Mafunso 6 Ofunsa Dokotala Wanu Ngati Zizindikiro Zanu za MDD Siziwongolera

Zamkati

• 1. Kodi ndikumwa mankhwala oyenera?
• 2. Kodi ndimamwa mankhwala osokoneza bongo?
• 3. Kodi ndikumwa mankhwala oyenera?
• 4. Kodi zina mwa njira zanga zochiritsira ndi ziti?
• 5. Kodi pangakhale zina zomwe zikuyambitsa matenda anga?
• 6. Mukutsimikiza kuti ndili wokhumudwa?

Antidepressants amagwira bwino ntchito kuthana ndi matenda omwe ali ndi vuto lalikulu lachisokonezo (MDD). Komabe gawo limodzi mwa magawo atatu a anthu apeza mpumulo wokwanira kuzizindikiro zawo ndi mankhwala oyamba omwe amayesa. Pafupifupi anthu omwe ali ndi MDD sadzapeza mpumulo wathunthu kwa wopanikizika, ngakhale atatenga yani poyamba. Ena adzachira kwakanthawi, koma pamapeto pake, zizindikilo zawo zimatha kubwerera.

Ngati mukukumana ndi zinthu monga chisoni, kugona mokwanira, komanso kudzidalira komanso mankhwala sakuthandizani, ndi nthawi yoti mukalankhule ndi dokotala za zina zomwe mungachite. Nawa mafunso asanu ndi limodzi oti akutsogolereni pazokambiranazi ndikufikitsani munjira yoyenera yothandizira.

1. Kodi ndikumwa mankhwala oyenera?

Mpaka theka la anthu omwe ali ndi vuto la kupsinjika mtima samatenga mankhwala oponderezana ndi momwe dokotala wawo adawauzira - kapena ayi. Kudumpha mlingo kungakhudze momwe mankhwala amagwirira ntchito.

Ngati simunachite kale, pitani malangizo a dosing kuti muwonetsetse kuti mukumwa mankhwalawo moyenera. Osasiya kumwa mankhwala mwadzidzidzi kapena popanda kufunsa dokotala. Ngati mavuto akukuvutitsani, funsani dokotala ngati mungathe kusintha mlingo wochepa, kapena mankhwala ena omwe ali ndi zotsatira zochepa.

2. Kodi ndimamwa mankhwala osokoneza bongo?

Mitundu ingapo yama antidepressants imavomerezedwa kuchiza MDD. Dokotala wanu atha kukuyambitsani pa serotonin reuptake inhibitor (SSRI) ngati fluoxetine (Prozac) kapena paroxetine (Paxil).

Zosankha zina ndi izi:

• serotonin-norepinephrine
  reuptake inhibitors (SNRIs) monga duloxetine (Cymbalta) ndi venlafaxine (Effexor
  Zamgululi
• antidepressants atypical
  monga bupropion (Wellbutrin) ndi mirtazapine (Remeron)
• alirazamalik
  antidepressants monga nortriptyline (Pamelor) ndi desipramine (Norpramin)

Kupeza mankhwala omwe amakugwirirani ntchito kumatha kuyesedwa. Ngati mankhwala oyamba omwe mumayesa sakuthandiza patatha milungu ingapo, dokotala wanu akhoza kukusinthani kuti mupeze mankhwala ena opanikizika. Khalani oleza mtima, chifukwa zimatha kutenga milungu itatu kapena inayi kuti mankhwala anu ayambe kugwira ntchito. Nthawi zina, zimatha kutenga masabata 8 musanaone kusintha kwakusintha kwanu.

Njira imodzi yomwe dokotala angakufananitseni ndi mankhwala oyenera ndi kuyesa kwa cytochrome P450 (CYP450). Kuyesaku kumayang'ana mitundu ina ya majini yomwe imakhudza momwe thupi lanu limagwiritsira ntchito mankhwala opatsirana. Izi zitha kuthandiza dokotala kudziwa kuti ndi mankhwala ati omwe angakonzedwe bwino ndi thupi lanu, zomwe zingayambitse zovuta zina ndikuchita bwino.

3. Kodi ndikumwa mankhwala oyenera?

Dokotala wanu angakuyambitseni pa mlingo wochepa wa mankhwala opatsirana pogonana kuti muwone ngati ikugwira ntchito. Ngati sizitero, pang'onopang'ono aziwonjezera mlingo. Cholinga ndikukupatsani mankhwala okwanira kuti muchepetse matenda anu, osayambitsa zovuta zina.

4. Kodi zina mwa njira zanga zochiritsira ndi ziti?

Mankhwala opatsirana pogonana si njira yokhayo yothandizira MDD. Muthanso kuyesa psychotherapy monga chidziwitso cha machitidwe othandizira (CBT). Ndi CBT, mumagwira ntchito ndi othandizira omwe amakuthandizani kuzindikira malingaliro oyipa ndikupeza njira zothanirana ndi zovuta pamoyo wanu. amapeza kuti kuphatikiza kwa mankhwala ndi CBT kumayenda bwino pazizindikiro zakukhumudwa kuposa chithandizo chamankhwala chokha.

Vagus nerve stimulation (VNS) ndi mankhwala ena omwe madokotala amagwiritsa ntchito kukhumudwa pamene mankhwala opatsirana pogonana sagwira ntchito. Mu VNS, waya amalumikizidwa pamitsempha ya vagus yomwe imachokera kumbuyo kwa khosi lanu kupita kuubongo wanu. Amalumikizidwa ndi chida chokhala ngati pacemaker chomwe chimatumiza mphamvu zamagetsi kuubongo wanu kuti muchepetse zofooka.

Chifukwa cha kukhumudwa kwakukulu, mankhwala a electroconvulsive therapy (ECT) ndi njira inanso. Izi sizomwezi "chithandizo chodzidzimutsa" chomwe chimaperekedwa kwa odwala m'malo otetezera amisala. ECT ndi mankhwala otetezeka komanso othandiza pakukhumudwa komwe kumagwiritsa ntchito mafunde amagetsi ofatsa poyesa kusintha zamaubongo aubongo.

5. Kodi pangakhale zina zomwe zikuyambitsa matenda anga?

Pali zifukwa zambiri zomwe zingawonjezere kukhumudwa. Ndizotheka kuti china chake chomwe chikuchitika m'moyo wanu chikukupweteketsani inu, ndipo mankhwala pawokha sikokwanira kuthana ndi vutoli.

Taganizirani izi zina zomwe zingayambitse kukhumudwa:

• zovuta zaposachedwa m'moyo,
  monga kutaya wokondedwa, kupuma pantchito, kusamuka kwakukulu, kapena kusudzulana
• kusungulumwa pakukhala
  wekha kapena osagwirizana mokwanira
• shuga wambiri, wokonzedwa
  zakudya
• masewera olimbitsa thupi ochepa
• Kupsinjika kwakukulu kuchokera ku a
  ntchito yovuta kapena ubale wopanda thanzi
• kugwiritsa ntchito mankhwala osokoneza bongo kapena mowa

6. Mukutsimikiza kuti ndili wokhumudwa?

Ngati mwayesapo antidepressants angapo ndipo sanagwire ntchito, ndizotheka kuti matenda ena kapena mankhwala omwe mumamwa ndi chifukwa chake mukukumana ndi zizindikiro za MDD.

Zinthu zomwe zingayambitse matenda okhumudwa ndi monga:

• wokangalika kapena
  chithokomiro chosagwira ntchito (hypothyroidism kapena hyperthyroidism)
• kulephera kwa mtima
• lupus
• Matenda a Lyme
• matenda ashuga
• matenda amisala
• multiple sclerosis (MS)
• sitiroko
• Matenda a Parkinson
• kupweteka kosalekeza
• kuchepa kwa magazi m'thupi
• matenda obanika kutulo
  (OSA)
• kugwiritsa ntchito mankhwala osokoneza bongo
• nkhawa

Mankhwala omwe angayambitse zizindikiro zowawa ndi awa:

• kupweteka kwa opioid kumachepetsa
• kuthamanga kwa mankhwala a magazi
• corticosteroids
• mapiritsi olera
• mankhwala ogonetsa

Ngati mankhwala akuyambitsa matenda anu, kusintha mankhwala ena kungathandize.

Ndizothekanso kuti muli ndi vuto linanso lamaganizidwe, monga matenda amisala.Ngati ndi choncho, muyenera kukambirana ndi dokotala njira zina zamankhwala. Matenda a bipolar ndi matenda ena amisala amafuna chithandizo chosiyanasiyana kuchokera ku MDD.