ukukhathazeka 

Ukukhathazeka kuyisifo esivamile sempilo yengqondo esithinta izigidi emhlabeni wonke. Ngesimo esithambile, ukukhathazeka kungakhulisa ukuqwashisa nokugxila, kuphoqelele abantu ukuba bazilungiselele kahle imisebenzi ebalulekile, njengezivivinyo noma izethulo. Kodwa-ke, uma kungalawulwa kahle, ukukhathazeka okungapheli kungaba nomthelela omkhulu emisebenzini yansuku zonke, kwenze ngisho nemisebenzi elula izizwe ingaphezu kwamandla. Abantu abaningi baba nezimpawu zokukhathazeka ngaphandle kokuqaphela ukuthi ziyini noma ukuthi zingabhekana kanjani nazo ngempumelelo. Ake sihlole izici ezibalulekile zokukhathazeka, okuhlanganisa izimpawu zokukhathazeka kwabesifazane nabesilisa. 

Kuyini Ukukhathazeka?

Ukukhathazeka kuwukusabela komzimba okuvamile ezenzakalweni ezicindezelayo wonke umuntu ahlangabezana nazo esikhathini esithile ekuphileni kwakhe. Kuvela njengemizwa yokungakhululeki, yokwesaba, noma yokukhathazeka engasukela ekungaphumulini okuncane kuye ekucindezelekeni okukhulu ngokomzwelo. Lo mzwelo usebenza njengempendulo yomzimba kuwo ukucindezeleka futhi kungaba yinzuzo ezimweni zansuku zonke. Ingaxwayisa isistimu yethu ngezingozi ezingaba khona futhi isisize sihlale sigxilile futhi sizilungiselele.

Nokho, ukukhathazeka kuba ukukhathazeka lapho kuphazamisa ukuphila kwansuku zonke. Kwabanye abantu, ukukhathazeka kuhlala njalo futhi kunzima ukukulawula. Kungathinta ukusebenza kwazo ezicini ezihlukahlukene zokuphila, okuhlanganisa ukusebenza komsebenzi, umsebenzi wesikole, nobudlelwano bomuntu siqu.

Ukukhathazeka kwehluka ekwesabeni, nakuba amagama evame ukusetshenziswa ngokushintshana. Nakuba ukwesaba kuyimpendulo yamanje, ehlala isikhathi esifushane kusongo oluthile, ukukhathazeka kuyimpendulo egxile esikhathini esizayo, ethatha isikhathi eside ekusongeleni okusabalele. 

Lapho ukukhathazeka kuba ngokweqile futhi kuphikelela, kungase kubonise ukuphazamiseka kokukhathazeka. Lezi zifo ziwuhlobo oluvame kakhulu lwezimo zempilo yengqondo, ezithinta cishe ama-30% abantu abadala ngesikhathi esithile empilweni yabo. Kubandakanya ukuphazamiseka kokukhathazeka okujwayelekile (i-GAD), ukuphazamiseka kokwesaba, ama-phobias athile, nokuphazamiseka kokukhathazeka komphakathi.

Izimpawu Zokukhathazeka

Izimpawu zokukhathazeka kwabesilisa nabesifazane zingahluka esigulini ngasinye futhi zingathinta kokubili inhlalakahle ngokomzimba nangokwengqondo. Izimpawu ezijwayelekile zomzimba zihlanganisa: 

• Ukushaya kwenhliziyo okusheshayo
• Ukuphelelwa umoya
• Ukujuluka ngokweqile
• Ukungezwani kwemisipha
• Ukuthuthumela
• Ukukhathala
• Izinkinga zesisu njengesicanucanu noma ubuhlungu besisu
• Ukuphathwa yikhanda nokuphazamiseka kokulala 

Ngaphambili kwezengqondo, ukukhathazeka kuvame ukudala: 

• Ukukhathazeka okuphikelelayo 
• Umuzwa wokubhujiswa okuzayo
• Ukuphumula 
• Ukuthukuthela
• Ukubunzima ukugxila
• Ukuzizwa emaphethelweni 
• Inkinga yokulawula ukukhathazeka kwabo. 

Ezimweni ezimbi kakhulu, abantu bangase bahlaselwe ukwesaba noma bahlakulele i-agoraphobia, ukugwema izimo ezibangela ukukhathazeka kwabo.

Izimbangela Nezingozi Zokukhathazeka

Ukukhathazeka kunesethi eyinkimbinkimbi yezimbangela ezibandakanya kokubili izici zofuzo nezemvelo. 

• I-Genetics: Umlando wokukhathazeka womndeni kanye nokwehluka kwezakhi zofuzo kuxhunyaniswa nokuba sengozini enkulu yokukhathazeka. 
• Okuhlangenwe nakho Kwemvelo: Badlala indima ebalulekile ekuvuseni noma ekwandiseni izimpawu zokukhathazeka. Lokhu kungaba:
  • Ukuhlukumezeka kwasebuntwaneni (umlando wokuhlukunyezwa ngokomzwelo noma ngokomzimba, ukunganakwa, noma ukulahlekelwa umzali)
  • Ingcindezi ehlobene nomsebenzi
  • Ubunzima bezezimali
  • Izinguquko ezibalulekile empilweni
  • Ukugula noma izimo zempilo eziqhubekayo
  • Ezinye izimo zempilo yengqondo, njengokucindezeleka
  • Ukusetshenziswa kwezidakamizwa noma ukusetshenziswa kabi, okuhlanganisa izidakamizwa notshwala
  • Ukuhlukaniswa komphakathi
  • Izehlakalo zempilo ezingezinhle
  • Izici zezenhlalo nezomnotho ezifana nobumpofu, ukuntuleka kwemisebenzi, namazinga aphansi emfundo
  • Ukuswela izinto ezibonakalayo
• Izici ze-Neurobiological: Ama-neurotransmitters abalulekile afana ne-gamma-aminobutyric acid (GABA), i-serotonin, ne-norepinephrine ahilelekile ekulawuleni ukukhathazeka. Izakhiwo zobuchopho (i-hippocampus, i-amygdala, ne-prefrontal cortex) ziye zathinteka ekucubunguleni ukwesaba nezimpendulo ezingokomzwelo.

Izinkinga

Ukukhathazeka kungaba nomthelela omkhulu kokubili impilo engokomzimba nengqondo, okuholela ezinkingeni ezihlukahlukene uma kungelashwa. Lokhu kungase kuhlanganise: 

• Ukucindezeleka: Le nhlanganisela yokukhathazeka kanye ukucindezeleka kungenza izimpawu zibe zimbi kakhulu futhi kwenze ukwelashwa kokukhathazeka kube inselele.
• Iziphazamiso Zokulala: Abantu abaningi abanezinkinga zokukhathazeka babika ubunzima bokulala, ukuhlala belele, noma ukulala okungaphumuli. 
• Ukukhubazeka kwengqondo: Ukukhathazeka okungapheli nakho kungathinta ukusebenza kwengqondo, kukwenze kube nzima ukugxila, ukulawula imizwa, nokwenza imisebenzi yansuku zonke ngempumelelo. Lokhu kungaholela ekwehleni kokukhiqiza kanye nobunzima emsebenzini noma empilweni yomuntu siqu. 
• Ukuzihlukanisa emphakathini: Ukwesaba ukwahlulela noma ukuphoxeka kungabangela abantu ukuba bagweme izimo zomphakathi, okuholela esizungu kanye nenethiwekhi yosekelo enciphile.
• Impilo Yomzimba: Ucwaningo luthole ukuxhumana phakathi kokukhathazeka nezimo ezibuhlungu ezingapheli njenge-fibromyalgia, migraines, izinkinga zesisu, kanye nesimiso senhliziyo nemithambo yegazi (okungase kukhulise ingozi yezinkinga zenhliziyo).

Sifo

Akukho ukuhlolwa okukodwa kokukhomba ukukhathazeka. 

• Ukuhlolwa Komtholampilo: Odokotela ngokuvamile baqala ngokuhlolwa okuphelele kwezokwelapha, okuhlanganisa ukuhlolwa komzimba nokubuyekezwa komlando wezokwelapha wesiguli. 
• Ukuhlolwa Kwelebhu: Ukuhlolwa kwegazi noma ukuskena kwesithombe kungakhipha izimo zomzimba ezingase zibangele izimpawu. Isibonelo, i-hyperthyroidism ingalingisa izimpawu zokukhathazeka futhi idinga ukukhishwa.
• Ireferensi Yezengqondo: Uma kungatholakali imbangela engokomzimba, udokotela angase adlulisele isiguli kudokotela wengqondo. 
• Izazi zokusebenza kwengqondo noma izifo zengqondo sebenzisa imibandela ethile evela ku-Diagnostic and Statistical Manual of Mental Disorders (DSM-5) ukuze uhlole ukuphazamiseka kokukhathazeka. 
• Amathuluzi amaningana okuhlola angasiza enqubweni yokuxilongwa, njenge-Generalized Anxiety Disorder scale-7 (GAD-7) kanye ne-GAD-2.

Ukwelashwa

Ukwelapha ukukhathazeka kuhlanganisa inhlanganisela yemithi yokwelapha engokwengqondo nemithi, okuhlanganisa:

• I-Cognitive Behavioral Therapy (CBT): I-CBT ivame ukubhekwa njenge-psychotherapy ephumelela kakhulu yezinkinga zokukhathazeka. Kusiza abantu ukuthi bazi izindlela zabo zokucabanga ezingezinhle nokuziphatha okubabangela ukukhathazeka. 
• Amasu Okuphumula: Ukuphumula okusetshenzisiwe kungenye indlela yokwelapha efundisa abantu ukukhulula imisipha yabo ezimweni ezibangela ukukhathazeka.
• Imithi: 
  • Ukukhetha i-serotonin reuptake inhibitors (ama-SSRIs)  
  • I-Serotonin-norepinephrine reuptake inhibitors (SNRIs) 
  • Benzodiazepines 
  • Izinketho ezingezona ezemithi: 
• Ukuvivinya njalo
  • Ukuzijwayeza izindlela zokucabanga
  • Ukugcina ukudla okunempilo 
  • Ukunciphisa ukudla kwe-caffeine 
  • Ukuqinisekisa ukulala ngokwanele 

Uzoyibona Nini Udokotela

Kubalulekile ukufuna usizo lochwepheshe uma: 

• Izimpawu zokukhathazeka ziphazamisa impilo yakho yansuku zonke. 
• Uzithola ukhathazeka ngokweqile.
• Kuthinta umsebenzi wakho, ubudlelwano, noma ezinye izici zempilo yakho 
• Ukwesaba noma ukukhathazeka kwakho kunzima ukulawula futhi kubangela ukucindezeleka
• Lapho umuntu eba nezimpawu zokukhathazeka isikhathi eside, ngokuvamile amasonto amabili noma ngaphezulu. 
• Usola ukuthi ukukhathazeka kwakho kungase kuhlotshaniswe nenkinga yempilo engokomzimba
• Uzabalaza nokunye okukukhathazayo ngempilo yengqondo, njengokucindezeleka noma ukusebenzisa izidakamizwa kanye nokukhathazeka

Prevention

Ukuvimbela ukukhathazeka kuhilela ukwenza izinguquko endleleni yokuphila engaba nomthelela omkhulu ekunciphiseni izimpawu kanye nokwenza ngcono impilo yonke. Lokhu kubandakanya:

• Umsebenzi Ojwayelekile Womzimba: Hlela okungenani imizuzu engu-30 yokuzivocavoca ezinsukwini eziningi zeviki. 
• Ukudla Okunempilo: Ukudla a Ukudla okunazo zonke okunothisiwe ngezithelo, imifino, okusanhlamvu okuphelele namaprotheni angenalutho kungasiza ukuzinzisa isimo sengqondo namandla. 
• Gwema Izinto Ezingenza Ukukhathazeka Kube Kubi: Lezi wutshwala, i-caffeine, i-nicotine, nezidakamizwa zokungcebeleka.
• Ukulala Ikhwalithi Eyanele: Yakha isimiso sokulala esingaguquki, uhlose ukuphumula amahora ayisishiyagalombili ubusuku ngabunye. 
• Ukuzibandakanya Kumasu Wokuziphumuza: Lokhu kungase kuhlanganise izithombe eziqondisiwe, izivivinyo zokuphefumula zamabomu, nokuphumula kwemisipha okuqhubekayo. Imikhuba yokucabanga, njengokuzindla noma i-yoga, ingasiza futhi abanye abantu ukulawula izimpawu zabo zokukhathazeka ngempumelelo.
• Ukwakha Inethiwekhi Yokusekela Eqinile: Ukukhuluma ngemizwa yakho nabangane othembekile namalungu omndeni noma ukujoyina amaqembu okusekela kungakunikeza impumuzo futhi kukusize uzizwe unesizungu lapho ubhekana nezinkinga zokukhathazeka.

Isiphetho

Ukukhathazeka kuyindaba eyinkimbinkimbi ethinta izigidi zabantu emhlabeni wonke. Uma ubhekene nokukhathazeka, ungangabazi ukuthola ukwesekwa. Kungakhathaliseki ukuthi ukukhuluma nomngane omethembayo, ukwenza izinguquko endleleni yokuphila, noma ukubonisana nodokotela, ziningi izindlela zokubhekana nezinkinga zokukhathazeka. Ngendlela efanele nokusekelwa, kungenzeka ukunciphisa izimpawu zokukhathazeka ngekhwalithi yempilo ethuthukisiwe. 

Imibuzo Evame Ukubuzwa

1. Ingabe ukukhathazeka kuvamile?

Ukukhathazeka kuwukusabela okuvamile ezimweni eziningi ezahlukene ezimpilweni zethu. Wonke umuntu angaba nemizwa yokukhathazeka ngesikhathi esithile, njengangaphambi kwenhlolokhono yomsebenzi, ukuhlolwa, noma ukuhlolwa kwezokwelapha. Le mizwa yokukhathazeka noma yokungakhululeki ingaba yinto evamile futhi ibe usizo ezimweni ezithile. Ukukhathazeka kungasiqhubezela phambili, kusisize sihlale siphapheme, futhi kusishukumisele ukuba sixazulule izinkinga. Kodwa-ke, ukukhathazeka kuba ukukhathazeka lapho kuqala ukuphazamisa ikhono lakho lokuphila impilo yakho. 

2. Iyini imbangela yokukhathazeka?

Isizathu esiqondile sokukhathazeka asiqondwa ngokugcwele, kodwa inhlanganisela yezinto eziningi cishe idlala indima. Ezinye zezimbangela ezingaba yizimpande zihlanganisa:

• I-Genetics: Ucwaningo lubonisa ukuthi ukukhathazeka kungagijima emindenini, okubonisa isakhi sofuzo.
• Okwenzeka ebuntwaneni: Izehlakalo ezibuhlungu ngesikhathi sobuntwana, ezinjengokuhlukunyezwa, ukunganakwa, noma ubuxhwanguxhwangu, zingandisa ingozi yokuba nokukhathazeka kamuva ekuphileni.
• Izimo zempilo zamanje: Ukucindezeleka okuhlobene nomsebenzi, imfundo, ubudlelwano, noma izinkinga zezezimali kungabangela ukukhathazeka.
• Impilo yomzimba: Ukuphila nesifo esibi kakhulu noma esingamahlalakhona kungaba nomthelela ekukhathazekeni.
• Ikhemikhali yobuchopho: Ukungalingani kuma-neurotransmitters kungase kubambe iqhaza ezinkingeni zokukhathazeka.
• Izici zemvelo: Ukuzihlukanisa nomphakathi, izehlakalo zempilo ezimbi, nezingcindezi zomphakathi konke kungaba nomthelela ekukhathazekeni.

3. Zivame kangakanani izinkinga zokukhathazeka?

Izinkinga zokukhathazeka zithinta cishe u-3.3% wabantu baseNdiya (abantu abayizigidi ezingama-44.9). Zivame kakhulu kwabesifazane nasezindaweni zasemadolobheni. I-Kerala, i-Manipur, i-West Bengal, i-Himachal Pradesh, ne-Andhra Pradesh anamanani aphezulu kakhulu.

UDkt. Mazher Ali

MBBS, MD (Psychiatry)
CARE Hospitals Outpatient Centre, Banjara Hills, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529