Ingabe unenkinga yokulawula ukuqhuma kwentukuthelo okungazelelwe? Ake sixoxe nge-Intermittent Explosive Disorder (IED)!

Ingabe ngezinye izikhathi uyathukuthela ngento encane kangangokuthi awukwazi ngisho nokuyicabanga? Uyamemeza, uphonsa into phansi, noma ushaye umuntu? Lokhu kungaba yinto ejulile kunomkhuba omubi nje noma "umuntu othukuthela ngokushesha." Namuhla sizokhuluma ngalolu hlobo lokuqhuma kwentukuthelo okungazelelwe, isimo sempilo yengqondo esibizwa ngokuthi `(Intermittent Explosive Disorder - IED)`.

Kuyini "Isifo Sokuqhuma Esiqhubekayo - IED"?

Kalula nje, i-Intermittent Explosive Disorder (IED) yisimo sempilo yengqondo esibonakala ngokuziphatha okungazelelwe, okungalawuleki, okunolaka noma ukuqhuma kwentukuthelo. Into ebaluleke kakhulu ukuthi laba bantu basabela entukuthelweni ngendlela engalingani nhlobo nesimo. Ngisho nento encane kunzima kakhulu ukuba bayiphathe. Cabanga nje, uma othile egxuma phambi kwakho emgqeni, bese uthukuthela kakhulu uze uphume emotweni yakho uzibulale ngayo, lokho akuyona intukuthelo evamile.

Kodwa into emangalisayo ukuthi, uma bengathukuthele, abantu abane-"IED" baziphatha ngendlela evamile futhi kahle. Lesi yisimo esingaphansi kwesigaba se-"Impulse control disorders", okungukuthi, izifo lapho kunzima khona ukulawula imizwa ephakama engqondweni.

Ucwaningo luthole ukuthi abantu abangafika ku-80% abane-IED bangase babe nesinye isimo sempilo yengqondo. Esivame kakhulu kulezi yizinkinga zokukhathazeka, ukuphazamiseka kwengqondo okuguquguqukayo, i-autism, kanye nokukhubazeka kwengqondo.

Ubani othinteka kakhulu yilesi simo `(IED)`?

Lesi simo singathinta izingane ezineminyaka engu-6 noma abantu abadala. Kodwa-ke, sivame ukutholakala kubantu abadala abasebasha abangaphansi kweminyaka engu-40. Kuthiwa sivame kakhulu kwabesilisa .

Abacwaningi balinganisela ukuthi phakathi kuka-1.4% no-7% wabantu emhlabeni bangase babe ne-Intermittent Explosive Disorder. Lokhu kusho ukuthi nakuba kungavamile kakhulu, inani elikhulu labantu lihlushwa yilesi simo.

Yiziphi izimpawu ze-`(Intermittent Explosive Disorder - IED)`?

Isici esiyinhloko salesi simo ukuthi intukuthelo ivele iqhume ngokuzumayo ngendlela engafanele nhlobo, engahlosiwe, futhi engalingani nhlobo nesimo. Laba bantu bayazi ukuthi ukuziphatha kwabo akulungile futhi akufanelekile, kodwa ngaleso sikhathi bakuthola kunzima ukuzilawula.

Nansi indlela lezi zenzo zomsindo ezibangelwa yintukuthelo ezibangelwa yilezi:

• Akuyona into eyenziwa ngamabomu, kuyinto eyenzeka ngokuzumayo nangokungazelelwe. Akuyona into ehlelwe kusengaphambili.
• Le ntukuthelo iqala ngemizuzu embalwa nje kwenzeke okuthile (ukucasulwa).
• Le ntukuthelo ngokuvamile ayihlali isikhathi esingaphezu kwemizuzu engama-30.
• Lesi sigameko sibangela umuntu okukhulunywa ngaye ukucindezeleka okukhulu kwengqondo nokudabuka.
• Lokhu kuziphatha kubangela izinkinga esikoleni, emsebenzini nasekhaya.

Ivela kanjani le ntukuthelo?

Le ntukuthelo ingazibonakalisa ngezindlela eziningi. Nazi izibonelo ezimbalwa:

• Ukucasuka: Ukuziphatha okufana nokugingqika phansi, ukukhala, nokumemeza njengengane encane.
• Izinsongo ngamazwi: ukumemeza, ukusongela abanye, ukuthuka.
• Ukuhlasela abantu noma izilwane ngokomzimba: ukusunduza, ukushaya, ukushaya, futhi ngezinye izikhathi ngisho nokusebenzisa isikhali ukulimaza.
• Ukulimala kwempahla: ukuphonsa izinto ngokuthanda, ukukhahlela, ukuphula ifenisha, ukuvalela iminyango.
• Udlame lwasekhaya: Ukuhlukunyezwa kwamalungu omndeni.
• Ulaka lomgwaqo: Cabanga uthukuthele kakhulu uze ufune ukubulala umuntu ngoba esanda kukudlula emgwaqweni.

Lezi zenzakalo zolaka ngezinye izikhathi zingaba zincane, futhi ngezinye izikhathi zingaba zimbi kakhulu kangangokuthi othile angalimala kakhulu, noma aze afe.

Yiziphi izinto ongazizwa ngaphambi kokuba uthukuthele?

Ngaphambi kokuba kwenzeke ukuqhuma okukhulu okunje, ungase ube nezinye zalezi zimpawu:

• Intukuthelo, umuzwa wentukuthelo ongenakukwazi ukugcinwa engqondweni.
• Ukucasuka.
• Ngizwa ukucindezeleka okukhulu nokucindezeleka enhliziyweni yami.
• Kufana nemicabango engaphakathi kwekhanda lakho egijima ngesivinini esikhulu njalo.
• Angikwazi ukukhuluma kahle nabanye abantu.
• Kunjengokungathi umzimba wami unamandla engeziwe ngokuzumayo.
• Ukuthuthumela.
• Isilinganiso senhliziyo sikhuphuka ngokuzumayo (ukushaya kwenhliziyo).
• Ukuqina kwesifuba.

Ngemva kokukhululwa kwalentukuthelo, kuba nomuzwa wesikhashana wokukhululeka, kodwa bese kuvela imizwa yokudabuka, ukuzisola, kanye namahloni . Uyazibuza, "Ngenzeni?"

Kungani kwenzeka i-Intermittent Explosive Disorder (IED)?

Abacwaningi basazama ukuthola ukuthi yini ngempela ebangela lokhu, kodwa bacabanga ukuthi kungenxa yezici ezintathu eziyinhloko:

1. Izici zofuzo: Lokhu kungasebenza emindenini. Lokhu kusho ukuthi uma othile emndenini wakho enalesi simo, nawe unamathuba amaningi okuba naso. Izifundo zikhombisile ukuthi kunethonya lofuzo elingu-44% kuya ku-72% ekuthuthukisweni kokuziphatha okunjalo okungenangqondo nobudlova.

2. Izici zebhayoloji: Izinguquko esakhiweni nasekusebenzeni kobuchopho bethu zingaba nomthelela kulokhu. Isibonelo, ama-scan e-MRI (Magnetic Resonance Imaging) athole ukuthi ingxenye yobuchopho ebizwa ngokuthi i-amygdala, elawula imizwa yethu, iyathinteka. Bathole nokuthi amazinga e-neurotransmitter serotonin (ikhemikhali ethwala imiyalezo phakathi kwezinzwa futhi esebenza njenge-hormone) aphansi kunokujwayelekile kubantu abane-IED.

3.Izici Zemvelo: Ukuhlukunyezwa ngamazwi noma ngokomzimba useyingane, noma ukubona ukuhlukunyezwa ekhaya, kungadlala indima ekuthuthukisweni kwalesi simo. Futhi, isenzakalo esisodwa noma ngaphezulu esibuhlungu esihlangatshezwa ebuntwaneni singaba yimbangela.

Isifo Sokuqhuma Esiqhubekayo (IED) sitholakala kanjani?

Uma ucabanga ukuthi wena noma othile omaziyo, ikakhulukazi ingane yakho, bangase babe nalezi zimpawu, kubalulekile ukubona udokotela ofanelekayo kuqala . Cishe bazokudlulisela kuchwepheshe wezempilo yengqondo ochwepheshe ekuxilongeni nasekwelapheni lezi zimo. Lokhu kungaba udokotela wezifo zengqondo, isazi sokusebenza kwengqondo, noma isisebenzi sezenhlalo sezokwelapha.

Baxilonga i-IED besebenzisa izindlela ezithile ezivela ku-American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM). Bazokhuluma nawe ngokucophelela futhi bakubuze imibuzo ejulile mayelana nezimpawu zakho nokuziphatha kwakho. Bazokubuza imibuzo ngezinto ezifana nalezi:

• Umlando wezokwelapha wakho nomndeni wakho, ikakhulukazi mayelana nezimo zempilo yengqondo.
• Mayelana nobudlelwano bakho bomuntu siqu (Umlando wobudlelwano).
• Imininingwane yesikole nendawo yokusebenza.
• Mayelana nekhono lakho lokulawula izifiso zakho.

Ungase ukwazi ngisho nokuthola ulwazi mayelana nokuziphatha kwakho nomlando wakho emndenini wakho nakubangane abaseduze.

Ukuze utholakale une-``(IED)'' ngokuqinisekile, kufanele ubonise ukungakwazi ukulawula imizwa enamandla, njengokuthi:

• Noma, izehlakalo ezivame kakhulu, kodwa ezingalimazi kangako: okungukuthi, ulaka ngamazwi (ukumemeza, ukusongela, ukuphikisana) noma ulaka olungokomzimba empahleni, ezilwaneni, noma kubantu (kodwa ngaphandle kokulimala okukhulu noma umonakalo wempahla) okwenzeka okungenani kabili ngesonto izinyanga ezintathu .
• Noma, izehlakalo ezingavamile kodwa ezingathi sína: Izehlakalo ezintathu zomonakalo wempahla kanye/noma ukuhlaselwa kwezilwane noma abantu okuholela ekulimaleni, zingakapheli izinyanga eziyi-12 (unyaka owodwa) .

Into ebaluleke kakhulu ukuthi izinga lentukuthelo alilingani nesimo futhi linzima ngendlela engavamile. Futhi lezi akuzona izenzo ezihleliwe kusengaphambili. Zenzeka ngokuzumayo, ngenxa yentukuthelo noma ukuphazama. Futhi, udokotela uzoqinisekisa ukuthi lezi zimpawu azibangelwa esinye isifo sengqondo, esinye isifo somzimba, noma ukusetshenziswa kwezidakamizwa.

Umuntu kumele okungenani abe neminyaka eyi-6 ubudala ukuze atholakale enalesi simo, kodwa ngokuvamile siqala ukubonakala ebuntwaneni noma ebusheni.

Yiziphi izindlela zokwelapha i-"Intermittent Explosive Disorder - IED"?

Ukwelashwa kwalesi simo ikakhulukazi ukwelashwa kwengqondo (ukwelashwa ngokukhuluma) futhi ngezinye izikhathi imithi. Udokotela wakho uzonquma ngokusekelwe eminyakeni yakho, uhlobo kanye nobunzima bezimpawu zakho.

Umgomo oyinhloko wokwelashwa ukufeza ukuphulukiswa okuphelele kwezimpawu, noma okungenani ukunciphisa ubukhali besibonakaliso esisodwa noma ezimbili. Nakuba abanye abantu bengase bangakwazi ukululama ngokugcwele, umgomo okungenani ukugcina umuntu ephephile kanye nabanye nokunciphisa ukuvama, amandla, kanye nokuvama kokuqubuka kwesifo.

`(Ukwelashwa Ngengqondo)` kwe-`(IED)`

Ukwelashwa kwengqondo kuyindlela eyinhloko nebaluleke kakhulu yokwelapha lokhu. Ikakhulukazi , i-Cognitive Behavioral Therapy (CBT) isetshenziswa ngempumelelo kakhulu kule njongo.

>`(CBT)` iyindlela yokwelapha ehlelekile negxile emigomweni. Kulokhu, umelaphi uyakusiza ukuthi ubheke ngokujulile imicabango nemizwa yakho. Ungaqonda ukuthi imicabango yakho ithinta kanjani izenzo zakho. `(CBT)`, ungasusa imicabango engalungile, elimazayo kanye namaphethini okuziphatha okubi ekhanda lakho bese ufunda ukucabanga nokuziphatha ngendlela enempilo esikhundleni salokho. `(IED)` ingasiza abantu abane-`(CBT)` ukuthi baphathe izimo ezinzima empilweni yansuku zonke futhi balawule izifiso ezivusa intukuthelo.

Amanye amasu athile asetshenziswa ku-IED ku-CBT yile:

• Ukuhlelwa kabusha kwengqondo: Lokhu kuhilela ukuhlonza nokushintsha imibono eyiphutha kanye nemicabango emibi onayo ngezenzakalo ezivusa intukuthelo noma izinto ozibona njengezinsongo.
• Ukuqeqeshwa kokuphumula: Ukuphefumula okujulile kanye nokuphumula kwemisipha okuqhubekayo (indlela lapho uqinisa futhi uphumuza kancane kancane imisipha emzimbeni wakho ngenkathi ucabanga ngezimo ezivusa intukuthelo) kungakusiza ukunciphisa impendulo yakho entukuthelweni.
• Ukuqeqeshwa kwamakhono okubhekana nesimo: Ukulingisa nodokotela wezifo zengqondo, izimo lapho intukuthelo ingavuka khona, kanye nokuzijwayeza izimpendulo ezinempilo, njengokusuka endaweni yesehlakalo.
• Ukuvimbela ukuphinda ubuye: Abantu abane-IED bafundiswa ukuthi kuyinto evamile ukuba baphindele ekuziphatheni okunolaka, nokuthi akufanele kubhekwe njengokwehluleka, kodwa 'njengephutha' elincane noma 'ukubuyela emuva'.

Imithi ye-`(IED)`

Eminye imithi ingandisa "umkhawulo" wakho, okusho ukuthi ungathukuthela kancane ngisho nangezinto ezincane kakhulu.

I-Fluoxetine (i-Selective Serotonin Reuptake Inhibitor - SSRI) iyisidakamizwa esifundwe kabanzi sokwelapha i-IED. Eminye imithi eye yacwaningwa nge-IED ifaka phakathi i-Phenytoin, i-Lithium, i-Oxcarbazepine, ne-Carbamazepine.

Odokotela bangase banikeze lezi zinhlobo zemithi ye-IED:

• `(Imithi yokucindezeleka)`
• `(Ama-antipsychotics)` (imithi yokugula kwengqondo)
• `(Imithi Yokuquleka)` (imithi enikezwa izimo ezifana nesifo sokuwa)
• `(Imithi yokuvimbela ukucindezeleka)` (Imithi yokuvimbela ukucindezeleka)
• `(Izilawuli zemizwa)` (izidakamizwa eziqinisa imizwa)

Okubalulekile: Le mithi kufanele ithathwe kuphela ngaphansi kokuqondisa kukadokotela, ngesilinganiso esinqunyiwe, nangesikhathi esinqunyiwe. Ukuthatha noma ukuyeka imithi ngokuthanda kwakho kungabangela imiphumela emibi kakhulu.

Yiziphi izici eziyingozi zokuthuthukisa i-Intermittent Explosive Disorder (IED)?

Abacwaningi bathole izici eziningana eziyingozi ezibangela lesi simo:

• Ukuba ngumuntu osemusha.
• Ukuntuleka kwemisebenzi.
• Ukuba ongashadile (ongashadile).
• Izinga lemfundo eliphansi kakhulu.
• Ukuxhashazwa ngokomzimba noma ngokocansi, ikakhulukazi ngesikhathi sobuntwana.
• Ukuba nelungu lomndeni eliseduze elinesifo sokuqhuma kwesikhashana.

Uma unokwesaba noma ukungabaza ukuthi ingane yakho ingaba nalesi simo, kungcono ukukhuluma nodokotela ngaso.

Iyini i-prognosis yomuntu onesifo sokuqhuma kwesikhashana (i-IED)?

Izifundo zibonisa ukuthi abantu abane-IED banokwaneliseka okuncane empilweni kanye nekhwalithi yokuphila ephansi. Lokhu kungaba nomthelela omubi empilweni yakho iyonke, futhi kungabangela izinkinga ezinkulu empilweni yakho, empilweni yomndeni, emsebenzini, nasebudlelwaneni nabantu.

Izindaba ezinhle ukuthi i-IED ingaphathwa ngempumelelo nge-Cognitive Behavioral Therapy (CBT) kanye, uma kudingeka, nemithi. Kodwa-ke, kubalulekile ukukhumbula ukuthi izifundo zibonisa ukuthi i-IED ivame ukuba yisimo sesikhathi eside, esihlala iminyaka eyi-12-20, noma ngisho nokuphila konke.

Ngaphezu kwalokho, abantu abane-IED banamathuba amaningi okubhekana nezimo ezilandelayo:

• `(Ukucindezeleka)` (Ukucindezeleka)
• `(Ukukhathazeka)` (Ukukhathazeka)
• `(Inkinga yokusebenzisa utshwala)` (Ukuluthwa utshwala)
• `(Inkinga yokusebenzisa izidakamizwa)` (Ukulutheka kwezinye izidakamizwa)

Kubaluleke kakhulu: Abantu abane-IED basengozini enkulu yokuzilimaza (isib., ukuzisika, ukuzishisa) nokuzibulala. Ngakho-ke, uma ucabanga ukuthi wena noma othile emndenini wakho angase abe ne-Intermittent Explosive Disorder, kubalulekile ukufuna iseluleko sezokwelapha ngokushesha okukhulu.

Ngingazinakekela kanjani uma nginesifo sokuqhuma esiqhubekayo (i-IED)?

Uma utholakale une-Intermittent Explosive Disorder, kunezinto ezibalulekile ongazenza ukuze uzinakekele. Okubaluleke kakhulu kulokhu ukufuna ukwelashwa kochwepheshe nokwezokwelapha bese unamathela kukho. Ekwelashweni, ungafunda izinto eziningi ezingakusiza ukuvimbela intukuthelo ukuthi ingenzeki, futhi uma isenzeka, uyilawule:

• Amasu okuphumula: Izinto ezifana nokuzivocavoca okujulile kokuphefumula kanye nokuzindla.
• Ukushintsha indlela ocabanga ngayo (Ukuhlelwa kabusha kwengqondo): Ukubona nokushintsha imicabango ebangela intukuthelo.
• Amakhono okuxhumana: Ukufunda ukuveza imizwa yakho nezidingo zakho ngokucacile kwabanye ngaphandle kwentukuthelo.
• Shintsha indawo okuyo, futhi ufunde ukubalekela izindawo ezicindezelayo uma kungenzeka: Ngezinye izikhathi, ukusuka nje endaweni noma kumuntu isikhashana kungenza umehluko omkhulu.

Enye into ebaluleke kakhulu ukugwema ngokuphelele utshwala nezinye izidakamizwa. Lokhu kunganciphisa kakhulu ikhono lakho lokulawula izifiso zakho futhi kwandise ingozi yakho yokuziphatha kobudlova.

Kufanele ngimbone nini udokotela mayelana `(Intermittent Explosive Disorder - IED)`?

Uma wena noma ingane yakho nitholakale ninesifo sokuqhuma kwesikhashana, kufanele nihlangane nethimba lakho lezokwelapha (udokotela, uchwepheshe wezokwelapha) njalo ukuze nibone ukuthi ukwelashwa kwenu (i-psychotherapy kanye/noma imithi) kuyasebenza yini nokuthi kukhona yini izinguquko okudingeka zenziwe.

Uma ukuziphatha kwakho noma kwengane yakho kubangela ukulimala noma ingozi kwabanye (abanye abantu, izilwane), funa usizo lwezokwelapha ngokushesha. Futhi, uma umuntu one-`(IED)` ecabanga ngokuzilimaza noma ukuzama ukuzibulala, usizo luyadingeka ngokushesha. Sicela wazise udokotela noma umuntu omethembayo ngokushesha, noma ubhekisele esikhungweni sezempilo yengqondo esiseduze (isib., iyunithi yezifo zengqondo yesibhedlela sikahulumeni).

Khumbula, i-Intermittent Explosive Disorder (IED) yisimo sempilo yengqondo. Akuyona umkhuba omubi noma umkhuba omubi. Njenganoma yisiphi isifo sengqondo, ukufuna usizo ngokushesha nje lapho ubona izimpawu kungasiza ekunciphiseni ukuphazamiseka nezinkinga empilweni yakho. Ochwepheshe bezempilo yengqondo bangakunikeza uhlelo lokwelashwa olufanela wena futhi lukusize ulawule imicabango yakho nokuziphatha kwakho.

Imindeni kanye nabathandekayo babantu abane-IED bavame ukuzizwa becindezelekile kakhulu, becindezelekile, futhi benesizungu. Kubalulekile ukunakekela impilo yakho yengqondo nokufuna usizo uma unalezi zimpawu. Uma usebudlelwaneni nomuntu one-IED, cabanga ngokuthatha izinyathelo zokuzivikela wena nezingane zakho.

Izinto ezibaluleke kakhulu okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, ake sifingqe ezinye zezinto ezibaluleke kakhulu okudingeka uzikhumbule kulokho esikhulume ngakho.

• Isifo Sokuqhuma Esiqhubekayo (IED) siyisimo sangempela sempilo yengqondo. Akuyona nje "intukuthelo embi" noma "intukuthelo embi."
• Lesi simo singaphathwa ngempumelelo ngokwelashwa kwengqondo, futhi uma kudingeka, ngemithi.
• Kungcono ukuthola usizo nokwelashwa ngokushesha okukhulu ukuze izinkinga zixazululwe zingakabi zimbi kakhulu.
• Ungabi namahloni okucela usizo esimweni esinjengalesi. Awuwedwa.
• Njengomuntu one-IED, amalungu omndeni wakhe adinga ukwesekwa nosizo. Nawo angahlupheka ngenxa yalokhu.

Uma uneminye imibuzo mayelana nalokhu, sicela ukhulume nodokotela noma nomeluleki wezempilo yengqondo oqeqeshiwe.

Isifo Sokuqhuma Esiqhubekayo , i-IED, ukuphathwa kwentukuthelo, ukuziphatha okungazelelwe, impilo yengqondo, i-CBT, ukwelashwa