Ese nawe warahindutse nyuma y'ihungabana rikomeye kandi ry'igihe kirekire? Reka tuvuge kuri CPTSD (Complex PTSD)!

Twese tugomba guhura n'ibintu bigoye kandi bibabaza mu buzima bwacu tudashobora no kwiyumvisha, sibyo? Ariko hari ibintu bimwe na bimwe bitarangira mu munsi umwe cyangwa ibiri. Bitubabaza igihe kirekire, bikaducukumbura mu mitima yacu. Uyu munsi, tugiye kuvuga ku kibazo cyo mu mutwe gishobora guterwa n'ibintu bikomeye bibabaza bimaze igihe kirekire. Ibi byitwa CPTSD cyangwa Complex Post-Traumatic Stress Disorder . Wenda wabyumvise, cyangwa nawe ubwawe wumva ibi bimenyetso. Reka turebe icyo ari cyo.

CPTSD (Complex PTSD) ni iki? Mu magambo make...

Muri make, CPTSD ni indwara yo mu mutwe ishobora kugaragara iyo uhuye n’ihungabana ridashira mu gihe kirekire. Ibi bishobora guteza impinduka zikomeye atari mu mutwe wawe gusa ahubwo no mu myitwarire yawe. Tekereza nawe, nk'uko igikomere bifata igihe kugira ngo gikire, ibikomere bikomeye byo mu mutima na byo bifata igihe kugira ngo bikire, kandi rimwe na rimwe bishobora gutera ibibazo bitandukanye mu mutwe.

Hari ibisubizo byinshi by'ingenzi by'imihangayiko bishobora kugaragara muri CPTSD:

• Guhora wumva uhangayitse cyangwa ufite ubwoba (Anxiety): Ushobora guhora wumva ko hari ikintu kibi kigiye kubaho.
• Ibintu bitunguranye cyangwa inzozi mbi: Ushobora kumva ko ikintu giteye ubwoba kirimo kongera kubaho koko, cyangwa ushobora kugira inzozi mbi zijyanye na cyo kenshi.
• Kwirinda ahantu, abantu, n'ibintu bifitanye isano n'ibyabaye mu gihe cy'ihungabana: Ushobora kudashaka kuba hafi cyangwa kujya ahantu hakwibutsa ibyabaye.
• Kugorwa no kugenzura amarangamutima (Ibisubizo by'amarangamutima byiyongera): Ushobora kurakara vuba, guhangayika, gukora ibintu uhubutse, ndetse no kuba umunyamahane ku bintu bito.
• Ingorane zihoraho mu gukomeza umubano: Kugorwa no guhuza n'abantu, kubagirira icyizere no kubaka umubano.

Tekereza, hari umuntu witwa Nilanthi. Kuva akiri umwana, mu rugo hahoraga habera intambara, kandi se yahoraga agirira nabi nyina na we cyane. Imyaka yarashize gutya. Nubwo Nilanthi akiri muto ubu, ahora agira ubwoba, agora kwizera abantu, kandi arakazwa n'utuntu duto. Akunda kurota ibintu byamubayeho akiri umwana. Ubwo bwoko bw'ibintu bushobora kuba urugero rwa CPTSD.

Ni ibihe bibazo by’ihungabana rirambye bishobora gutera CPTSD?

• Guhohoterwa ku mubiri cyangwa imibonano mpuzabitsina igihe kirekire ku mwana.
• Ihohoterwa ryo mu ngo rirambye.
• Kuba umuntu wakorewe ihohoterwa rishingiye ku gitsina cyangwa ihohoterwa rishingiye ku gitsina.
• Kuba mu buzima busanzwe bw'intambara igihe kirekire (Intambara).
• Ihohoterwa rikunze kugaragara mu baturage.

Iyi ndwara ntikunze kugaragara ku bantu bahuye n’ihungabana rikomeye mu bwana, ahubwo ishobora no kurwara CPTSD mu gihe cy’ubukure iyo bahuye n’ihungabana nk’iryo ry’igihe kirekire.

Ese CPTSD yemewe n'abaganga?

Iki kibazo kiragoye. Ndetse no mu bahanga mu by'imitekerereze ya muntu, hari ibitekerezo bitandukanye ku bijyanye no kumenya niba CPTSD ari indwara yihariye cyangwa ari kimwe mu bigize PTSD (Post-Traumatic Stress Disorder).

Tekereza kuri ibi: Umuryango Mpuzamahanga wita ku Buzima (OMS) washyize CPTSD mu gitabo cyayo giheruka, "Itsinda Mpuzamahanga ry'Indwara (ICD-11)," mu 2019. Ariko, Ishyirahamwe ry'Abanyamerika ryita ku ndwara zo mu mutwe (APA) ntiryemera CPTSD nk'indwara yihariye mu gitabo cyayo "Diagnostic and Statistical Manual of Mental Disorders (DSM-5) . Ariko, DSM-5 irimo indwara yitwa "dissociative PTSD" nk'igice cya PTSD, kandi ibimenyetso byayo bisa cyane na CPTSD.

Impuguke zimwe zitekereza ko CPTSD, PTSD, na BPD (Borderline Personality Disorder) byose bishobora kuba ari indwara zo mu mutwe ziterwa n'ihungabana ku buryo bumwe. Ni ukuvuga ko zishobora kuba zifitanye isano ukurikije uburemere bw'ibimenyetso byazo.

None se itandukaniro riri hagati ya CPTSD na PTSD ni irihe?

Iki ni ikibazo abantu benshi bibaza. Itandukaniro rikomeye ni igihe indwara ya shock imaze n'ibimenyetso byayo.

Twatekerezaga ko PTSD iterwa n'ihungabana ry'igihe gito, nk'impanuka cyangwa ibiza bisanzwe. Ariko ubushakashatsi bwagaragaje ko abantu bahura n'ihungabana ry'igihe kirekire kandi rikomeje kwiyongera bagaragaza ibindi bimenyetso byiyongera kuri PTSD. Ni muri ibyo bimenyetso by'inyongera niho CPTSD ivurwa.

Muri CPTSD na PTSD,

• Kongera kwibonera icyo gikorwa (ibisubizo by'ibyabaye),
• Kuba maso cyane (kuba maso buri gihe kandi bitari ngombwa ku bidukikije),
• Uburyo bwo guhangana n'ihungabana ryo mu mutwe no mu myitwarire bushobora kugaragara, nko kwirinda ibintu bikwibutsa ibyabaye mu buryo butunguranye.

Ariko kandi, abantu barwaye CPTSD bahura n'ibindi bibazo :

• Ibibazo bihoraho kandi bikwirakwira mu bijyanye no kugenzura amarangamutima: Kurakara vuba bitewe n'ibintu bito, kumva ubabaye, no kudashobora kugenzura amarangamutima.
• Ibibazo bijyanye n'umwirondoro wawe n'uko wiyumva: Ibitekerezo bibi ku uwo uri we n'agaciro kawe. Kumva ufite isoni, uwicira urubanza, no gutsindwa ni ibintu bisanzwe.
• Ibibazo byo kubungabunga umubano: Biragoye cyane kubaka no kubungabunga umubano ukomeye kandi ufite ishingiro n'abandi.

Ni irihe tandukaniro riri hagati ya CPTSD na BPD (Borderline Personality Disorder)?

CPTSD na BPD bisangiye ibimenyetso bimwe, nko kugira imyitwarire itunguranye, kumva ko nta cyo umaze, no kugorwa no kugumana umubano uhamye. Ibi byatumye impuguke zimwe na zimwe zibaza niba koko ibyo byombi ari ibintu bitandukanye.

Dukurikije ibipimo biriho ubu, itandukaniro rikomeye ni uko CPTSD isaba ihungabana ridashira kugira ngo itere imbere. Nubwo BPD idasaba ihungabana kugira ngo itere imbere , BPD ikunze kujyana cyane n'ibintu bikomeretsa, nko guhohoterwa no kutitabwaho mu bwana.

Irindi tandukaniro ni uko BPD ikunze kugaragara mu bantu bakuru bakiri bato, ariko CPTSD ishobora kubaho mu myaka iyo ari yo yose.

Ni mu rugero rungana iki CPTSD ikunze kubaho?

Kubera ko CPTSD ari indwara nshya yagaragaye, nta bushakashatsi buhagije buhari ku buryo ikunze kugaragara. Ariko, abahanga bavuga ko iyi ndwara ishobora kugira ingaruka hagati ya 1% na 8% by'abatuye isi. Ibi bivuze ko muri Sri Lanka hashobora kuba hari abantu barwaye iyi ndwara.

Ni ibihe bimenyetso bya CPTSD?

Dukurikije urutonde rw'Ishami ry'Umuryango w'Abibumbye ryita ku Buzima rwa `ICD-11`, CPTSD irimo ibimenyetso byinshi by'ingenzi bya PTSD. Ni ukuvuga:

• Gusubira inyuma: Kumva nk'aho ikintu giteye impagarara kirimo kongera kubaho koko.
• Kwirinda no kwirinda abantu, ibyabaye, n'ibintu bihungabanya ibidukikije byateje ihungabana.
• Kuba maso cyane ni ukuba maso cyane bitewe no gutinya akaga gashobora kubaho.
• Ibitekerezo n'amarangamutima mabi kenshi.

Uretse ibi, hari ibindi bimenyetso byinshi bidasanzwe kuri CPTSD:

• Gukabya mu gihe umuntu aterwa n'ibintu bibi bimutera kurakara, uburakari n'imyitwarire mibi (Affective dysregulation): Muri make, kurakara vuba, kurakara, no kugorwa no kugenzura amarangamutima no mu tuntu duto cyane.
• Kugira ibyiyumvo bibi kuri njye: Guhorana isoni, kwicira urubanza, kumva ko nananiwe, no kumva nta cyo maze.
• Ingorane zikomeye mu gushinga no kubungabunga umubano ufite akamaro: Biragoye cyane kwizera abantu no kubaka umubano wa hafi.

"Ndibuka ko nari mfite inshuti yababaye cyane nkiri umwana. Ntiyashoboraga kwizera abandi bantu. Nubwo umuntu yamwenyuraga akamuvugisha, yatekerezaga ko arimo atega umutego. Yari afite inshuti nke cyane." - Ubu bwoko bw'ibibazo bushobora kugaragara muri CPTSD.

Ni iki gitera CPTSD? Ni iki kiba ku bwonko bwacu?

Nk’uko ICD-11 ibivuga, CPTSD iterwa no guhura n’ibintu bibabaje cyangwa urukurikirane rw’ibintu biteye ubwoba cyane. Ibi bintu akenshi biba bimara igihe kirekire, bigasubiramo ibintu, kandi bibamo ibintu bidashoboka gutoroka cyangwa bikaba byateza akaga.

Ingero zimwe na zimwe ni izi:

• Ihohoterwa ryo mu ngo rirambye.
• Guhohoterwa rishingiye ku gitsina cyangwa ku mubiri mu bwana.
• Iyicarubozo.
• Guhangana n'itsembabwoko.
• Kuba imbata.

Ubu bwoko bw'ihungabana rikomeye kandi ry'igihe kirekire rishobora gutera impinduka mu miterere y'ubwonko bwawe . Ubushakashatsi bwagaragaje ko ihungabana rishobora gutera impinduka zihoraho mu bice byinshi by'ingenzi by'ubwonko bwacu. Ibi bice ni ibi bikurikira:

• `Amygdala`: Iki ni cyo gice cy'ingenzi cy'ubwonko bwacu gitunganya ubwoba n'andi marangamutima. Ni nk'agace gato gagenzura amarangamutima yacu, cyane cyane amenya amarangamutima nk'ubwoba. Iki gice gishobora gukora cyane bitewe n'ihungabana, niyo mpamvu duhora dufite ubwoba kandi turi maso.
• Hippocampus: Iki ni cyo gice cy'ingenzi cy'ubwonko bwacu kibika ibyo twibuka kandi kikadufasha kwiga ibintu bishya. Ihungabana rishobora kugabanya imikorere y'iki gice, ari nayo mpamvu rimwe na rimwe tugira ingorane zo kwibuka ibyabaye no kwiga ibintu bishya.
• Igitekerezo cya Prefrontal: Aha niho dukora ibintu byinshi by'ingenzi, nko gutegura, gufata ibyemezo, kugaragaza imico yacu, no kugenzura imyitwarire y'abandi. Ihungabana rishobora kandi guhindura imikorere y'uru rwego, ari nayo mpamvu bigoye kugenzura amarangamutima no gufata ibyemezo uhubutse.

Ubushakashatsi bumwe na bumwe bw’ibishushanyo by’imitsi bwagaragaje ko izi mpinduka zigaragara cyane mu bwonko bw’abantu bafite CPTSD kurusha abafite PTSD.

Ni gute wamenya neza niba ufite CPTSD?

Nta gipimo cyihariye gitangwa kugira ngo umenye CPTSD. Ahubwo, umuganga cyangwa umujyanama mu by'ubuzima bwo mu mutwe azakubaza ibi bikurikira:

• Ibimenyetso byawe.
• Amateka yawe y'ubuvuzi.
• Amateka yawe y'ubuzima bwo mu mutwe.
• Uburyo wahuye n'ihungabana.

Abaganga bakoresha ibipimo biri mu ishami ry’Umuryango w’Abibumbye ryita ku Buzima `ICD-11` kugira ngo bapime CPTSD. Ariko, kubera ko CPTSD ari indwara nshya yamenyekanye, bamwe mu baganga bashobora kuba batayizi. Kubwibyo, bishobora kugorana gato kubona isuzuma ryemewe. Muganga ashobora no kukubwira ko ufite PTSD aho kuba CPTSD. Kubwibyo, niba ufite ibi bimenyetso, ni ngombwa cyane kubonana n'umujyanama w’ubuzima bwo mu mutwe ufite uburambe muri uru rwego.

Ni ubuhe buryo bwo kuvura CPTSD?

Inkuru nziza ni uko hari uburyo bwo kuvura CPTSD! Uburyo bw'ingenzi bwo kuvura ni psychotherapy, cyangwa "talk therapy" nkuko twese tubizi. By'umwihariko, ikoresha ubwoko bw'ubuvuzi bw'imyitwarire bwo mu mutwe bwitwa trauma-focused CBT .

Ubu buvuzi butangwa n'inzobere mu by'ubuzima bwo mu mutwe zabihuguriwe kandi zifite uruhushya, nk'inzobere mu by'imitekerereze y'abantu cyangwa imitekerereze y'abantu. Ubu buvuzi butanga ubufasha, uburezi, n'ubuyobozi kuri wowe n'abakunzi bawe kugira ngo bigufashe gukora neza no kunoza imibereho yawe.

Muri CBT yibanda ku ihungabana, ibi bintu bibaho:

• Umenya uburyo umubiri wawe witwara mu gihe cy'ihungabana n'imihangayiko.
• Menya uburyo bwo guhangana n'ibimenyetso.
• Bifasha kumenya imiterere y'ibitekerezo ifite ibibazo no kubihindura (guhindura).
• Uburyo bwo kuvura abantu bafite PTSD na CPTSD akenshi birinda ibintu cyangwa ibintu bifitanye isano n'ihungabana ryabo. Kubera iyo mpamvu, ntibabona amahirwe yo kumenya ko bashobora kugenzura ubwoba bwabo nubwo baba bahuye n'ibyo bintu. Mu buryo bwo kuvura abantu bafite PTSD, umuvuzi agenda akwereka ibintu bigutera ubwoba buhoro buhoro. Aragutoza kuguma muri ibyo bihe no guhangana nabyo.

Ubundi buryo bwo kuvura bushingiye ku ihungabana ni ugukuraho ubukana bw'amaso no kuyahindura uko abyifuza (EMDR) . Muri ubu buryo bwo kuvura, utekereza ku byabaye mu gihe wibanda ku majwi cyangwa ingendo runaka umuvuzi ashyiramo. Intego ni ukugabanya agahinda wumva utewe n'ibyo bintu uko igihe kigenda gihita.

Ubuvuzi bwo Gutunganya Ibitekerezo (CPT) ni ubundi bwoko bw'ubuvuzi bushingiye ku ihungabana. Ubu buvuzi bwibanda ku gukemura ibitekerezo n'amarangamutima biguhangayikishije kandi akenshi bibaho nyuma y'ikintu giteye ihungabana.

Umuti uvura CPTSD

Kugeza ubu, nta miti yihariye yemejwe n'Ikigo gishinzwe ibiribwa n'imiti muri Amerika (FDA) yo kuvura PTSD cyangwa CPTSD. Ariko, abaganga bashobora gutanga imiti nk'iyi kugira ngo ifashe mu kugabanya bimwe mu bimenyetso bya CPTSD:

• Imiti igabanya kwiheba: Nka `Selective Serotonin Reuptake Inhibitors (SSRIs)` cyangwa `Serotonin na Norepinephrine Reuptake Inhibitors (SNRIs).`
• Imiti igabanya ububabare.
• Imiti yo gusinzira.

Iyi miti igabanya ibimenyetso gusa, ntabwo ikiza indwara burundu. Kubwibyo, ubuvuzi bw'ibanze bwo kuvura indwara zo mu mutwe.

Ni iki giteganyijwe ku ndwara ya CPTSD?

Kubera ko CPTSD ari indwara nshya yagaragaye, abashakashatsi mu by'ubuvuzi ntibarabona amahirwe yo kuyikoraho ubushakashatsi bw'igihe kirekire.

Kuri benshi, CPTSD ishobora kuba indwara y'ubuzima bwabo bwose. Ariko ntugahangayike! Ikintu cyiza ni uko ibimenyetso byawe bishobora gukemurwa neza ukoresheje imiti yo mu mutwe, ndetse nibiba ngombwa, n'imiti. Ibi bivuze ko ubu buryo bwo kuvura bushobora kugufasha kubaho ubuzima busanzwe.

Niba ufite CPTSD, wiyitaho ute?

Uretse gushaka ubuvuzi, hari ibintu byinshi ushobora gukora kugira ngo ugire ubuzima bwiza bwo mu mutwe:

• Kora imyitozo ngororamubiri yoroheje kugira ngo ugabanye stress kandi wongere ibyiyumvo byawe. Ndetse no kugenda n'amaguru cyangwa ikintu nk'icyo cya yoga ni byiza.
• Shyiraho intego zifatika ushobora kugeraho. Ntukitege ibintu bikomeye icyarimwe. Ishimire intsinzi nto.
• Marana umwanya n'abantu wizeye. Babwire ibyakubayeho n'icyagutera ibimenyetso.
• Shaka ibihe n'ahantu bituma wumva umerewe neza kandi ufite amahoro, ujye ubitabira kenshi, kandi ujye muri ibyo bice.
• Jya mu itsinda rishinzwe gufasha abahuye n'ihungabana. Bituma ubasha kuganira n'abantu bahuye n'ibibazo nk'ibyawe.
• Gira ubuntu kuri wowe ubwawe, ihangane. Wibuke ko ibimenyetso bitashira mu ijoro rimwe. Biza buhoro buhoro.

Igikuru ni ukumenya ko utari wenyine. Ntutinye gusaba ubufasha.

Ni ryari ukwiye kujya kwa muganga?

Mu gihe urimo kuvurwa indwara ya CPTSD, ni ngombwa cyane kujya kwa muganga wawe cyangwa inzobere mu by’ubuzima bwo mu mutwe buri gihe. Niba ibimenyetso byawe birushijeho gukomera, menyesha muganga wawe ako kanya.

Ni ryari ugomba kujya mu Ishami ry’Ubuvuzi bw’Ingoboka (ETU) ?

Niba wumva ushaka kwiyahura cyangwa urimo gutekereza kwiyahura, jya mu cyumba cy’ubutabazi bw’ibanze kiri hafi yawe, cyangwa uhamagare inomero y’ubutabazi bw’ibanze ikwiye muri Sri Lanka (urugero: 1926 National Mental Health Helpline).

Gusaba ubufasha nyuma y’ikibazo cy’ihungabana bishobora kugorana cyane. Ariko ibuka ko kubona ubuvuzi bwa CPTSD ari ingenzi. Uko igihe kigenda gihita, ubuvuzi bushobora kugufasha gukira. Vugana na muganga wawe ku bijyanye n’uburyo bwo kuvura. Bari hano kugira ngo bagufashe kandi bagushyigikire.

Amaherezo, ibintu byo kwibuka (Ubutumwa bwo kujyana mu rugo)

Rero, twaganiriye cyane kuri CPTSD uyu munsi. Mu gihe usoma ibi, ushobora kuba warabonye ukuntu iyi ndwara yo mu mutwe ikomeye kandi igoye.

• CPTSD ni ihungabana ryo mu mutwe riterwa n'ihungabana rikomeye kandi rirambye.
• Uretse PTSD, ibi binatera ibibazo bijyanye no kugenzura amarangamutima, kwihesha agaciro no gukomeza umubano.
• Iyi ndwara ishobora kugorana kuyimenya, ariko umuhanga w’inararibonye arashobora kubikora.
• Icyiza kurushaho ni uko iyi ndwara ishobora gukemurwa neza hakoreshejwe uburyo bwo kuvura indwara zo mu mutwe (cyane cyane indwara ziterwa n’ihungabana, EMDR, CPT) ndetse nibiba ngombwa, imiti.
• Niba ufite ibi bimenyetso, ntubabare wenyine kandi shakisha inama kwa muganga. Gusaba ubufasha si ikimenyetso cy'intege nke, ni kimwe mu mbaraga zikomeye ushobora kugira kuri wowe ubwawe.

Wibuke ko nubwo udashobora kugenzura ibyabaye mu bihe byashize, ushobora gutera intambwe uyu munsi kugira ngo unoze ahazaza hawe. Ndakwifurije imbaraga zo kubikora!

` CPSD, indwara ikomeye yo guhangayika nyuma yo guhungabana, ubuzima bwo mu mutwe, ihungabana, stress, psychotherapy, PTSD