Ukudakumba okungapheliyo

Umxholo

• Ukudakumba okungapheliyo kwahluke njani kuxinzelelo lwe-Exo?
• Ziintoni Iimpawu zoxinzelelo lweNdalo?
• Ukudakumba okungapheliyo kuchongwa njani?
• Uxinezeleka njani ngaphakathi?
• Amayeza
• Unyango
• Unyango lwe-Electroconvulsive Therapy (ECT)
• Utshintsho kwindlela yokuphila
• Nguwuphi umbono wabantu abaNoxinzelelo olungapheliyo?
• Izixhobo zabantu abaDandathekileyo
• Amaqela enkxaso
• Umnxeba woNcedo lokuzibulala
• Uthintelo lokuzibulala

Yintoni uxinzelelo olungapheliyo?

Ukudakumba okungapheliyo luhlobo lwesifo sokudakumba (MDD). Nangona yayiqhele ukubonwa njengesiphazamiso esahlukileyo, uxinzelelo olungapheliyo ngoku alufane lufumaneke. Endaweni yoko, ngoku ichongwa njenge-MDD. I-MDD, ekwabizwa ngokuba luxinzelelo lweklinikhi, kukuphazamiseka kwemozulu okubonakaliswa ziimvakalelo eziqhubekayo kunye ezinzulu zosizi ixesha elide. Ezi mvakalelo zinefuthe elibi kwimood kunye nokuziphatha kunye nemisebenzi eyahlukeneyo yomzimba, kubandakanya ukulala kunye nokutya. Phantse iipesenti ezisi-7 zabantu abadala eUnited States bafumana i-MDD ngonyaka. Abaphandi abasazi esona sizathu sokudakumba. Nangona kunjalo, bakholelwa ekubeni kunokubangelwa yindibaniselwano:

• izinto zofuzo
• izinto zebhayoloji
• iimeko zengqondo
• iimeko zokusingqongileyo

Abanye abantu badandatheka emva kokuswelekelwa ngumntu abamthandayo, ukuphelisa ubudlelwane, okanye ukwenzakala. Nangona kunjalo, uxinzelelo olungapheliyo lwenzeka ngaphandle komsitho ocacileyo woxinzelelo okanye esinye isenzo. Iimpawu zihlala zivela ngesiquphe kwaye ngaphandle kwesizathu.

Ukudakumba okungapheliyo kwahluke njani kuxinzelelo lwe-Exo?

Abaphandi basebenzise ukwahlula uxinzelelo olungapheliyo kunye noxinzelelo lwangaphandle ngokubakho okanye ukungabikho komsitho oxinzelelekileyo ngaphambi kokuqala kwe-MDD:

Ukudakumba okungapheliyo kwenzeka ngaphandle kobukho boxinzelelo okanye umothuko. Ngamanye amagama, ayinasizathu sangaphandle. Endaweni yoko, inokubangelwa ikakhulu yimfuza kunye nezinto eziphilayo. Yiyo loo nto ukudakumba okungapheliyo kunokubhekiswa kuko njengokudakumba "ngokusekwe kwindalo".

Ukudakumba okumangalisayo kwenzeka emva kwesiganeko soxinzelelo okanye esothusayo. Olu hlobo loxinzelelo ludla ngokubizwa ngokuba "lusebenze kwakhona".

Iingcali zempilo yengqondo bezisebenzisa ukwahlula phakathi kwezi ntlobo zimbini ze-MDD, kodwa oku akusekho njalo. Uninzi lweengcali zempilo yengqondo ngoku zenza isifo esiqhelekileyo se-MDD ngokusekelwe kwiimpawu ezithile.

Ziintoni Iimpawu zoxinzelelo lweNdalo?

Abantu abanokudakumba okungapheliyo baqala ukufumana iimpawu ngequbuliso nangaphandle kwesizathu. Uhlobo, ukuphindaphinda, kunye nobukrakra beempawu zinokwahluka kumntu-kumntu.

Iimpawu zoxinzelelo olungapheliyo ziyafana nezo ze-MDD. Ziquka:

• iimvakalelo eziqhubekayo zosizi okanye zokuphelelwa lithemba
• Ukuphelelwa ngumdla kwimisebenzi okanye kwizinto ozithandayo ezazikade zimnandi, kubandakanya isondo
• ukudinwa
• ukunqongophala kwenkuthazo
• kunzima ukugxila, ukucinga, okanye ukwenza izigqibo
• ubunzima bokulala okanye ukulala
• ukubekwa wedwa koluntu
• iingcinga zokuzibulala
• intloko ebuhlungu
• iintlungu zemisipha
• ukuphelelwa ngumdla wokutya okanye ukutya kakhulu

Ukudakumba okungapheliyo kuchongwa njani?

Umboneleli wakho wokhathalelo oluphambili okanye ugqirha wezempilo yengqondo unokuchonga i-MDD. Baza kuqala bakubuze ngembali yakho yonyango. Qiniseka ukuba ubazisa malunga nawaphi na amayeza owathathayo nangayo nayiphi na imeko ekhoyo yezonyango okanye yezempilo. Kukwaluncedo ukubaxelela ukuba kukho naliphi na ilungu losapho lwakho eline-MDD okanye ebelikhe lanalo ngaphambili.

Umboneleli wakho wezempilo uya kukubuza malunga neempawu zakho. Bazofuna ukwazi ukuba ziqale nini iimpawu kwaye ukuba baqale emva kokuba ufumene isiganeko soxinzelelo okanye esibuhlungu. Umboneleli wakho wezempilo unokukunika uluhlu lwemibuzo evavanya indlela oziva ngayo. Eli phepha lemibuzo linokubanceda ukuba babone ukuba unayo i-MDD.

Ukuchongwa ukuba une-MDD, kuya kufuneka uhlangabeze iikhrayitheriya ezithile ezidweliswe kwiNcwadana yokuHlola kunye neNgcaciso yeMicimbi yokuPhazamiseka kwengqondo (DSM). Le ncwadana ihlala isetyenziswa ziingcali zempilo yengqondo ukufumanisa imeko yempilo yengqondo. Eyona migaqo iphambili yoxilongo lwe-MDD "kukudakumba okanye ukuphulukana nomdla okanye ukonwaba kwimisebenzi yemihla ngemihla ngaphezulu kweeveki ezimbini."

Nangona incwadana yemigaqo isetyenziselwa ukwahlula phakathi kweendlela zangaphakathi kunye nezangaphandle zoxinzelelo, ingxelo yangoku ayisabonisi umahluko. Iingcali zempilo yengqondo zinokufumanisa isifo soxinzelelo lwangaphakathi ukuba iimpawu ze-MDD ziphuculwe ngaphandle kwesizathu.

Uxinezeleka njani ngaphakathi?

Ukoyisa i-MDD ayisiyonto ilula, kodwa iimpawu zinokunyangwa ngokudibanisa amayeza kunye nonyango.

Amayeza

Amayeza aqhelekileyo asetyenziselwa ukunyanga abantu abane-MDD abandakanya i-serotonin reuptake inhibitors (i-SSRIs) ekhethiweyo kunye ne-serotonin ekhethiweyo kunye ne-norepinephrine reuptake inhibitors (SNRIs). Abanye abantu banokumiselwa i-tricyclic antidepressants (TCAs), kodwa la machiza awasetyenziswanga njengakuqala. La mayeza anyusa amanqanaba eekhemikhali ezithile zobuchopho ezikhokelela ekunciphiseni kweempawu zokudakumba.

Ii-SSRI zihlobo lonyango olunokuthintela uxinzelelo olunokuthi luthathwe ngabantu abane-MDD. Imizekelo yee-SSRI zibandakanya:

• iparoxetine (Paxil)
• fluoxetine (Prozac)
• i-sertraline (iZoloft)
• I-escitalopram (iLexapro)
• Ikitalopram (Celexa)

I-SSRIs inokubangela iintloko, isicaphucaphu kunye nokuqaqanjelwa sisisu ekuqaleni. Nangona kunjalo, ezi ziphumo bezingalindelekanga zihlala zihamba emva kwexesha elifutshane.

I-SNRIs lolunye uhlobo lonyango olunokusetyenziswa ukunyanga abantu abane-MDD. Imizekelo yee-SNRIs ibandakanya:

• venlafaxine (i-Effexor)
• duloxetine (ICymbalta)
• I-desvenlafaxine (iPristiq)

Kwezinye iimeko, ii-TCA zingasetyenziselwa njengendlela yonyango kubantu abane-MDD. Imizekelo yee-TCAs zibandakanya:

• itrimipramine (iSurmontil)
• imipramine (Tofranil)
• Umda we-nortriptyline (Pamelor)

Iziphumo ebezingalindelekanga ze-TCAs ngamanye amaxesha zinokuba zibi kakhulu kunalezo zivela kwezinye i-anti-depressants. Ii-TCAs zinokubangela ukozela, isiyezi kunye nokuzuza ubunzima. Funda ngononophelo ulwazi olunikezwe yikhemesti kwaye uthethe nogqirha wakho ukuba unengxaki. Amayeza ahlala efuna ukuthathwa ubuncinci kwiiveki ezine ukuya kwezintandathu ngaphambi kokuba iimpawu ziqale ukuphucula. Ngamanye amaxesha, kunokuthatha ukuya kuthi ga kwiiveki ezili-12 ukubona ukuphuculwa kweempawu.

Ukuba iyeza elithile alibonakali lisebenza, thetha nomboneleli wakho malunga nokutshintshela kwelinye iyeza. Ngokutsho kweZiko leSizwe lezeMpilo yeNgqondo (i-NAMI), abantu abangakhange babengcono emva kokuthatha amayeza abo okuqala okulwa noxinzelelo babenethuba elingcono lokuphucula xa bezama elinye iyeza okanye indibaniselwano yonyango.

Nokuba iimpawu ziqala ukuphucula, kuya kufuneka uqhubeke nokuthatha amayeza akho. Kuya kufuneka uyeke ukuthatha amayeza phantsi kweliso lomboneleli okumisele amayeza akho. Kuya kufuneka uyeke iyeza ngokuthe chu endaweni yazo zonke ngaxeshanye. Ukuyekisa ngesiquphe uxinzelelo kunokukhokelela kwiimpawu zokurhoxa. Iimpawu ze-MDD zinokubuyela kwakhona ukuba unyango luphela ngokukhawuleza.

Unyango

I-Psychotherapy, ekwabizwa ngokuba lonyango lokuthetha, kubandakanya ukudibana nonyango rhoqo. Olu hlobo lonyango lunokukunceda ujongane nemeko yakho kunye nayo nayiphi na imiba enxulumene noko. Ezona ntlobo zimbini ziphambili zonyango lwengqondo kukunyanga ngokuziphatha (CBT) kunye nonyango lwangaphakathi (IPT).

I-CBT inokukunceda uthathe indawo yeenkolelo ezingalunganga kunye nezisempilweni, ezilungileyo. Ngokuziqhelanisa neengcinga ezilungileyo ngabom kunye nokunciphisa umda kwiingcinga ezingalunganga, unokuyiphucula indlela ebuchaphazela ngayo ubuchwephesha bakho kwiimeko ezimbi.

I-IPT inokukunceda usebenze kubudlelwane obuphazamisayo obunokuba negalelo kwimeko yakho.

Kwiimeko ezininzi, indibaniselwano yamayeza kunye nonyango iyasebenza ekunyangeni abantu abane-MDD.

Unyango lwe-Electroconvulsive Therapy (ECT)

Unyango lwe-Electroconvulsive (ECT) lunokwenziwa ukuba iimpawu aziphuculi ngonyango kunye nonyango. I-ECT ibandakanya ukudibanisa ii-electrode entlokweni ezithumela iimpembelelo zombane kwingqondo, zibangele ukubanjwa okufutshane. Olu hlobo lonyango alothusi njengoko luvakala kwaye luphucule ngokumangalisayo kule minyaka idlulileyo. Inokukunceda ukuphatha abantu ngoxinzelelo olungapheliyo ngokutshintsha unxibelelwano lweekhemikhali kwingqondo.

Utshintsho kwindlela yokuphila

Ukwenza uhlengahlengiso oluthile kwindlela ophila ngayo nakwimisebenzi yemihla ngemihla kunokunceda ekuphuculeni iimpawu zokudakumba okungapheliyo. Nokuba imisebenzi ayimnandanga ekuqaleni, umzimba wakho kunye nengqondo ziya kulungelelana ngokuhamba kwexesha. Nazi izinto onokuzama ngazo:

• Yiya ngaphandle wenze into esebenzayo, njengokuhamba intaba okanye ukuhamba ngebhayisikile.
• Thatha inxaxheba kwizinto obuzonwabele phambi kokuba uxinezeleke.
• Chitha ixesha nabanye abantu, kubandakanya abahlobo kunye nabantu obathandayo.
• Bhala kwijenali.
• Ukulala iiyure ezintandathu ubuncinci ubusuku ngabunye.
• Gcina ukutya okusempilweni okuqukethe ukutya okuziinkozo, iiproteni ezingatyebanga kunye nemifuno.

Nguwuphi umbono wabantu abaNoxinzelelo olungapheliyo?

Uninzi lwabantu abane-MDD lubangcono xa bebambelela kwisicwangciso sabo sonyango. Ngokwesiqhelo kuthatha iiveki ezininzi ukubona ukuphuculwa kweempawu emva kokuqala kwerejimeni ye-antidepressants. Abanye banokufuna ukuzama iintlobo ezimbalwa ezahlukeneyo zoxinzelelo lokuthintela uxinzelelo.

Ubude bokubuyela kwimeko yesiqhelo buxhomekeke nakwindlela abafumene ngayo unyango kwangoko. Xa ishiywe inganyangwa, i-MDD inokuhlala iinyanga ezininzi okanye iminyaka. Nje ukuba unyango lufunyenwe, nangona kunjalo, iimpawu zinokuhamba kwisithuba seenyanga ezimbini ukuya kwezintathu.

Nokuba iimpawu ziqala ukuncipha, kubalulekile ukuqhubeka uthatha onke amayeza ngaphandle kokuba umboneleli okumisele amayeza akho ukuxelela ukuba kulungile ukuyeka. Ukuphelisa unyango kwangoko kungakhokelela ekubuyeleni kwakhona okanye kwiimpawu zokurhoxa ezibizwa ngokuba yi-antidepressant discontinuation syndrome.

Izixhobo zabantu abaDandathekileyo

Kukho amaqela amaninzi enkxaso kumntu nakwi-intanethi kunye nezinye izixhobo ezikhoyo kubantu abajamelana ne-MDD.

Amaqela enkxaso

Imibutho emininzi, efana ne-National Alliance on Mental Illness, ibonelela ngemfundo, amaqela enkxaso, kunye neengcebiso. Iinkqubo zoncedo lwabasebenzi kunye namaqela ezenkolo nawo anokubonelela ngoncedo kwabo banexinzelelo lokuphela.

Umnxeba woNcedo lokuzibulala

Cofa u-911 okanye uye kwigumbi likaxakeka ngoko nangoko ukuba uneengcinga zokuzenzakalisa wena okanye abanye. Ungatsalela umnxeba iNqanaba lokuPhila lokuThintela ukuzibulala ku-800-273-TALK (8255). Le nkonzo ifumaneka iiyure ezingama-24 ngosuku, iintsuku ezisixhenxe ngeveki. Unokuthetha nabo kwi-intanethi.

Uthintelo lokuzibulala

Ukuba ucinga ukuba umntu usemngciphekweni wokuzenzakalisa okanye wenzakalise omnye umntu:

• Tsalela u-911 okanye inombolo yakho yongxamiseko yasekuhlaleni.
• Hlala naloo mntu de kufike uncedo.
• Susa nayiphi na imipu, iimela, amayeza, okanye ezinye izinto ezinokubangela ingozi.
• Mamela, kodwa musa ukugweba, ukuphikisa, ukugrogrisa, okanye ukukhwaza.

Ukuba ucinga ukuba umntu othile ucinga ngokuzibulala, fumana uncedo kwingxaki okanye kumnxeba onqabileyo wokuthintela ukuzibulala. Zama iNqanaba lokuSebenza lokuThintela ukuzibulala ku-800-273-8255.

Imithombo: Ukuzibulala kuThintelo kuZwelonke kunye Ukusetyenziswa gwenxa kweziyobisi kunye noLawulo lweeNkonzo zeMpilo yeNgqondo