Yini i-Electroconvulsive Therapy (ECT)? Inhloso, Inqubo & Imiphumela

I-Electroconvulsive therapy (ECT) iyinqubo yezokwelapha esebenzisa ama-current kagesi alawulwa ngokucophelela ukuze kuqale ukuhlaselwa okufushane ebuchosheni bakho ngenkathi ungaphansi kwe-anesthesia. Lokhu kwelashwa kuye kwahlanzwa emashumini eminyaka futhi manje kuthathwa njengenye yezindlela zokwelapha eziphumelela kakhulu zokucindezeleka okukhulu kanye nezimo ezithile zempilo yengqondo. Ngenkathi umqondo ungase uzizwe umkhulu ekuqaleni, i-ECT yanamuhla iphephile, iqashwe eduze, futhi inganikeza ithemba lapho ezinye izindlela zokwelapha zingasebenzi.

Yini i-electroconvulsive therapy?

I-ECT iyindlela yokwelapha yokukhuthaza ubuchopho esebenza ngokuthumela ama-pulses kagesi amancane ebuchosheni bakho ukuze kubangele ukuhlaselwa okulawulwayo. Ukuhlaselwa ngokwako kuthatha imizuzwana engaba ngu-30 kuya ku-60 kuphela, kodwa kubonakala sengathi kuqala kabusha amakhemikhali athile obuchopho angasiza ngezimpawu ezinzima zempilo yengqondo. Uzobe ulele ngokuphelele ngesikhathi senqubo, ngakho ngeke uzwe noma yimuphi ubuhlungu noma ukhumbule ukwelashwa ngokwako.

Le ndlela yokwelapha isiqhele kakhulu ezinsukwini zayo zokuqala. I-ECT yanamuhla isebenzisa imithamo kagesi enembile, i-anesthesia ethuthukisiwe, kanye nezidambisi zemisipha ukwenza okuhlangenwe nakho kube lula futhi kuphephe ngangokunokwenzeka. Le nqubo yenziwa esibhedlela nethimba eliphelele lezokwelapha elikhona, okuhlanganisa i-anesthesiologist, udokotela wezengqondo, kanye nabahlengikazi.

Kungani kwenziwa i-electroconvulsive therapy?

I-ECT ngokuvamile incomwa uma unokucindezeleka okukhulu okungazange kuphendule kwezinye izindlela zokwelapha njengemithi noma ukwelashwa. Ivame ukucatshangelwa uma isimo sakho sisongela impilo noma uma udinga ukuthuthuka okusheshayo ezimpawini zakho. Udokotela wakho angase asikisele i-ECT uma uzamile imithi eminingi yokulwa nokucindezeleka ngaphandle kwempumelelo, noma uma uhlangabezana nezimpawu ezinzima njengemibono yokuzibulala, ukungakwazi ukudla noma ukuphuza, noma ukuhoxiswa okuphelele emisebenzini yansuku zonke.

Ngaphandle kokucindezeleka, i-ECT ingasiza futhi ngezinye izimo eziningi zempilo yengqondo. Lokhu kufaka phakathi i-bipolar disorder ngesikhathi sezigaba ezinzima ze-manic noma zokucindezeleka, izinhlobo ezithile ze-schizophrenia, ne-catatonia (isimo lapho ungase unganyakazi noma ungasabeli). Ngezinye izikhathi i-ECT isetshenziswa ngesikhathi sokukhulelwa lapho imithi ingase ibeke engozini ingane esakhula.

Yini inqubo ye-ECT?

Inqubo ye-ECT ngokuvamile yenzeka egumbini lenqubo noma egumbini lokusebenza esibhedlela. Uzofika cishe ihora ngaphambi kokwelashwa kwakho okuhleliwe ukuze uqedele amalungiselelo angaphambi kwenqubo. Umhlengikazi uzohlola izimpawu zakho ezibalulekile, aqale umugqa we-IV, futhi aqinisekise ukuthi ukhululekile futhi ukulungele inqubo.

Ngaphambi kokuthi ukwelashwa kuqale, ithimba lakho lezokwelapha lizokunika i-anesthesia ejwayelekile nge-IV yakho, okusho ukuthi uzolala ngokuphelele ngemizuzwana. Bazokunika futhi nomuthi okhulula imisipha ukuvimbela umzimba wakho ukuthi unyakaze ngesikhathi sokuhlaselwa. Uma usulalile, udokotela wezengqondo uzobeka ama-electrode amancane ezindaweni ezithile zekhanda lakho.

Ukukhuthazwa kukagesi kwangempela kuthatha imizuzwana embalwa nje. Ubuchopho bakho buzoba nokuhlaselwa okufushane, kodwa ngenxa yomuthi okhulula imisipha, umzimba wakho ngeke unyakaze. Ithimba lezokwelapha liqapha umsebenzi wobuchopho bakho, isigqi senhliziyo, nokuphefumula kuyo yonke inqubo. Yonke inqubo ngokuvamile ithatha imizuzu engaba ngu-15 kuya kwengama-30 kusukela ekuqaleni kuya ekugcineni.

Ngemuva kokwelashwa, uzovuka endaweni yokululama lapho abahlengikazi bezokuqapha khona kuze kube yilapho uqaphela ngokugcwele. Abantu abaningi bazizwa bebuthaka kancane futhi bangase babe nekhanda elibuhlungu elincane, elifana nokuvuka kunoma iyiphi inqubo yezokwelapha ebandakanya i-anesthesia. Ngokuvamile uzobe usulungele ukuhamba ekhaya phakathi nehora elilodwa noma amabili.

Ungalungiselela kanjani i-ECT yakho?

Ukulungiselela i-ECT kuhilela izinyathelo eziningana zokuqinisekisa ukuphepha kwakho kanye nomphumela ongcono kakhulu. Udokotela wakho uzoqala ngokwenza ukuhlolwa okucophelelayo kwezokwelapha, okuhlanganisa ukuhlolwa kwegazi, i-electrocardiogram (ECG) ukuhlola inhliziyo yakho, futhi ngezinye izikhathi ukuthwebula ubuchopho. Bazobuye babuyekeze yonke imithi yakho yamanje, njengoba eminye ingadingeka ukuthi ilungiswe noma imiswe okwesikhashana ngaphambi kokwelashwa.

Uzodinga ukuzila ukudla okungenani amahora angu-8 ngaphambi kwenqubo yakho, okusho ukuthi akukho ukudla noma iziphuzo ngemuva kwamabili ngobusuku obandulela ukwelashwa kwakho kwasekuseni. Lokhu kubalulekile ngoba i-anesthesia ingaba yingozi uma unokudla esiswini sakho. Ithimba lakho lezokwelapha lizokunikeza imiyalelo ethile mayelana nokuthi yimiphi imithi okufanele uyithathe noma uyeke ekuseni kokwelashwa kwakho.

Kuyasiza ukuhlela ukuthi othile akuqhubele ekhaya ngemuva kweseshini ngayinye, njengoba ungase uzizwe ukozela noma udidekile amahora ambalwa. Ungase futhi ufune ukuhlela isikhathi sokuphumula ngemuva kokwelashwa kwakho. Abantu abaningi bakuthola kukhuthaza ukuletha umngane omethembayo noma ilungu lomndeni esibhedlela ukuze bathole ukwesekwa, yize bazolinda endaweni yomndeni ngesikhathi senqubo yangempela.

Ungawafunda kanjani imiphumela yakho ye-ECT?

Imiphumela ye-ECT ayilinganiswa ngezinombolo zokuhlolwa zendabuko, kodwa kunalokho ngokuthuthuka kwezimpawu zakho kanye nempilo yakho yonke yengqondo. Udokotela wakho wezifo zengqondo uzoqapha inqubekela phambili yakho esebenzisa izikali zokulinganisa ukucindezeleka ezijwayelekile nezingxoxo ezivamile mayelana nendlela ozizwa ngayo. Abantu abaningi baqala ukuqaphela ukuthuthuka ngemuva kokwelashwa okungu-2 kuya ku-4, yize inkambo egcwele ivamise ukuhilela amasonto angu-6 kuya kwangu-12 ngaphezu kwamasonto ambalwa.

Udokotela wakho uzobheka izinguquko eziningana ezinhle njengoba ukwelashwa kuqhubeka. Lokhu kungabandakanya ukuthuthukiswa kwemizwa, amaphethini okulala angcono, ukwanda kwesifiso sokudla, amandla engeziwe, kanye nentshisekelo entsha emisebenzini owawuyijabulela ngaphambili. Bazophinda baqaphe noma yimaphi ama-side effects, ikakhulukazi izinguquko zememori, ezivame ukuba zesikhashana kodwa kubalulekile ukuzilandela.

Impumelelo nge-ECT ivame ukulinganiswa ngokuthi ukwazi kwakho ukubuyela emisebenzini yakho yansuku zonke kanye nobudlelwano bakho. Ithimba lakho lokwelapha lizosebenza nawe ukuthola ukuthi uzuze nini imiphumela engcono kakhulu futhi likusize ukuthi udlulele ekwelashweni kokugcina noma ezinye izindlela zokwelapha ukuze ugcine izimpawu zakho zilawulwa.

Ungayigcina kanjani impilo yakho yengqondo ngemuva kwe-ECT?

Ngemuva kokuqeda inkambo yakho ye-ECT, ukugcina impilo yakho yengqondo kuba umzamo wokubambisana phakathi kwakho nethimba lakho lezempilo. Abantu abaningi bazodinga olunye uhlobo lokwelashwa oluqhubekayo ukuvimbela izimpawu ukuthi zingabuyi. Lokhu kungabandakanya izikhathi ze-ECT zokugcina njalo emavikini ambalwa noma izinyanga, imithi yokulwa nokucindezeleka, noma izikhathi zokwelapha ezivamile.

Imikhuba yakho yansuku zonke idlala indima ebalulekile ekugcineni izinzuzo ze-ECT. Izimiso zokulala ezivamile, ukuzivocavoca okulula, ukudla okunempilo, kanye namasu okulawula ukucindezeleka konke kungasiza ukusekela isimo sakho sengqondo esithuthukisiwe. Abantu abaningi bathola ukuthi imisebenzi efana nokuhamba, i-yoga, noma ukuzindla kubasiza bazizwe belinganisela futhi beqinile.

Ukuhlala uxhumene nohlelo lwakho lokusekela kubaluleke ngokulinganayo. Lokhu kufaka phakathi ukugcina ama-aphoyintimenti avamile nodokotela wakho wezifo zengqondo, ukugcina ubudlelwano nomndeni nabangane, futhi mhlawumbe ukujoyina amaqembu okusekela lapho ungaxhumana khona nabanye abaqonda okuhlangenwe nakho kwakho. Khumbula ukuthi ukululama kuyinqubo eqhubekayo, futhi kujwayelekile ukuba nezinsuku ezinhle nezinsuku eziyinselele.

Yiziphi izici eziyingozi zokudinga i-ECT?

Izici eziningana zingakhuphula amathuba okuthi ungadinga i-ECT njengenketho yokwelapha. Isici esiyingozi esibaluleke kakhulu ukuba nokucindezeleka okukhulu, okumelana nokwelashwa okungathuthukiswanga ngemithi eminingi nemizamo yokwelapha. Uma uzamile ama-antidepressants ahlukene amaningana ngaphandle kwempumelelo, noma uma ukucindezeleka kwakho sekuyingozi empilweni, i-ECT iba isincomo esingaba khona.

Ubudala bungaba yisici, nakuba kungabi ngendlela ongase uyilindele. I-ECT ivame ukucatshangelwa kubantu abadala asebekhulile abangase bangakwazi ukubekezelela imithi yezifo zengqondo ngenxa yezinye izimo zempilo noma ukuxhumana kwemithi. Ngezinye izikhathi futhi incomwa kubantu abasebancane ukucindezeleka kwabo kubi kakhulu kangangokuthi ukulinda imithi ukuthi isebenze kungaba yingozi.

Ezinye izimo zezokwelapha zingenza i-ECT ithuthukiswe kakhulu. Lokhu kufaka phakathi ukuba nesifo se-bipolar esineziqephu ezinzima, ukuzwa ukucindezeleka ngesikhathi sokukhulelwa lapho imithi ingase ilimaze ingane, noma ukuba nezimo zezokwelapha ezenza imithi yezifo zengqondo ibe yingozi. Ngaphezu kwalokho, uma uke waba nempumelelo nge-ECT esikhathini esidlule, udokotela wakho angase ayincomise futhi uma izimpawu zibuyela.

Ingabe kungcono ukuba ne-ECT noma ukuzama ezinye izindlela zokwelapha kuqala?

I-ECT ngokuvamile akuyona indlela yokwelapha yokuqala, okusho ukuthi odokotela bavame ukuzama ezinye izinketho kuqala ngaphandle kokuthi usesimweni esisongela impilo. Kubantu abaningi, uhambo lokwelashwa luqala ngokuqeqeshwa kwengqondo, imithi, noma inhlanganisela yakho kokubili. Lokhu kwelashwa akuhlaseli kangako futhi kungasebenza kahle kakhulu kubantu abaningi abanokucindezeleka nezinye izimo zempilo yengqondo.

Nokho, i-ECT iba yisinqumo esingcono uma ezinye izindlela zokwelapha zingasebenzanga noma uma udinga ukuthuthuka okusheshayo. Uma uhlangabezana nezimpawu ezinzima njengokungakwazi ukudla, ukuphuza, noma ukuzinakekela, i-ECT inganikeza ukukhululeka okusheshayo kunokulinda amasonto ukuthi imithi isebenze. Ivame futhi ukukhethwa uma usengozini esheshayo yokuzilimaza noma ukuzibulala.

Isinqumo sincike ngempela esimweni sakho esithile, umlando wezokwelapha, nokuthi usabele kanjani kwezinye izindlela zokwelapha. Abanye abantu empeleni bakhetha i-ECT ngoba isebenza ngokushesha kunemithi futhi ayidingi ukuthatha amaphilisi nsuku zonke. Udokotela wakho wezifo zengqondo uzokusiza ukuthi ulinganise izinzuzo nezingozi ngokusekelwe ezimweni zakho ngazinye kanye nemigomo yokwelashwa.

Ziyini izinkinga ezingaba khona ze-ECT?

Njenganoma iyiphi inqubo yezokwelapha, i-ECT ingaba nemiphumela emibi, nakuba izinkinga ezingathi sína zingavamile uma yenziwa ngamaqembu ezokwelapha anolwazi. Imiphumela emibi evame kakhulu yesikhashana futhi ihlanganisa ukudideka ngokushesha ngemva kokuvuka, ikhanda, ubuhlungu bemisipha, kanye nesicanucanu. Lokhu ngokuvamile kulungiswa emahoreni ambalwa futhi kungalawulwa ngemithi elula.

Ushintsho lwememori yimiphumela emibi ekhathaza abantu abaningi abacabangela i-ECT. Ungase uhlangabezane nokulahlekelwa yimemori ngesikhathi sokwelashwa kwakho, futhi abanye abantu baqaphela izikhala ememori yabo ezenzeke emasontweni noma ezinyangeni ngaphambi kokwelashwa. Izindaba ezinhle ukuthi izinkinga eziningi zememori zithuthuka ngokuhamba kwesikhathi, futhi izinkumbulo ezibaluleke kakhulu kuwe ngokuvamile zibuyela.

Izinkinga ezingathi sína azivamile kodwa zingabandakanya izinkinga zesigqi senhliziyo, ubunzima bokuphefumula, noma ukudideka okude. Yingakho i-ECT ihlale yenziwa endaweni yasesibhedlela enokuqapha okugcwele kwezokwelapha kanye nemishini ephuthumayo etholakalayo. Ithimba lakho lezokwelapha lizohlola ngokucophelela impilo yakho yonke ngaphambi kokuncoma i-ECT ukuze kuncishiswe lezi zingozi.

Ngokuvamile, abanye abantu bangase bahlangabezane nezinkinga zememori eziqhubekayo noma babe nobunzima bokwakha izinkumbulo ezintsha ngemva kokwelashwa. Udokotela wakho uzoxoxa ngalezi zingozi nawe ngokuningiliziwe futhi akusize uqonde ukuthi ziqhathaniswa kanjani nezingozi zokushiya isimo sakho sempilo yengqondo singelashwa.

Kufanele ngibone nini udokotela mayelana ne-ECT?

Kufanele uxoxe nge-ECT nodokotela wakho uma uhlangabezana nokucindezeleka okukhulu okungathuthukanga ngeminye imithi. Lokhu kungasho ukuthi uzamile imithi eminingi yokulwa nokucindezeleka ngaphandle kwempumelelo, noma ubelokhu ekwelashweni izinyanga ngaphandle kokuthuthuka okukhulu. Uma izimpawu zakho ziphazamisa ikhono lakho lokusebenza, ukugcina ubudlelwano, noma ukunakekela izidingo eziyisisekelo njengokudla nokulala, sekuyisikhathi sokuhlola zonke izinketho zokwelapha ezitholakalayo.

Ukunakwa kwezokwelapha ngokushesha kuyadingeka uma unemicabango yokuzilimaza noma yokuzibulala, noma uma ungakwazi ukudla, ukuphuza, noma ukuzinakekela ngenxa yokucindezeleka. Lezi zimo zivame ukudinga ukungenelela okusheshayo, futhi i-ECT inganikeza ukukhululeka okusheshayo kunokulinda eminye imithi ukuthi isebenze. Unganqikazi ukuya egumbini eliphuthumayo noma ushayele umugqa wezinkinga uma usengozini esheshayo.

Kufanele futhi ucabangele ukuxoxa nge-ECT uma ukhulelwe futhi uhlangabezana nokucindezeleka okukhulu, njengoba imithi eminingi yezengqondo ingaba yingozi ezinganeni ezisakhula. Ngaphezu kwalokho, uma usumdala futhi unzima ukubekezelela imithi yezengqondo ngenxa yemiphumela emibi noma ukuxhumana neminye imithi, i-ECT ingase ibe enye indlela ephephe kakhulu.

Okokugcina, uma uke waba ne-ECT ngempumelelo esikhathini esidlule futhi uqaphela ukuthi izimpawu zakho ziyabuya, ungalindi ukuxhumana nodokotela wakho. Ukungenelela ngokushesha kuvame ukuvimbela ukuphindeka okuphelele futhi kungasho ukuthi udinga ukwelashwa okuncane ukuze uphinde uzizwe kahle.

Imibuzo evame ukubuzwa nge-ECT

Umbuzo 1. Ingabe i-ECT iphephile ezigulini ezindala?

Yebo, i-ECT ivame ukubhekwa njengephephile futhi isebenza kahle ezigulini ezindala. Eqinisweni, abadala ngezinye izikhathi basabela kangcono ku-ECT kunabantu abasebancane, futhi bangase babe nemiphumela emibi emincane evela ku-ECT uma iqhathaniswa nemithi eminingi yezengqondo. Ubudala bodwa abuyona isithiyo ekutholeni i-ECT, futhi abantu abaningi abaneminyaka yobudala engama-70, 80, ngisho nama-90 baye baphathwa ngempumelelo.

Ithimba lezokwelapha linakekela ngokukhethekile lapho liphatha iziguli ezindala, liqapha ngokucophelela ukusebenza kwenhliziyo nezinye izimo zezempilo ngesikhathi senqubo. Ezigulini ezindala ezinemibandela yezokwelapha eyenza imithi yezengqondo ibe yingozi, i-ECT ivame ukunikeza enye indlela ephephe kakhulu enokuxhumana okuncane kwemithi nemiphumela emibi.

Umbuzo 2. Ingabe i-ECT ibangela ukulimala kobuchopho unomphela?

Cha, i-ECT ayibangeli umonakalo ongapheli ebuchosheni. Iminyaka eminingi yocwaningo ikhombisile ukuthi i-ECT iphephile futhi ayilimazi isakhiwo noma ukusebenza kobuchopho. Ngenkathi abanye abantu behlangabezana nezinguquko zesikhashana zenkumbulo, lezi azifani nomonakalo wobuchopho futhi ngokuvamile ziyathuthuka ngokuhamba kwesikhathi. Izindlela zanamuhla ze-ECT zenzelwe ukunciphisa noma yimaphi imiphumela emibi yokuqonda ngenkathi kwandisa izinzuzo zokwelapha.

Ucwaningo lokucabanga ngobuchopho lwabantu abathole i-ECT alukhombisi bufakazi bomonakalo wesakhiwo noma izinguquko ezingezinhle zesikhathi eside. Eqinisweni, olunye ucwaningo luphakamisa ukuthi i-ECT ingasiza ekukhuthazeni ukukhula kwamaseli amasha obuchopho futhi ithuthukise ukuxhumana kobuchopho ezindaweni ezithinteka ukucindezeleka.

Umbuzo 3. Ngizodinga ukwelashwa okungaki kwe-ECT?

Abantu abaningi badinga phakathi kokwelashwa kwe-ECT okungu-6 kuya ku-12 ukuze bathole imiphumela engcono kakhulu, nakuba lokhu kungahluka ngokuya ngempendulo yakho kanye nobukhulu besimo sakho. Ukwelashwa ngokuvamile kunikezwa izikhathi ezi-2 kuya kwezi-3 ngesonto amasonto amaningana. Udokotela wakho uzoqapha intuthuko yakho ngokucophelela futhi angase alungise uhlelo lokwelashwa ngokusekelwe endleleni ozosabela ngayo.

Abanye abantu baqala ukuzizwa ngcono ngemva kokwelashwa okungu-2 kuya ku-4 nje, kanti abanye bangase badinge inkambo ephelele ngaphambi kokuba bathole ukuthuthuka okukhulu. Ngemva kokuqeda uchungechunge lokuqala, abantu abaningi bayazuza ekuqhubekeni kwamaseshini e-ECT njalo emavikini ambalwa noma izinyanga ukuze bavimbele izimpawu ukuthi zingabuyi.

Umbuzo 4. Ngizoyikhumbula inqubo ye-ECT?

Cha, ngeke uyikhumbule inqubo ye-ECT uqobo ngoba uzobe ungaphansi kwe-anesthesia ejwayelekile ngesikhathi sokwelashwa. Abantu abaningi abakhumbuli lutho kusukela cishe imizuzu engama-30 ngaphambi kwenqubo kuze kube yilapho bevuka endaweni yokululama. Lokhu kujwayelekile futhi kulindelekile.

Ungase ube nokudideka okuthile noma ukuzwa ubuthuntu lapho uvuka okokuqala, okufana nendlela ongazizwa ngayo ngemva kwanoma iyiphi inqubo yezokwelapha ebandakanya i-anesthesia. Lokhu kudideka kuvame ukucaca phakathi nehora elilodwa noma amabili, futhi uzoqashwa ngabasebenzi bezokwelapha kuze kube yilapho uqaphele ngokugcwele futhi usulungele ukuhamba ekhaya.

Q.5 Ingabe i-ECT ingenziwa ngaphandle kwesiguli?

Yebo, i-ECT ivame ukwenziwa ngaphandle kwesiguli, okusho ukuthi ungaqhubeka uye ekhaya ngosuku olufanayo. Abantu abaningi bafika esibhedlela noma esikhungweni sokwelapha amahora ambalwa ngaphambi kwenqubo yabo ehleliwe futhi bayakwazi ukuhamba phakathi namahora ambalwa ngemva kokwelashwa. Lokhu kwenza i-ECT ibe lula kakhulu kunakuqala lapho abantu babevame ukuhlala esibhedlela.

Nokho, uzodinga othile ukuthi akuqhubele ekhaya ngemva kokwelashwa ngakunye, njengoba ungase uzizwe ukozela noma udidekile amahora amaningana. Abanye abantu bakhetha ukuthatha ikhefu losuku emsebenzini noma kweminye imisebenzi ukuze baphumule futhi balulame, nakuba abaningi bekwazi ukubuyela emisebenzini evamile ngosuku olulandelayo.