Kua rerekē anō hoki koe i muri i tētahi whara kino, roa hoki? Me kōrero tātou mō te CPTSD (PTSD Matatini)!

Me tūtaki tātou katoa ki ngā wheako uaua, mamae hoki o ō tātou ao, kāore e taea e tātou te whakaaro, tika? Engari, tera ētahi wheako kāore e mutu i roto i te rā kotahi, e rua rānei. Ka roa te whakamamae i a tātou, ka keri ki roto i ō tātou ngākau. I tēnei rā, ka kōrero tātou mō tētahi raruraru hinengaro ka puta mai i ngā āhuatanga tino kino kua roa e pāngia ana. Ko te ingoa o tēnei ko te CPTSD , ko te Complex Post-Traumatic Stress Disorder rānei. Kua rongo pea koe i tēnei, kua pāngia rānei koe e ēnei tohu. Kia kite tātou he aha te mea.

He aha te CPTSD (PTSD Matatini)? He māmā noa iho...

Ki te kī ngāwari, he mate hinengaro te CPTSD ka puta mai mēnā ka pāngia koe e te whara mau tonu mō te wā roa. Ka taea e tēnei te whakaputa i ngā huringa nui, ehara i te mea ko tō hinengaro anake, engari ko tō whanonga anō hoki. Whakaarohia, pērā i te roa o te wā e ora ai te patunga, he roa hoki te wā e ora ai ngā patunga kare ā-roto kino, ā, i ētahi wā ka arahi pea ki ngā āhuatanga whakararuraru o te hinengaro.

He maha ngā urupare ahotea matua ka kitea i roto i te CPTSD:

• Te manukanuka, te mataku tonu (Mangumāku): Tērā pea ka whakaaro tonu koe kei te tupu tetahi mea kino.
• Ngā mahara whakamuri, ngā moemoeā kino rānei: Tērā pea ka rite koe ki te mea kei te tupu anō te kaupapa mamae, tērā pea ka maha tonu ō moemoeā kino e pā ana ki taua mea.
• Te karo i ngā wāhi, i ngā tāngata, me ngā mea e pā ana ki te huihuinga mamae: Tērā pea kāore koe e hiahia ki te noho tahi me rātou, ki te haere rānei ki ngā wāhi e whakamahara ana i a koe ki te huihuinga.
• Te uaua ki te whakahaere i ngā kare ā-roto (Te pikinga ake o ngā urupare kare ā-roto): Ka tere pea tō riri, tō pōrearea, tō mahi ohorere, ā, ka kaha rawa te riri ki ngā mea iti noa iho.
• Ngā uauatanga tonu ki te pupuri i ngā whanaungatanga: He uaua ki te hono atu ki te tangata, ki te whakawhirinaki ki a rātou, me te whakatū hononga.

Whakaarohia, he tangata ko Nilanthi tōna ingoa. Mai i tōna tamarikitanga, he pakanga tonu i te kāinga, ā, he maha ngā wā i tukinotia ai e tōna pāpā tōna whaea me ia. Pēnei tonu te haere o ngā tau. Ahakoa he taitamariki a Nilanthi ināianei, he mataku tonu ia, he uaua ki te whakawhirinaki ki te tangata, ā, ka riri ia mō ngā mea iti. He maha āna moemoeā mō ngā mea i pā ki a ia i tōna tamarikitanga. He tauira pea tēnei momo āhuatanga o te CPTSD.

He aha ngā whara mau tonu ka puta ai te CPTSD?

• Te tukino ā-tinana, ā-ira rānei i te tamaiti mō te wā roa.
• Te tūkino ā-whare mō te wā roa.
• Te noho hei patunga o te hokohoko tangata, hokohoko moepuku rānei.
• Te noho roa i roto i te taiao pakanga (Pakanga).
• Te tūkino hapori auau.

Ehara i te mea he mea noa tēnei āhuatanga mō te hunga i pāngia e te whara kino i te tamarikitanga, engari ka taea hoki te whakawhanake i te CPTSD i te pakeketanga mēnā ka pāngia rātou e tēnei whara mō te wā roa.

He tohu hauora te CPTSD?

He take uaua tēnei. Ahakoa i waenga i ngā tohunga hinengaro, he rerekē ngā whakaaro mō te mea he āhuatanga motuhake te CPTSD, he wāhanga rānei o te PTSD (Post-Traumatic Stress Disorder).

Whakaarohia tēnei: ​​Kua whakaingoatia e te World Health Organization (WHO) te CPTSD hei mate motuhake i roto i tana pukapuka hou, te 'International Classification of Diseases (ICD-11),' i te tau 2019. Heoi, kāore te American Psychiatric Association (APA) e whakaae ana ki te CPTSD hei mate motuhake i roto i tana 'Diagnostic and Statistical Manual of Mental Disorders (DSM-5) . Heoi, kei roto i te DSM-5 tētahi mate e kiia nei ko te 'dissociative PTSD' hei wāhanga iti o te PTSD, ā, he tino rite ōna tohu ki te CPTSD.

E whakapono ana ētahi tohunga ko te CPTSD, te PTSD, me te BPD (Borderline Personality Disorder) he mate hinengaro e pā ana ki te whara i roto i te whānuitanga kotahi. Arā, tera pea he hononga tetahi ki tetahi i runga i te kaha o ō rātou tohu.

Nā, he aha te rerekētanga i waenga i te CPTSD me te PTSD?

He pātai tēnei e pātaihia ana e te tini tāngata. Ko ngā rerekētanga matua ko te roa o te ohorere me ngā tohu.

I whakaaro mātou i mua ko te PTSD i puta mai i te whara poto, pērā i te aituā, i te āituā taiao rānei. Engari kua kitea e ngā rangahau ko te hunga e pāngia ana e te whara roa, e pāngia ana e te whara tonu, ka puta ake he tohu tāpiri atu i tua atu i te PTSD. Mā ēnei tohu tāpiri ka kitea te CPTSD.

I roto i te CPTSD me te PTSD,

• Te wheako anō i te kaupapa (ngā maharatanga whakamuri),
• Te mataara nui rawa (te tūpato tonu me te kore e tika mō te taiao e karapoti ana i te tangata),
• Tērā pea ka kitea ngā urupare ahotea hinengaro me ngā whanonga, pērā i te karo i ngā mea e whakamahara ana i a koe ki te huihuinga mamae.

Heoi anō, ka pāngia anō hoki te hunga whai CPTSD e ētahi atu raruraru :

• Ngā raruraru mau tonu, me ngā raruraru whānui o te whakahaere kare ā-roto: Te riri wawe mō ngā mea nohinohi, te pouri, me te kore e taea te whakahaere i ngā kare ā-roto.
• Ngā raruraru ki te tuakiri me te mārama ki a koe anō: Ngā whakaaro kino mōu ake me tō uara. He mea noa te whakama, te hara, me te kore angitu.
• Ngā raruraru ki te pupuri i ngā whanaungatanga: He tino uaua ki te hanga me te pupuri i ngā whanaungatanga kaha, whai tikanga ki ētahi atu.

He aha te rerekētanga i waenga i te CPTSD me te BPD (Borderline Personality Disorder)?

He rite tonu ngā tohu o te CPTSD me te BPD, pērā i te whanonga ohorere, te koretake o te whakaaro, me te uaua ki te pupuri i ngā whanaungatanga pumau. Nā tēnei kua pātai ētahi tohunga mēnā he rerekē ngā āhuatanga e rua.

E ai ki ngā paearu o nāianei, ko te rerekētanga matua ko te hiahia o te CPTSD ki tētahi whara mau tonu kia puta. Ahakoa kāore e hiahiatia he whara kia puta mai i te BPD , he maha ngā wā ka honoa te BPD ki ngā wheako whara, pērā i te tukino, te whakarere rānei i te tamarikitanga.

Ko tētahi atu rerekētanga ko te BPD ka puta i te wā taitamarikitanga, engari ka taea e te CPTSD te puta i ngā tau katoa.

He pēhea te noa o te CPTSD?

Nā te mea he mate hou te CPTSD, kāore anō kia nui ngā rangahau mō tōna auau. Heoi, e ai ki ngā tohunga, ka pā pea tēnei mate ki te 1% me te 8% o te taupori o te ao. Ko te tikanga, tera pea he tāngata kei Sri Lanka e pāngia ana e tēnei mate.

He aha ngā tohu o te CPTSD?

E ai ki te whakarōpūtanga `ICD-11` a te World Health Organization, kei roto i te CPTSD te nuinga o ngā tohu matua o te PTSD. Arā:

• Ngā mahara whakamuri: Te āhua nei kei te tupu anō te kaupapa mamae.
• Te karo me te wehe i ngā tāngata, ngā huihuinga, me ngā whakaohooho taiao i puta ai te mamae.
• Ko te mataara nui rawa he āhua o te mataara nui rawa atu i te wehi i te tūponotanga.
• Ngā whakaaro me ngā kare ā-roto kino e auau ana.

Haunga tēnei, he maha atu anō ngā tohu e motuhake ana ki te CPTSD:

• Te tauhohenga nui rawa atu ki ngā whakaohooho kare ā-roto kino, te riri, me te whanonga pukuriri (Affective dysregulation): Ki te kī māmā noa, ka tere te riri, ka pōuri, ā, ka uaua ki te whakahaere i ngā kare ā-roto ahakoa mō ngā mea iti rawa.
• Te whai whakaaro kino ki a koe anō: Te mamae tonu i te whakama, te hara, te kare o te kore angitu, me te koretake.
• He tino uaua ki te whakatū me te pupuri i ngā whanaungatanga whai tikanga: He tino uaua ki te whakawhirinaki ki te tangata me te whakatū whanaungatanga tata.

"Kei te maumahara ahau, i a au tētahi hoa i tino mamae i tōna tamarikitanga. Kāore rawa ia i whakawhirinaki ki ētahi atu tāngata. Ahakoa ka menemene mai tētahi, ka kōrero mai ki a ia, i mahara ia kei te whakatakoto ia i tētahi mahanga. He iti noa iho āna hoa." – Ka kitea tēnei momo āhuatanga i roto i te CPTSD.

He aha te take o te CPTSD? He aha te mea ka pā ki tō tātou roro?

E ai ki te ICD-11, ka puta te CPTSD i te pānga ki tētahi huihuinga mamae, ki tētahi raupapa huihuinga tino whakamataku rānei. He roa te wā o ēnei huihuinga, he auau, ā, he āhuatanga e kore e taea te mawhiti, e morearea rānei.

Ko ētahi tauira ko:

• Te tūkino ā-whare mō te wā roa.
• Te tukino ā-ira tangata, ā-tinana rānei i te wā tamarikitanga.
• Te whakamamae.
• Te aro atu ki te kohuru tangata.
• Te noho hei pononga.

Ka taea e tēnei momo ahotea whara kino, roa hoki te whakaputa huringa ki te matū me te hanganga o tō roro . Kua whakaatuhia e ngā rangahau ka taea e te whara te whakaputa huringa tuturu ki ētahi wāhanga matua o tō tātou roro. Ko ēnei wāhanga ko:

• `Amygdala`: Koinei te wāhanga matua o tō tātou roro e tukatuka ana i te wehi me ētahi atu kare ā-roto. He rite ki tētahi pokapū iti e whakahaere ana i ō tātou kare ā-roto, inā koa ko ērā e mōhio ana ki ngā kare ā-roto pēnei i te wehi. Ka taea e tēnei wāhanga te tino hohe nā te whara, koia tātou e mataku tonu ai, e mataara tonu ai hoki.
• Hipokamupa: Koinei te wāhanga matua o tō tātou roro e pupuri ana i ō tātou mahara, e āwhina ana hoki i a tātou ki te ako i ngā mea hou. Ka taea e te whara te whakaiti i te mahi a tēnei wāhanga, koia te take e uaua ai tātou ki te maumahara ki ngā kaupapa me te ako i ngā mea hou.
• Te cortex o mua o te kanohi: Koinei te wāhi e mahi ai tātou i ngā mahi nui maha, pērā i te whakamahere, te whakatau kaupapa, te whakaatu i ō tātou tuakiri, me te whakahaere i ngā whanonga pāpori. Ka taea hoki e te whara te whakarerekē i te mahi a tēnei wāhi, koia te take he uaua ki te whakahaere i ngā kare ā-roto me te whakatau whakaaro ohorere.

Kua whakaatuhia e ētahi rangahau neuroimaging he nui ake te kitea o ēnei huringa i roto i te roro o te hunga whai CPTSD i te hunga whai PTSD.

Me pēhea te tautuhi tika mēnā kei a koe te CPTSD?

Kāore he whakamātautau motuhake hei tautuhi i te CPTSD. Engari, ka pātai atu tētahi tākuta, tētahi kaitohutohu hauora hinengaro rānei ki a koe mō ngā mea e whai ake nei:

• Ō tohumate.
• Tō hītori hauora.
• Tō hītori hauora hinengaro.
• Te āhua i pāngia ai koe e te mamae.

Ka whakamahia e ngā tākuta ngā paearu i roto i te `ICD-11` a te Whakahaere Hauora o te Ao hei tātaritanga i te CPTSD. Heoi, nā te mea he mate hou te CPTSD, kāore pea ētahi tākuta e mōhio ana ki tēnei mate. Nō reira, he uaua pea te whiwhi tātaritanga mana. Tērā pea ka kī atu te tākuta he PTSD tōu, ehara i te CPTSD. Nō reira, ki te mea kei a koe ēnei tohu, he mea tino nui kia kite koe i tētahi kaitohutohu hauora hinengaro he mātau ki tēnei mara.

He aha ngā maimoatanga mō te CPTSD?

Ko te rongo pai, kei reira ngā maimoatanga mō te CPTSD! Ko te maimoatanga matua ko te hinengaro hinengaro, arā, ko te "whakaora kōrero" e mōhiotia ana e tātou katoa. Ina koa, ka whakamahia he momo whakaora whanonga hinengaro e kiia nei ko te CBT e arotahi ana ki te whara .

Ka whakaratohia tēnei maimoatanga e tētahi tohunga hauora hinengaro whai raihana, whai whakangungu, pērā i tētahi tohunga hinengaro, i tētahi tohunga hinengaro rānei. Ka tautoko, ka ako, ka ārahi hoki tēnei maimoatanga i a koe me ō whanaunga hei āwhina i a koe kia pai ake te mahi me te whakapai ake i tō oranga.

I roto i te CBT e arotahi ana ki te whara, ka puta enei mea:

• Ka ako koe i te urupare a tō tinana ki te whara me te ahotea.
• Akohia me pēhea te whakahaere i ngā tohu.
• Ka āwhina i te tautuhi i ngā tauira whakaaro raruraru me te whakarerekē i aua tauira (te whakarerekē i te anga).
• Whakaora Whakamātautau: He maha ngā wā ka karohia e te hunga whai PTSD me te CPTSD ngā mea, ngā āhuatanga rānei e pā ana ki tō rātou whara. Nō reira, kāore rātou e whai wāhi ki te ako ka taea e rātou te whakahaere i ō rātou wehi ahakoa kei te pāngia rātou e aua whakaohooho. I roto i te whakaora whakamātautau, ka āta whakaatu te kaiwhakaora i a koe ki ngā āhuatanga e wehi ai koe. Ka whakangungu rātou i a koe kia noho tonu ki roto i aua āhuatanga, kia anga atu ki aua āhuatanga.

Ko tētahi atu rongoā e aro ana ki te whara ko te Eye Movement Desensitization and Reprocessing (EMDR) . I roto i tēnei rongoā, ka whakaaroaro koe ki ngā huihuinga whara, me te arotahi ki ngā oro, ki ngā nekehanga rānei e whakaurua mai ana e te kaiwhakaora hinengaro. Ko te whāinga he whakaiti i te mamae e pā ana ki aua huihuinga i roto i te wā.

Ko te Whakaora Tukatuka Hinengaro (CPT) tētahi atu momo whakaora e aro ana ki te whara. Ka arotahi tēnei whakaora ki te aro atu ki ngā whakaaro me ngā kare ā-roto e pāngia ana e te mamae, e puta ake ana i roto i tō hinengaro i muri i tētahi huihuinga whara.

Rongoā mō te CPTSD

I tēnei wā, kāore he rongoā motuhake kua whakaaetia e te US Food and Drug Administration (FDA) hei rongoā i te PTSD, i te CPTSD rānei. Heoi, ka tohua pea e ngā tākuta ngā rongoā pēnei i ēnei hei āwhina i te whakahaere i ētahi o ngā tohu o te CPTSD:

• Ngā rongoā ārai pouri: Pērā i ngā 'Selective Serotonin Reuptake Inhibitors (SSRIs)' me ngā 'Serotonin and Norepinephrine Reuptake Inhibitors' (SNRIs) rānei.
• Ngā rongoā ārai-manukanuka.
• Ngā rongoā moe.

Ka whakaora noa iho ēnei rongoā i ngā tohumate, kāore e whakaora katoa i te mate. Nō reira, ko te hinengaro whakaora te maimoatanga matua.

He aha te matapae mō te CPTSD?

Nā te mea he mate hou te CPTSD, kāore anō kia whai wāhi ngā kairangahau hauora ki te whakahaere i ngā rangahau roa mōna.

Ki te tini, ka noho te CPTSD hei mate mō te wā roa. Kaua e manukanuka! Ko te mea pai ko te taea te whakahaere pai i ō tohu mā te hinengaro whakaora, me te rongoā hoki mēnā e tika ana. Ko te tikanga o tēnei ka taea e ēnei maimoatanga te āwhina i a koe ki te noho i te oranga noa.

Mena kei a koe te CPTSD, me pēhea koe e tiaki ai i a koe anō?

Haunga te rapu maimoatanga, he maha ngā mea ka taea e koe te mahi hei oranga mōu ake hinengaro:

• Whakakorikori tinana māmā hei whakaiti i te ahotea me te whakapai ake i tō wairua. He pai tonu te hikoi poto, te mahi rānei i tētahi mea pēnei i te yoga.
• Whakatakotoria he whāinga tūturu ka taea e koe te whakatutuki. Kaua e tumanako ki ngā mea nunui i te wā kotahi. Kia harikoa ki ngā wikitoria iti.
• Whakapaua te wā ki te hunga e whakawhirinaki ana koe. Kōrerotia ō wheako me ngā mea e whakaoho ana i ō tohumate.
• Tāutuhia ngā wā me ngā wāhi e whakamarie ai koe, e whakamarie ai hoki i a koe, whai wāhi atu ki aua wā, ā, haere atu ki aua wāhi.
• Hono atu ki tētahi rōpū tautoko mō te hunga kua pāngia e te mamae. He mea whakamana te kōrero ki te hunga kua pāngia e ngā āhuatanga ōrite ki a koe.
• Kia atawhai ki a koe anō, kia manawanui. Kia maumahara, kāore ngā tohumate e memeha haere i te pō kotahi. Ka āta haere mai.

Ko te mea nui ko te mārama kāore koe i te mokemoke. Kaua e wehi ki te tono āwhina.

Āhea koe me toro atu ki te tākuta?

I a koe e rongoatia ana mō te CPTSD, he mea tino nui kia kite tonu koe i tō tākuta, i tō tohunga hauora hinengaro rānei. Mēnā ka kino haere ō tohumate, me whakamōhio tonu atu ki tō tākuta.

Āhea koe me haere ki te Wāhanga Maimoatanga Ohotata (ETU) ?

Ki te hiahia koe ki te whara i a koe anō, ki te whakaaro rānei koe ki te whakamomori, haere tonu ki te rūma whawhati tata, waea atu rānei ki tētahi nama whawhati tata i Sri Lanka (hei tauira, 1926 National Mental Health Helpline).

He tino uaua te tono āwhina i muri i tētahi huihuinga mamae. Engari kia maumahara, he mea nui te whiwhi maimoatanga mō te CPTSD. I roto i te wā, ka taea e te maimoatanga te āwhina i a koe ki te ora. Kōrero ki tō tākuta mō ngā kōwhiringa maimoatanga. Kei konei rātou hei āwhina me te tautoko i a koe.

Hei whakamutunga, ngā mea hei maumahara (Karere hei tango ki te kāinga)

Nō reira, he nui ngā kōrero kua kōrerohia e tātou mō te CPTSD i tēnei rā. I a koe e pānui ana i tēnei, kua kite pea koe i te kino me te uaua o tēnei mate hinengaro.

• Ko te CPTSD he mamae hinengaro e puta mai ana i te whara kino, roa hoki.
• Haunga te PTSD, ka puta hoki ngā raruraru ki te whakahaere kare ā-roto, te whakaaro nui ki a ia anō, me te pupuri i ngā whanaungatanga.
• He uaua pea te kite i tēnei āhuatanga, engari ka taea e te tohunga mohio te whakatau.
• Ko te mea pai rawa atu, ka taea te whakahaere pai i tēnei āhuatanga mā te hinengaro whakaora (ina koa ko te Trauma-focused CBT, EMDR, CPT) me te rongoā mēnā e tika ana.
• Ki te pā mai ēnei tohu ki a koe, kaua e mamae ko koe anake, engari me rapu tohutohu hauora. Ehara te tono āwhina i te tohu ngoikore, engari ko tētahi o ngā kaha nui rawa atu ka taea e koe te whai māu ake.

Kia maumahara, ahakoa kāore e taea e koe te whakahaere i ngā mea i tupu i tō mua, ka taea e koe te mahi i tētahi hikoi i tēnei rā hei whakapai ake i tō heke mai. Kei te hiahia ahau kia kaha koe ki te mahi i tēnā!

` CPTSD, mate ahotea whai muri i te whara uaua, hauora hinengaro, whara, ahotea, whakaora hinengaro, PTSD