I-Postpartum Psychosis: Iimpawu kunye nezixhobo

Umxholo

• Lithini inqanaba lokuvela kwengqondo yasemva kokubeleka?
• Isifo sengqondo emva kokubeleka kunye nokudakumba emva kokubeleka
• Iiblues zasemva kokubeleka
• Uxinzelelo lwasemva kokubeleka
• Ingqondo yasemva kokubeleka
• Iimpawu zengqondo yasemva kokubeleka
• Ziziphi izinto ezinobungozi?
• Baziqonda njani oogqirha emva kokubeleka?
• Unyango lwengqondo yasemva kokubeleka
• Imbonakalo yengqondo yasemva kokubeleka
• Q:
• A:

Intro

Ukubeleka umntwana kuzisa utshintsho oluninzi, kwaye oku kunokubandakanya utshintsho kumama kunye neemvakalelo zomama omtsha. Abanye abantu basetyhini banamava angaphezulu kwamahla ndinyuka aqhelekileyo exesha lokubeleka. Izinto ezininzi zidlala indima kwimpilo yengqondo yasemva kokubeleka. Ngeli xesha, isiphelo esibi kakhulu sokutshintsha kwemeko yimeko eyaziwa njenge-postpartum psychosis, okanye i-puerperal psychosis.

Le meko ibangela ukuba umfazi abe neempawu ezinokumoyikisa. Usenokuva amazwi, abone izinto ezingeyonyani, kwaye abe namava okuba lusizi kunye noxinzelelo. Ezi mpawu zigunyazisa unyango olungxamisekileyo.

Lithini inqanaba lokuvela kwengqondo yasemva kokubeleka?

Uqikelelo lwe-1 ukuya kwe-2 kwabafazi abayi-1 000 abanamava engqondo emva kokubeleka. Imeko inqabile kwaye ihlala ivela kwiintsuku ezimbini ukuya kwezintathu zokuhanjiswa.

Isifo sengqondo emva kokubeleka kunye nokudakumba emva kokubeleka

Oogqirha bachonge iintlobo ezahlukeneyo zokugula kwengqondo emva kokubeleka. Amanye amagama aqhelekileyo onokuthi uvile ngawo afaka:

Iiblues zasemva kokubeleka

Kuqikelelwa ukuba ama-50 ukuya kuma-85 eepesenti yabasetyhini bafumana i-blues yasemva kokubeleka ngaphakathi kweeveki ezimbalwa zokuhanjiswa. Iimpawu ezinxulunyaniswa ne-postpartum blues okanye "baby blues" zibandakanya:

• iinyembezi
• ixhala
• ukucaphuka
• utshintsho olukhawulezileyo kwiimvakalelo

Uxinzelelo lwasemva kokubeleka

Xa iimpawu zoxinzelelo zihlala ngaphezulu kweeveki ezimbini ukuya kwezintathu kwaye ziphazamise ukusebenza komfazi, unokuba noxinzelelo lwasemva kokubeleka. Iimpawu ezinxulumene nale meko zibandakanya:

• imo ebuhlungu rhoqo
• ukuziva unetyala
• ukungabi naxabiso, okanye ukungafaneleki
• ixhala
• ukuphazamiseka kokulala nokudinwa
• ubunzima bokugxila
• utshintsho lokutya

Umfazi onexinzelelo lwasemva kokubeleka unokuba neengcinga zokuzibulala.

Ingqondo yasemva kokubeleka

Uninzi loogqirha bacinga ukuba isifo sengqondo emva kokubeleka sinokuba nezona ziphumo zempilo yengqondo.

Yinto engaqhelekanga kubo bonke oomama abatsha ukuba neziqendu zosizi, uloyiko kunye noxinzelelo. Xa ezi mpawu ziqhubeka okanye ziguquka zibe ziingcinga ezinokuba yingozi, kufuneka zifune uncedo.

Iimpawu zengqondo yasemva kokubeleka

I-Psychosis kuxa umntu ephulukana nokunxibelelana nenyani. Banokuqala ukubona, ukuva, kunye / okanye ukukholelwa izinto ezingeyonyani. Esi siphumo sinokuba yingozi kakhulu kumama omtsha nosana lwakhe.

Iimpawu zengqondo yasemva kokubeleka ziyafana nezo ze-bipolar, episode manic. Isiqendu sihlala siqala ngokungakwazi ukulala kunye nokuziva ungenasiphelo okanye ngakumbi ukucaphuka. Ezi mpawu zinika indlela ezibukhali ngakumbi. Imizekelo ibandakanya:

• ukuva izinto ezingekhoyo (ukuva izinto ezingeyonyani, ezinje ngengcebiso yokuba umama azenzakalise okanye ukuba usana luzama ukumbulala)
• iinkolelo ezingekhoyo ezihlala zihambelana nosana, njengokuthi abanye bazama ukonzakalisa usana lwakhe
• edidekile ngendawo nexesha
• ukungaziphathi ngendlela engaqhelekanga
• Ukutshintsha kwemoods ngokukhawuleza ukusuka kosizi olugqithisileyo ukuya kumandla amakhulu
• Iingcinga zokuzibulala
• iingcinga ezinobundlobongela, njengokuxelela umama ukuba enzakalise usana lwakhe

I-postpartum psychosis inokuba nzima kumama nakumntwana wakhe omncinci. Ukuba ezi mpawu ziyenzeka, kubalulekile ukuba owasetyhini afumane uncedo lwezonyango kwangoko.

Ziziphi izinto ezinobungozi?

Ngelixa abanye abantu basetyhini banokuba nesifo sengqondo emva kokubeleka ngaphandle kwemingcipheko, kukho izinto ezithile ezaziwayo zokunyusa umngcipheko kumfazi kule meko. Ziquka:

• Imbali yokuphazamiseka kwengqondo
• Imbali yengqondo yasemva kokubeleka kukukhulelwa kwangaphambili
• Imbali yesifo se-schizoaffective okanye i-schizophrenia
• Imbali yosapho ye-postpartum psychosis okanye i-bipolar disorder
• ukukhulelwa kokuqala
• Ukupheliswa kwamayeza onyango ngengqondo ngexesha lokukhulelwa

Izizathu ezichanekileyo zengqondo yasemva kokubeleka azaziwa. Oogqirha bayazi ukuba bonke abantu basetyhini abasemva kwexesha lokubeleka bahlangabezana nokutshintsha kwamanqanaba eehomoni. Nangona kunjalo, ezinye zibonakala ngathi zibuthathaka ngakumbi kwiziphumo zempilo yengqondo zotshintsho kwiihomoni ezinje nge-estrogen, progesterone, kunye / okanye ihomoni yedlala lengqula. Zininzi ezinye izinto zempilo ezinokuba nefuthe kwizizathu zengqondo yasemva kokubeleka, kubandakanya ufuzo, inkcubeko, kunye nokusingqongileyo kunye nezinto eziphilayo. Ukungalali ngokwaneleyo nako kunokudlala indima.

Baziqonda njani oogqirha emva kokubeleka?

Ugqirha uya kuqala ngokukubuza malunga neempawu zakho kunye nokuba unexesha elingakanani uhlangabezana nazo. Baya kuphinda babuze malunga nembali yakho yonyango edlulileyo, kubandakanya ukuba unembali:

• ukudakumba
• ukuxhuzula
• ixhala
• esinye isifo sengqondo
• Imbali yosapho yengqondo yempilo
• iingcinga zokuzibulala, okanye ukwenzakalisa umntwana wakho
• ukuhlukunyezwa kwesiyobisi

Kubalulekile ukuba uthembeke kwaye uvule kangangoko nogqirha wakho ukuze ufumane uncedo olufunayo.

Ugqirha uya kuzama ukulawula ezinye iimeko kunye nezinto ezinokubangela utshintsho kwindlela yokuziphatha, ezinje ngehomoni yedlala lengculaza okanye usulelo lwasemva kokubeleka. Ukuvavanywa kwegazi kumanqanaba ehomoni ye-thyroid, ukubalwa kweeseli ezimhlophe, kunye nolunye ulwazi olufanelekileyo lunokunceda.

Ugqirha unokucela umntu wasetyhini ukuba agqibe isixhobo sovavanyo loxinzelelo. Le mibuzo yenzelwe ukunceda oogqirha bachonge abasetyhini abanengxaki yoxinzelelo lwasemva kokubeleka kunye / okanye isifo sengqondo.

Unyango lwengqondo yasemva kokubeleka

Ingqondo yasemva kokubeleka yingxakeko yezonyango. Umntu kufuneka abize i-911 kwaye afune unyango kwigumbi likaxakeka, okanye umntu awise kwigumbi likaxakeka okanye kwiziko leengxaki. Rhoqo, owasetyhini uya kufumana unyango kwiziko lokunyangwa ngaphakathi okungenani kwiintsuku ezimbalwa de imeko yakhe izinze kwaye akasekho semngciphekweni wokuzenzakalisa okanye usana lwakhe.

Unyango ngexesha lesiqendu se-psychotic kubandakanya amayeza okunciphisa uxinzelelo, ukuzinzisa imeko, kunye nokunciphisa isifo sengqondo. Imizekelo ibandakanya:

• Antipsychotic: La mayeza anciphisa izehlo zokuba nemibono. Imizekelo ibandakanya i-risperidone (Risperdal), i-olanzapine (iZyprexa), i-ziprasidone (iGeodon), kunye ne-aripiprazole (Abilify).
• Ukuzinza kwomoya: La mayeza anciphisa iziqendu zomntu. Imizekelo ibandakanya i-lithium (Lithobid), carbamazepine (Tegretol), lamotrigine (Lamictal), kunye ne-divalproex sodium (Depakote).

Akukho nanye indibaniselwano efanelekileyo yamayeza ekhoyo. Umfazi ngamnye wahlukile kwaye angaphendula ngcono kwizidambisi zonyango okanye kumayeza okuxhalabisa endaweni okanye ngokudibene neziyobisi ezivela kwezi ndidi zingasentla.

Ukuba umfazi akaphenduli kakuhle kumayeza okanye ufuna unyango olungaphezulu, unyango lokothuka ngombane (ECT) luhlala lusebenza kakhulu. Olu nyango lubandakanya ukuhambisa inani elilawulwayo lokukhuthaza amandla ombane kwingqondo yakho.

Iziphumo zenza isaqhwithi okanye isenzo esifana nokuthimba kwingqondo esinceda "ukuseta kwakhona" ukungalingani okubangelwe sisiqendu se-psychotic. Oogqirha basebenzise i-ECT ngokukhuselekileyo iminyaka ukunyanga uxinzelelo olukhulu kunye nokuphazamiseka kwengqondo okuguquguqukayo.

Imbonakalo yengqondo yasemva kokubeleka

Ezona mpawu zibukhali zengqondo yasemva kokubeleka zinokuhlala ukusuka kwiiveki ezimbini ukuya kwezili-12. Abanye abantu basetyhini banokufuna ixesha elide ukuze bachache, ukusuka kwiinyanga ezintandathu ukuya kwezili-12. Nokuba emva kokuba iimpawu eziphambili zengqondo ziphelile, abasetyhini banokuba neemvakalelo zokudakumba kunye / okanye unxunguphalo. Kubalulekile ukuhlala kuwo nawaphi na amayeza amiselweyo kwaye ufune unyango oluqhubekayo kunye nenkxaso yezi mpawu.

Abasetyhini abancancisa iintsana zabo kufuneka babuze oogqirha babo ngokhuseleko. Amayeza amaninzi asetyenziselwa ukunyanga i-postpartum psychosis idluliswa ngobisi lwebele.

Kuqikelelwa ukuba iipesenti ezingama-31 zabasetyhini abanembali yengqondo yasemva kokubeleka baya kuphinda bayifumane le meko kokunye ukukhulelwa, ngokophando olupapashwe kwiAmerican Journal of Psychiatry.

Ezi zibalo akufuneki zikugcine ekufumaneni omnye umntwana, kodwa yinto ekufuneka uyigcinile engqondweni njengoko ulungiselela ukuhanjiswa. Ngamanye amaxesha ugqirha uyakumisela isimilo esimiselweyo njenge-lithium yomfazi ukuba ayithathe emva kokubeleka. Oku kunokuthintela isifo sengqondo sasemva kokubeleka.

Ukuba nesiqendu se-postpartum psychosis akuthethi ukuba uya kuba neziqendu ezizayo zengqondo okanye uxinzelelo. Kodwa oko kuthetha ukuba kubalulekile ukuba uzazi iimpawu kunye nalapho unokufuna khona unyango ukuba iimpawu zakho ziqala ukubuya.

Q:

Ngaba umfazi onamava okanye umntu ojonge ukukhathalela umntu amthandayo angalufumana phi uncedo lwengqondo lwasemva kokubeleka?

Isigulana esingaziwayo

A:

Biza u-911. Chaza ukuba wena (okanye umntu omkhathaleleyo) usandula ukuba nosana kwaye uchaze into enamava okanye engqinelwayo. Chaza inkxalabo yakho ngokhuseleko nokuba sempilweni. Abasetyhini abahlangabezana nengqondo yasemva kokubeleka basengxakini kwaye bafuna uncedo esibhedlele ukuze bahlale bekhuselekile. Musa ukushiya umfazi yedwa ohlangabezana neempawu kunye neempawu zengqondo yasemva kokubeleka.

UKimberly Dishman, MSN, WHNP-BC, RNC-OBAIimpendulo zimele uluvo lweengcali zethu zonyango. Yonke imixholo inolwazi ngokungqongqo kwaye akufuneki ukuba ithathelwe ingqalelo njengengcebiso yezonyango.