Loaʻa iā ʻoe a i ʻole kekahi āu i ʻike ai ka maʻi bipolar? A laila ʻike ʻoe i ka paʻakikī o ka mālama ʻana i kou noʻonoʻo ma kahi hoʻokahi. I kekahi lā ua hauʻoli nui ʻoe a pīhoihoi (kapa mākou i kēia mania). I ka lā aʻe ua kaumaha a kaumaha loa ʻoe ʻaʻole ʻoe makemake e noho i ke ao nei. Hiki i kēia mau piʻi a me nā iho ke hoʻolilo i ke ola i mea huikau loa. I kēia lā e kamaʻilio mākou e pili ana i ke kaumaha e kū mai ana i kēia maʻi bipolar, ʻo ia hoʻi, ke kaumaha bipolar . E kamaʻilio kākou e pili ana i nā lāʻau lapaʻau no kēia ma ke ʻano maʻalahi hiki iā ʻoe ke hoʻomaopopo.
He aha nā lāʻau lapaʻau nui no ke kaumaha bipolar?
I ka wā ma mua, ua mālama ʻia kēia mau kūlana me nā lāʻau lapaʻau i hoʻoulu ai i ka hiamoe nui a he nui nā hopena ʻaoʻao. Akā, ʻaʻole ia ka hihia i kēia manawa. Ua holomua nui ka ʻepekema lapaʻau. I kēia lā, ʻo nā mea hoʻopaʻa manaʻo ke kumu nui o ka mālama ʻana i ka maʻi bipolar.
I ka ʻōlelo maʻalahi, kōkua kēia mau lāʻau lapaʻau i ka hoʻomalu ʻana i kēia mau loli o ke ʻano a mālama i kou ʻano i ke kūpaʻa. ʻOiai lākou e hoʻomalu ana i nā hanana kaumaha, kōkua pū lākou i ka pale ʻana i nā hanana manic.
E hoʻomanaʻo, ʻoi aku ka maʻamau o nā hanana kaumaha ma mua o nā hanana manic i ka maʻi bipolar, no laila he mea nui e mālama pono i kēia.
ʻO kekahi o nā ʻano nui o nā mea hoʻopaʻa manaʻo a nā kauka e ʻōlelo pinepine ai:
- Litiuma
- Lamotrigine
- ʻO Valproate
- ʻO Carbamazepine
I kekahi manawa, hoʻohana paha kāu kauka i kēia mau lāʻau lapaʻau 'off-label', ʻoiai ʻaʻole i ʻae ʻia no ke kaumaha bipolar. ʻO ke ʻano kēia, hoʻohana ʻia kahi lāʻau lapaʻau i ʻae ʻia no kekahi kūlana ʻē aʻe inā hōʻike ka ʻike a me ka ʻike o ke kauka he kūpono ia no kēia kūlana. Hiki i kekahi mau maʻi ke hoʻomalu i ko lākou kūlana me hoʻokahi mea hoʻopaʻa manaʻo . Akā inā ʻaʻole lawa kēlā, hiki i ke kauka ke hoʻoholo e hoʻohui i kahi mea hoʻopaʻa manaʻo ʻē aʻe a i ʻole kahi lāʻau lapaʻau mai kahi papa lāʻau ʻē aʻe.
Ke hoʻohana ʻia nei nā lāʻau antidepressants no kēia? He mea paʻakikī iki kēia!
He nīnau kēia a ka poʻe he nui e nīnau ai. ʻOiai he kūpono loa nā antidepressants i ka mālama ʻana i ke kaumaha unipolar, hoʻohana ʻia lākou me ke akahele nui i ka kaumaha bipolar.
E noʻonoʻo, inā hāʻawi ʻoe i kahi mea me ka maʻi bipolar i kahi antidepressant me ka ʻole o kahi mea hoʻopaʻa manaʻo, hiki iā ia ke hoʻoulu i kēlā hanana manic. ʻO ia hoʻi, hiki iā lākou ke hele mai ke kaumaha a i ka maniacal a i ka maniacal. Ma muli o kēia pilikia, ʻaʻole hāʻawi wale nā kauka i kahi antidepressant no ka maʻi bipolar.
ʻO kekahi o nā mea i loaʻa i kahi noiʻi nui i kapa ʻia ʻo STEP-BD i mālama ʻia e ka National Institute of Mental Health (NIMH) ma ʻAmelika Hui Pū ʻIa, ʻo ka hoʻohui ʻana i kahi antidepressant i kahi mea hoʻopaʻa manaʻo ʻaʻole ia he ʻokoʻa nui i ka hopena. Ua hoʻomaopopo kēia iā mākou i ke koʻikoʻi o ka loaʻa ʻana o nā lāʻau ʻē aʻe no ke kaumaha bipolar.
Pehea e kōkua ai nā lāʻau antipsychotic?
Ua hōʻike ʻia nā noiʻi hou nei he kūpono loa kekahi mau lāʻau antipsychotic no ke kaumaha bipolar. Ua kapa ʻia kēia mau mea ʻo 'Atypical Antipsychotics'.
I ka ʻōlelo maʻalahi, hana kēia mau lāʻau lapaʻau ma ka hoʻopili ʻana i nā ʻelele kemika (neurotransmitters) i loko o ko kākou lolo e kāohi ana i ke ʻano a me ke ʻano. E kaupaona kāu kauka i nā pono a me nā pōʻino o kēlā me kēia lāʻau lapaʻau a koho i ka lāʻau lapaʻau maikaʻi loa no ʻoe e lanakila ai i kou kaumaha me ka ʻole o ka pilikia o ka mania.
Aia kekahi mau lāʻau antipsychotic i hoʻohana ʻia no ke kaumaha bipolar ma ka papa ma lalo nei.
| Inoa o ka lāʻau lapaʻau (laʻana) | Pehea e hoʻohana ai |
|---|---|
| Lumateperone, Quetiapine | Hoʻohana wale ʻia ma ke ʻano he lāʻau lapaʻau pōkole no ke kaumaha bipolar. |
| ʻO Olanzapine lāua ʻo Fluoxetine | Hoʻohana ʻia kēia mau lāʻau ʻelua ma ke ʻano he hui pū ʻana. |
| ʻO Lurasidone | Hoʻohana ʻia hoʻokahi a i ʻole i ka hui pū ʻana me Lithium/Valproate. |
| ʻO Cariprazine | ʻOiai he lāʻau lapaʻau i ʻāpono ʻia no ka mania bipolar, hiki ke hoʻohana ʻia ma ke ʻano he koho off-label no ke kaumaha. |
E aʻo pū kākou e pili ana i nā lāʻau hoʻohaʻahaʻa CNS.
Hoʻokomo pū kēia hui i nā lāʻau i kapa ʻia ʻo benzodiazepines. ʻO nā laʻana e komo pū me nā lāʻau e like me Clonazepam, Lorazepam, a me Alprazolam.
Hoʻohana wale ʻia kēia mau mea no nā kūlana koʻikoʻi e like me ka hoʻomaha nui ʻole, ka hopohopo, a me ka hiamoe ʻole. ʻAʻole kēia he mau lāʻau lapaʻau maikaʻi no ka hoʻohana lōʻihi. Loaʻa iā lākou kahi pilikia kiʻekiʻe o ka maʻi ʻona . No laila, hoʻohana wale ʻia lākou no kahi manawa pōkole loa, ma lalo o ka nānā pono ʻana o ke kauka.
He mea e makaʻu ai anei ka electroconvulsive therapy (ECT)?
Hiki i ka Electroconvulsive Therapy (ECT) ke hoʻoweliweli i kekahi poʻe, akā he lāʻau lapaʻau kūpono a palekana hoʻi ia no ke kaumaha bipolar koʻikoʻi.
He kūpono loa ia no nā poʻe maʻi me nā hōʻailona psychotic a i ʻole ka poʻe i loaʻa i ka pilikia nui o ka pepehi kanaka . He lāʻau palekana a maikaʻi hoʻi ʻo ECT no nā wahine me ke kaumaha bipolar koʻikoʻi a i ʻole ka mania i ka wā hāpai, me ka ʻole o ka hōʻeha ʻana i ka pēpē.
ʻAʻole anei lawa ka lāʻau lapaʻau wale nō? Ke koʻikoʻi o ka psychotherapy
He mea nui loa kēia. I ka mālama ʻana i ke kaumaha bipolar, hoʻokahi wale nō ʻaoʻao o ka hoʻohālikelike ka lāʻau lapaʻau. ʻO kekahi ʻaoʻao, ʻo ia ka psychotherapy .
E kōkua kēia iā ʻoe e hoʻokele maikaʻi i kāu mau pilina pili kanaka, e lawe i kāu mau lāʻau lapaʻau e like me ke kauoha, a hoʻonohonoho i kāu hana maʻamau i kēlā me kēia lā (ka hiamoe, ke ala ʻana, ka ʻai ʻana, a me ka inu ʻana).
ʻO kekahi mea i loaʻa ma ke aʻo ʻana ʻo STEP-BD i ʻōlelo ʻia ma luna nei, ʻo ia ka wā e hui pū ʻia ai ka psychotherapy i hoʻonohonoho ʻia me ka lāʻau lapaʻau, piʻi ka nui o ka hoʻōla ʻana ma kahi o 150%!
Aia kekahi mau ʻano psychotherapy holomua i hoʻohana ʻia no kēia:
- ʻO ka Cognitive Behavioral Therapy (CBT): Kōkua iā ʻoe e ʻike a hoʻololi i kou mau manaʻo a me nā ʻano maikaʻi ʻole.
- ʻO ka Lapaʻau Rhythm Interpersonal a me Social (IPSRT): Kōkua iā ʻoe e mālama i kahi ʻano paʻa ma ka hoʻomaʻamaʻa ʻana i kāu mau hana maʻamau a me nā pilina pili kanaka.
- Lapaʻau i kālele ʻia i ka ʻohana: He ʻano lapaʻau e pili ana i kou ʻohana a hoʻokomo iā lākou i ke kaʻina hana me kā lākou kākoʻo.
Leka Lawe-Home
- He maʻi hiki ke mālama ʻia ke kaumaha bipolar. Mai hoʻōki. Me ka mālama kūpono, hiki iā ʻoe ke ola i kahi ola maʻamau.
- ʻO ka hapa nui o ka lāʻau lapaʻau, ʻo ia ka lāʻau hoʻopaʻa i ke ʻano. E hoʻohana i kēia mau mea e like me ka ʻōlelo a kāu kauka, ma ke ʻano kūpono a no ka lōʻihi kūpono.
- Pono e hoʻohana ʻia nā lāʻau antidepressant me ke akahele loa. Mai hoʻohana iā lākou me ka ʻole o ka nānā ʻana a ke kauka.
- He mea nui ka psychotherapy e like me ka lāʻau lapaʻau. Ke hele pū kēia mau mea ʻelua, maikaʻi loa nā hopena.
- Inā he mau nīnau kāu, hopohopo, a i ʻole nā hopena ʻaoʻao e pili ana i kāu lāʻau lapaʻau, e kūkākūkā ākea me kāu kauka. Mai hūnā i kekahi mea iā ʻoe iho.
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