Sonke sizizwa sidabukile futhi sidangele ngezinye izikhathi. Kuvamile. Kodwa wake wazizwa ungenalutho olujulile ngaphakathi, ngaphandle kwesizathu esithile, umuzwa wokungabi nalutho ongasakulethi injabulo, ngisho nasezintweni owawuzijabulela, umuzwa wokuthi umhlaba wonke umnyama nomhlophe? Lokhu akusikho nje ukudabuka. Namuhla sizokhuluma ngesimo esinjalo, okungukuthi i-Melancholic Depression, uhlobo olubi kakhulu lwe-Depression. Lokhu akusikho ubuthakathaka engqondweni yakho, kodwa empeleni isimo sezokwelapha esihlobene nezinguquko emzimbeni, ikakhulukazi ohlelweni lwezinzwa oluphakathi.
Kuyini ngempela lokhu okubizwa ngokuthi ukucindezeleka kwe-Melancholic?
Kalula nje, ukucindezeleka kwe-Melancholic kuyindlela yokucindezeleka enzima kakhulu nejulile. Abanye abantu bayibiza nangokuthi i-Melancholia. Abacwaningi bakholelwa ukuthi lesi simo sithinta kakhulu uhlelo lwethu lwezinzwa oluphakathi. Phakathi kuka-25% no-30% wabantu abanokucindezeleka banalolu hlobo lokucindezeleka.
Ukwelapha lesi simo kungaba yinselele ngoba singase singasabeli kahle kwezinye zezindlela zokwelapha ukucindezeleka okuvamile, njengemithi efana ne-SSRIs (Selective serotonin reuptake inhibitors) noma ukwelashwa ngenkulumo.
Kodwa lokho akusho ukuthi akukho ukwelashwa ngakho. Kunezindlela ezimbili zokwelapha ezisebenza kahle kakhulu kulokhu:
- Ukwelashwa nge-electroconvulsive (ECT): Lokhu kuhilela ukuthumela izimpawu zikagesi ezincane kakhulu, ezilawulwayo ebuchosheni ukuze kuncishiswe izimpawu.
- Ama-Tricyclic antidepressants (TCAs): Lawa uhlobo lwemithi eyaqala ukwethulwa ngenxa yokucindezeleka.
Into ebalulekile ukuthi, noma izimpawu zalesi simo zinzima, ungakwazi ukulawula lezi zimpawu futhi uphile kahle ngosizo lochwepheshe wezempilo yengqondo oqeqeshiwe, okuhlanganisa nodokotela wakho.
Ziyini izimpawu zalesi simo?
Ukucindezeleka okudabukisayo akukhona nje ukudabuka noma ukukhala, kodwa futhi kunezimpawu zomzimba ezengeziwe. Ungase uzizwe ungenamandla futhi ungenalutho ngaphakathi. Ungase ungakwazi ngisho nokujabulela izinto ezinhle. Imicabango yakho kanye nokunyakaza kwakho kungase kwehle. Ake sihlukanise lezi zimpawu.
| Isigaba sezimpawu | Incazelo |
|---|---|
| Izici ezimbili eziyinhloko | 1. Ukulahlekelwa injabulo. 2. Ukungakwazi ukuphendula ngendlela enhle noma eyanelisayo. |
| Ezinye izici ezivamile |
|
| Izinguquko ekunyakazeni komzimba (izimpawu zengqondo) | |
| Izinguquko zokuziphatha |
|
| Ubuhlungu bomzimba | Ucwaningo oluthile lubonise ukuthi abantu abangafika ku-70% abanalesi simo bangase babe nobuhlungu bemisipha. |
Kungani lokhu kwenzeka? Yiziphi izizathu?
Isizathu esiyinhloko salokhu sibhekwa njengezinguquko zebhayoloji ebuchosheni bethu kanye nasesimisweni samahomoni. Cabanga nje, ubuchopho bethu bunezingxenye ezikhethekile ezilawula inkumbulo, imicabango, kanye nemizwa. Kukhona uhlelo oluxhunywe kulezi zinto futhi olusebenza olubizwa ngokuthi ``i-Hypothalamic-pituitary-adrenal (HPA) axis''. Kalula nje, lolu uhlelo oluyinhloko emzimbeni wethu olulawula izinto eziningi, njengokucindezeleka kanye nesifiso sokudla.
Kumuntu onesifo sokucindezeleka kwe-Melancholic, le axis ye-HPA ayisebenzi kahle. Ngakho-ke, uma sicindezelekile, i-hormone `(cortisol)` ekhiqizwa umzimba wethu isezingeni eliphezulu ngokungadingekile. Lokhu kwanda kwamazinga `(cortisol)` kungathinta ngqo isifiso sethu sokudla, i-metabolism, kanye nenkumbulo. Ngaphezu kwalokho, izinguquko ohlelweni lokubonisa (`(neurons)`) oluthwala imiyalezo phakathi kwamangqamuzana ezinzwa ebuchosheni nazo zingaba yimbangela.
Ubani osengozini enkulu yokuthola lesi simo?
- Ubudala: Izimpawu zokucindezeleka kwe-Melancholic zivame ukubonakala kamuva ekuphileni, okungukuthi, njengoba ukhula.
- Izakhi zofuzo: Lesi simo sivame ukwenzeka emindenini. Uma othile emndenini wakho eke waba nalolu hlobo lwesifo sengqondo ngaphambili, nawe ungase ube sengozini.
- Isimo Sezulu Nezinkathi Zonyaka: Kwabanye abantu, lezi zimpawu zingase zibe zimbi kakhulu ngezikhathi zokukhanya kwelanga okuphansi, amahora amafushane okukhanya kwelanga, kanye nesimo sezulu esibandayo.
- Izinguquko ngemva kokubeletha: Abanye omama abanokucindezeleka kwangemva kokubeletha nabo bangase babe nalezi zimpawu zokudabuka.
Udokotela uhlonza kanjani lokhu?
Udokotela wakho noma umeluleki wezempilo yengqondo uzoxilonga lesi simo ngemva kokutadisha ngokucophelela izimpawu zakho. Ukuze uxilongwe, kumele ube nesinye noma zombili lezi zimpawu ezilandelayo ezibalulekile:
Izici Eziyinhloko: Ukulahlekelwa yikhono lokujabulela impilo noma ukusabela ezintweni ezijabulisayo.
Ngaphezu kwalokho, kumele okungenani ube nezici ezintathu ezilandelayo:
- Umuzwa wokuphelelwa yithemba okujulile ongahlobene nosizi, njengokulahlekelwa othandekayo.
- Ukulahlekelwa yisifiso sokudla noma ukwehla okukhulu kwesisindo.
- Izinguquko ekunyakazeni ngokomzimba (ukuhamba kancane noma ukungaphumuli).
- Ukuzizwa ucindezelekile futhi udangele kakhulu ekuseni kunangezinye izikhathi zosuku.
- Ukuvuka okungenani amahora amabili ngaphambi kwesikhathi esilindelwe.
- Imizwa yecala elikhulu ngawe.
Yiziphi izindlela zokwelapha?
Ukucindezeleka okubangelwa ukudabuka kwemizwa kwelashwa ngenhlanganisela yemithi kanye nezinye izindlela zokwelapha.
| Indlela yokwelapha | Mane nje ngakho |
|---|---|
| Imithi (Ama-antidepressant) | Odokotela bavame ukunikeza uhlobo lwemithi ebizwa ngokuthi ama-tricyclic antidepressants (TCAs) . Imithi efana ne-Amitriptyline, i-Imipramine, ne-Nortriptyline ingeyalolu hlobo. Ngaphezu kwalokho, udokotela wakho angase ancome eminye imithi kuye ngesimo sakho. |
| Ukwelashwa nge-electroconvulsive (ECT) | Uma ezinye izindlela zokwelapha zingasebenzi, udokotela wakho angase akuphakamisele i-ECT. Lokhu kuhilela ukukufaka ngaphansi kwe-anesthesia ejwayelekile nokuthumela imifudlana kagesi emincane ebuchosheni bakho ukuze kubuyiselwe ibhalansi yamakhemikhali ebuchosheni futhi kuncishiswe izimpawu. Lokhu kuyindlela yokwelapha ephephile kakhulu futhi ephumelelayo. |
| Ukwelapha ngengqondo | Eyaziwa nangokuthi 'i-talk therapy', le ndlela ihilela ukukhuluma nodokotela wezifo zengqondo noma isazi sokusebenza kwengqondo ngemizwa yakho, imicabango, kanye nokuziphatha kwakho. Kodwa-ke, ngokungafani nezinye izinhlobo zokucindezeleka, lokhu kwelashwa kukodwa kungase kungasebenzi kahle ekucindezelekeni okudabukisayo. Kuvame ukusetshenziswa kanye nemithi. |
Ungaphila kanjani nalesi simo?
Udokotela wakho uzokwakha uhlelo lokwelashwa olukufanele. Ngenkathi ulandela lolo hlobo lokwelashwa, ungenza nezinguquko ezincane endleleni yakho yokuphila.
- Phuza imithi yakho njengoba nje uyalelwe: Phuza imithi yakho njengoba nje uyalelwe, ngesikhathi esifanele, futhi njalo thintana nodokotela wakho ngaphambi kokuthatha eminye imithi noma isithasiselo.
- Ukuzivocavoca: Yenza okuthile okunikeza umzimba wakho ukuzivocavoca nsuku zonke, njengokuhamba, ukubhukuda, ukudansa, noma i-yoga.
- Yenza ukulala kube yinto eza kuqala: Zijwayeze ukulala nokuvuka ngesikhathi esifanayo.
- Ukudla okunempilo: Yidla ukudla okunempilo nokulinganiselayo.
- Gwema ukubhema notshwala: Lokhu kungenza ukucindezeleka kube kubi nakakhulu.
- Chitha isikhathi nabangani: Khuluma futhi uchithe isikhathi nomndeni nabangane abakuthandayo nabakuqondayo.
Siza umuntu okhathalela umuntu onje.
Uma unelungu lomndeni noma umngane onalesi simo, ukwesekwa kwakho kubaluleke kakhulu. Kodwa ukunakekela umuntu onjalo akulula. Ungase uzizwe ukhathele, unesizungu futhi ucindezelekile. Ngakho-ke, kubaluleke kakhulu ukuzinakekela nawe.
- Cabanga nangempilo yakho: lala kahle, udle ukudla okunempilo, futhi uvivinye umzimba.
- Cela usizo: Ungazami ukwenza yonke into wedwa. Cela usizo kwamanye amalungu omndeni nabangani.
- Zinike ikhefu futhi: Zibekele isikhathi esincane usuku ngalunye. Funda incwadi, ulalele ingoma, yenza into oyithandayo.
- Funa iseluleko sezokwelapha uma uzizwa ucindezelekile: Uma ukucindezeleka kokunakekela othile kungabekezeleleki, khuluma nodokotela noma umeluleki ngakho.
Umlayezo Wokuya Nawe Ekhaya
- Ukucindezeleka okubangelwa ukudabuka akusikho ubuthakathaka benhliziyo noma umuzwa wobuvila. Kuyisifo sangempela esibangelwa izinguquko ebuchosheni nakuma-hormone.
- Isici esiyinhloko salokhu ukuthi ngisho nezinto ezazijabulisa ngaphambili azisenalo injabulo noma injabulo.
- Kunezindlela zokwelapha eziphumelela kakhulu (njengemithi ye-ECT kanye ne-TCA) zalesi simo.
- Uma wena noma othile omaziyo ebhekene nalezi zimpawu, kubaluleke kakhulu ukubonana nodokotela ngokushesha okukhulu bese ucela iseluleko, kunokuhlupheka wedwa.
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