Ululawula njani uxinzelelo olunganyangekiyo

Umxholo

• Luthini uxinzelelo olunganyangekiyo?
• Lufunyaniswa njani uxinzelelo kunyango olunganyangekiyo?
• Yintoni ebangela uxinzelelo olunganyangekiyo?
• Ukuchongwa okungachanekanga
• Izinto zofuzo
• Ukuphazamiseka emzimbeni
• Ezinye izinto ezinobungozi
• Lunyangwa njani unyango olunganyangekiyo?
• Ukudakumba
• Amanye amayeza
• Unyango ngengqondo
• Iinkqubo
• Kuthekani ngokusetyenziswa kwezinto ezikhuthazayo?
• Yintoni imbonakalo?

Luthini uxinzelelo olunganyangekiyo?

Ukuziva ulusizi okanye unganathemba amaxesha ngamaxesha yinto eqhelekileyo kunye nendalo yobomi. Kwenzeka kuye wonke umntu. Kubantu abanoxinzelelo, ezi mvakalelo zinokuba namandla kwaye zihlala ixesha elide. Oku kunokukhokelela kwiingxaki emsebenzini, ekhaya, okanye esikolweni.

Uxinzelelo luhlala lunyangwa ngokudityaniswa kwamayeza oxinzelelo kunye nezinye iintlobo zonyango, kubandakanya unyango lwengqondo. Kweminye, i-anti-depressants ibonelela ngoncedo olwaneleyo ngokwabo.

Ngelixa i-anti-depressants isebenza kakuhle kubantu abaninzi, aziziphuculi iimpawu zabantu abanexinzelelo. Ukongeza, qaphela kuphela inkqubela phambili kwiimpawu zabo.

Uxinzelelo olungaphenduliyo kwi-anti-depressants yaziwa njengoxinzelelo olunganyangekiyo kunyango. Abanye bakwabhekisa kuyo njengonyango olunengxaki yoxinzelelo.

Funda ukuze ufunde ngakumbi malunga nokudakumba okunganyangekiyo kunyango, kubandakanya neendlela zonyango ezinokunceda.

Lufunyaniswa njani uxinzelelo kunyango olunganyangekiyo?

Akukho zindlela zisemgangathweni zokuchonga uxinzelelo olunganyangekiyo kunyango, kodwa oogqirha ngokubanzi benza oku kuxilongwa ukuba umntu ukhe wazama ubuncinci iintlobo ezimbini ezahlukeneyo zonyango lwe-antidepressant ngaphandle kophuculo.

Ukuba ucinga ukuba unoxinzelelo olunganyangekiyo kunyango, kubalulekile ukuba ufumane ukuxilongwa kugqirha. Ngelixa unokuba noxinzelelo olunganyangekiyo kunyango, baya kufuna ukuphinda bajonge izinto ezimbalwa kuqala, ezinje:

• Ngaba uxinzelelo lwakho lwachongwa ngokuchanekileyo kwasekuqaleni?
• Ngaba zikhona ezinye iimeko ezinokuthi zibangele okanye zonakalise iimpawu?
• Ngaba i-anti-depressant yayisetyenziselwa idosi elungileyo?
• Ngaba i-anti-depressant yathathwa ngokuchanekileyo?
• Ngaba i-anti-depressant yazama ixesha elaneleyo?

I-anti-depressants ayisebenzi ngokukhawuleza. Ngokwesiqhelo bafuna ukuthathwa iiveki ezintandathu ukuya kwezisibhozo ngeedosi ezifanelekileyo ukuze babone ukusebenza kwazo ngokupheleleyo. Kubalulekile ukuba amayeza azanywe ixesha elide ngokwaneleyo ngaphambi kokuthatha isigqibo sokuba ayisebenzi.

Nangona kunjalo, olunye uphando lubonisa ukuba abantu ababonisa ukuphucuka okuthile kwiiveki ezimbalwa zokuqala i-antidepressant kunokwenzeka ukuba baphucule ngokupheleleyo kwiimpawu zabo.

Abo bangenayo nayiphi na impendulo kwangoko kunyango kunqabile ukuba baphucule ngokupheleleyo, kwanasemva kweeveki ezininzi.

Yintoni ebangela uxinzelelo olunganyangekiyo?

Iingcali aziqinisekanga ukuba kutheni abanye abantu bengaphenduli kwizidambisi zengqondo, kodwa kukho iingcamango ezininzi.

Ezinye zezona zidumileyo zibandakanya:

Ukuchongwa okungachanekanga

Enye yeengcamango eziqhelekileyo kukuba abantu abangaphenduliyo kunyango abanangxaki yokudakumba. Banokuba neempawu ezifanayo nezo zoxinzelelo, kodwa eneneni bane-bipolar disorder okanye ezinye iimeko ezineempawu ezifanayo.

Izinto zofuzo

Inye okanye ezingaphezulu izinto zemfuza ezinokuba nenxaxheba kuxinzelelo olunganyangekiyo kunyango.

Umahluko othile kwimfuza unokunyusa indlela umzimba owaphula ngayo uxinzelelo, olunokuthi lubenze bangasebenzi kakuhle. Olunye uhlobo lokwahluka kwemfuza lunokutshintsha indlela umzimba ophendula ngayo kwizidambisi zengqondo.

Ngelixa uphando oluninzi luyafuneka kule ndawo, oogqirha ngoku banoku-odola kuvavanyo lwemfuza olunokukunceda ekufumaniseni ukuba zeziphi izinto ezichasene noxinzelelo ziya kusebenza ngcono kuwe.

Ukuphazamiseka emzimbeni

Enye inkolelo kukuba abantu abangaphenduliyo kunyango banokuqhubekeka nezondlo ezithile ngokwahlukileyo. Olunye uphononongo lufumanise ukuba abanye abantu abangaphenduliyo kunyango lwe-anti-depressant banamanqanaba asezantsi e-foline kulwelo olujikeleze ingqondo kunye nomqolo womqolo (i-cerebrospinal fluid).

Okwangoku, akukho mntu uqinisekileyo ukuba yintoni ebangela eli nqanaba liphantsi le-folate okanye ukuba inxulumene njani nokudakumba okunganyangekiyo.

Ezinye izinto ezinobungozi

Abaphandi bafumanise izinto ezithile ezonyusa umngcipheko wokuba noxinzelelo olunganyangekiyo kunyango.

Ezi zinto zibeka emngciphekweni zibandakanya:

• Ubude bexinzelelo. Abantu abanodandatheko olukhulu ixesha elide kunokwenzeka ukuba babe nokudakumba okunganyangekiyo.
• Ubunzima beempawu. Abantu abaneempawu zokudakumba kakhulu okanye iimpawu eziphantsi kakhulu kunqabile ukuba baphendule kakuhle kwii-anti-depressants.
• Ezinye iimeko. Abantu abanezinye iimeko, ezinje ngexhala, kunye nokudakumba kunokwenzeka ukuba babe noxinzelelo olungaphenduliyo kwizidambisi.

Lunyangwa njani unyango olunganyangekiyo?

Ngaphandle kwegama, uxinzelelo olunganyangekiyo lunokunyangwa. Kungathatha ixesha ukufumana isicwangciso esifanelekileyo.

Ukudakumba

Amachiza okunyanga uxinzelelo lukhetho lokuqala lokunyanga uxinzelelo. Ukuba uzame i-anti-depressants ngaphandle kwempumelelo enkulu, ugqirha wakho uya kuqala ngokucebisa nge-anti-depressant kwiklasi eyahlukileyo yeziyobisi.

Iklasi yeziyobisi liqela lamayeza asebenza ngendlela efanayo. Iiklasi ezahlukeneyo zamachiza okunyanga uxinzelelo zibandakanya:

• i-serotonin reuptake inhibitors ekhethiweyo, efana ne-citalopram (Celexa), i-escitalopram (Lexapro), i-fluoxetine (i-Prozac), i-paroxetine (i-Paxil), kunye ne-sertraline (iZoloft)
• i-serotonin-norepinephrine reuptake inhibitors, enje nge-desvenlafaxine (Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), milnacipran (Savella), kunye venlafaxine (Effexor)
• i-norepinephrine kunye ne-dopamine reuptake inhibitors, enjenge-bupropion (Wellbutrin)
• tetracycline antidepressants, ezinje nge maprotiline (Ludiomil) kunye ne mirtazapine
• tricyclic antidepressants, ezinje nge-amitriptyline, desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), kunye nortriptyline (Pamelor)
• i-monoamine oxidase inhibitors, efana ne-phenelzine (Nardil), selegiline (Emsam), kunye ne-tranylcypromine (iParnate)

Ukuba i-anti-depressant yokuqala oyizamileyo yayikukukhetha i-serotonin reuptake inhibitor, ugqirha wakho unokucebisa ngokuchasene noxinzelelo kule klasi okanye kwi-anti-depressant eklasini elahlukileyo.

Ukuba ukuthatha i-anti-depressant enye akuphuculi mpawu zakho, ugqirha wakho unokumisela nokuba zibekho ngexesha elinye. Kwabanye abantu, indibaniselwano inokusebenza ngcono kunokuthatha iyeza elinye lodwa.

Amanye amayeza

Ukuba i-anti-depressant iyodwa ayiziphuculi iimpawu zakho, ugqirha wakho unokumisela uhlobo olwahlukileyo lonyango oza kuthatha nalo.

Ukudibanisa amanye amayeza kunye ne-anti-depressant ngamanye amaxesha kusebenza ngcono kune-anti-depressant ngokwayo. Olunye unyango luhlala lubizwa ngokuba lunyango lokonyusa.

Amanye amayeza aqhelekileyo asetyenziswa kunye ne-anti-depressants afaka:

• ilithium (Lithobid)
• i-antipsychotic, ezinje nge-aripiprazole (Abilify), i-olanzapine (iZyprexa), okanye i-quetiapine (iSeroquel)
• idlala lengqula

Amanye amayeza anokucetyiswa ngugqirha wakho abandakanya:

• iziyobisi zedopamine, ezinje ngepramipexole (Mirapex) kunye ne-ropinirole (Requip)
• ketamine

Izongezo zesondlo zinokukunceda, ngakumbi ukuba unokusilela. Ezinye zezi zinto zinokubandakanya:

• Ioyile yentlanzi okanye i-omega-3 fatty acids
• ifolic acid
• I-methylfolate
• ademetionine
• zinc

Unyango ngengqondo

Ngamanye amaxesha, abantu abangenayo impumelelo enkulu yokuthatha i-anti-depressants bafumanisa ukuba unyango lweengqondo okanye unyango lokuziphatha kwengqondo (CBT) lusebenza ngakumbi. Kodwa ugqirha wakho uya kukucebisa ukuba uqhubeke ukuthatha amayeza.

Ukongeza, ezinye zibonisa ukuba i-CBT iphucula iimpawu kubantu abangaphuculiyo emva kokuthatha i-anti-depressants. Kwakhona, uninzi lwezi zifundo lubandakanya abantu ngaxeshanye bethatha amayeza kwaye benze i-CBT.

Iinkqubo

Ukuba amayeza kunye nonyango zibonakala ngathi azenzi iqhinga, kukho iinkqubo ezimbalwa ezinokunceda.

Ezimbini zeenkqubo eziphambili ezisetyenziselwa uxinzelelo olunganyangekiyo zibandakanya:

• Ukukhuthaza imithambo-luvo yeVagus. I-Vagus nerve stimulation isebenzisa isixhobo esifakelweyo ukuthumela amandla ombane amancinci kwinkqubo yomzimba wakho yemithambo-luvo, enokunceda ekuphuculeni iimpawu zoxinzelelo.
• Unyango lwe-Electroconvulsive. Olu unyango lujikeleze ukususela ngo-1930 kwaye ekuqaleni kwakubizwa ngokuba yi-electroshock therapy. Kule minyaka ingamashumi idlulileyo, iwelekile kwaye ihlala iphikisana. Kodwa inokusebenza kwiimeko apho kungekho enye into esebenzayo. Oogqirha bahlala belugcina olu nyango njengecebo lokugqibela.

Kukho iindlela ezahlukeneyo zonyango abanye abantu abazama ukudakumba. Akukho phando lukhulu lokuxhasa ukusebenza kwezi zonyango, kodwa kunokuba kufanelekile ukuzama ukongeza kolunye unyango.

Ezinye zezi ziquka:

• ukutshiza
• ukuvuselela ingqondo enzulu
• unyango olukhanyayo
• Ukukhuthaza amandla emagnethi

Kuthekani ngokusetyenziswa kwezinto ezikhuthazayo?

Kwiminyaka yakutshanje, kukho umdla omkhulu ekusebenziseni iziyobisi ezikhuthazayo kunye neyeza zokuthomalalisa uxinzelelo olunganyangekiyo.

Izikhuthazo ngamanye amaxesha ezisetyenziswa ngamachiza okulwa uxinzelelo zibandakanya:

• imodafinil (Provigil)
• imethylphenidate (Ritalin)
• lisdexamfetamine (IVavvanse)
• Adderall

Kodwa ukuza kuthi ga ngoku, uphando olujikeleze ukusetyenziswa kwezikhuthazi ekunyangeni uxinzelelo alunakulinganiswa.

Umzekelo, kolunye uphando, ukusebenzisa i-methylphenidate kunye ne-anti-depressants akuzange kuphucule iimpawu zoxinzelelo.

Iziphumo ezifanayo zafunyanwa kolunye uphononongo olwalujonge ukusetyenziswa kwe-methylphenidate ene-anti-depressants kunye neyathi yavavanya ukusebenzisa i-modafinil ene-anti-depressants.

Nangona ezi zifundo zingafumananga sibonelelo sipheleleyo, zibonise ukuphucuka kweempawu, ezinje ngokudinwa kunye nokudinwa.

Ke, izinto ezikhuthazayo zinokuba lukhetho ukuba unokudinwa okanye ukudinwa okugqithisileyo okungaphuculiyo ngoxinzelelo lodwa. Banokukhetha ukuba unengxaki yokusilela kokuphazamiseka kwengqondo kunye noxinzelelo.

I-Lisdexamfetamine sesinye sezona zivuseleli zifundwa kakuhle ezisetyenziselwa uxinzelelo olunganyangekiyo kunyango. Nangona ezinye izifundo zifumene iimpawu eziphuculweyo xa zidibene ne-anti-depressants, olunye uphando alufumananga sibonelelo.

Uhlalutyo lwezifundo ezine ze-lisdexamfetamine kunye ne-anti-depressants zifumanise ukuba indibaniselwano yayingaseluncedo kunokuba uthathe i-anti-depressants yodwa.

Yintoni imbonakalo?

Ukulawula uxinzelelo olunganyangekiyo kunyango kunokuba nzima, kodwa akunakwenzeka. Ngexesha elincinci kunye nomonde, wena nogqirha wakho ninokuphuhlisa isicwangciso sonyango esiphucula iimpawu zakho.

Okwangoku, cinga ukunxibelelana nabanye abajongene nemiceli mngeni efanayo yenkxaso kunye nolwazi malunga noko kubasebenzeleyo.

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