and show a certain amount of emotional defeat at most things requiring effort. Relaxing is their favorite thing and they always try to allow time to relax or sleep. To look at them, even if they are a person of color, there is a sense of paleness and a chalkiness of skin. When someone is perfectly vibrant and healthy, their skin should be shiny and the eyes should have a sparkle. A deficient person’s eyes may be dull and yet they can often seem watery and red around the rims.

They are usually complaining about being cold, even in the Summer, but have no real toleration of extremes of Summer heat as well. These are also the ones who will have long-term bone and joint problems with childhood complaints of growing pains, adult incidences of arthritic pains and later years of bone loss or osteoporosis (see my article: Kidneys in Support of Everything).

If they are thin, they may have little excitement for the effort to eat. Mostly, these type of people rely on quick energy items like high sugar and carbohydrate foods. Usually, this type of person is quite allergic and the type of cravings they have will tell the story. For instance if they are allergic to vitamin C, they are always reaching for fruit and fruit juices, to sugar, refined foods, to iron, meat or chocolate or coffee, and if they are kidney deficient and achy in the low back they are usually eating lots of chips and salty things and are allergic to salt.

These people need a type of herbs called adaptogens or what we in the Chinese Medical world call tonifying  herbs. These herbs lay the matrix for building blood and supporting the storehouse of usable energy. Along with them, we would usually use herbs that help to build an internal environment of warmth and herbs to move energy to avoid stagnation in the blood or the liver. Prior to that, we have to test the absorbability of the body to basic elements of life and blood such as your basic vitamins, sugars, and proteins. For this, we would use NAET allergy elimination technique to improve the body’s ability to absorb the basics. It is not usually a good idea to try to use herbs when it is the body’s general tendency to fight them, so clearing the allergies may be the first approach. When someone is very tired we will use acupuncture energy treatments to bolster the energy sooner.

Building maintainable energy in a very deficient person can be a long, slow process because almost anything you try to do to help their energies also taxes them in the short term. When you are trying to reverse a condition that is often a lifelong state of health is a major undertaking and requires a great deal of patience and perseverance on the part of both the patient and the practitioner.

Take this same person and add one factor, a systemically weak respiratory system and you have the most pervasive type of tired person. This is the person that goes from not just being sick pretty much all the time but lives in fear of that next bout of pneumonia. This person always sees the past as their friend and live in fear of the present and especially the future. Unless their energy is up they can live in a constant environment of darkness and sadness.

Excess Types

When a person of at least average appearance and demeanor comes in and says that they’re tired, we must first ask ourselves where this person’s energies are blocked. For the most part, they have enjoyed a life of at least average energy and strength but at the present time, it is not making itself available. The most common places to look for the excess types are the Liver and Gallbladder complex, and the Spleen and Stomach and the Blood.

For the Liver and Gallbladder types, the first thing we look at is stressors, either long-term or cataclysmic in some ways involving recent years or months like a death or a divorce or some other major shift.  Sometimes the stressors and stagnations can be long repressed from childhood. Sometimes too, the stressors can be just on the body; the weight of too much work suddenly catching up to them and it can come out in anger peevishness or ongoing frustration. When asked about being short-tempered, most will readily admit it but are at a loss to explain why they are coming off at everyone all the time.

Gallbladders that are clogged can be much the same except that it can be that the body and the gallbladder are just occluded and the patient is tired all the time with the feeling that they have pressure in the body that is always pushing past the limits of their skin.

Neither the liver or the gallbladder patient ever sleep well. They are waking up all night and never able to relax and even on their best nights only sleep lightly. They constantly feel tight in their muscles and never really feel that they can get those muscles to stretch out and unwind. Worst of all they can never really relax and just fall asleep unless it is two or three o’clock in the afternoon when they are slapping themselves to stay awake. They may finally gain some steam in the early evening, but are ravenous at dinnertime and can't wait for dinner to give them some sense of energy and strength. Then as they approach bed the cycle all begins again.

The person with the blockages in the area of the Stomach or Spleen has the weight of a mind that is always working and can never shut off. They spend their day in the fog of having so much to do and are always pressured by no time to get things done. They seem to be in a constant state of panic, but if they felt that they ever deserved a rest, the weight of what hasn’t been done would push them out of their chair and back to work again.

Tiredness, and perhaps the word is weariness, comes in the form of a constant irritation of internal activity pregnant with the weight of duties yet to be finished, a place where the buzzing never stops. Though they are tired of the mundane quality of everyday life, it is a world they create because they need the familiarity.  Their physical pain and blockage comes in the form of a tightness in the solar plexus that seems rock hard, constantly aches and is almost always there. Food does not necessarily taste good, but it is familiar, and the food, like their lives, is stuck and neither ever seems to move much.

With the day well behind them, you would think that they would deserve a nice rest, but these are the people that have the hardest time shutting off and going to sleep. Eventually, they become weary and overburdened by everything and carry the weight of concern and a doggedness toward duty with a fatalistic martyrish quality worthy of either a saint or a pack horse. Eventually, they can start having panic attacks or start showing signs of obsessive or compulsive behavior. In the end, their saving grace can be a medication like a beta blocker or some other antidepressant just to help them shut off and rest.

So the point is that the energy exists, but it is just blocked or the stagnation of the energy is just working against them. If balanced and then brought back to health, they can get out of the rut they’re in and regain a carefree sense of peace, rest, self-acceptance and clarity of mind.

The really maddening thing about the whole hodgepodge is that all of these types could be the correct diagnosis at different times and the chicken or egg of it all could be really what precludes what?  Of course, if someone lived on a poor diet for a long time they could become hypoglycemic which would lead to a compromised immune response.  This could open the door to chronic colds etc. in which the compromised state could lead to autoimmune or allergic reactions taking place which could damage the liver’s effectiveness over time etc.

Of course the whole list of events could just as well have started with overwork followed by exposure to a virus at a vulnerable time and we could have ended up with hypoglycemia.  In Chinese Medicine we even acknowledge that all you have to do is be born to less than propitious times or less than healthy parents and you could be forced to live a compromised life from the start.  It is most certainly true that when you are clinically tired you’re going to experience compromised immunity, and when you get sick all the time you’re going to be tired.  It’s a vicious circle, and at any point that we enter the merry-go-round, we can be pulled into to the vortex of the ongoing problem.

In Chinese medicine, however, we can pretty clearly establish roots and hierarchies.  While I always try to stress that the analogies we use in Chinese physiology are not the same as our more clinical sense of exactness in the west, it is appropriate to the solutions that we find.

Lung paradigm

In terms of tiredness and sickness, we tend to think of three organ paradigms.  The first would be the Lungs which we think of as an umbrella at the top of the body.  It is supposed to protect us from exterior elements as an umbrella would repel rain, and on its inner side force naturally rising energy to curl back down to cycle through the body.  We think of most exterior pathogens (evils such as germs and viruses) entering through the upper back, neck, nose, and mouth when the Lungs are not strongly supported by defensive Yang energy.  We say it enters via a wind of cold, heat or damp origin.

Still, most of the time we enter into battle once our defenses are caught sleeping (or we forget to cover up) and fevers arise, we surround them with phlegm etc.  But if we don’t have the force to battle back even when discovered, it may strike deeper and attack the stomach and spleen (for all intensive purposes the pancreas) which renders our ability for mustering more troops compromised, and goes further to ruin any chance of using energy which we take in, to create a viable force for providing for energy, much less put up a defense.

Kidney paradigm

In all my cases of chronic problems involving weaknesses and being subjected to attack,  we find ourselves backing up and starting the recuperative process at the level of the kidney energy which is what we call the storehouse of the body, emanating from the Dantien in the center of our body below the belly button.

When we are tired and deficient we are cold all day long which we call kidney yang deficiency, and hot at night(if the kidney yin is also depleted.  Our joints might ache as a feeling of cold or heat in the bones themselves.  We are attacked by everything and depressed.  The number of things we become allergic to rises in number, darkness may develop around our eyes, our ears may ring, we may have to urinate often, our interest in sex wanes and our hair may become dry.  Most of all, our bodily microcosm doesn't know where to begin our rise to recovery.

Every practitioner knows that it is the deficient disease that takes time and is hard.  It is hard because it is not just drawing out the little extra energy with a needle that alleviates our pain, but a long and careful process of rebuilding What is hardest and most challenging is getting the patient to realize that every day is another brick in rebuilding the structure of our health.  Too often the patients are impatient to be through the process and use the energy or undermine themselves with erosive health behaviors, and get into a vacillating state of short-term gain and relapse.

The next source of energy is air.  Air (oxygen, carbon, helium and other constituents), is not necessarily at its optimum in the passive process of just breathing. It is the combination of air intake combined with exercise that makes this part of a dynamic energy building process. Energy can come in two forms. It can be active or it can be stagnant or passive.  Many patients who have been coming for chronic pain treatments are waiting for me to make their stagnant energies into an active form that they would call feeling better. To some extent, this can be facilitated, but truth be known that until they start to activate their own energies, that old feeling of being energetic, cannot be realized. The more we demand of our energies the greater the capacity of energy fulfillment. In short, exercise and demand more of yourselves, or be forever tired.

Emotional Stimulation or Depression

When we look back at detours in our energetic health we see passages in our lives where we fell into a bit of an energetic inertia due to our emotional reactions to certain stimulus. Of course, the possibilities are endless: loss of love, loss of job, fear of failure or other fears, anger or frustrations or issues of prejudice or unfairness are all possible reasons why we might fall into this emotional slump or an outright depression.  It is important here to clarify that depression can either be a state of being emotionally bereft leading to a total lack of direction or ambition, or, less understood,  a total lack of energy leading toward emotional stagnation.

We all know that when life is good and we are enthusiastic about what we are doing, as well as finding happiness in the people around us, we also feel energetic. This seems like a picture that cannot fail us and it will always be that way. What if in an unbalanced way a person just wants to do more of this stuff; work more and play more. Let’s say that when we run down we use coffee or some other stimulant to suffice for energy when it is really just giving us a sense of wakefulness while tapping into those energetic reserves. And so begins the cycle… Hans Selye, the person who first applied the concept of stress, the tolerance of a material to certain external loads or burdens, to the human condition, says that there are both good stresses and bad stresses, and we need both, but an excess of either is what leads to an unraveling of our well-being.

Getting energy back is not easy

So, you can see that getting back to this sense of worth, activity, vitality and emotional well-being that we call energy is not easy or even easy to identify.  It is a problem that is multi-faceted and yet readily solvable. Most people have found, however, that once on the road to recovery, if pointed in the right direction, their energies just keep getting better and better.