Ingabe nawe ushintshile ngemva kokuhlukumezeka okukhulu kwesikhathi eside? Ake sixoxe nge-CPTSD (i-Complex PTSD)!

Sonke kufanele sibhekane nokuhlangenwe nakho okunzima nokubuhlungu ekuphileni kwethu esingenakukucabanga, akunjalo? Kodwa kunezinye izinto ezingapheli ngosuku olulodwa noma ezimbili. Zisihlupha isikhathi eside, zijula ​​ezinhliziyweni zethu. Namuhla, sizokhuluma ngenkinga yengqondo engabangelwa izimo ezibuhlungu kakhulu ebezilokhu ziqhubeka isikhathi eside. Lokhu kubizwa ngokuthi i-CPTSD noma i-Complex Post-Traumatic Stress Disorder . Mhlawumbe uke wezwa ngalokhu, noma uzizwa lezi zimpawu wena ngokwakho. Ake sibone ukuthi kuyini.

Kuyini i-CPTSD (i-Complex PTSD)? Kalula nje...

Kalula nje, i-CPTSD yisimo sengqondo esingakhula uma ubhekene nokulimala okungapheli isikhathi eside. Lokhu kungabangela izinguquko ezinkulu hhayi engqondweni yakho kuphela kodwa nasekuziphatheni kwakho. Cabanga ngakho, njengoba nje inxeba lithatha isikhathi ukuphola, amanxeba angokomzwelo anzima nawo athatha isikhathi ukuphola, futhi ngezinye izikhathi angaholela ezimweni ezahlukahlukene ezicindezelayo engqondweni.

Kunezindlela eziningana zokuphendula ukucindezeleka okuyinhloko ezingabonakala ku-CPTSD:

• Ukuzizwa ukhathazekile noma wesaba njalo (Ukukhathazeka): Ungase uhlale uzizwa sengathi kukhona okubi okuzokwenzeka.
• Ukubuyela emuva noma amaphupho amabi: Ungase uzizwe sengathi lesi sigameko esibuhlungu siyaphinda senzeke, noma ungase ube namaphupho amabi ahlobene naso.
• Ukugwema izindawo, abantu, nezinto ezihlobene nesigameko esibuhlungu: Ungase ungafuni ukuba seduze noma ukuya ezindaweni ezikukhumbuza ngesigameko.
• Ubunzima bokulawula imizwa (Izimpendulo ezingokomzwelo eziphakeme): Ungase uthukuthele kalula, ucasuke, wenze izinto ngokuphamazela, futhi uze ube nolaka ngezinto ezincane.
• Ubunzima obuqhubekayo ekuqiniseni ubudlelwano: Ubunzima bokuxhumana nabantu, ukubathemba, nokwakha izibopho.

Cabanga nje, kukhona umuntu ogama lakhe linguNilanthi. Kusukela esemncane, kwakuhlale kunezimpi ekhaya, futhi uyise wayehlukumeza unina kanye naye kakhulu. Iminyaka yadlula kanje. Ngisho noma uNilanthi esemncane manje, uhlala esaba, enenkinga yokuthemba abantu, futhi ethukuthelela izinto ezincane. Uvame ukuphupha ngezinto ezamehlela esengumntwana. Lolu hlobo lwesimo lungaba yisibonelo se-CPTSD.

Yiziphi izinkinga ezingapheli ezingabangela i-CPTSD?

• Ukuhlukunyezwa ngokomzimba noma ngokocansi kwengane isikhathi eside.
• Udlame lwasekhaya lwesikhathi eside.
• Ukuba yisisulu sokushushumbiswa kwabantu noma ngokocansi.
• Ukuhlala endaweni efana nempi isikhathi eside (iMpi).
• Udlame oluvamile emphakathini.

Lesi simo asivamile nje kuphela kulabo abake babhekana nokulimala okukhulu ebuntwaneni, kodwa futhi bangaba ne-CPTSD lapho sebekhulile uma bebhekene nokulimala okunjalo kwesikhathi eside.

Ingabe i-CPTSD iyaqashelwa ngokwezokwelapha?

Lokhu kuyinkinga eyinkimbinkimbi kancane. Ngisho naphakathi kososayensi bezengqondo, kunemibono ehlukene ngokuthi i-CPTSD iyisimo esihlukile noma iyingxenye ye-PTSD (Post-Traumatic Stress Disorder).

Cabanga ngalokhu: I-World Health Organization (WHO) iqambe i-CPTSD njengesimo esihlukile encwadini yayo yakamuva, ethi `International Classification of Diseases (ICD-11),` ngo-2019. Kodwa-ke, i-American Psychiatric Association (APA) ayiqapheli i-CPTSD njengesimo esihlukile ku -`Diagnostic and Statistical Manual of Mental Disorders (DSM-5) yayo. Kodwa-ke, i-DSM-5 ifaka isimo esibizwa ngokuthi `dissociative PTSD` njengeqembu le-PTSD, futhi izimpawu zaso zifana kakhulu ne-CPTSD.

Abanye ochwepheshe bakholelwa ukuthi i-CPTSD, i-PTSD, kanye ne-BPD (Borderline Personality Disorder) zonke zingase zibe yizimo zempilo yengqondo ezihlobene nokuhlukumezeka ezisezingeni elifanayo. Okusho ukuthi, zingase zihlobane ngokwezinga lezimpawu zazo.

Ngakho-ke umehluko uyini phakathi kwe-CPTSD ne-PTSD?

Lona umbuzo abantu abaningi abawubuzayo. Umehluko omkhulu ubude besikhathi sokushaqeka kanye nezimpawu.

Sasivame ukucabanga ukuthi i-PTSD ibangelwa ukuhlukumezeka kwesikhashana, njengengozi noma inhlekelele yemvelo. Kodwa ucwaningo luthole ukuthi abantu ababhekene nokuhlukumezeka kwesikhashana, okuphindaphindiwe, baba nezimpawu ezengeziwe ngaphezu kwe-PTSD. Yilezi zimpawu ezengeziwe lapho kutholakala khona i-CPTSD.

Kuzo zombili i-CPTSD kanye ne-PTSD,

• Ukuphinde ubone lesi senzakalo (ukubuyela emuva),
• Ukuphaphama ngokweqile (ukuqaphela njalo nangokungadingekile okukuzungezile),
• Izimpendulo zokucindezeleka kwengqondo nokuziphatha zingase zibonakale, njengokugwema izinto ezikukhumbuza ngesehlakalo esibuhlungu.

Kodwa-ke, abantu abane-CPTSD nabo babhekana nezinye izinkinga :

• Izinkinga ezingapheli nezisakazekile zokulawula imizwa: Ukuthukuthela kalula ngezinto ezincane, ukuzizwa udangele, nokungakwazi ukulawula imizwa.
• Izinkinga ngobunikazi kanye nokuzizwa ungumuntu: Imicabango engemihle ngokuthi ungubani nokuthi ubaluleke kangakanani. Imizwa yokuhlazeka, umuzwa wecala, kanye nokwehluleka ivamile.
• Izinkinga zokulondoloza ubudlelwano: Kunzima kakhulu ukwakha nokugcina ubudlelwano obuqinile nobunenjongo nabanye.

Uyini umehluko phakathi kwe-CPTSD kanye ne-BPD (Borderline Personality Disorder)?

I-CPSD kanye ne-BPD zinezimpawu eziningi ezifanayo, njengokuziphatha okungazelelwe, imizwa yokuzizwa ungelutho, kanye nobunzima bokugcina ubudlelwano obuzinzile. Lokhu kuholele ochwepheshe abathile ukuba bazibuze ukuthi ngabe lezi zimo ezimbili empeleni ziyizimo ezihlukene.

Ngokwezindlela zamanje, umehluko omkhulu ukuthi i-CPTSD idinga ukuhlukumezeka okungapheli ukuze kukhule. Nakuba i-BPD ingadingi ukuhlukumezeka ukuze kukhule , i-BPD ivame ukuhlotshaniswa kakhulu nokuhlangenwe nakho okubuhlungu, njengokuhlukunyezwa kwasebuntwaneni noma ukunganakwa.

Omunye umehluko ukuthi i-BPD ivame ukuvela kubantu abadala abasebasha, kodwa i-CPTSD ingenzeka kunoma yimuphi ubudala.

Ivame kangakanani i-CPTSD?

Ngenxa yokuthi i-CPTSD iyisimo esisanda kutholakala, kusenocwaningo olwanele mayelana nokuthi sivame kangakanani. Kodwa-ke, ochwepheshe balinganisela ukuthi lesi simo singathinta phakathi kuka-1% no-8% wabantu bomhlaba. Lokhu kusho ukuthi kungase kube nabantu eSri Lanka abahlushwa yilesi simo.

Ziyini izimpawu ze-CPTSD?

Ngokusho kwesigaba se-'ICD-11' se-World Health Organization, i-CPTSD ihlanganisa eziningi zezimpawu eziyinhloko ze-PTSD. Okungukuthi:

• Ukubuyela emuva: Ukuzizwa sengathi lesi sigameko esibuhlungu siyaphinda senzeka.
• Ukugwema nokuhlukana nabantu, izenzakalo, kanye nezinto ezibangela usizi.
• Ukuphaphama ngokweqile kuyisimo esiqhubekayo sokuqapha ngokweqile ngenxa yokwesaba ingozi.
• Imicabango nemizwa emibi evame ukwenzeka.

Ngaphezu kwalokhu, kunezinye izimpawu eziningana ezihlukile kwi-CPTSD:

• Ukusabela ngokweqile ezivuselelweni ezimbi zemizwa, intukuthelo, kanye nokuziphatha okunolaka (Ukuphazamiseka kwemizwa): Kalula nje, ukuthukuthela ngokushesha, ukucasuka, kanye nokuthola ubunzima bokulawula imizwa ngisho nasezintweni ezincane kakhulu.
• Ukuba nomuzwa ongemuhle ngawe: Ukuhlushwa njalo yihlazo, umuzwa wecala, imizwa yokwehluleka kanye nokuzizwa ungelutho.
• Ubunzima obukhulu ekwakheni nasekulondolozeni ubudlelwano obunenjongo: Kunzima kakhulu ukwethemba abantu nokwakha ubudlelwano obuseduze.

"Ngiyakhumbula, nganginomngane owayehlupheka kakhulu esemncane. Wayengasoze abathembe abanye abantu. Ngisho noma othile emomotheka futhi ekhuluma naye, wayecabanga ukuthi ubeka ugibe. Wayenabangane abambalwa kakhulu." - Lolu hlobo lwesimo lungabonakala ku-CPTSD.

Yini ebangela i-CPTSD? Kwenzekani ebuchosheni bethu?

Ngokusho kwe-ICD-11, i-CPTSD ibangelwa ukuchayeka esigamekweni esibuhlungu noma uchungechunge lwezehlakalo ezisongela kakhulu. Lezi zehlakalo ngokuvamile zihlala isikhathi eside, ziyaphindaphindwa, futhi zihilela izimo lapho kungenakwenzeka khona ukubaleka noma ngisho nokuba yingozi.

Ezinye izibonelo yilezi:

• Udlame lwasekhaya lwesikhathi eside.
• Ukuhlukunyezwa ngokocansi noma ngokomzimba ngesikhathi sobuntwana.
• Ukuhlushwa.
• Ukubhekana nokuqothulwa kohlanga.
• Ukuba yisigqila.

Lolu hlobo lokucindezeleka okukhulu, kwesikhathi eside okubangelwa yizinhlekelele lungabangela izinguquko kumakhemikhali kanye nesakhiwo sobuchopho bakho . Ucwaningo lukhombisile ukuthi ukuhlukumezeka kungabangela izinguquko ezihlala njalo ezingxenyeni eziningana ezibalulekile zobuchopho bethu. Lezi zingxenye yilezi:

• `Amygdala`: Lena yingxenye eyinhloko yobuchopho bethu ecubungula ukwesaba neminye imizwa. Kufana nendawo encane elawula imizwa yethu, ikakhulukazi leyo eqaphela imizwa efana nokwesaba. Le ngxenye ingaba matasa kakhulu ngenxa yokulimala, yingakho sihlala sesaba futhi siqaphile.
• I-Hippocampus: Lena yingxenye eyinhloko yobuchopho bethu egcina izinkumbulo zethu futhi isisize sifunde izinto ezintsha. Ukulimala kunganciphisa ukusebenza kwale ngxenye, yingakho ngezinye izikhathi siba nenkinga yokukhumbula izenzakalo nokufunda izinto ezintsha.
• I-Prefrontal cortex: Yilapho senza khona izinto eziningi ezibalulekile, njengokuhlela, ukwenza izinqumo, ukuveza ubuntu bethu, kanye nokulawula ukuziphatha komphakathi. Ukulimala kungashintsha nokusebenza kwale ndawo, yingakho kunzima ukulawula imizwa nokwenza izinqumo ngokuphamazela.

Ezinye izifundo ze-neuroimaging zibonise ukuthi lezi zinguquko zibonakala kakhulu ebuchosheni babantu abane-CPTSD kunalabo abane-PTSD.

Ubona kanjani ngokunembile ukuthi une-CPTSD?

Akukho ukuhlolwa okuqondile kokuxilonga i-CPTSD. Kunalokho, udokotela noma umeluleki wezempilo yengqondo uzokubuza ngalokhu okulandelayo:

• Izimpawu zakho.
• Umlando wakho wezokwelapha.
• Umlando wakho wezempilo yengqondo.
• Indlela owabhekana ngayo nobunzima.

Odokotela basebenzisa izindlela eziku-'ICD-11' ye-World Health Organisation ukuze bathole i-CPTSD. Kodwa-ke, ngenxa yokuthi i-CPTSD iyisimo esisanda kutholakala, abanye odokotela bangase bangazi ngaso. Ngakho-ke, kungaba nzima ukuthola ukuxilongwa okusemthethweni. Udokotela angakutshela nokuthi une-PTSD esikhundleni se-CPTSD. Ngakho-ke, uma unalezi zimpawu, kubaluleke kakhulu ukubona umeluleki wezempilo yengqondo onolwazi kulo mkhakha.

Yiziphi izindlela zokwelapha i-CPTSD?

Izindaba ezinhle ukuthi kunezindlela zokwelapha i-CPTSD! Ukwelashwa okuyinhloko ukwelashwa kwengqondo, noma "ukwelashwa ngokukhuluma" njengoba sonke sikwazi. Ngokukhethekile, kusebenzisa uhlobo lokwelashwa kokuziphatha kwengqondo olubizwa ngokuthi i-CBT egxile ekuhlukumezekeni .

Lokhu kwelashwa kunikezwa uchwepheshe wezempilo yengqondo oqeqeshwe futhi onelayisensi, njengodokotela wengqondo noma wezifo zengqondo. Lokhu kwelashwa kunikeza ukwesekwa, imfundo, kanye nesiqondiso kuwe nakubantu obathandayo ukuze kukusize usebenze kangcono futhi uthuthukise inhlalakahle yakho.

Ku-CBT egxile ku-Trauma, lezi zinto zenzeka:

• Ufunda ngendlela umzimba wakho osabela ngayo ekuhluphekeni nasekucindezelekeni.
• Funda ukuthi ungaphatha kanjani izimpawu.
• Kuyasiza ekuboneni amaphethini okucabanga ayinkinga bese ewashintsha (ukuwashintsha).
• Ukwelashwa ngokuchayeka: Abantu abane-PTSD kanye ne-CPTSD bavame ukugwema izinto noma izimo ezihlobene nokulimala kwabo. Ngenxa yalokho, abatholi ithuba lokufunda ukuthi bangakwazi ukulawula ukwesaba kwabo ngisho nalapho bechayeka kulezo zinto ezibashukumisayo. Ekwelashweni ngokuchayeka, umelaphi ukuchayeka kancane kancane ezimweni ezikwenza wesabe. Bakuqeqesha ukuthi uhlale kulezo zimo futhi ubhekane nazo.

Olunye ukwelashwa okugxile ekuhlukumezekeni yi -Eye Movement Desensitization and Reprocessing (EMDR) . Kulolu hlobo lokwelapha, ucabanga ngesehlakalo esibuhlungu ngenkathi ugxila emisindweni ethile noma ukunyakaza okwethulwa yi-therapist. Umgomo ukunciphisa ukucindezeleka okuzwayo ngalezo zehlakalo ngokuhamba kwesikhathi.

Ukwelashwa Kokucubungula Ubuchopho (CPT) olunye uhlobo lokwelapha okugxile ekuhlukumezekeni. Lokhu kwelashwa kugxile ekubhekaneni nemicabango nemizwa ecindezelayo futhi evame ukuba yinkinga ephakama engqondweni yakho ngemva kwesigameko esibuhlungu.

Imithi ye-CPTSD

Okwamanje, azikho izidakamizwa ezithile ezivunyelwe yi-US Food and Drug Administration (FDA) ukwelapha i-PTSD noma i-CPTSD. Kodwa-ke, odokotela bangase banikeze imithi efana nale ukusiza ekuphatheni ezinye zezimpawu ze-CPTSD:

• Imithi Yokudambisa Ukucindezeleka: Njenge-`Selective Serotonin Reuptake Inhibitors (SSRIs)` noma i-`Serotonin kanye ne-Norepinephrine Reuptake Inhibitors (SNRIs).`
• Imithi yokulwa nokukhathazeka.
• Imithi yokulala.

Le mithi iqeda izimpawu kuphela, ayilaphi lesi sifo ngokuphelele. Ngakho-ke, ukwelashwa kwengqondo kuyindlela eyinhloko yokwelapha.

Iyini i-prognosis ye-CPTSD?

Ngenxa yokuthi i-CPTSD iyisimo esisanda kutholakala, abacwaningi bezokwelapha abakatholi ithuba lokwenza izifundo zesikhathi eside ngaso.

Kwabaningi, i-CPTSD ingaba yisimo sokuphila konke. Kodwa ungakhathazeki! Into engcono kakhulu ukuthi izimpawu zakho zingaphathwa kahle ngokwelashwa kwengqondo, futhi uma kudingeka, imithi. Lokhu kusho ukuthi lezi zindlela zokwelapha zingakusiza uphile impilo evamile.

Uma une-CPTSD, uzinakekela kanjani?

Ngaphezu kokufuna ukwelashwa, kunezinto eziningana ongazenzela inhlalakahle yakho yengqondo:

• Zivocavoce kancane ukuze unciphise ukucindezeleka futhi uthuthukise isimo sakho sengqondo. Ngisho nokuhamba ibanga elifushane noma into efana ne-yoga kuhle.
• Zibekele imigomo enengqondo ongayifinyelela. Ungalindeli izinto ezinkulu ngesikhathi esisodwa. Jabula ngokunqoba okuncane.
• Chitha isikhathi nabantu obathembayo. Batshele ngalokho okukuhlangabezile nokuthi yini engabangela izimpawu zakho.
• Thola izikhathi nezindawo ezikwenza uzizwe ukhululekile futhi unokuthula, zibandakanye njalo kuzo, bese uya kulezo zindawo.
• Joyina iqembu lokusekela labo abake badlula ekulimaleni. Ukukhuluma nabantu abake badlula ezintweni ezifanayo nezakho kungaba namandla amakhulu.
• Yiba nomusa kuwe, bekezela. Khumbula, izimpawu azipheli ngobusuku obubodwa. Ziza kancane kancane.

Into ebaluleke kakhulu ukuqonda ukuthi awuwedwa. Ungesabi ukucela usizo.

Kufanele ubonane nini nodokotela?

Ngesikhathi welashwa i-CPTSD, kubaluleke kakhulu ukubona udokotela wakho kanye/noma uchwepheshe wezempilo yengqondo njalo. Uma izimpawu zakho ziba zimbi kakhulu, yazisa udokotela wakho ngokushesha.

Kufanele uye nini e-Emergency Treatment Unit (ETU) ?

Uma uzizwa sengathi uzozilimaza noma ucabanga ukuzibulala, iya ekamelweni lezimo eziphuthumayo eliseduze ngokushesha, noma ushayele inombolo yezimo eziphuthumayo efanele eSri Lanka (isib. 1926 National Mental Health Helpline).

Ukucela usizo ngemva kwesenzakalo esibuhlungu kungaba nzima kakhulu. Kodwa khumbula, ukuthola ukwelashwa kwe-CPTSD kubalulekile. Ngokuhamba kwesikhathi, ukwelashwa kungakusiza ukuthi welapheke. Khuluma nodokotela wakho ngezinketho zokwelapha. Balapha ukuzokusiza nokukusekela.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Ngakho-ke, sikhulume kakhulu nge-CPTSD namuhla. Njengoba ufunda lokhu, kungenzeka ukuthi usuqaphele ukuthi lesi simo sengqondo sibucayi futhi siyinkimbinkimbi kangakanani.

• I-CPSD iwukucindezeleka kwengqondo okubangelwa ukuhlukumezeka okunzima okuqhubekayo.
• Ngaphezu kwe-PTSD, lokhu kubangela nezinkinga ngokulawulwa kwemizwelo, ukuzethemba, kanye nokugcina ubudlelwano.
• Lesi simo singaba nzima ukusibona, kodwa uchwepheshe onolwazi angakwenza.
• Into engcono kakhulu ukuthi lesi simo singaphathwa kahle ngokwelashwa kwengqondo (ikakhulukazi i-Trauma-focused CBT, i-EMDR, i-CPT) kanye, uma kudingeka, nemithi.
• Uma unalezi zimpawu, ungahlupheki wedwa futhi nakanjani funa iseluleko sezokwelapha. Ukucela usizo akulona uphawu lobuthakathaka, kungenye yamandla amakhulu ongaba nawo kuwe.

Khumbula, noma ungeke ukwazi ukulawula okwenzekile esikhathini esidlule, ungathatha isinyathelo namuhla sokuthuthukisa ikusasa lakho. Ngikufisela amandla okwenza kanjalo!

I - CPSD, isifo sokucindezeleka esiyinkimbinkimbi ngemva kwenhlekelele, impilo yengqondo, ukuhlukumezeka, ukucindezeleka, ukwelashwa kwengqondo, i-PTSD