I-Postpartum Psychosis: Izimpawu Nezinsizakusebenza

-Delile

• Lithini izinga lokuvela kwengqondo yangemva kokubeletha?
• I-Postpartum psychosis vs.ukucindezeleka kwangemva kokubeletha
• I-Postpartum blues
• Ukudangala kwangemva kokubeletha
• I-Postpartum psychosis
• Izimpawu zengqondo ngemuva kokubeletha
• Yiziphi izinto eziyingozi?
• Odokotela bayihlola kanjani i-postpartum psychosis?
• Ukwelashwa kwengqondo ngemuva kokubeletha
• Umbono we-postpartum psychosis
• Q:
• A:

Isingeniso

Ukubeletha ingane kuletha ushintsho oluningi, futhi lokhu kungafaka ushintsho kumzwelo nomzwelo kamama omusha. Abanye besifazane babhekana nokunyuka nokwehla okujwayelekile kwesikhathi sokubeletha. Izici eziningi zidlala indima empilweni yengqondo ngemuva kokubeletha. Ngalesi sikhathi, ukuphela okunzima kakhulu kwe-spectrum yokushintsha yisimo esaziwa nge-postpartum psychosis, noma i-puerperal psychosis.

Lesi simo senza ukuthi owesifazane abe nezimpawu ezingamethusa. Angase ezwe amazwi, abone izinto ezingelona iqiniso, futhi ezwe imizwa eyeqile yokudabuka nokukhathazeka. Lezi zimpawu zidinga ukwelashwa okuphuthumayo.

Lithini izinga lokuvela kwengqondo yangemva kokubeletha?

Kulinganiselwa ukuthi u-1 kuye kwababili kwabesifazane abangu-1 000 baba nesifo sengqondo ngemuva kokubeletha. Isimo asivamile futhi sivame ukwenzeka zingakapheli izinsuku ezimbili noma ezintathu kokubeletha.

I-Postpartum psychosis vs.ukucindezeleka kwangemva kokubeletha

Odokotela bathole izinhlobo eziningana zezifo zengqondo zangemva kokubeletha. Amanye amagama ajwayelekile okungenzeka ukuthi uzwile ngawo afaka:

I-Postpartum blues

Kulinganiselwa ukuthi amaphesenti angama-50 kuya kwangu-85 abesifazane ahlangabezana nokuhlanya kokubeletha kungakapheli amasonto ambalwa ebelethile. Izimpawu ezihambisana ne-postpartum blues noma "baby blues" zifaka:

• ukukhala
• ukukhathazeka
• ukucasuka
• izinguquko ezisheshayo kwemizwa

Ukudangala kwangemva kokubeletha

Lapho izimpawu zokucindezeleka zihlala ngaphezu kwamasonto amabili kuya kwamathathu futhi ziphazamisa ukusebenza kowesifazane, angaba nokudangala kwangemva kokubeletha. Izimpawu ezihambisana nalesi simo zifaka:

• isimo esidabukisayo njalo
• imizwa yecala
• ukungabi nalutho, noma ukungafaneleki
• ukukhathazeka
• ukuphazamiseka kokulala nokukhathala
• ubunzima bokugxila
• izinguquko zokudla

Owesifazane onokudangala kwangemva kokubeletha naye angaba nemicabango yokuzibulala.

I-Postpartum psychosis

Odokotela abaningi bacabanga ukuthi i-postpartum psychosis inemiphumela emibi kakhulu yezempilo yengqondo.

Akuvamile ukuthi bonke omama abasha babe neziqephu zosizi, ukwesaba, nokukhathazeka. Lapho lezi zimpawu ziqhubeka noma ziphenduka imicabango engaba yingozi, kufanele zifune usizo.

Izimpawu zengqondo ngemuva kokubeletha

I-Psychosis yilapho umuntu elahlekelwa ukuxhumana neqiniso. Bangase baqale ukubona, ukuzwa, kanye / noma ukukholwa izinto ezingelona iqiniso. Lo mphumela ungaba yingozi kakhulu kumama omusha nasenganeni yakhe.

Izimpawu zengqondo ngemuva kokubeletha ziyefana nalezi ze-bipolar, isiqephu somuntu. Isiqephu ngokuvamile siqala ngokungakwazi ukulala nokuzizwa ungenakho ukuphumula noma ukucasuka ikakhulukazi. Lezi zimpawu zingena esikhundleni sezimbi kakhulu. Izibonelo zifaka:

• ukubona izinto ezingekho (ukuzwa izinto ezingelona iqiniso, njengeziphakamiso zomama zokuzilimaza noma ukuthi ingane izama ukumbulala)
• izinkolelo eziyinkohliso ezivame ukuhlobana nosana, njengokuthi abanye bazama ukulimaza ingane yakhe
• kudidekile ngendawo nesikhathi
• ukungaziphathi ngendlela engajwayelekile
• ukuguquka kwemizwa ngokushesha kusuka ekudabukeni okwedlulele kuya ekubeni namandla kakhulu
• imicabango yokuzibulala
• imicabango enobudlova, njengokutshela umama ukuthi alimaze ingane yakhe

I-Postpartum psychosis ingaba nzima kumama nezingane zakhe. Uma lezi zimpawu zenzeka, kubalulekile ukuthi owesifazane athole usizo lwezokwelashwa ngokushesha.

Yiziphi izinto eziyingozi?

Ngenkathi abanye besifazane bengaba nengqondo yangemva kokubeletha bengenazo izinto eziyingozi, kunezici ezithile ezaziwa ngokwengeza ubungozi besifazane kulesi simo. Kubandakanya:

• umlando wesifo se-bipolar
• umlando we-postpartum psychosis ekukhulelweni kwangaphambilini
• umlando wesifo se-schizoaffective noma i-schizophrenia
• umlando womndeni we-postpartum psychosis noma i-bipolar disorder
• ukukhulelwa kokuqala
• ukuyekiswa kwemithi yengqondo yokukhulelwa

Izimbangela eziqondile zengqondo yangemva kokubeletha azaziwa. Odokotela bayazi ukuthi bonke abesifazane esikhathini sokubeletha babhekene nokushintshashintsha kwamazinga ama-hormone. Kodwa-ke, abanye babonakala bezwela kakhulu emiphumeleni yempilo yengqondo yezinguquko kumahomoni afana ne-estrogen, progesterone, kanye / noma ama-hormone e-thyroid. Ezinye izici eziningi zezempilo zingaba nomthelela ezimbangela zengqondo yangemva kokubeletha, kufaka phakathi izakhi zofuzo, isiko, kanye nezimo zemvelo kanye nezebhayoloji. Ukungalali kahle nakho kungadlala indima.

Odokotela bayihlola kanjani i-postpartum psychosis?

Udokotela uzoqala ngokukubuza ngezimpawu zakho nokuthi unesikhathi esingakanani uhlangabezana nazo. Bazobuza futhi ngomlando wakho wezokwelapha owedlule, kufaka phakathi uma ngabe uke waba nomlando we:

• ukudana
• ukuphazamiseka kwengqondo okuguquguqukayo
• ukukhathazeka
• okunye ukugula ngengqondo
• umlando wezempilo yengqondo yomndeni
• imicabango yokuzibulala, noma ukulimaza ingane yakho
• ukusetshenziswa kabi kwezidakamizwa

Kubalulekile ukuthi uthembeke futhi uvule ngangokunokwenzeka nodokotela wakho ukuze uthole usizo oludingayo.

Udokotela uzozama ukukhipha ezinye izimo nezinto ezingadala ushintsho ekuziphatheni, njengamahomoni wegilo noma ukutheleleka kwangemva kokubeletha. Ukuhlolwa kwegazi kwamazinga ama-hormone e-thyroid, ukubalwa kwamaseli amhlophe egazi, nolunye ulwazi olufanele kungasiza.

Udokotela angacela owesifazane ukuthi aqedele ithuluzi lokuhlola ukucindezeleka. Le mibuzo yenzelwe ukusiza odokotela ukukhomba abesifazane ababhekene nokudangala kwangemva kokubeletha kanye / noma ne-psychosis.

Ukwelashwa kwengqondo ngemuva kokubeletha

I-Postpartum psychosis yisimo esiphuthumayo sezokwelapha. Umuntu kufanele abize u-911 futhi afune ukwelashwa egumbini labezimo eziphuthumayo, noma omunye umuntu abathathe ayise egumbini lezimo eziphuthumayo noma esikhungweni sezinhlekelele. Imvamisa, owesifazane uzothola ukwelashwa esikhungweni seziguli ezingalalisiwe okungenani izinsuku ezimbalwa kuze kube yilapho isimo sakhe sengqondo sesizinzile futhi akasekho engozini yokuzilimaza yena noma ingane yakhe.

Ukwelashwa ngesikhathi sesiqephu se-psychotic kufaka phakathi imishanguzo yokwehlisa ukucindezeleka, ukuzinzisa imizwa, nokunciphisa isifo sengqondo. Izibonelo zifaka:

• Ama-antipsychotic: Le mithi inciphisa izehlakalo zokuba nemibono. Izibonelo zifaka phakathi i-risperidone (Risperdal), i-olanzapine (i-Zyprexa), i-ziprasidone (i-Geodon), ne-aripiprazole (Abilify).
• Ukuqiniswa kwemizwelo: Le mithi inciphisa iziqephu zomuntu. Izibonelo zifaka i-lithium (Lithobid), i-carbamazepine (iTegretol), i-lamotrigine (i-Lamictal), ne-divalproex sodium (i-Depakote).

Ayikho inhlanganisela eyodwa ekahle yemithi ekhona. Owesifazane ngamunye uhlukile futhi angaphendula kangcono kuma-anti-depressants noma emithini yokulwa nokukhathazeka esikhundleni noma ngokuhlanganiswa nomuthi ovela ezigabeni ezingenhla.

Uma owesifazane engaphenduli kahle emithini noma edinga ukwelashwa okuqhubekayo, i-electroconvulsive shock therapy (ECT) ivame ukusebenza kahle kakhulu. Lokhu kwelashwa kubandakanya ukufaka inani elilawulwayo lokukhuthaza ugesi ebuchosheni bakho.

Umphumela udala isiphepho noma umsebenzi ofana nokuquleka ebuchosheni okusiza "ukusetha kabusha" ukungalingani okwenze isiqephu se-psychotic. Odokotela basebenzise i-ECT ngokuphepha iminyaka ukwelapha ukucindezeleka okukhulu kanye ne-bipolar disorder.

Umbono we-postpartum psychosis

Izimpawu ezinzima kakhulu ze-postpartum psychosis zingahlala noma kuphi ukusuka emavikini amabili kuya kwayi-12. Abanye besifazane bangadinga isikhathi eside ukuthi balulame, kusuka ezinyangeni eziyisithupha kuya kweziyi-12. Noma sezihambile izimpawu ezinkulu zengqondo, abesifazane bangaba nemizwa yokudangala kanye / noma nokukhathazeka. Kubalulekile ukuhlala kunoma imiphi imithi enqunyiwe futhi ufune ukwelashwa okuqhubekayo nokusekelwa kwalezi zimpawu.

Abesifazane abancelisa izingane zabo ibele kufanele babuze udokotela wabo ngokuphepha. Imithi eminingi esetshenziselwa ukwelapha i-postpartum psychosis idluliswa ngobisi lwebele.

Kulinganiselwa ukuthi amaphesenti angama-31 abesifazane abanomlando wokugula kwengqondo ngemuva kokubeletha bazophinde babhekane nalesi simo kokunye ukukhulelwa, ngokusho kocwaningo olushicilelwe kwiThe American Journal of Psychiatry.

Lezi zibalo akufanele zikuvimbe ekutholeni enye ingane, kodwa kuyinto okufanele uyikhumbule njengoba ulungiselela ukulethwa. Kwesinye isikhathi udokotela uzonikeza isisimamisi semizwa njenge-lithium okufanele sithathwe ngowesifazane ngemuva kokubeletha. Lokhu kungahle kuvimbele i-postpartum psychosis.

Ukuba nesiqephu se-postpartum psychosis akusho ukuthi uzoba neziqephu zesikhathi esizayo zengqondo noma zokudangala. Kepha kusho ukuthi kubalulekile ukuthi wazi izimpawu nokuthi ungalutholaphi usizo lwezokwelapha uma izimpawu zakho ziqala ukubuya.

Q:

Owesifazane obhekene nezimpawu noma othile obheke ukunakekela othandekayo angalutholaphi usizo lwe-postpartum psychosis?

Isiguli esingaziwa

A:

Shayela ku-911. Chaza ukuthi wena (noma umuntu omkhathalelayo) usanda kuba nengane bese uchaza lokho okuhlangabezanwe nakho noma okufakazelwa ngakho. Yisho ukukhathazeka kwakho ngokuphepha nenhlalakahle. Abesifazane abanesifo sengqondo ngemuva kokubeletha basenkingeni futhi badinga usizo esibhedlela ukuze bahlale bephephile. Ungashiyi owesifazane yedwa ohlangabezana nezimpawu nezimpawu ze-postpartum psychosis.

UKimberly Dishman, MSN, WHNP-BC, RNC-OBAIzimpendulo zimelela imibono yochwepheshe bethu bezokwelapha. Konke okuqukethwe kunolwazi oluqinile futhi akufanele kuthathwe njengezeluleko zezokwelapha.