Ngokusho kokubuyekezwa kocwaningo olubanzi lwe-2022, abukho ubufakazi besayensi balokho osekuyisikhathi eside sitshelwa yi-psychiatry-kanye nemidiya evamile-mayelana ne-neurobiology yokucindezeleka. Lezi zibuyekezo, ngazwi linye, zizopakisha i-wallop enamandla yabacabangi abagxekayo. Kodwa-ke, emphakathini waseMelika uwonke, ideski lihlanganiswe ngokumelene nanoma yimaphi amaqiniso esayensi enza i-mythology yokukhubazeka kwengqondo yengqondo.
Imithelela yalokhu kubuyekezwa ihlukaniswe ngezigaba ezilandelayo: (1) Esikutsheliwe; (2) Iqiniso Lesayensi; (3) Yini Ingabe Izinguquko Ezihlobene Nokucindezeleka? kanye (4) Nedekhi Estakiwe ngokumelene Namaqiniso Esayensi Amazinyo Ezinganekwane Zobuchopho-Iphutha.
Esikutsheliwe
Umphakathi jikelele uye wezwa njalo izimemezelo ezivela kwiziphathimandla zezifo zengqondo ukuthi ukucindezeleka kuyisenzakalo se-neurobiological (noma isifo sobuchopho) esibangelwa: (1) ukungahambi kahle kobuchopho okuvezwe yi-neuroimaging; (2) ukukhubazeka kwamakhemikhali e-neurotransmitter, ngokuvamile “ukungalingani kwamakhemikhali e-serotonin”; kanye (3) nokukhubazeka okubonakalayo kofuzo okuholela ekwenyukeni sengozini kwezingcindezi ezingokwengqondo nezenhlalo.
Esinye isibonelo salokho abantu baseMelika abakuzwa kuziphathimandla yiHarvard Medical School's “Yini Ebangela Ukucindezeleka” (January 2022), eyathi: “Intuthuko enkulu emkhakheni wezinto eziphilayo zokucindezeleka ihlanganisa ukuthola izixhumanisi phakathi kwezingxenye ezithile zobuchopho nemiphumela yokucindezeleka, ukuthola ukuthi amakhemikhali abizwa ngokuthi ama-neurotransmitters akwenza kanjani ukuxhumana phakathi kwamangqamuzana obuchopho kube nokwenzeka, nokufunda umthelela wezakhi zofuzo nendlela yokuphila. izehlakalo ezisengozini nezimpawu zokucindezeleka.”
Iqiniso Lesayensi
Okwakamuva kakhulu kokubuyekezwa okuthathu mayelana ne-neurobiology of depression yashicilelwa ngo-Okthoba 2022 ngu Peter Sterling, USolwazi weNeuroscience ePerelman School of Medicine, eNyuvesi yasePennsylvania, futhi ibizwa ngokuthi: "I-Neuroscientist Ihlola Imodeli Yebhayoloji Ejwayelekile Yokucindezeleka. " USterling wahlola ubufakazi benkolelo-mbono yokuthi ukucindezeleka kuyikho "ukuphazamiseka kwengqondo okubangelwa ukukhubazeka okuthile endleleni ethile yemizwa,” futhi waphetha ngokuthi “ubufakazi bamuva obuvela emithonjeni eminingi [ecaphuna omagazini abangu-44] buyahluleka ukusekela le nkolelo-mbono.” Kushicilelwe kuwebhu Uhlanya eMelika, uSterling ufingqa lokho akutholile:
(1) I-Neuroimaging ayikubonisi ukungahambi kahle kobuchopho kubantu abacindezelekile; i-neuroimaging ayihlukanisi ngisho phakathi kokukhulu abantu yokucindezeleka vs enempilo.
(2) Ucwaningo lwenhlangano ye-genome-wide lukhomba amakhulu ezinhlobonhlobo zomphumela omncane, kodwa lokhu akumhlonzi umuntu ocindezelekile, ngisho nenani labantu elicindezelekile.
(3) Ithiyori ‘yokungalingani kwamakhemikhali’ yokucindezeleka yehlulekile ngenxa yokuswela ubufakazi, ngaleyo ndlela iphuca izidakamizwa ‘eziqeda ukucindezeleka’ ingqondo enengqondo.
(4) Ukucindezeleka, kuyilapho kubikezelwa ngokubuthakathaka yinoma iyiphi ‘i-biomarker,’ is okubikezelwa kakhulu ukuhlukumezeka kwasebuntwaneni kanye nokucindezeleka okungapheli komphakathi.
Ubufakazi obunamandla kakhulu bokuthi i-neuroimaging ayikuhlonzi ukungahambi kahle kobuchopho okuhlobene nokudangala buvela ekubuyekezweni kwesibili kuka-2022, okushicilelwe kujenali. I-Neuron, eyabhalwa noRaymond Dolan e-University College London—ocatshangelwa omunye wososayensi bezinzwa abanethonya elikhulu emhlabeni.
U-Dolan nababhali abakanye naye, ku- “I-Neuroimaging esebenzayo ku-Psychiatry kanye necala lokuhluleka kangcono,” iphetha: “Naphezu kweminyaka engamashumi amathathu yocwaningo olunzulu lwe-neuroimaging, sisantula umbiko we-neurobiological nganoma yisiphi isimo sengqondo”—okuhlanganisa ukucindezeleka.
Ecabanga ngezihloko ze-neuroimaging ezingaphezu kuka-16,000 30 ezanyatheliswa phakathi neminyaka engu-30 edlule, uDolan nababhali abakanye naye baphetha: “Kusenzima ukuphikisa ukugxeka okuthi isici esiyinhloko sesayensi yengqondo ukungazi. . . . Ukubeka iso elibandayo ezincwadini ze-neuroimaging yengqondo kumema isiphetho sokuthi naphezu kweminyaka engu-XNUMX yocwaningo olunzulu nentuthuko enkulu yezobuchwepheshe, le nkampani ayizange ilethe i-akhawunti ye-neurobiological (okungukuthi, incazelo yemishini) yanoma yikuphi ukuphazamiseka kwengqondo, futhi ayizange inikeze okuthembekile. i-biomarker esekwe ku-imaging ye-clinical utility."
Yize lezi zibuyekezo zososayensi abadumile bezinzwa uPeter Sterling noRaymond Dolan zithole ukunakwa okuncane komphakathi, ukubuyekezwa kwesithathu kuka-2022 kuzuze ukusabalala kwemithombo yezindaba. Isihloko esithi “I-Serotonin Theory of Depression: Ukubuyekezwa Okuhlelekile Kwesambulela sobufakazi,” yanyatheliswa kumagazini I-Psychiatry yamaphilisi, ebhalwe phambili ngudokotela wezengqondo Joanna Moncrieff, e-University College London kanye nosihlalo ohlanganyele we-Critical Psychiatry Network.
UMoncrief nabacwaningi akanye nabo bahlola amakhulu ezinhlobo zocwaningo ezazama ukuthola ubudlelwano phakathi kokucindezeleka ne-serotonin, futhi baphetha ngokuthi abukho ubufakazi bokuxhumana phakathi kwamazinga aphansi e-serotonin nokucindezeleka, bathi: “Siphakamisa ukuthi sekuyisikhathi. ukuvuma ukuthi inkolelo-mbono ye-serotonin yokucindezeleka ayisekelwa ngokomthetho.”
Abaxolisi bePsychiatry wazama ukukholisa umphakathi jikelele ukuthi okutholwe nguMoncrieff bekungeyona indaba yezindaba, nokuthi abezengqondo sekuyisikhathi eside bayilahla inkolelo-mbono yokungalingani kwe-serotonin yokucindezeleka. Kodwa-ke, uma kubhekwa iqiniso lokuthi iningi lomphakathi alizwanga lutho kwabezengqondo mayelana nokulahlwa kwalo mbono, okwalandela kube sesidlangalaleni. inhlekisa ngezifo zengqondo kanye nabalingani bayo abakhulu be-Big Pharma ngokuphindiwe kwabo.
I-Institute psychiatry isebenzise isu elihlukile lokubhekana nokuthola ukuthi ucwaningo lwe-neuroimaging lwehlulekile ukuhlinzeka nge-akhawunti ye-neurobiological yanoma yisiphi isimo sengqondo, okuhlanganisa ukudangala. I-Psychiatry kanye nabezindaba abajwayelekile bamane bakushaye indiva lokhu.
Okunye okunganakwa ukutholakala kokuthi abantu abacindezelekile abakwazi ukubonwa ngezakhi zabo zofuzo. Sterling uyaphawula ekubukezeni kwakhe, “Ithemba elikhulu nge-Human Genome Project cishe ngo-2003 laliwukubona izinhlobo eziyinhloko zofuzo ‘ezibangela’ ‘ukuphazamiseka kwengqondo.’” Nokho, azikho izinhlobo ezinjalo zofuzo eziye zatholakala.
Uma kubhekwa umlando wekhulu lamashumi amabili lama-eugenics, nokuthi wasetshenziswa kanjani ukuthethelela ukuvala inzalo e-United States-kanye nokubulawa kwabantu eJalimane lobuNazi-kwabantu abatholakala benesifo sengqondo, ufuzo lwakamuva kufanele lube lukhathazayo. Umlando usitshela ukuthi uma izinkolelo-mbono eziphathelene nezakhi zofuzo zithathwa ngokungathi sína, futhi isidingo sesizwe sokusebenza kahle nokukhiqiza sinqwabelanisa nokubekezelela ukungezwani komuntu ngamunye, khona-ke isizwe esinjalo siyofuna ukuqeda abantu abangasebenzi kahle nabangenzi lutho, kuhlanganise nabacindezeleke kakhulu. Ngakho-ke, uma umphakathi ukholelwa ukuthi ukuphazamiseka okunzima kokuziphatha nokuhlupheka ngokomzwelo kubangelwa izakhi zofuzo, futhi uma umphakathi onjalo wamukela uhlobo lwe-fascism olwamukelwa yiJalimane lamaNazi, umlando usitshela ukuthi kwenzekani ngokulandelayo.
U-Sterling akayena nje isazi sezinzwa esivelele kodwa uyisishoshovu sesikhathi eside sobulungiswa bezenhlalo, okwathi eseyinsizwa, ubambe iqhaza kuma-Freedom Rides. Ngenxa yokuqonda kwakhe imithelela yezombangazwe yemibono yebhayoloji yengqondo, amaqiniso esayensi ngezakhi zofuzo nokucindezeleka akuwona neze umsebenzi omncane kuye.
Olunye lwezifundo ezimbalwa ezidicilela phansi umqondo wokuthi kukhona okuhlukile kofuzo okungasetshenziswa ukukhomba ukudangala okukhulunywe ngakho ekubuyekezweni kuka-Sterling ngo-2021. uphenyo olushicilelwe ku I-Journal ye-Affective Disorders okuhlanganisa amacala ayi-5,872 kanye nezilawuli ezingama-43,862, futhi okuhlole izinhlobo zofuzo eziyi-22,028. Ababhali babika ukuthi lolu cwaningo “luyahluleka ukukhomba izakhi zofuzo ezithonya amathuba okuba nesifo semizwa” futhi “asikho isakhi sofuzo esiveza umphumela ophawulekayo ngokwezibalo.”
Ini Ingabe Izinguquko Ezihlobene Nokucindezeleka?
Izinyathelo zebhayoloji eziyishumi nambili [okuhlanganisa i-structural magnetic resonance imaging (MRI), i-task-based functional magnetic resonance imaging (fMRI), i-fMRI yesifunda sokuphumula, nezinye izinyathelo zebhayoloji eziyisishiyagalolunye] ziyehluleka ukuhlukanisa 'abacindezelekile' kubantu 'abanempilo',” kubika uSterling, “kodwa izici ezimbili ezingokwengqondo zikwenza ngokucacile lokho . . . . Abantu abacindezelekile maningi kakhulu amathuba okuba babike ukuhlukumezeka kwasebuntwaneni futhi mancane kakhulu amathuba okuba bathole ukwesekwa komphakathi.
Kudala, kwakungeyona into engavamile ngodokotela bengqondo ukuthi empeleni bachithe isikhathi befunda ngempilo yeziguli zabo. Nokho, njengoba New York Times kubikwe ngo-2011 (“I-Talk Ayikhokhi, Ngakho I-Psychiatry Iphendukela Esikhundleni Sokwelapha Izidakamizwa”), “Ucwaningo lukahulumeni lwango-2005 lwathola ukuthi amaphesenti angu-11 nje kuphela odokotela bengqondo abanikeza ukwelapha ngenkulumo kuzo zonke iziguli, isabelo ebesilokhu siwohloka iminyaka futhi okungenzeka ukuthi sehle kakhulu kusukela ngaleso sikhathi.”
Namuhla, isazi sokusebenza kwengqondo esiyingqayizivele kakhulu-mhlawumbe "udokotela wengqondo ophikisanayo" -onikeza noma yini enye ngaphandle kokuphathwa kwemithi ("ukuphathwa kwe-med" kuqukethe i-10 kumaminithi we-15 njalo ezinyangeni ezimbili noma ezintathu, ukuhlola izimpawu kanye nemithi yokwelapha). Iningi lodokotela bengqondo alinikezi lutho ngaphandle kwemizamo ye-biochemical-electrical yokunciphisa izimpawu.
Uma ngempela umuntu echitha isikhathi nabantu abacindezelekile, kusobala ukuthi isithako esivamile abahlanganyela kuso siwuhlobo oluthile lobuhlungu obudlulele, futhi uma umuntu echitha ngisho nehora elalele iningi labantu abacindezelekile, akunzima kangako ukuthola umthombo walokho. ubuhlungu.
Ezinye zezinhlungu ezicindezelayo ezivame kakhulu zihlanganisa: ubuhlungu obukhulu obungapheli bomzimba (isb., I-rheumatoid arthritis noma umdlavuza wamathambo); ubuhlungu obukhulu bezezimali (isb., ukuqothuka, ukungasebenzi, nobumpofu); ubuhlungu bezomthetho (isb., ukukhululwa ngeshwele, ukuvivinywa, nokunye ukubandakanyeka ohlelweni lwezobulungiswa bobugebengu); ubuhlungu obukhulu phakathi kwabantu (isb., ukuhlukaniswa, umshado odabukisayo, noma isehlukaniso esibi eside); ukuhlukumezeka okungalapheki (kusukela ebuntwaneni nakwezinye izindawo); kanye nobuhlungu obukhona obudlulele (isb., ukungabi nanjongo, ukungabi nasiqondiso, nokulahlekelwa ubuqotho).
Esizukulwaneni esedlule, kwakwaziwa kahle ukuthi ukuguqula izinhlungu phakathi kwabantu ngokuvamile kwakuwusizo ezigulini eziningi ezicindezelekile. Isimo Esisebenzisanayo Sokucindezeleka (1999) ubhala amakhulukhulu ezifundo mayelana nesimo sokudangala kwabantu ngabanye—kanye nomjikelezo ononya wokusebenzelana. Kokunye ukuhlola kwabesifazane abashadile abangajabulile okwatholakala ukuthi banokucindezeleka, abangamaphesenti angu-70 babo babekholelwa ukuthi ukuhlukana kwabo emshadweni kwakwandulela ukucindezeleka kwabo, futhi abangamaphesenti angu-60 babekholelwa ukuthi umshado wabo ongajabulisi wawuyimbangela eyinhloko yokucindezeleka kwabo.
Iningi labantu baseMelika alazi ukuthi ukuguquguquka kwezenhlalo nezomnotho kuhlotshaniswa nokucindezeleka. Imiphumela yocwaningo luka-2013 lukazwelonke olukhishwe ngabakwa Uhulumeni wase-U.S. Ukuxhashazwa Kwezidakamizwa Nokuphathwa Kwezinsizakalo Zezempilo Yengqondo (SAMHSA) kuhlanganisa ukuhlobana kwezenhlalo nezomnotho kokudangala nokuzibulala (imicabango ejulile yokuzibulala, amacebo, noma imizamo). Imiphumela yocwaningo ihlinzeka ngobufakazi obuningi bokuthi ukuntuleka kwemisebenzi, ubumpofu, nokuzibandakanya ohlelweni lwezobulungiswa bobugebengu kuhlotshaniswa kakhulu nokucindezeleka nokuzibulala.
Idekhi Estakiwe ngokumelene Nezimo Zesayensi Zokuqamba Amazinyo Ezinganekwane Zobuchopho
Ukugxila ku-biochemical-electrical causality kunezinye izinto eziguquguqukayo-njengoba ngichaza kabanzi Umsebenzi Ongenasizathu-ukuwina kwezepolitiki nakwezezimali kwamaqembu amaningana:
(1) Izinkampani zokwelapha. Ithiyori manje elahliwe yokungalingani kwe-serotonin yokudangala iye yathonya ngamandla kubantu abaningi abacindezelekile kanye nodokotela babo, okuholele enkolelweni yokuthi bekuyoba ukunganaki. hhayi ukusebenzisa ama-serotonin reuptake inhibitors (SSRIs) akhethiwe njenge-Prozac, i-Zoloft, noma i-Paxil. Ngo-2001, I-CNN ibike: “Selokhu yethulwa ekuqaleni kuka-1988, iProzac ibilokhu ingomunye wezidakamizwa ezithengiswa kakhulu emlandweni; Ukuthengiswa kwayo okungamaRandi ayizigidi eziyizinkulungwane ezingama-21 kumele ama-30% emali etholwa nguLilly ngaleso sikhathi.” Kusukela ngo-2001, i-blockbuster SSRI imithi—kanye neminye imithi yokucindezeleka okuthiwa ilungisa okunye ukungalingani kwamakhemikhali okungekho—iqhubekile yenza izigidigidi zamaRandi ezinkampanini zezidakamizwa.
(2) Imidiya Ejwayelekile. Ngo-2019, ngokusho kweMediaRadar, Imali yeBig Pharma engu-$6.6 billion ngonyaka ezikhangisweni ze-TVikubeke njengemodeli yesine ngobukhulu ezikhangisweni ze-TV e-United States. Ithelevishini iyingxenye eyodwa kuphela yemidiya evamile lapho i-Big Pharma ithenga khona ukukhangisa. Uma kubhekwa ukuthi imidiya evamile incike kulawa madola okukhangisa e-Big Pharma, ayikhuthazwa kakhulu ukwenza ubuntatheli obuphenyayo obubucayi nge-Big Pharma nezidakamizwa zayo.
3) Ababhali bezidakamizwa futhi udokotela wengqondo "abaholi bemicabango." Omunye wodokotela bengqondo “abahola umcabango” odalulwe ngu 2008 ukulalelwa kweCongress kwakungudokotela wezengqondo wase-Harvard u-Joseph Biederman (ohlonishwe ngokudala isifo se-bipolar sezingane), owayethole u-$1.6 million kubenzi bezidakamizwa phakathi kuka-2000 no-2007. Isizindalwazi sokukhokha. Ngo-2013, kusetshenziswa le database, intatheli ezimele URobert Whitaker ubike: “Kusukela ngo-2014 kuya ku-2020, izinkampani ezenza imithi yakhokha amaRandi ayizigidi ezingu-340 kodokotela bengqondo base-U.S. ukuze basebenze njengabaluleki babo, abeluleki, nezikhulumi, noma banikeze ukudla kwamahhala, iziphuzo nendawo yokulala kulabo abahambela imicimbi yokukhangisa.” I-Open Payments ibala odokotela bengqondo abangu-31,784 (cishe amaphesenti angama-75 odokotela bengqondo e-United States) okwathi, uWhitaker, "abathole okuthile okuyigugu ezinkampanini zezidakamizwa kusukela ngo-2014 kuya ku-2020." Ngaleso sikhathi, odokotela bengqondo abangamashumi ayisithupha nambili bathola amadola ayisigidi noma ngaphezulu; odokotela bengqondo abayishumi nesishiyagalolunye bathole imali engaphezu kwezigidi ezimbili zamaRandi.
(4) Izikhungo zokugula ngengqondo njenge I-American Psychiatric Association (APA) kanye namaqembu abizwa ngokuthi “amele isiguli” afana nala INational Alliance on Mental Illness (NAMI) bathole uxhaso kuBig Pharma. Njengoba imali enkulu itholakala kwiNational Institute of Health’s (NIH) “Brain Initiative,” Isikhungo Sikazwelonke Sezempilo Yengqondo (i-NIMH) sigxile ekubangeleni i-biochemical-electrical (ngoJuni 2022, I-NIMH “Strategic Plan” iminyaka emihlanu ezayo ohlwini Goal #1: Chaza Izindlela Zokuziphatha Zobuchopho Ezingaphansi Kokuziphatha Okuyinkimbinkimbi).
(5) Abacwaningi abaxhaswa ngezimali ukwenza ucwaningo lwe-biochemical-electrical.
(6) Labo abaphezulu kubaphathi bomphakathi labo ngokusobala abakhetha ukugcina isimo senhlalo-yomnotho nepolitiki, futhi abaziyo ukuthi uma abantu bekholelwa ukuthi ukuhlupheka kwabo ngokomzwelo kubangelwa hhayi ngokuguquguquka kwezenhlalo-umnotho-ezombusazwe kodwa esikhundleni salokho ngamaphutha e-neurobiological, lolu hlelo lwenkolelo lungaba indlela enamandla nengabizi kakhulu yokugcina isimo sikhona kunombutho wamaphoyisa ohlome kakhulu.
Kunesinye isizathu esenza ukuthi amaqiniso esayensi acaciswe yilezi zibuyekezo ezintathu ezibanzi cishe angeke enze isithunzi kunganekwane yokukhubazeka kobuchopho yokucindezeleka. Lapho abantu begajwe ubuhlungu futhi becindezelekile, kuba nzima ngabo nomkhaya wabo othukile ukuba bacabange ngokujulile. Lapho abezindaba abavamile benikeza izinketho ezimbili kuphela zezincazelo zokucindezeleka kwabo—i-biochemical-electrical causality noma ukusolwa komuntu siqu—yebo, bakhetha ubungozi be-biochemical-electrical causality. Lapho iziphathimandla ezingekho emthethweni zinikeza izinketho ezimbili, abantu abaphikisana nabagunyazi abacabangisisayo bayazi khetha eyesithathu; kodwa abantu abacindezelekile kanye nemikhaya yabo ngokuvamile banokwesaba okukhulu namandla amancane kakhulu okucabanga ngokuhlolisisayo nokumelana neziphathimandla ezingekho emthethweni.
Manje njengoba abezengqondo sebekuvumile esidlangalaleni ukushoda kobufakazi obusekela inkolelo-mbono yayo yokungalingani kwamakhemikhali yokucindezeleka, izidakamizwa ezilwa nokucindezeleka ziye zalahlekelwa umbono wazo wesayensi yezinzwa esidlangalaleni. Kodwa-ke, abezengqondo baye bagxila esimemezelweni sokuthi ukuntuleka kwezizathu ze-neuroscientific yezidakamizwa ezidambisa ukucindezeleka “akunamsebenzi”. (igama elisetshenziswe udokotela wengqondo uRonald Pies), ngoba ama-antidepressants ayasebenza. Liyini iqiniso lesayensi?
Abanye abantu babika ukuthi ama-antidepressants abo abanikeze ukukhululeka kwezimpawu; abanye babika ukuthi akukho mphumela; kanti abanye babika imiphumela engemihle kakhulu kanye nokuhoxiswa kwamaphupho amabi. Ucwaningo olukhulu lwango-2022, eyabhalwa ngu-Marc Stone esikhungweni se-FDA's Center for Drug Evaluation and Research, ihlole izivivinyo ezingama-232 ezingahleliwe, eziyizimpumputhe eziphindwe kabili, ezilawulwa yi-placebo kuma-antidepressants (lezi zivivinyo zihanjiswe izinkampani zezidakamizwa ku-FDA phakathi kuka-1979 no-2016, okuhlanganisa abantu abadala nezingane ezingu-73,388. ababambiqhaza). Ngisho nakulezi zifundo ezithunyelwe yinkampani yezidakamizwa, u-Stone kanye nabacwaningi akanye nabo bathola ukuthi “bayi-15% kuphela ababambiqhaza abanomphumela omkhulu wokudambisa ukucindezeleka okungaphezu komphumela we-placebo.” Ngaphezu kwalokho, izivivinyo zokudambisa ukucindezeleka zenkampani yezidakamizwa ezihanjiswe ku-FDA ziyizifundo zesikhashana esifushane nje. , ngokuvamile cishe amasonto ayisithupha.
Ngokuhamba kwesikhathi, imiphumela iba mibi kakhulu. Ngo-2017, iphephabhuku I-Psychotherapy kanye neSomatics, ku"Imiphumela Emibi Yesikhathi Eside Phakathi Kwabantu Abanesifo Sokucindezeleka Okukhulu Abalashwe Ngemithi,” kubika lokhu okulandelayo: Ukulawula ukuqina kokucindezeleka, imiphumela yezifundo ezingu-3,294 XNUMX phakathi nenkathi yeminyaka eyisishiyagalolunye yabonisa ukuthi imithi yokucindezeleka ingase ibe nenzuzo esheshayo, yesikhashana kwabanye abantu, kodwa ngemva kweminyaka eyisishiyagalolunye, isidakamizwa esidambisa ukucindezeleka. abasebenzisi babenezimpawu ezinzima kakhulu kunalabo bantu abangawasebenzisi ama-antidepressants.
Ngo 2022, the Ukubukezwa kwe-Psychology Clinic yafingqa iqiniso le-antidepressant: “Ukutholakala okukhulayo kokwelashwa okuphumelelayo kufanele kufinyeze iziqephu zokucindezeleka, kunciphise ukuphindeka, futhi kunciphise ukuphindeka. . . . Ingabe lokhu kwehliswa kwenzeke? Impendulo enamandla ngokusobala ithi CHA.”
Udokotela wengqondo uThomas Insel, umqondisi we-NIMH kusukela ngo-2002 kuya ku-2015, yamukelwa ngo-2017: “Ngachitha iminyaka engu-13 e-NIMH ngicindezela ngempela isayensi yezinzwa nezakhi zofuzo zokuphazamiseka kwengqondo, futhi lapho ngibheka emuva kulokho ngiyaqaphela ukuthi nakuba ngicabanga ukuthi ngiphumelele ukuthola amaphepha amaningi apholile anyatheliswa ososayensi abapholile ngezindleko ezinkulu— Ngicabanga ukuthi amaRandi ayizigidi eziyizinkulungwane ezingu-20—angicabangi ukuthi sasusa inaliti ekunciphiseni ukuzibulala, ekwehliseni ukulaliswa esibhedlela, ekuthuthukiseni ukululama emashumini ezigidi zabantu abagula ngengqondo.” Kodwa-ke, ukusungulwa kodokotela bengqondo kuye kwaphindeka kabili ekufuneni kwabo inhlamvu yemilingo ye-neurobiological; U-Insel uthi encwadini yakhe ka-2022 Healing: “Umqondo wokugula ngengqondo ‘njengokungalingani kwamakhemikhali’ manje usuvule indlela ezifweni zengqondo ‘njengeziphazamiso zokuxhumanisa’ noma zokujikeleza kobuchopho.”
Njengoba u-Upton Sinclair asho ngokudumile, “Kunzima ukwenza indoda iqonde okuthile kuyilapho iholo layo lincike ekubeni akayiqondi.”
I-ZNetwork ixhaswa kuphela ngokuphana kwabafundi bayo.
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1 Amazwana
Lesi isihloko esihle kakhulu. Nginesizinda semfundo esisemthethweni, esingokwengqondo. Njengamanje ngibhalise, futhi, esifundweni samasonto ayisishiyagalombili esidingida izindaba zokugula ngengqondo kanye nempilo. Nakuba kungelula ukwethula lesi sihloko kuleso simo, noma kunjalo, sikhona lapho okuqondiwe khona. Eminyakeni eminingi edlule nginesiguli esasiyisazi sokusebenza kwengqondo (eminyakeni engaba ngu-35-40 edlule) esasiba nobunzima kakhulu ekwenzeni umsebenzi waso ngenxa yokubusa kwemithi phezu kokuhlaziywa kwengqondo. Ngaleso sikhathi, kwakuwumbuzo osebenzayo womshwalense owawuzokhokhela imithi ngaphezu kwezinye izindlela zokwelapha. Angiphikisani nendima yemithi, kodwa cishe ikhemikhali ekhethekile, ukwelashwa okuphilayo kokuhlukumezeka akuzixazululi izinkinga ezinkulu zokuhlukumezeka. Ngaphandle kokubhekisela kumaphuzu aqondile e-athikili evele lapha ngoJuni 5, 2018 (“Ingabe Abantu BaseMelika Bangabantu Abaphukile?”), isihloko siphakamisa umbuzo obalulekile ohlobene. Lapho ukuhlupheka “ngenxa yokugula kwengqondo” kuba cishe njalo isifo somuntu ngamunye ngaphandle kwesimo senhlalo esibanzi, ukubekwa kwemvelo, njll., le ndaba yokululama, ukubuyisana, nempilo yengqondo ilinganiselwe kakhulu futhi ingaba isithiyo enhlalakahleni.