Major Depressive disorder

**Matenda a nkhawa** (**MDD**), omwenso amadziwika kuti **nkhawa**, ndi matenda a maganizo ndipo wodwala amatha kupanikizika ndi matendawa kwa milungu yosachepera iwiri wosasangalala malinga ndi zimene zam'chitikira pa nthawiyo. Munthu akayamba kudwala matendawa, kawirikawiri amayambanso kudzikayikira, kukhala wosasangalala pa zochitika zoyenera kusangalala, amafooka, ndiponso amamva ululu popanda chifukwa chomveka. Anthu omwe ali ndi matendawa nthawi zina amaona amakhulupirira zinthu zomwe si zoona kapenanso amaona kapena kumva zinthu zimene kulibe. Anthu ena amavutika kwambiri ndi pa nthawi zinazake pa nthawi zinazake pachaka, pomwe amavutika ndi matendawa nthawi zonse. Matenda a nkhawa angasokoneze kwambiri moyo wa munthu, ntchito yake, maphunziro ake, kumusowetsa tulo ngakhalenso kumulepheretsa kudya ndi kusokonezanso thanzi lake. Anthu akuluakulu oyambira pa awiri kufika 8 pa Anthu 1000 aliwonse omwe li ndi matenda a nkhawa amafa mochita kudzipha, ndipo hafu ya anthu onse omwe amadzipha amakhala kuti anali ndi matenda a nkhawa kapena matenda ena a maganizo.}	

Pali zinthu zingapo zimene zimayambitsa matenda a nkhawa, monga kuyamwira matendawa komanso chifukwa cha zochitika pamoyo wa munthu. Zina mwa zinthu zimene zimayambitsa matendawa ndi zakumtundu, kusintha kwambiri kwa zinthu pamoyo, mankhwala ena akuchipatala, matenda ena akuluakulu, ndiponso kugwiritsa ntchito mankhwala osokoneza bongo. Zikuoneka kuti anthu 40 pa 100 aliwonse amene amadwala matendawa amachita kuyamwira kuchokera ku mtundu wawo. Madokotala amatha kudziwa kuti munthu ali ndi matenda a nkhawa malinga ndi zimene munthuyo wakhala akuchita ndiponso mmene kaganizidwe ka munthuyo kalili. Palibe njira ya ku labu imene ingagwiritsidwe ntchito poyeza kuti madokotala adziwe ngati munthu ali ndi matenda a nkhawa. Komabe, madokotala amatha kumuyeza munthu kuti adziwe ngati ali ndi matenda ena omwe zizindikiro zake n'zofanana ndi matenda a ankhawa. Munthu yemwe akudwala matenda a nkhawa amamva ululu woopsa ndipo izi zimachitika kwa nthawi yaitali kuposa kungokhumudwa, komwe kumachitika pamoyo wa munthu aliyense. Bungwe la United States Preventive Services Task Force (USPSTF) limalimbikitsa kuti anthu amene akwanitsa zaka 12 zakubadwa azikayezetsa kuti adziwe ngati ali ndi matenda a nkhawa, pomwe kafukufuku waCochrane amapeza kuti mafunso amene amagwiritsidwa ntchito pofufuza kuti adziwe ngati munthu ali ndi vutoli sapereka n'komwe njira zimene zingathandize munthuyo.

Komabe, anthu omwe ali ndi matendawa angathandizidwe ndithu ngati thandizo la uphungu ndiponso mankhwala a antidepressant.	 Zikuoneka kuti mankhwala akuchipatala amathandiza ndithu, koma makamaka ngati matendawo akula kwambiri. Sizikudziwika ngati mankhwala akuchipatala amawonjezeranso chiopsezo choti munthu angathe kudzipha. Uphungu umene munthu angapatsidwe ungaphatikizepo wothandiza munthu kusintha khalidwe ndiponso wothandiza munthu kuti azichita zinthu ndi anthu ena. Ngati njira zimenezi sizikuthandiza, mungayese njira ya electroconvulsive therapy ndipo imeneyi ingathe kuthandiza. Munthu yemwe akudwala matendawa angathenso kugonekedwa m'chipatala ngati zikuoneka kuti akhoza kudzipha ndipo angagonekedwe m'chipatalamo ngakhale kuti mwiniwakeyo sakugwirizana nazo.

M'chaka cha 2015 chokha, anthu pafupifupi 216 miliyoni (atatu pa anthu 100 aliwonse padziko lonse) anadwala matenda a nkhawa. M'dziko la Japan lokha, chiwerengero cha anthu amene amadwala matendawa pa nthawi inayake m'moyo wawo ndi 7 pa 100 aliwonse, pomwe ku France ndi 21 pa 100 aliwonse. Anthu omwe amavutika matendawa kwa moyo wawo wonse m'mayiko olemera ndi ochuluka ndi 15 pa 100 aliwonse poyerekezera ndi anthu a m'mayiko osiyana omwe ndi 11 pa 100 aliwonse. Vutoli ndi lachiwiri pa matenda amene anthu amangokhala nawo kwa moyo wawo wonse, ndipo amatenda omwe ali pamalo oyamba ndi matenda a msana. Anthu ambiri amadwala amatenda a nkhawa akafika zaka za m'ma 20 ndi 30. Ndipo akazi ndi amene amadwala kwambiri matendawa poyerekezera ndi amuna. Bungwe la American Psychiatric Association linaika "matenda ovutika kwambiri maganizo" pagulu la matenda lotchedwa *[[Diagnostic and Statistical Manual of Mental Disorders]]* (DSM-III) mu 1980. Gulu la matendali linagawidwa n'kupanga gulu lina lamatenda a muubongo kuchoka m'gulu lomwe lija la DSM-II, lomwe mulinso matenda a  dysthymia ndiponso matenda a nkhawa omwe amayamba chifukwa chosamukira kudera lina ndiponso kukhumudwa. Anthu omwe akupezeka ndi matendawa panopa komanso omwe anapezeka nawo kale akhoza kumasalidwa.	

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