Hun rei tak chhunga trauma na tak i tawh hnuah pawh i danglam tawh em? CPTSD (Complex PTSD) chungchang hi han sawi ila!

Kan nunah hian kan ngaihtuah phak loh thil harsa leh hrehawm tak tak kan hmachhawn a ngai vek a ni lawm ni? Mahse ni khat emaw ni hnih emaw chhunga tawp lo thil tawn thenkhat a awm. Hun rei tak chhung min tihduhdah a, kan thinlungah an lai a. Vawiin hian hun rei tak atanga lo awm tawh, natna khirh tak tak atanga lo chhuak thei rilru lam harsatna kan sawi dawn a ni. Hei hi CPTSD emaw Complex Post-Traumatic Stress Disorder emaw an ti a. Hei hi i hre tawh mai thei, a nih loh leh nangmah ngei pawhin heng symptoms te hi i hre ve mai thei. Eng nge a nih i en ang u.

CPTSD (Complex PTSD) tih hi eng nge ni? A awlsam zawngin...

A awlsam zawngin sawi ila, CPTSD hi rilru lam natna a ni a, hun rei tak chhung chronic trauma i tawrh chuan a lo awm thei a ni. Hei hian i rilruah chauh ni lovin i nungchangah pawh danglamna nasa tak a thlen thei a ni. Ngaihtuah teh, hliam dam nan hun a mamawh ang bawkin, rilru lama hliam na tak takte pawhin dam nan hun a mamawh a, a châng chuan rilruah dinhmun lungchhiatthlâk tak tak chi hrang hrang a thlen thei a ni.

CPTSD-ah hian stress response lian tak tak hmuh tur a awm a:

• Lungngaihna emaw hlauhna emaw awm reng (Lungkhamna): Thil tha lo tak thleng tur angin i inhriat reng mai thei.
• Flashback emaw mumang chhia emaw: Chu thil rapthlak tak chu a thleng leh tak tak niin i hria a , a nih loh leh chu mi nena inzawm mumang chhia i nei fo thei bawk.
• Hmun, mi, leh thilthleng lungchhiatthlâk tak nêna inzawm thilte pumpelh: Chu thilthleng hriatrengna hmuna awm emaw, kal emaw chu i duh lo mai thei.
• Emotion control harsa (Heightened emotional responses): I thinrim awlsam a, i buai thei a, thil tenawm tak takah i che thei a, thil tenawm tak takah pawh i che nasa thei bawk.
• Inlaichinna vawng nung tura harsatna awm reng: Mite nena inzawmna siam harsa, rinna leh inzawmna siam harsa.

Ngaihtuah teh, Nilanthi tih hming pu mi pakhat a awm. A naupan lai atang tawhin in lamah insualna a awm fo thin a, a pa chuan a nu leh amah a tiduhdah nasa hle. Kum tam tak chu hetiang hian a liam ta. Tunah hian Nilanthi hi a la naupang viau nachungin a hlau reng reng a, mi rin harsa a ti a, thil tenawm tak tak avangin a thinrim hle bawk. A naupan laia a chunga thil thlengte chu a mumang a ni fo thin. Chutiang dinhmun chu CPTSD entirnan a ni thei.

CPTSD thlen thei chronic traumas te chu engte nge ni?

• Hun rei tak chhunga naupang taksa emaw, mipat hmeichhiatna lama tihduhdahna.
• Hun rei tak chhung chhungkuaa tharum thawhna.
• Mihring emaw, sex emaw hmanga sumdawnna tuar nih.
• Indona hmuna rei tak awm (War).
• Khawtlang nun tharum thawhna thleng fo.

Hetiang dinhmun hi naupan laia trauma na tak tuar te tan chauh a awm lo va, chutiang hun rei tak chhunga trauma an tawh chuan puitlingah pawh CPTSD an nei thei bawk.

CPTSD hi damdawi lam atanga pawm a ni em?

Hei hi thil buaithlak deuh a ni. Psychologist-te zingah pawh CPTSD hi PTSD (Post-Traumatic Stress Disorder) natna hran emaw, a tel emaw tih chungchangah ngaihdan hrang hrang a awm.

Hei hi han ngaihtuah teh: World Health Organization (WHO) chuan kum 2019-a a lehkhabu thar ber, `International Classification of Diseases (ICD-11),` -ah CPTSD chu natna hran atan a vuah a, mahse, American Psychiatric Association (APA) chuan an `Diagnostic and Statistical Manual of Mental Disorders (DSM-5) -ah CPTSD chu natna hran angin a pawm lo. Mahse, DSM-5 hian PTSD subset atan `dissociative PTSD` tih condition a keng tel a, a symptoms te hi CPTSD nen a inang hle.

Mithiam thenkhat chuan CPTSD, PTSD, leh BPD (Borderline Personality Disorder) te hi spectrum khata trauma-related mental health condition an ni vek thei niin an ngai. Chu chu an natna lan chhuah dan nasat danah an inzawm thei tihna a ni.

Chuti a nih chuan CPTSD leh PTSD hi eng nge an danglamna?

Hei hi mi tam takin an zawh thin a ni. A danglamna ber chu shock hun chhung leh a symptoms te hi a ni.

PTSD hi hun rei lote chhunga trauma, accident emaw, natural disaster emaw avanga lo awm niin kan ngai thin. Mahse zirchianna atanga a lan dan chuan hun rei tak, trauma tawk nawn fo thinte chuan PTSD bakah hian symptom dang an nei leh thin. Heng symptom dangte hmang hian CPTSD hi hmuhchhuah a ni.

CPTSD leh PTSD-ah te pawh, .

• Thil thleng (flashbacks) tawn nawn lehna, .
• Hypervigilance (mahni chhehvel thila fimkhur reng leh tul lo taka fimkhur reng), .
• Rilru leh nungchang lama lungkhamna chhanna chu hmuh theih a ni a, chu chu thil rapthlak tak thleng hriat nawn tirtu thilte pumpelh ang chi hi a ni.

Mahse, CPTSD vei te hian harsatna dang an tawk bawk :

• Emotion regulation chungchanga harsatna rei tak leh zau tak: Thil tenawm tak avanga thinrim awlsam, lungngaihna leh rilru natna thunun thei lo.
• Identity leh sense of self chungchanga buaina: I nihna leh i hlutna chungchangah ngaihtuahna tha lo. Mualphona te, sualna te, hlawhchhamna te hi a awm fo thin.
• Inlaichinna vawng nung tura harsatna: Mi dangte nena inzawmna nghet tak, awmze nei tak siam leh vawn reng hi a harsa hle.

CPTSD leh BPD (Borderline Personality Disorder) hi eng nge an danglamna?

CPTSD leh BPD hian chhinchhiahna inang tam tak an nei a, chu chu thil tih duh lohna, hlutna nei lo anga inhriatna, leh inlaichinna nghet tak neih harsat te hi a ni. Hei hian mithiam ṭhenkhat chuan an pahnih hi dinhmun hrang hrang an ni tak tak em tih zawhna a siam a ni.

Tuna tehfung hman mek ang chuan a danglamna ber chu CPTSD a lo awm theih nan chronic trauma a mamawh a ni. BPD hian trauma a mamawh hauh lo nain , BPD hi naupan laia tihduhdahna emaw, ngaihsak lohna emaw ang chi thil rapthlak tak takte nen a inzawm tlat a ni.

A danglamna dang chu BPD hi puitling naupang takah a lang tlangpui a, mahse CPTSD hi kum eng pawhah a awm thei a ni.

CPTSD hi engtiang chiahin nge a hluar?

CPTSD hi natna hriat chhuah thar tak a nih avangin a hluar dan zirchianna a la tling lo. Mahse, mithiamte chuan he natna hian khawvel mihring 1% leh 8% inkar a nghawng thei niin an chhut. Chumi awmzia chu Sri Lanka ramah hian hetiang natna vei an awm thei tihna a ni.

CPTSD natna lan chhuahna chu engte nge ni?

World Health Organization-in `ICD-11` classification a siam dan chuan CPTSD hian PTSD symptom bulpui tam tak a huam a ni. Chu chu:

• Flashbacks: Thil rapthlak tak chu a thleng leh tak tak ang tih hriatna.
• Mihring, thilthleng leh boruak tichhe thei thilte laka inthiarfihlim leh inlakhran, trauma thlentu.
• Hypervigilance hi hlauhawm hlauhna avanga fimkhur lutuk reng reng a ni.
• Ngaihtuahna tha lo leh rilru natna nei fo thin.

Hei bakah hian CPTSD-a chhinchhiahna dang engemaw zat a awm a:

• Negative emotional stimuli, thinrim, leh aggressive behavior laka overreaction (Affective dysregulation): A awlsam zawngin, thinrim thuai, thinrim, leh thil tenawm ber pawha emotion thunun harsa.
• Mahni inhriatna tha lo neih: Mualphona, sualna, hlawhchhamna leh hlutna nei lo anga inhriatna te tuar reng.
• Inlaichinna awmze nei siam leh vawn nun kawngah harsatna nasa tak: Mi rin leh inlaichinna hnai tak siam hi a harsa hle.

"Ka hre reng a, naupan lai atanga hrehawm tuar nasa tak ṭhian pakhat ka nei a. Midang a ring thei ngai lo. Mi pakhatin nui chungin biak pawh ni se, thang a siam niin a ngai a. Ṭhian a nei tlem hle. – Hetiang dinhmun hi CPTSD-ah hian hmuh theih a ni.

Eng thilin nge CPTSD hi a thlen? Kan thluak hi eng nge thleng?

ICD-11-in a tarlan dan chuan CPTSD hi thil rapthlak tak emaw, thil thleng hrang hrang, hlauhawm tak tak emaw avanga lo awm a ni. Hêng thilthlengte hi a tlangpuiin hun rei tak daih, tih nawn leh ṭhin a ni a, tlanchhuah theih loh emaw, hlauhawm tak pawh ni thei dinhmunte pawh a tel a ni.

Entirna thenkhat chu:

• Hun rei tak chhung chhungkuaa tharum thawhna.
• Naupan laia mipat hmeichhiatna emaw taksa lama tihduhdahna.
• Nghaisa.
• Genocide hmachhawn mek.
• Sal tang a nih.

Hetiang chi, hun rei tak chhunga traumatic stress na tak hian i thluak chemistry leh structure a tidanglam thei a ni . Research atanga a lan dan chuan trauma hian kan thluak hmun pawimawh engemaw zatah inthlak danglamna nghet tak a thlen thei a ni. Heng a then te hi:

• `Amygdala`: Hei hi kan thluak chhunga hlauhna leh rilru natna dangte process tu ber a ni. Kan emotion control tu center te tak te ang mai a ni a, a bik takin hlauhna ang emotion hrechiangtu te hi a ni. He part hi trauma vangin a overactive thei a, chuvang chuan kan hlau reng a, kan inring reng bawk.
• Hippocampus: Hei hi kan thluaka kan hriatrengna khawlkhawmtu leh thil thar zir tura min puitu ber a ni. Trauma hian he part hnathawh hi a ti tlem thei a, chuvang chuan thil thleng hriatreng leh thil thar zir harsa kan ti fo thin.
• Prefrontal cortex: Hei hi thil pawimawh tam tak kan tihna hmun a ni a, chu chu ruahmanna siam te, thutlukna siam te, kan mizia lantir te, leh khawtlang nungchang thunun te hi a ni. Trauma hian he hmuna hnathawh dan pawh a tidanglam thei a, chuvang chuan rilru natna thunun leh thutlukna siam harsa tak a ni.

Neuroimaging study thenkhatah chuan heng inthlak danglamna te hi PTSD vei te thluak ah hian a langsar zawk tih hmuhchhuah a ni.

Engtin nge CPTSD i vei tih dik taka i hriat theih ang?

CPTSD hriat theihna tur test bik a awm lo. Chu ai chuan doctor emaw mental health counselor emaw chuan a hnuaia mite hi a zawt ang che:

• I symptoms te chu.
• I damdawi lam chanchin.
• I rilru hriselna history.
• Trauma i tawk tawh dan.

Doctor-te chuan CPTSD hriat theihna atan World Health Organization-in `ICD-11` a criteria an hmang a. Mahse, CPTSD hi natna hriat chhuah thar a nih avangin doctor thenkhat chuan an hre lo mai thei. Chuvangin official diagnosis lak a harsa deuh thei. Doctor pawhin CPTSD ai chuan PTSD i nei tih a hrilh thei che a ni. Chuvangin heng symptoms te hi i neih chuan mental health counselor , he lama tawnhriat nei tha tak pan a pawimawh hle.

CPTSD enkawlna tur engte nge ni?

Thu lawmawm tak chu CPTSD enkawlna tur a awm tih hi a ni! Enkawlna ber chu psychotherapy, a nih loh leh kan hriat vek angin "talk therapy" a ni. A bik takin, cognitive behavioral therapy chi khat, trauma-focused CBT tih a hmang a ni.

He enkawlna hi trained, licensed mental health professional , psychologist emaw psychiatrist emaw te pek a ni. He enkawlna hian nang leh i hmangaih tak takte tanpuina, zirtirna leh kaihhruaina a pe a, chu chuan i hnathawh that leh i hriselna tihchangtlun nan a pui a ni.

Trauma-focused CBT-ah chuan heng thilte hi a thleng thin:

• I taksain trauma leh stress a dawn dan i zir thin.
• Symptoms enkawl dan zir rawh.
• Thil ngaihtuah dan buaithlak tak takte hriatchhuah a, tihdanglam (reframing) a pui thin.
• Exposure therapy: PTSD leh CPTSD vei te hian an trauma nena inzawm thil emaw, dinhmun emaw an pumpelh fo thin. Chuvang chuan chutiang thil tihchakna an tawh lai pawhin an hlauhthawnna chu an thunun thei tih zir theihna hun an nei lo. Exposure therapy-ah chuan therapist chuan zawi zawiin hlauthawng thei dinhmunah a hruai lut che a ni. Chutiang dinhmunah chuan awm reng tur leh hmachhawn turin an zirtir che a ni.

Trauma-a innghat therapy dang chu Eye Movement Desensitization and Reprocessing (EMDR) a ni. He therapy-ah hian therapist-in a rawn luhtir sound emaw movement bik emaw ngaihtuah chungin traumatic event(s) chu i ngaihtuah thin. A tum ber chu hun kal zelah chutiang thilthlengte avanga lungngaihna i neih chu tihziaawm a ni.

Cognitive Processing Therapy (CPT) hi trauma lam hawia enkawlna chi dang a ni bawk. He therapy hian thil rapthlak tak thleng hnua i rilruah ngaihtuahna leh rilru hahna lo awm thin, lungngaihna leh buaina nei fo thinte chu hmachhawn a tum ber a ni.

CPTSD damdawi hman tur

Tunah hian US Food and Drug Administration (FDA)-in PTSD emaw CPTSD emaw enkawlna atana a pawmpui damdawi bik a awm lo. Mahse, doctor-te chuan CPTSD natna lan chhuahna ṭhenkhat enkawl nân heng ang damdawi hi an pe thei a ni:

• Antidepressant: `Selective Serotonin Reuptake Inhibitors (SSRIs)` emaw `Serotonin leh Norepinephrine Reuptake Inhibitors (SNRIs) te ang chi te.`
• Lungkhamna dona damdawi.
• Mut damdawi te.

Heng damdawi te hian natna lanchhuahna a ti reh mai a, natna a tidam kim lo. Chuvangin psychotherapy hi a enkawl ber a ni.

CPTSD hi eng prognosis nge ni?

CPTSD hi natna hmuhchhuah thar a nih avangin damdawi lam zirchiangtute chuan hun rei tak chhunga zirchianna neih theihna hun remchang an la nei lo.

Mi tam tak tan chuan CPTSD hi dam chhung zawnga natna a ni thei. Mahse, lungngai suh! A tha ber chu i symptoms te hi psychotherapy leh a tul chuan damdawi hmanga enkawl tha theih a ni. Chumi awmzia chu heng enkawlnate hian nun pangngaia i awm theih nan a pui thei che tihna a ni.

CPTSD i neih chuan engtin nge i in enkawl ang?

Enkawlna zawng bakah hian nangmah ngeiin i rilru hriselna atana i tih theih tur thil engemaw zat a awm a:

• Stress tihziaawmna tur leh i mood tihchangtlun nan exercise light tak nei la. Kea kal rei vak lo emaw, yoga ang chi emaw pawh hi a tha.
• I tihhlawhtlin theih thiltum dik tak siam rawh. Vawi khatah thil lian tak tak beisei suh. Hnehna tenau teah hlim takin awm rawh.
• I rintlak mite nen hun hmang rawh. I thil tawn leh i symptoms tichhuaktu chu eng nge ni thei tih hrilh rawh.
• I rilru hahdam leh thlamuang taka awm theihna hun leh hmunte chu hmu chhuak la, chu chu hmang fo la, chu hmunah chuan kal rawh.
• Trauma tawk tawhte tan support group-ah tel ve rawh. Nangmah ang bawka thil tawn tawhte nena inbiakna neih hi thiltihtheihna a ni.
• I chungah ngilnei la, dawhthei rawh. Zan khat thil thuah hian symptoms a reh lo tih hre reng ang che. Zawi zawiin an rawn kal a.

A pawimawh ber chu nangmah chauh i ni lo tih hriatthiam hi a ni. Ṭanpuina dil hlau suh.

Engtikah nge doctor i hmuh ang?

CPTSD vei enkawl i nih lai hian i doctor leh/ emaw mental health professional te hmuh fo a pawimawh hle. I symptoms a zual chuan doctor hnenah hriattir nghal rawh.

Engtikah nge Emergency Treatment Unit (ETU) ah i kal ang ?

Mahni inhriatthiam lohna i neih emaw, mahni intihhlum tumna i neih emaw chuan emergency room hnai ber pan nghal la, a nih loh leh Sri Lanka-a emergency number dik takah call rawh (e.g. 1926 National Mental Health Helpline).

Thil rapthlak tak thleng hnua tanpuina dil chu thil harsa tak a ni thei. Mahse, CPTSD enkawlna lak hi a pawimawh hle tih hre reng ang che. Hun a kal zel a, enkawlna hian damna a pui thei che a ni. I doctor nen enkawl dan tur chungchang sawipui rawh. I tanpui tur leh thlawp turin an awm a ni.

A tawp berah chuan thil hriat reng tur (Take-Home Message) .

Chuvangin, vawiin hian CPTSD chungchang hi kan sawi nasa hle. He thu i chhiar lai hian he rilru dinhmun hi a pawizia leh a buaithlak zia i hrechhuak tawh mai thei.

• CPTSD hi rilru lama harsatna, hun rei tak, trauma na tak avanga lo awm a ni.
• PTSD bakah hian hei hian emotional regulation, mahni inngaihsakna leh inlaichinna vawn nun kawngah harsatna a thlen bawk.
• Hetiang dinhmun hi hriat a harsa deuh thei a, mahse professional tawnhriat ngah tak chuan a ti thei a ni.
• A tha ber chu he natna hi psychotherapy (a bik takin Trauma-focused CBT, EMDR, CPT) leh a tul chuan damdawi hmanga enkawl tha theih a ni.
• Heng symptoms te hi i neih chuan nangmah chauhin tuar suh la, doctor thurawn la ngei ang che. Ṭanpuina dil hi chak lohna chhinchhiahna a ni lo, nangmah tan chakna ropui ber pakhat a ni.

I hun kal tawha thil thleng kha thunun thei lo mah la, vawiinah hian i hmalam hun siam\hat tumin hma i la thei tih hre reng ang che. Chutiang ti thei tura chakna ka duhsak che u a ni!

` CPTSD, complex post-traumatic stress disorder, rilru hriselna, trauma, stress, rilru lam enkawlna, PTSD