
samanyikrut chinta vikar

samanyikrut chinta vikar (gadd) haah eka mansik aanee vartanukicha vikar aahe, visheshtah eka chinta vikar jyache vaishishtya mhanje ghatana kinwa kriyakalapambaddal atee, aniyantrit aanee anekada atarkik chinta. chinta anekada dainandin kamat hastakshep karate aanee gadd asalelya vyaktinna anekada aarogya, aarthik, mrutyu, kutumb, natesambandhanchya samasya kinwa kamachya adachani yasarkhya dainandin babimbaddal jaast kalji vatate. lakshananmadhye atee chinta, aswasthata, zope yenyas tras hone, thakwa, chidchid, gham yene aanee thartharane yancha samavesh asoo shakato.
gadchya aupcharik nidanasathi lakshane satatyapurn aanee satat, kiman sahaa mahine tikoon asane aavashyak aahe. gadd asalelya vyaktinna anekada itar mansik vikaransah itar vikar asatat (udaa.jee., mejar depressive disorder), madak padarthancha vapar vikar, laththapana aanee tyala aaghat kinwa gadd asalelya kutumbacha itihas asoo shakato. vyaktikade gadd asoo shakate qee nahee heey nirdharit karnyasathi aanee yaa vikarasathi aupcharik mulyamapanachi hummy denyasathi, chikitsak gadd-7 aanee gadd-2 prashnavali yasarkhi tapasani sadhane vapartat. yavyatirikt, kahivela tapasani sadhane chikitsakanna rogachya lakshananche gambhirya tapasanyas saksham karoo shakatat.
gadcha aanuvanshik kinwa anuvanshik aadhar asalyache manale jaate (udaa.jee., jyaa vyaktikade gadd aahe tyachya pratham-stariy natevaikanna swatah gadd asanyachi shakyata jaast asate), parantu yaa natyache nemke swaroop purnapane kautuk kele jaat nahee. jyaa vyaktinna chinta vikar aahet (gads) tyanchya anuvanshik abhyasatoon asey soochit hote qee chinta vikar vikasit karnyasathi aanuvanshik yogdan fakt andaje 30-40% aahe, jeey soochit karate qee ekhadya vyaktila gadd vikasit hoto qee nahee heey nirdharit karnyasathi paryavaraniy ghatak adhik mahattvache asoo shakatat. gadd aanee mejar depressive disorder (emm. dii. dii.) yanchyat eka majboot parasparsambandh aahe, jyat gadche aajivan nidan jhalelyanpaiki 72 takke lokanna tyanchya aayushyachya kahee tappyavar emm. dii. dii. chey nidan dekhil hote.
gadche pathophysiology menduchya anek bhaganna soochit karate jeey bheeti, chinta, smaranshakti aanee bhavnanshi sambandhit uttejananchya prakriyes madhyasthi karatat (i.eae., amigdala, insula aanee frontal cortex). amigdala haah menducha eka bhag aahe joou bhavna anubhavanyashi sambandhit aahe. amigdalamadhye, basolateral amigdala complexes sanvedanatmak mahitee olakhate aanee gabergic neurons sakriy karate jyamule chintechi sharirik lakshane disu shakatat. gabergic neurons tanav, chinta aanee bhitichya bhavna qamee karoon majjasansthevar niyantran thevatat. jevha gabergic neuronschee sankhya apuri asate, tevha tyaa nakaratmak bhavna spasht hotat aanee tanavache sharirik pratisad sodu shakatat. asey suchavale gele aahe qee jee. aii. dii. asalelya vyaktinmadhye jee. aii. dii. nasalelya vyaktinpeksha uttejananna pratisad mhanoon adhik amigdala aanee madhya purvavarti aachchadan (emm. pii. eff. see.) kriyakalap asatat. tathapi, pudhil aachchadanchya itar bhaganmadhil gadd aanee kriyakalap patali yanchyatil sambandh haah chaloo sanshodhanacha vishay aahe, kahee sahitya asey suchavate qee jyaa vyaktinkade gadd aahe asha vishisht pradeshanmadhye adhik sakriyata aahe parantu itar sanshodhan asey suchavate qee jyaa vyaktinmadhye gadd aahe asha vyaktinmadhye sakriyatechi patali qamee jhaali aahe. 
upcharanmadhye manasopacharancha samavesh hoto, udaa.jee. sandnyanatmak vartanukichi upcharpaddhati (see. bii. tii.) kinwa metacognitive therapy aanee aushadhashastriy hastakshep (udaa.jee. ganja, cytalopram, eskitalopram, certrallin, duloxetin aanee wenlafaxin). see. bii. tii. aanee nivadak serotonin reptech inhibitors (ess. ess. aar. aay. ess.) heey pahilya-kramankache mansik aanee aushadhashastriy upchar aahet; itar paryayanmadhye nivadak norpinephrine reptech inhibitors (ess. aine. aar. aay. ess.) yancha samavesh hoto. europemadhye pregabalin dekhil vaparale jaate. purak aanee paryayi aushadhe (cams), vyayam, upcharatmak masaj aanee itar hastakshepanchya sakaratmak parinamancha (asalyas) abhyas keela gela aahe.
gadd kinwa aajivan jokhamichya prasarasandarbhat andaj (i.eae.gadsathi aajivan rugna jokhim (ell. emm. aar.) heey gadchya nidanasathi konate nikash vaparale jaatat yavar avalambun badalate (udaa.jee., dii. ess. emm.-5 viruddha aay. see. dii.-10) jaree nidanatmak nikashannusar andaj mothya pramanat badalat naheet. sarvasadharanpane, aay. see. dii.-10 heey dii. ess. emm.-5 peksha adhik samaveshak aahe, tyamule aay. see. dii.-10 vaparoon pradurbhav aanee aajivan jokhamishi sambandhit andaj jaast asatat. pradurbhavachya sandarbhat, dilelya varshat, united states aanee europemadhil sumare done (2 takke) takke praudhanna gadd asalyache suchavale gele aahe. tathapi, aayushyachya konatyahi tappyavar gadd vikasit honyacha dhoka 9 takke asalyacha andaj aahe. jaree aekhadyachya aayushyat gadcha ekach bhag anubhavane shakya asale taree, gadcha anubhav ghenare bahutek lock tyanchya aayushyat varanvar eka junat kinwa chaloo sthitee mhanoon anubhavtat. purushanpeksha striyanmadhye gadche nidan duppat vela hote.
nidan.
dii. ess. emm.-5 nikash.
american cychiatric association prakashit kelelya diagnostic andd statistical manual auph mental disorder dii. ess. emm.-5 (2013) dware paribhashit kelelya gadsathichya nidanatmak nikashanchi vyakhya khalilpramane kelee aaheh diagnostic andd statistical manual auph mental disorderchya (2004) prakashanantar gadmadhye konatehi mothe badal jhaale naheet; kirkol badalanmadhye nidanatmak nikashanchya shabdancha samavesh aahe.
aay. see. dii.-10 nikash.
rogachya aantarrashtriy sankhyikeey vargikaranachya (aay. see. dii.-10) 10vya punaravruttimadhye varr varnan kelelya dii. ess. emm.-5 nikashanpeksha gadsathi nidan nikashancha eka vegala sanch pradan keela aahe. visheshtah, aay. see. dii.-10 khalilpramane gadche nidan karnyas anumati deteh
aay. see. dii.-10 <aay. dii. 2> teepah mulansathi aay. see. dii.-10 chey vegvegale nikash gadche nidan karnyasathi lagoo kele jaau shakatat (<aay. dii. 1> pahaa).
nidan nikashancha itihas.
american cychiatric association 1980 madhye dii. ess. emm.-3 madhye nidan mhanoon gadchi suruvat kelee, jevha chinta neurosis gadd aanee panic disordermadhye vibhagala gela. dii. ess. emm.-3 madheel vyakhyesathi aniyantrit aanee pasarleli chinta kinwa chinta aavashyak aahe jee atee aanee avastav aahe aanee 1 mahina kinwa tyahoon adhik kaal tikate. gadd aanee mejar depressionchya sahvyadhichya uchch pramanamule anek bhashyakaranni asey suchavale qee gadchi swatantra vikarapeksha mejar depressioncha eka pailu mhanoon adhik changlya prakare sankalpana kelee jaeel. anek samikshakanni asey mhatale aahe qee yaa vikarachi nidanatmak vaishishtye dii. ess. emm.-3-aar. paryant changlya prakare sthapit jhaleli navhati. gadd aanee itar vikaranchi sahvyadhi kalantarane qamee hott asalyane, dii. ess. emm.-3-aar. neey gadd nidanasathichi velechi aavashyakta 6 mahine kinwa tyahoon adhik kaal badalali. dii. ess. emm.-aay. vhee. neey 'atee chintechi' vyakhya aanee nidanasathi aavashyak asalelya sambandhit manobhautikiy lakshananchi sankhya badalali. nidanatil aanakhi eka pailu dii. ess. emm.-aay. vhee. neey spasht keela qee jeey lakshan "varanvar" udbhavate teey hote. dii. ess. emm.-aay. vhee. laa gadche nidan karnyasathi chintevar niyantran thevanyat adchan dekhil aavashyak hotee. dii. ess. emm.-5 neey yavar bharr deela qee, anek vegvegalya vishayanvar jaast divas jaast chinta karavi lagate. asey mhatale gele aahe qee yaa vikarachya nidanatmak vaishishtyanmadhil satat badalanmule pradurbhav aanee ghatana yasarkhya mahamarishastriy aakadevariche moolyankan karane katheen jhaale aahe, tasech sanshodhkansathi yaa vikarache jaivik aanee mansik aadhar olakhanyatil adchan vadhali aahe. parinami, yaa vikarasathi vishesh aushadhe tayar karane dekhil adhik katheen aahe. yamule gadche ess. ess. aar. aay. saha mothya pramanat aushadhopachar suru rahile aahet.
jokhim ghatak.
anuvanshiki, kutumb aanee paryavaran.
anuvanshiki aanee chinta vikar yanchyatil sambandh heey sanshodhanache satatche kshetra aahe. heey vyapakpane samajale jaate qee gadsathi aanuvanshik aadhar astitvat aahe, parantu yaa aanuvanshik aadharache nemke swaroop purnapane samajale gele nahee.  tapaskartyanni pudhil abhyasasathi swarasya asalele anek anuvanshik sthan olakhale asale taree, gadd nirman karnare mhanoon olakhale gelele konatehi eka januk kinwa janukancha sanch nahee.  tathapi, ekhadya vyaktila gadd vikasit honyacha jaast dhoka aahe qee nahee, gadshey sambandhit mendutil sanrachanatmak badal kinwa ekhadi vyakti ekhadya vishisht upchar paddhatila pratisad denyachi shakyata qamee-adhik pramanat aahe qee nahee heey nirdharit karnyat anuvanshik ghatak bhoomika bajavu shakatat.  gadchya vikasat bhoomika bajavana anuvanshik ghatakanchi charcha samanyatah paryavaraniy ghatakanchya (udaa.jee., jivanacha anubhav kinwa chaloo asalela tanav) joou gadchya vikasat dekhil bhoomika bajavu shakato. gadchya sambhavya aanuvanshik aadharavar tapas karnyachya paramparik paddhatinmadhye kautumbik abhyas aanee julya abhyasancha vapar karane samavisht aahe (gads chinta vikar asalelya vyaktincha dattak abhyas dnyat nahee). kautumbik aanee julya abhyasanche meta-vishleshan asey suchavate qee gadsathi aanuvanshik aadhar asalyacha bhakkam purava aahe, jyaa gadd asalelya vyaktinchya pratham-shrenichya natevaikanmadhye, tyach loksankhyetil gair-sambandhit vyaktinpeksha, gadd asanyachi shakyata jaast asate. duheri abhyas asehi suchavatat qee gadd aanee mejar depressive disorder (emm. dii. dii.) yanchyat anuvanshik sambandh asoo shakato, jeey gadd (udaa.jee., gadd asalelya vyaktinmadhye emm. dii. dii. chee sahvyadhi 60 takke asalyacha andaj aahe). jevha gadd heey serve chinta vikaranmadhye manale jaate (udaa.jee.panic disorder, samajik chinta vikar), anuvanshik abhyas asey suchavatat qee chinta vikaranchya vikasat aanuvanshik yogdan fakt andaje 30-40% aahe, jeey soochit karate qee ekhadya vyaktila gadd vikasit houu shakato qee nahee heey nirdharit karnyasathi paryavaraniy ghatak adhik mahattvache aahet. gadchya vikasatil paryavaraniy prabhavanchya sandarbhat, asey suchavale gele aahe qee palakanna chinteshi sambandhit vartananche sambhavya model asalyane palakanchya vartanacha eka mahattvacha prabhav asoo shakato. heey dekhil suchavale gele aahe qee gadd asalelya vyaktinni jeevanat mothya sankhyene tanavashi sambandhit chhotya ghatana anubhavalya aahet aanee gadchya vikasat (itar vaiyaktik vaishishtyanchi parva naan karata) tanavashi sambandhit ghatananchi sankhya mahattvachi asoo shakate.
gadchya vikasasathi sambhavya anuvanshik yogdanachya abhyasane sambhavya dhoke olakhanyas (udaa.jee., amigdalamadhye) aanee chintechya vikaranmadhye sameel asalyache dnyat asalelya neurotransmitter aanee neurotransmitter receptorsmadhye dekhil samavisht aahe. adhik visheshtah, gadchya vikasashi tyanchya sambandhasathi abhyasalelya kinwa upcharanchya pratisadashi sambandh asalyache darshavilelya janukanmadhye khaleel goshtincha samavesh hotoh
pathophysiology.
gadche pathophysiology heey sanshodhanache eka sakriy aanee chaloo kshetra aahe jyamadhye anekada anuvanshiki aanee majjasansthesambandhi sanrachananche aantarchhed samavisht asate. samanyikrut chinta vikar haah amigdalachya karyatmak jodanitil badalanshi aanee tyachya bheeti aanee chintechya prakriyeshi jodala gela aahe. sanvedanatmak mahitee basolateral complexchya kendrakandware (bajukadil, besal aanee sahayak besal kendrakansah) amigdalamadhye pravesh karate. basolateral complexes sanvedanashi sambandhit bhitichya aathvaninvar prakriya karate aanee mendutil itaratra smrutee aanee sanvedanatmak prakriyesathi dhokyachya mahattvasandarbhat mahitee sampreshit karate, jase qee madhya purvabhimukh aachchadan aanee sanvedanatmak aachchadan. chintetil tyanchya bhoomikesathi paramparikpane kautuk kelelya majjasansthesambandhi sanrachananmadhye amigdala, insula aanee aurbitophrontal cortex (ofc) yancha samavesh hoto. heey vyapakpane gruheet dharale jaate qee yapaiki eka kinwa adhik majjasansthetil badalanmule jyaa vyaktinmadhye gadd aahe asha vyaktinmadhye bhavnik uttejananna gadd nasalelya vyaktinchya tulanet adhik amigdala pratisad midato asey manale jaate.
jyaa vyaktinkade gadd nahee tyanchya tulanet gadd asalelya vyaktinmadhye uttejakanna pratisad mhanoon jaast amigdala aanee madhya purvabhimukh aachchadan (emm. pii. eff. see.) sakriyata asalyache suchavale gele aahe. tathapi, amigdala aanee frontal cortex yanchyatil achook sambandh (udaa.jee.prefrontal cortex kinwa aurbitophrontal cortex (oo. eff. see.) purnapane samajale jaat nahee kaaran asey abhyas aahet jeey gadd asalelya vyaktinmadhye frontal cortexmadhil kriyakalap "vadhalela kinwa qamee" jhalyache suchavatat. parinami, jyaa vyaktinmadhye gadd aahe, tyaa vyaktinmadhye frontal cortexchi ksheen samaj asalyamule, gadd asalelya vyaktinmadhye gadd nasalelya vyaktimadhye amigdalapeksha adhik sanvedanshil amigdala aahe qaa kinwa frontal cortex hyperactivity vividh uttejananna amigdala pratisadat badal ghadavun aananyasathi jababdar aahe qaa, haah eka khula prashna aahe. alikadil abhyasanni frontal cortexche vishisht bhag olakhanyacha prayatna keela aahe (udaa.jee., dorsomedial prefrontal cortex (dii. emm. pii. eff. see.) jeey jyaa vyaktinkade gadd kinwa vishisht jaale aahet jyanchyakade gadd aahe asha vyaktinmadhye bhinnapane guntalele asoo shakatat asha vyaktinmadhye qamee-adhik pramanat pratikriyashil asoo shakate. jyaa vyaktinchyakade ekach vayat gadd nahee asha vyaktinchya (udaa.jee., gads kishoravayin mulanmadhye amigdala sakriyakaran).
upchar.
paramparik upchar paddhati mothya pramanat done shreninmadhye yetat, mhanje.eae., manochikitsatmak aanee aushadhashastriy hastakshep. yaa done paramparik upcharatmak drushtikonanvyatirikt, sakriy tapasanichya kshetranmadhye purak aanee paryayi aushadhe (cams), menduchi uttejana, vyayam, upcharatmak masaj aanee pudhil abhyasasathi prastavit kelelya itar hastakshepancha samavesh aahe. upchar paddhati ekach velee vaparlya jaau shakatat aanee anekada vaparlya jaau shakatat jenekarun ekhadi vyakti mansik upcharpaddhaticha pathpurava karoo shakel (mhanje.eae., mansopchar) aanee aushadhashastriy upchar. sandnyanatmak vartanukichi upcharpaddhati (see. bii. tii.) aanee aushadhe (jase qee ess. ess. aar. aay. ess.) hii donhi chinta qamee karnyasathi prabhavi asalyache disun aale aahe. see. bii. tii. aanee aushadh yaa donhinche sanyojan haah samanyatah upcharancha sarvat isht marg mhanoon pahila jaato. tivra chintechi patali qamee karnyasathi aushadhancha vapar karane heey rugnanna see. bii. tii. madhye prabhavipane sahbhagi honyas saksham karnyasathi mahatvache asoo shakate.
mansopchar.
manochikitsatmak hastakshepanmadhye upcharanchya prakaranchi eka bahulata samavisht aahe jee vyaktinna janivpurvak aanee avachetan manachya karyapaddhatibaddal antardrushti midvanyas saksham karnyasathi tyanchya vishisht paddhatinvar aadharit asate aanee jee kadhikadhi aaklan aanee vartan yanchyatil sambandhavar laksh kendrit karatat. sandnyanatmak vartanukichi chikitsa (see. bii. tii.) hii gadver upchar karnyasathi pratham-ola mansik upchar mhanoon mothya pramanavar manali jaate. yavyatirikt, yapaiki anek mansik hastakshep vaiyaktik kinwa samoohik upchar vyavasthemadhye kele jaau shakatat. vaiyaktik aanee gut rachana yaa donhi goshti sthoolpane upcharansathi prabhavi manalya jaat asalya taree, vaiyaktik upcharpaddhati upcharpaddhatimadhye dirghkal tikananya sahbhagala protsahan dete (mhanje.eae., kalantarane qamee taana).
manodaihik upcharpaddhati.
cycodynamic therapy haah frydian manashastravar aadharit eka prakarcha upchar aahe jyamadhye manasshastradnya ekhadya vyaktila manachya jagruk aanee avachetan ghatakanmadhye astitvat asalelya sangharshanche nirakaran karnyasathi tyanchya avachetan manatil vividh ghatakancha shodh ghenyas saksham karato. gadchya sandarbhat, chintecha manodaihik siddhant asey suchavato qee beshuddha munn raag kinwa shatrutvachya bhavna talhanyasathi sanrakshn yantrana mhanoon chintet guntalele asate kaaran asha bhavna samajik aliptata kinwa swatahbaddal itar nakaratmak aarop karoo shakatat. tyanusar, vividh manovikruti upcharpaddhati chinteche swaroop shodhanyacha prayatna karatat kaaran teey sanrakshn yantrana mhanoon chintecha vapar karnyachya avachetan prathet badal karnyas aanee tyadvare chinta lakshane qamee karnyas vyaktinna saksham karnyasathi gadmadhye karya karate. manasopacharanchya vividhatemadhye upcharpaddhatichi najikchi aavrutti, "alpakalin chinta-uttejak mansopchar (step)" yancha samavesh hoto.
vartanukivaril upchar.
vartanukichi chikitsa hii upcharatmak hastakshep aahe jee yaa sankalpanevar aadharit aahe qee chinta hii shastriy paristhitidvare shikali jaate (udaa.jee.eka kinwa adhik nakaratmak anubhav lakshat gheuun) aanee apparent conditioningdware (udaa.jee., ekhadyala asey aadhalate qee bhitidayak anubhav talhalyane chinta talhata yete). asha prakare, vartanukichi upcharpaddhati ekhadya vyaktila purvaniyojit pratisad (vartane) punha shikanyas aanee tyadvare bheeti aanee chinteche purvaniyojit pratisad banalelya aanee purvi aanakhi ayogya vartanukeela janm dilelya vartananna aavhan denyas saksham karate.
sandnyanatmak upchar.
sandnyanatmak upcharpaddhati (seaty) hii chinta hii ayogya manyata aanee vicharanchya paddhatincha parinam aahe yaa kalpanevar aadharit aahe. asha prakare, citymadhye vichar karnyachya adhik tarksangat paddhati olakhanyasathi aanee ayogya vicharanchya paddhatinna badalanyasathi vyaktinna madat karane samavisht aahe (i.eae., sandnyanatmak vikrutee) nirogi vicharanchya namunyansah (udaa.jee., aapattijanak sandnyanatmak vikruteela vicharanchya adhik utpadak namunyane badalane). see. tii. madheel vyakti vastunishtha purava kassa olakhayacha, gruhitkanchi chachani kashee karayachi aanee shevati ayogya vicharanche namune kase olakhayache heey shikatat jenekarun yaa namunyanna aavhan dile jaau shakate aanee tyanchi jaaga ghetali jaau shakate.
sweekruti aanee vachanbaddhata upchar.
sweekruti aanee vachanbaddhata upcharpaddhati (kayada) haah sweekruti-aadharit pratimanvar aadharit vartanukivar aadharit upcharpaddhati aahe. teen upcharatmak uddishte lakshya karnyachya uddeshane krutichi rachana kelee gelee aaheh (1) bhavna, vichar, aathvani aanee sanvedana talhanyasathi uddisht asalelya dhoranancha vapar qamee karane; (2) tyanchya vicharanna vyakticha shabdasha pratisad qamee karane (udaa.jee.mea nirash aahe' assa vichar karane mhanje tyaa vyaktiche jeevan kharokharach nirashajanak aahe assa arth hott nahee) aanee (3) tyanche vartan badalanyasathi vachanbaddhata thevanyachi vyaktichi kshamata vadhavane. ghatananvar niyantran thevanyachya vyaktichya prayatnanna tyanche vartan badalanyachya dishene kaam karnyakade valavoon aanee tyanchya jivanatil maulyavan disha aanee uddishtanvar laksh kendrit karoon tasech tyaa vyaktila tee vaiyaktik uddishte sadhya karnyas madat karananya vartanankade vachanbaddha houn hii uddishte sadhya kelee jaatat. hii manasshastriy upcharpaddhati aniyantrit ghatananna pratisad denyasathi aanee tyamule vaiyaktik moolye sakarnari vartane prakat karnyasathi savdhanta (uddeshane, vartamanat aanee nirnay naan ghenyachya paddhatine laksh dene) aanee sweekruti (mokalepana aanee sampark tikavoon thevanyachi tayari) kaushalye shikavate.
anishchitata upcharanchi asahishnuta.
anishchitatechi asahishnuta (aay. yuu.) mhanje anishchit aanee sandigdha ghatananchya ghatanechya sambhavyatechi parva naan karata tyanchi satatyapurn nakaratmak pratikriya hoy. anishchitata upcharpaddhatichi asahishnuta (aay. yuu. tii.) haah rogmukt rugnansathi swatantra upchar mhanoon vaparla jaato. asha prakare, aay. yuu. tii. chinta qamee karnyasathi rugnanna tyanchya jeevanat anishchitata sahan karanyachi, tyacha samna karanyachi aanee swikaranyachi kshamata vikasit karnyat madat karnyavar laksh kendrit karate. aay. yuu. tii. heey manoshikshan, chintechi jaaniv, samasya sodavanyache prashikshan, chintechya upayuktateche punarmulyankan, aabhasi pradarshanachi kalpana karane, anishchitatechi olakh aanee vartanukishi nigadit pradarshanachya mansik ghatkanvar aadharit aahe. abhyasanni pathpuravyachya kalavadhit satat sudharana hott rahilelya gadd rugnanmadhye yaa upcharpaddhatichya parinamkaraktesathi samarthan darshavile aahe.
preranadayi mulakhat.
gadchya upcharasathi barey honyacha darr sudharanyasathi eka aashadayak navinyapurn drushtikon mhanje see. bii. tii. aanee preranatmak mulakhat (emm. aay.) ekatra karane. prerak mulakhat hii rugnavar kendrit eka ranniti aahe jyacha uddesh aantarik prerana vadhavane aanee upcharanmule honanya badalabaddal dvidha manahsthiti qamee karane haah aahe. mea madhye chaar pramukh ghatak aaheth (1) sahanubhooti vyakt karane, (2) ichchit nasaleli vartane aanee tyaa vartananshi susangat nasalelya mulyanmadhil visangati vadhavane, (3) thet sangharsh karnyaivaji pratikarane pudhe jaane aanee (4) swa-parinamkaraktes protsahan dene. heey khule prashna vicharane aanee rugnanchi uttare kaljipurvak aanee chintansheelpane aikane, 'badal charcha' karane aanee badalanche fayade aanee tote yabaddal rugnanshi bolane yavar aadharit aahe. kahee abhyasanmadhye asey disun aale aahe qee see. bii. tii. aanee emm. aay. chey sanyojan heey keval see. bii. tii. peksha adhik prabhavi aahe.
sandnyanatmak vartanukichi upcharpaddhati.
sandnyanatmak vartanukichi upcharpaddhati (see. bii. tii.) haah eka purava-aadharit manochikitsecha prakar aahe joou gadver upchar karnyat parinamkarakta darshavito aanee sandnyanatmak aanee vartanukichya upcharatmak paddhatinna ektrit karato. see. bii. tii. chaa uddesh, chinta nirman karnare atarkik vichar olakhane aanee gruhitak chachani aanee journalling yasarkhya jagrukta tantranmadhye sahbhagi houn nishkriy vicharanchya paddhatinna aavhan dene heey aahe. kaaran see. bii. tii. madhye chinta aanee chinta vyavasthapanacha sarav samavisht aahe, see. bii. tii. madhye hastakshep tantranchi vipulata samavisht aahe jee vyaktinna chinta, chinta aanee svayanchalit nakaratmak vicharanche namune shodhanyas saksham karate. yaa hastakshepanmadhye chinta vyavasthapan prashikshan, sandnyanatmak punarrachana, pragatishil vishranti, paristhitijanya sampark aanee swayam-niyantrit asanvedansheelata yancha samavesh hoto. internet-vitarit see. bii. tii. kinwa aay. see. bii. tii. saha, gadver upchar karnyasathi vitaranachya anek paddhati prabhavi aahet.
bhavna-kendrit upcharpaddhati.
bhavna-kendrit upcharpaddhati (eae. eff. tii.) hii eka alpakalin manasopacharpaddhati aahe jee vyaktinvar upchar kartana bhavananchya manavtavadi garjanvar kendrit asate. eae. eff. tii. madhye prayogik upcharpaddhati, pranaligat upcharpaddhati aanee see. bii. tii. chey ghatak yasarkhya anek paddhatincha samavesh keela jaau shakato, jyamule vyaktinna katheen bhavnik avasthanmadhun kaam karata yeil. vyaktinna tyanchya asurakshit bhavnansah jaganyat aanee talhanyavar maat karnyat madat karane heey eae. eff. tii. chey prathamik uddisht aahe jenekarun karuna aanee snrakshak raag yasarkhe anukool anubhav mool bhavnik asurakshitatemadhye antarbhut asalelya bhavnik garjanna pratisad mhanoon nirman kele jaau shakatat.
sandplay therapy.
sandplay therapy (ess. pii. tii.) hii ashabdik upchar paddhativar aadharit eka hastakshep aahe. balpanatil aaghatanpasun (seaty) tyanchya bhavnik samasyanvar valoo aanee khelanyanchya aakruti vaparoon kheloon kaam karanyachi kshamata vyaktis dene haah ess. pii. tii. chaa mukhya uddesh aahe. jaree upcharpaddhati pramukhyane ashabdik sanketanvar kendrit asali taree, vyaktichya punarvasan prakriyedarmyan maukhik sanketanche nirikshan aanee dastaivajikaran dekhil kele jaate. ess. pii. tii. eka surakshit aanee sanrakshit jagetoon bahusanvedi anubhav dete jyamule vyaktila tyanche munn aanee bhavna niyantrit karanyachi sandhee milate. hii upcharatmak paddhat praudh aanee mule doghanmadhyehi dilee jaate.
aushadhopachar.
abhyas kelelya aushadhancha alikadil network meta-vishleshanat aadhava ghenyat aala, jyat serve abhyasalelya aushadhanchi placeboshy aanee ekmekanshi tulana kelee gelee aanee dusya aushadhanmadhye maaf honyachya darachi tulana kelee gelee. 1960 chya dashakapasun chinta door karnyasathi benzodiazepines (bii. zed. ess.) chaa vapar keela jaat aahe. benjodiazepineswar avalambun rahanyacha aanee sahansheel rahanyacha dhoka aahe. bii. zed. ess. chey anek parinam aahet jeey tyanna chintevar upchar karnyasathi eka changla paryay banavtat, jyat anciolytic, sammohan (zope prerit karane), myorelexant (snayunna aaram dene), anticonvalsant aanee amnestic (alpakalin smaranshakti bighadanare) gunadharm yancha samavesh aahe. prashasananantar lagechach chinta qamee karnyasathi bii. zed. ess. changle kaam karatat, parantu teey avalambitwala chalana denyachya tyanchya kshamatesathi dekhil olakhale jaatat aanee teey varanvar manoranjanatmak kinwa bigger-vaidyakeey paddhatine vaparale jaatat. avasadarodhi aushadhe (udaa.jee., ssris/snris) haah praudhanmadhye gadver upchar karnyacha mukhya aadhar banala aahe. konatyahi aushadh shrenitil pahilya-kramankachya aushadhanmadhye anekada ann aanee aushadh prashasana (eff. dii. aii.) kinwa itar tatsam niyamak sansthedvare manjur kelelya aushadhancha samavesh asato, jase qee eae. emm. aii. kinwa tii. jee. aii., kaaran hii aushadhe surakshit aanee prabhavi asalyache disun aale aahe.
gadchya upcharasathi eff. dii. aii.-manyataprapt aushadhe.
gadver upchar karnyasathi eff. dii. aii.-manyataprapt aushadhanmadhye khaleel goshtincha samavesh hotoh 
eff. dii. aii. manyata nasaleli aushadhe.
kahee aushadhe gadchya upcharasathi visheshtah eff. dii. aii. neey manjur nasali taree, ashee anek aushadhe aahet jee aitihasikdrushtya gadchya upcharasathi vaparali kinwa abhyasali gelee aahet. gadchya upcharasathi vaparlelya kinwa moolyamapan kelelya itar aushadhanmadhye khaleel goshtincha samavesh hotoh
nivadak serotonin punargrahan avarodhak.
gadsathichya aushadhopachar upcharanmadhye nivadak serotonin reptech inhibitors (ess. ess. aar. aay. ess.) samavisht aahet. ess. ess. aar. aay. see. serotonin reptech receptorschya pratibandhadvare serotoninchi patali vadhavate.
yaa uddeshasathi vaparlya jaanarya eff. dii. aii. manyataprapt ess. ess. aar. aay. madhye eskitalopram aanee paroxetinecha samavesh aahe. tathapi, samanyikrut chinta vikarasathi vaparlya jaanarya itar ess. ess. aar. aay. chya tulanet aanee ess. aine. aar. aay. chya tulanet paise kadhanyacha qamee dhoka asalyamule, margdarshak tattve suchavatat qee, pratham certralinecha vapar karane. jarr certrallin aprabhavi asalyache aadhalun aale tarr aanakhi eka ess. ess. aar. aay. kinwa ess. aine. aar. aay. vaparoon pahanyachi shifaras kelee jaate.
samanya dushparinamadhye malmal, laingik bighad, dokedukhi, atisar, baddhakoshthata, aswasthata, tarun praudh aanee paugandavasthetil aatmahatyecha vadhata dhoka yancha samavesh hoto. eskitalopram aanee certralinepeksha paroxetinemadhye laingik dushparinam, vajan vadhane aanee vajan qamee honyacha dhoka jaast asato. vruddha loksankhyemadhye kinwa raktastravacha dhoka vadhavnari sahavarti aushadhe ghenadhyanmadhye, sris raktastravacha dhoka aanakhi vadhavu shakate. ess. ess. aar. aay. chaa ativapar kinwa dusya ghatkashi sahavarti vapar jyamule serotoninchi patali vadhate, parinami serotonin syndrome houu shakato, joou jivghena asoo shakato.
serotonin norpinephrine reaptech inhibitors.
gadsathichya pahilya aushadhopachar upcharanmadhye serotonin-norpinephrine reptech inhibitors (ess. aine. aar. aay. ess.) dekhil samavisht aahet. heey see. aine. ess. madhye tyanchi patali vadhavanyasathi serotonin aanee noradrinaline punargrahan rokhatat.
yaa uddeshasathi vaparlya jaanarya eff. dii. aii. manyataprapt snrismadhye duloxetin (sayambalta) aanee wenlafaxin (effexer) yancha samavesh hoto. snrisachi parinamkarakta ssris sarkhich asali taree, anek mansopacharatadnya samanyikrut chinta vikaravaril upcharanmadhye pratham ssris vaparnyas pradhanya detat. chinta vikaranchya upcharansathi pahili pasanti mhanoon snarisapeksha ssarisala kinchit jaast pradhanya dene, heey nairashyachya rugnanchya abhyasachya paddhatshir punaravalokananmadhil ssarisachya tulanet snarisachya qamee sahanshilatechya nirikshanane prabhavit jhaale asave.
donhi snarisasathi samanya asalelya dushparinamadhye chinta, aswasthata, malmal, vajan qamee hone, nidranash, chakkar yene, tandri yene, gham yene, korade tond, laingik bighadalelepana aanee ashaktapana yancha samavesh hoto. ess. ess. aar. aay. chya tulanet, nidranash, korade tond, malmal aanee uchch raktadab yaa dushparinamanche praman snarismadhye jaast asate. donhi snarinmadhye achanak thambalyanantar bund honyachya lakshansamuchchayasathi kshamata asate, jyamule motormadhye adthala aanee chinta yasah lakshane udbhavu shakatat aanee tyanna qamee karanyachi aavashyakta asoo shakate. itar serotonergic ghatakanpramanech, snrismadhye serotonin syndrome nirman karanyachi kshamata asate, joou serotonergicchya atiriktatesathi sambhavya ghatak pranaligat pratisad aahe jyamule uttejit hone, aswasthata, gondhal, tachycardia, uchch raktadab, mydriasis, attaxia, myoclonus, snayunchi kadakpana, diaphoresis, atisar, dokedukhi, comp, hansache thoke, uchch taap, daure, erythmia aanee beshuddhi yasah lakshane udbhavtat. ssris sarkhya snarinmadhye aatmahatyechya kalpanansathi black boxes chetavani asate, parantu samanyatah asey manale jaate qee upchar naan kelelya nairashyat aatmahatyecha dhoka nairashyavar yogya upchar kelyavar aatmahatyechya jokhamipeksha khoop jaast asato.
pregabalin aanee gabapentin.
pregabalin (lira) heey gadchya upcharasathi prabhavi aahe. glutamate, norpinephrine aanee padarth pii sarkhya neurotransmitterche prakashan qamee karnyasathi heey voltage-aadharit calcium vahinivar karya karate. tyacha upcharatmak parinam vaparachya 1 aathvadyanantar disun yeto aanee parinamkaraktet lorazepam, alprazolam aanee wenlafaxinsarkhech aahe parantu pregabalinane mansik aanee sharirik chintechya lakshanansathi adhik susangat upcharatmak parinam nirman karoon shreshthata darshavili aahe. dirghakalin chachanyanni sahishnutechya vikasashivay satat parinamkarakta darshavili aahe aanee yavyatirikt, benzodiazepineschya vipareet, teey zopechya sanrachanet vyatyay aanat nahee aanee qamee gambhir sandnyanatmak aanee manoprerak durbalata nirman karate. tyacha gairavapar aanee avalambitva honyachi shakyata dekhil qamee aahe aanee yaa karananmule benjodiazepinespecsha yala pradhanya dile jaau shakate. pregabalinache utkat parinam kiman sahaa mahine satat vaparasathi tikoon asalyache disun yete, jyamule sahishnuta hii qamee chintechi baab asalyache soochit hote; yamule benzodiazepinesarkhya kahee utkat aushadhanpeksha pregabalinla fayda hoto.
pregabalinashy jawalun sambandhit asalelya, tyach krutichya yantranesah asalelya gabapentin (neurantine) yaa aushadhane dekhil gadchya upcharanmadhye parinamkarakta darshavili aahe, jaree pregabalinchya ulat, yaa sanketasathi tyala visheshtah manyata denyat aaleli nahee. tathapi, yaa sthitichya vyavasthapanamadhye teey samaan upayukt asanyachi shakyata aahe aanee paytant naslyamule, tulanet teey lakshaniyaritya qamee mahag asalyacha fayda aahe. tyanusar, gadver upchar karnyasathi gabapentin varanvar auph-label lihoon dile jaate.
gadver upchar karnyachya kshamatesathi purak aanee paryayi aushadhancha abhyas keela gela.
purak aanee paryayi aushadhe (cams) prabhavitebabat konatahi purava kinwa vividh purave nasatanahi gadd asalelya vyakti mothya pramanat vapartat. cam aushadhanchya parinamkaraktechya chachanyanmadhye anekada surakshechya sandarbhat vividh prakarche purvagrah aanee qamee darjache ahwal asatat. parinamkarakta sandarbhat, samikshakanni asey nidarshanas aanoon dile aahe qee cam chachanya kadhikadhi dnyat aushadhachya tulanet camchya tulanevar aadharit karyakshamatechya davyanche anuman lavtat, jyanantar tapaskartyanna vishayanmadhye konatahi farak aadhalat nahee aanee jyacha vapar cam aanee aushadh yanchyatil samanata suchavanyasathi keela jaato. kaaran heey puravyachya kamataratechi aanee karyakshamatechya sakaratmak davyachi tulana karate, tyamule 'bhinnatecha abhav' haah samarthanasathi yogya dawa nahee. shivay, cam sanyugansathi kathor vyakhya aanee manakancha abhav gadver upchar kartana camchya karyakshamatesambandhichya sahityavar aanakhi bhaar takto. gadd kinwa gadd lakshananvar upchar karnyachya tyanchya kshamatesathi shaikshanikdrushtya abhyasalele cams aanee shaikshanik nishkarshancha saransh khalee deela aahe. pudhil shaikshanik nishkarshancha saransh aahe. tyanusar, "khalilpaiki konatyahi camchi suraksha kinwa parinamkarakta yabaddal vaidyakeey margadarshan kinwa mutt mhanoon khalilpaiki kahihi ghetale jaau naye."
gadver upchar karnyachya sambhavyatesathi sahityamadhye charcha kelelya itar sambhavya paddhati.
gadd kinwa gadchya lakshananvar upchar karnyachya tyanchya kshamatesathi shaikshanikdrushtya abhyasalya gelelya itar paddhatincha saransh khalee deela aahe. pudhil shaikshanik nishkarshancha saransh aahe. tyanusar, "khalilpaiki konatyahi paddhatichi surakshitata kinwa parinamkarakta yabaddal vaidyakeey margadarshan kinwa mutt mhanoon khalilpaiki kahihi ghetale jaau naye".
jivanshaili.
jivanshailiche ghatak, jyat tanav vyavasthapan, tanav qamee karane, vishranti, vyayam, zopechi swachchata aanee caffeen aanee alcohole qamee karane yancha samavesh aahe, teey chintechya patalivar parinam karoo shakatat. sharirik halchalincha sakaratmak parinam disun aala aahe, tarr qamee sharirik halchali haah chintechya vikaransathi jokhim ghatak asoo shakato.
gadmadhil padarth aanee chinta.
samanyikrut chinta vikar (gadd) nirman karnare konatehi padarth nasale taree, kahee padarth kinwa kahee padarthanmadhun baher padane heey chintechya anubhavala protsahan denyat guntalele aahet. udaharanarth, benjodiazepinesmule chintepasoon aaram milananya vyaktinna parvadat asale taree, benzodiazepinesmadhun maghar ghene heey gham yene aanee thartharane yasarkhya itar pratikool ghatananmadhye chintechya anubhavashi sambandhit aahe.
tambakhuche sevan mage ghenyachi lakshane dhoomrapan karananyanmadhye chinta nirman karoo shakatat aanee caffeencha ativapar haah chinta vadhavane aanee tee kayam rakhanyashi jodalela aahe.
sahvyadhi.
nairashya.
rashtriy sahvyadhi sarvekshanat (2005), mothya nairashyache nidan jhalelya 58 takke rugnanna chinta vikar asalyache aadhalun aale; yaa rugnanmadhye, gads sahvyadhiche praman 17.2 takke aanee panic disorders 9.9 takke hote. nidan jhalelya chinta vikar asalelya rugnanmadhye sahvyadhi nairashyache praman dekhil jaast hote, jyat samajik bhay asalelya 22.4 takke, agoraphobia asalelya 9.4 takke aanee panic disorder asalelya 2.3 takke rugnancha samavesh hota. eka anudairdhya samooh abhyasat asey aadhalun aale qee 972 sahbhaginpaiki 12 takke lokanna emm. dii. dii. saha gadd comorbid hote. ektrit purave asey soochit karatat qee sahvyadhigrast nairashya aanee chinta asalelya rugnanmadhye ektya vikar asalelya rugnanpeksha aajarachi tivrata jaast aanee upcharanna qamee pratisad asato. yavyatirikt, samajik karya aanee jivanacha darja adhik kharab jhaala aahe.
anekansathi, nairashya aanee chinta yaa donhinchi lakshane pureshi gambhir nasatat (mhanje.eae. eka tarr mejar depressive disorder (emm. dii. dii.) kinwa chinta vikar yaa prathamik nidanache samarthan karnyasathi subsyndromal aahet. tathapi, dystemia heey gadd clientche sarvat prachalit sahvyadhi nidan aahe. rugnanna mishra chinta-nairashya vikar mhanoon dekhil vargikrut kele jaau shakate aanee tyanna purn vikasit nairashya kinwa chinta vikasit honyacha dhoka lakshaniyaritya vadhalela asato.
gadd aanee nairashya vikaranmadhil uchch sahvyadhisathi vividh spashtikaran suchavale gele aahe, jyat anuvanshik pleotropy (i.eae.gadd aanee naun-bipolar depression heey donhi vikaranmadhil sambhavya tod yantrana mhanoon bighadalele karyakari niyantran kinwa zopechya samasya aanee thakwa) yaa samanya karananmule honanya bhinn phenotypic abhivyakti darshavu shakatat.
sahvyadhi aanee upchar.
gadd asalelya rugnanmadhye aanee gadd aanee comorbid vikar asalelya rugnanmadhye upcharpaddhati samaan parinamkarak asalyache disun aale aahe. upchar suru kartana sahvyadhi vikar asalelya rugnanmadhye adhik gambhir lakshane asatat parantu sadhya sadhanansah asalelya rugnanpeksha adhik sudharana disun yete.
aushadhashastriy drushtikon I.eae. vividh sahvyadhisathi antidepressantcha vapar swikarla gela pahije. udaharanarth, serotonin reptech inhibitors aanee alp-karyaksham benzodiazepines (bii. zed. dii.) yancha vapar nairashya aanee chintesathi keela jaato. tathapi, chinta aanee madak padarthanchya vaparacha vikar asalelya rugnansathi, tyanchya vyasanadhin gunadharmanmule bii. zed. dii. talhale pahijet. see. bii. tii. haah eka prabhavi upchar asalyache aadhalun aale aahe kaaran yamule gadd aanee madak padarthanchya vaparachi lakshane sudharatat.
samanya loksankhyechya tulanet, nairashya, samanyikrut chinta vikar (jee. aii. dii.) aanee aaghatanantarcha taana vikar (pii. tii. ess. dii.) yasarkhe antargat vikar asalelya rugnanmadhye mrutyuche praman jaast asate, parantu hridayrog, cerebrovascular rog aanee karkarog yasarkhya loksankhyepramanech vay-sambandhit aajaranmule tyancha mrutyu hoto.
snayuncha taana aanee irritable bowell syndrome yasarkhya tanavashi sambandhit paristhitinsaha gadd anekada sahastitvat asato.
gadd asalele rugna kadhikadhi nidranash kinwa dokedukhi tasech vedna aanee paraspar samasya yasarkhi lakshane darshavu shakatat.
pudhil sanshodhan asey suchavate qee laksh qamee atee sakriyata vikar asalelya sumare 20 teey 40 takke vyaktinmadhye sahvyadhiyukt chinta vikar asatat, jyat gadd sarvat prachalit aahe.
gadd asalelya lokanmadhye alcoholchya vaparachya vikarasah 30 teey 35 takke aanee itar madak padarthanchya vaparachya vikarasathi 25 teey 30 takke ashee aajivan sahvyadhichi vyapti asate. gadd aanee madak padarthanchya vaparacha vikar yaa donhi vikar asalelya lokanmadhye itar sahvyadhisathi dekhil ayushyabhar jaast pramanat aadhaltat. eka abhyasat asey aadhalun aale aahe qee madyasevechya vikarane sahvyadhi asalelya 18 sahbhaginpaiki ardhyahun thoda jaast lokanmadhye gadd haah prathamik vikar hota.
mahamarishastra.
gadcha parinam bahudha andaje 3-6% praudhanvar aanee 5 takke mule aanee kishoravayin mulanvar hoto assa andaj aahe. jaree mulanmadhye 3 takke aanee paugandavasthetil mulanmadhye 10.8% haah rogacha pradurbhav asalyache soochit karnyasathi andaj vegvegale aahet. jevha gadd mule aanee paugandavasthetil lokanmadhye prakat hoto, tevha too samanyatah vayachya 8 teey 9 varshanchya aaspas suru hoto.
gadd kinwa aajivan jokhamichya prasarasandarbhat andaj (i.eae.gadsathi aajivan rugna jokhim (ell. emm. aar.) heey gadchya nidanasathi konate nikash vaparale jaatat yavar avalambun badalate (udaa.jee., dii. ess. emm.-5 viruddha aay. see. dii.-10) jaree nidanatmak nikashannusar andaj mothya pramanat badalat naheet. sarvasadharanpane, aay. see. dii.-10 heey dii. ess. emm.-5 peksha adhik samaveshak aahe, tyamule aay. see. dii.-10 vaparoon pradurbhav aanee aajivan jokhamishi sambandhit andaj jaast asatat. pradurbhavachya sandarbhat, dilelya varshat, united states aanee europemadhil sumare done (2 takke) takke praudhanna gadd asalyache suchavale gele aahe. tathapi, aayushyachya konatyahi tappyavar gadd vikasit honyacha dhoka 9 takke asalyacha andaj aahe. jaree aekhadyachya aayushyat gadcha ekach bhag anubhavane shakya asale taree, gadcha anubhav ghenare bahutek lock tyanchya aayushyat varanvar eka junat kinwa chaloo sthitee mhanoon anubhavtat. purushanpeksha striyanmadhye gadche nidan duppat varanvar hote aanee jeey vegale aahet, ghatasfotit aahet, berojgar aahet, vidhva aahet kinwa shikshanachi patali qamee aahe aanee nimn samajik-aarthik sthitee asalelyanmadhye yache nidan adhik vela hote. african american lokanna gadd honyachi shakyata jaast asate aanee haah vikar anekada vegvegalya namunyanmadhye prakat hoto. asey suchavale gele aahe qee mahilanmadhye gadcha adhik prasar houu shakato kaaran purushanpeksha striya garibeet jaganyachi shakyata jaast asate, adhik vela bhedbhavacha vishay asatat aanee purushanpeksha adhik vela laingik aanee sharirik shoshan kele jaate. ekhadya vyaktichya aayushyatil gadchya pahilya ghatanechya sandarbhat, gadchi pahili abhivyakti samanyatah kishoravayin varshanchya uttaradhat aanee visavya dashakachya suruvatichya kalat hote, suruvatiche sarasari vay andaje 31 varshe aanee suruvatiche sarasari vay 32.7 varshe asate. tathapi, gadd aayushyachya konatyahi tappyavar suru houu shakate kinwa punha udbhavu shakate. kharey tarr, vruddha loksankhyemadhye gadd samanya aahe.
united states.
united states dilelya varshat 18 varshe aanee tyahoon adhik vayache andaje 3.1 takke lock (9.5 laakh).
britton.
5.2019 madhye 9 takke praudhanna gadcha fatka basala hota.