Momwe Momwe Bongo Umapezekera ndi Kutchova Juga
Mankhwala osokoneza bongo komanso ma juga a rewire neural mabwalo chimodzimodzi
By Ferris Jabr | Lachiwiri, Novembala 5, 2013
Pamene Shirley anali ndi zaka zapakati pa 20s iye ndi abwenzi ena adasamukira ku Las Vegas pamalonda. Aka kanali koyamba kutchova juga. Pafupifupi zaka khumi pambuyo pake, akugwira ntchito ngati loya ku East Coast, nthawi zina amakhala mu Atlantic City. Pakufika kwake kwa 40s, komabe, anali kulumpha ntchito kanayi pa sabata kuti azichezera ma kasino otsegulidwa kumene ku Connecticut. Amasewera zakuda kwathunthu, nthawi zambiri amaika madola masauzande mozungulira, kenako nkungoyenda pansi pa mpando wamagalimoto ake 35 masenti kuti alipire ndalama pobwerera. Pomaliza, Shirley ankabeta ndalama iliyonse yomwe amapeza ndikulemba makhadi ambiri angongole. Iye anati: “Ndinkafuna kutchova njuga nthawi zonse. "Ndinkakonda kwambiri, koma ndinali ndimakonda kwambiri."
Mu 2001 malamulo adalowererapo. Shirley adapezeka ali ndi mlandu wakuba ndalama zambiri kuchokera kwa makasitomala ake ndipo adakhala zaka ziwiri kundende. Ali mnjira adayamba kupita kumisonkhano ya Anatchera osadziwika, akuwona othandizira ndikuchotsa moyo wake. Iye anati: “Ndinazindikira kuti ndayamba kusuta. "Zinanditengera nthawi yayitali kuti ndinene kuti ndayamba kusuta, koma ndinali, monga wina aliyense."
Zaka khumi zapitazo lingaliro loti wina akhoza kumayamba chizolowezi chofanana ndi kutchova juga momwe munthu amapezerera chizolowezi chomwa mankhwala osokoneza bongo linali lodzitsutsa. Kalelo, alangizi a Shirley sanamuwuzepo kuti anali chidakwa; adasankha yekha. Tsopano ofufuza avomereza kuti nthawi zina kutchova juga ndichizolowezi choledzeretsa.
M'mbuyomu, anthu amisala nthawi zambiri amawona kutchova juga ngati chinthu chokakamiza osati chongokakamira. Mu 1980, ndikusintha Kusanthula ndi Buku Lophatikiza la Mavuto a Mitsempha (DSM), American Psychiatric Association (APA) imatchulira kuti kutchova juga kwa matenda okhudzana ndi matenda osautsa - cholembera chovuta kwambiri ku gulu la matenda okhudzana ndi matenda omwe panthawiyo anali ndi kleptomania, pyromania ndi trichotillomania (kutsata tsitsi). Inen chomwe chadziwika kuti ndi lingaliro losaiwalika, bungweli lidasunthira njuga zamatenda pazovuta zomwe zili m'buku lomaliza la bukuli, a DSM-5, lofalitsidwa Meyi yapitayi. Lingaliro, lomwe lidatsata zaka za 15 zakunyinyirika, likuwonetsa kumvetsetsa kwatsopano kwa zomwe zimayambitsa bongo ndipo zasintha kale momwe njira zamankhwala amisala zimathandizira anthu omwe sangathe kusiya njuga.
Kugwiritsa ntchito bwino kwambiri ndikofunikira kwambiri chifukwa kutchova juga ndikovomerezeka komanso kupezeka kuposa kale. Anayi mwa Asilamu aku America ati adatchovera juga kamodzi m'miyoyo yawo. Kupatula Hawaii ndi Utah, dziko lililonse mdziko muno limapereka njuga zina zovomerezeka. Ndipo masiku ano simukufunikiranso kusiya nyumba yanu kuti mudzatchova njuga — zomwe mungafune ndi intaneti kapena foni. Kafukufuku osiyanasiyana adatsimikiza kuti anthu pafupifupi mamiliyoni awiri ku US amalephera kutchova juga, ndipo kwa nzika zambiri za 20 miliyoni chizolowere chimasokoneza ntchito ndi moyo wamtundu wina.
Awiri a mtundu
APA idakhazikitsidwa pamalingaliro ake pazofufuza zingapo zaposachedwa mu psychology, neuroscience ndi genetics zomwe zikuwonetsa kuti kutchova juga komanso kugwiritsa ntchito mankhwala osokoneza bongo ndizofanana kwambiri kuposa momwe zimakhalira kale. Kafukufuku wazaka makumi awiri zapitazi asintha modabwitsa magwiridwe antchito amomwe ubongo umasinthira bongo likamakula. Pakatikati mwa cranium yathu, ma circuits angapo omwe amadziwika kuti mphotho amalumikizitsa magawo osiyanasiyana obalalika omwe amakhudzidwa ndikukumbukira, kuyenda, chisangalalo ndi chidwi. Tikamagwira ntchito yomwe imatipangitsa kukhala ndi moyo kapena kutithandiza kupititsa majini athu, ma neuron omwe ali mu mphotho amatulutsa mankhwala otchedwa dopamine, kutipatsa chidwi pang'ono ndikutilimbikitsa kukhala ndi chizolowezi chosangalala ndi chakudya komanso amadumpha m'thumba. Mukalimbikitsidwa ndi amphetamine, cocaine kapena mankhwala ena osokoneza bongo, dongosolo lamalipiro limabalalika mpaka 10 kuposa dopamine kuposa masiku onse.
Kugwiritsa ntchito mankhwala mopitilira muyeso kumawabera mphamvu. Zinthu zowonjezera zimapangitsa kuti ubongo ukhale wogwedezeka kwambiri mu dopamine mwakuti imasinthasintha ndikupanga molekyulu ndikucheperachepera pazotsatira zake. Zotsatira zake, osokoneza bongo amapanga kulekerera kwa mankhwala, amafunika zochulukirapo komanso zokulirapo kuti akwere pamwamba. Podandaula kwambiri, anthu amangochokapo - amadzimva kuti ali ndi matenda, sangathe kugona ndikugwedezeka osagonjera - ubongo wawo utakhala wopanda kanthu kwa nthawi yayitali. Nthawi yomweyo, njira za neural zolumikizira gawo la mphotho ku preortal cortex zimafooketsa. Kupuma pamwambapa ndi kumbuyo kwa maso, kotsogola koyambirira kumathandizira anthu kuti azisala. Mwanjira ina, munthu amene amakonda kusiya kugwiritsa ntchito mankhwala osokoneza bongo, zimakhala zovuta kusiya.
Kafukufuku mpaka pano akuwonetsa kuti otchova njuga komanso omwe amakonda kugwiritsa ntchito mankhwala osokoneza bongo amagawana zamtunduwu womwe umatanthauzanso kunyengerera komanso kufunafuna mphotho. Monga momwe ogwiritsa ntchito mankhwala osokoneza bongo amafunikira kulimba kuti atchuke kwambiri, kuti azitero. Momwemonso, onse omwe amakhala osokoneza bongo komanso otchova njuga amapirira chizindikiro chodzilekanitsa ndi mankhwala kapena chisangalalo chomwe akufuna. Ndipo kafukufuku wochepa akuwonetsa kuti anthu ena ali pachiwopsezo kwambiri cha kugwiritsa ntchito mankhwala osokoneza bongo komanso kutchova juga mokakamiza chifukwa mapangidwe awo olipira amakhala osagwira - zomwe zingafotokozere chifukwa chake amafuna kwambiri.
Chochulukitsa, akatswiri azamisala aphunzira kuti mankhwala osokoneza bongo ndi kutchova juga amasintha magawo amodzimodzi mu ubongo womwewo. Malingaliro awa amabwera kuchokera ku kafukufuku wamagazi ndi zochitika zamagetsi muubongo wa anthu pomwe amaliza ntchito zosiyanasiyana pamakompyuta omwe amatsanzira masewera a kasino kapena kuyesa kuwongolera kwawo. M'mayesero ena, makhadi omwe amasankhidwa m'malo osiyanasiyana amapeza kapena kutaya ndalama za wosewera; ntchito zina zimatsutsa munthu kuti ayankhe mwachangu pazithunzi zina zomwe zimawonekera pazenera koma osachitapo kanthu kwa ena.
Kafukufuku waku Germany waku 2005 wogwiritsa ntchito masewera amtundu wamakhadi akusonyeza kuti otchova juga omwe ali ndi vuto-monga omwe amamwa mankhwala osokoneza bongo-asiya chidwi chawo: atapambana, maphunziro awo anali otsika poyerekeza ndi zamagetsi zomwe zimachitika mdera lofunikira muubwino wamaubongo. Pakafukufuku wa 2003 ku Yale University komanso kafukufuku wa 2012 ku University of Amsterdam, omwe amatchova juga omwe amatenga mayeso omwe amayeza kuti sanakhudzidwe ndi mphamvu zawo anali ndi mphamvu zochepa zamagetsi m'magawo am'mbuyo am'magazi omwe amathandiza anthu kuwunika zoopsa ndikupondereza zikhalidwe. Omwe amamwa mankhwala osokoneza bongo nthawi zambiri amakhala ndi kotekisi yoyipa.
Umboni wina woti kutchova juga ndi mankhwala osokoneza bongo kumasintha ubongo mwanjira zofananira zomwe zidapezeka pagulu la anthu osayembekezeka: omwe ali ndi vuto la neurodegenerative matenda a Parkinson. Wodziwika ndi kuuma kwa minofu ndi kunjenjemera, a Parkinson amayamba chifukwa cha kufa kwa ma dopamine omwe amatulutsa ma neuron mu gawo lina la midbrain. Kwa zaka makumi angapo ofufuza apeza kuti chiŵerengero chapamwamba kwambiri cha odwala a Parkinson — pakati pa 2 ndi 7 peresenti — amakhala otchova juga. Chithandizo cha matenda amtundu wina chimathandizira ku china. Pochepetsa zizindikiro za Parkinson, odwala ena amatenga levodopa ndi mankhwala ena omwe amachulukitsa milingo ya dopamine. Ochita kafukufuku amaganiza kuti nthawi zina kuchuluka kwa mankhwala kumapangitsa ubongo kukhala wopusa komanso wopatsa chidwi - amatero, omwe ali pamasewera osangalatsa - zisankho zosangalatsa komanso zopupuluma zomwe zimakhala zovuta kuzitsutsa.
Kumvetsetsa kwatsopano kwa kutchova juga kumathandizanso asayansi kudziwongolera okha. Pomwe akatswiri amaganiza kuti kusuta kumatha kukhala kudalira mankhwala, tsopano akutanthauzira kuti ndikulondola mobwerezabwereza zopindulitsa ngakhale atakumana ndi zovuta zazikulu. Izi zitha kukhala zakumwa zambiri za cocaine kapena heroin kapena chisangalalo chobwerezabwereza ndalama ku kasino. "Lingaliro lakale linali loti mukufunikira kugwiritsira ntchito mankhwala omwe amasintha minyewa yaubongo kuti ayambe kukhala osokoneza bongo, koma tsopano tikudziwa kuti pachilichonse chomwe timasintha mu ubongo, "akutero a Timothy Fong, katswiri wa zamisala komanso zikhalidwe zosokoneza bongo ku Yunivesite ya California , Los Angeles. Ndizomveka kuti machitidwe ena opindulitsa kwambiri, monga kutchova juga, amathanso kusintha kwambiri [m'thupi]."
Masewera a Dongosolo
Kukhazikitsanso kutchova juga ngati chizolowezi sichimangokhala maantantics: othandizira apeza kale kuti otchova njuga amayankha bwino kwambiri ku mankhwala ndi chithandizo chomwe chimagwiritsidwa ntchito ngati zosokoneza m'malo mwa njira zopangira kukakamiza monga trichotillomania. Pazifukwa zomwe sizikumveka, antidepressant ena amachepetsa zizindikiro za zovuta zina zoletsa; sanagwirepo ntchito njuga zamatenda, komabe. Mankhwala omwe agwiritsidwa ntchito pochiza bongo. Otsutsa a Opioid, monga naltrexone, amaletsa maselo aubongo kutulutsa dopamine, potero amachepetsa zikhumbo.
Kafukufuku wambiri akutsimikizira kuti njira yina yothandizira kuti usiye kugwiritsa ntchito mankhwala osokoneza bongo ndi chidziwitso chazikhalidwe, zomwe zimaphunzitsa anthu kupewa malingaliro ndi zizolowezi zosafunikira. Mwachitsanzo, anthu omwe ali ndi chizolowezi chotchova juga, amatha kuphunzira kuthana ndi zikhulupiriro zabodza, monga malingaliro akuti kuwonongeka kambiri kapena kuphonya kwaposachedwa, monga ma cherries atatu mwa atatu pamakina ogwiritsa ntchito (slot).
Tsoka ilo, ofufuza akuyerekeza kuti oposa 80 peresenti ya omwe amalephera kutchova juga samafunafuna chithandizo koyamba. Ndipo mwa iwo omwe atero, mpaka 75 peresenti amabwerera kumholo zamasewera, ndikupangitsa kupewa zonse zofunika kwambiri. Ku US konse, makamaka ku California, ma kasino akuyamba kugwiritsa ntchito kwambiri njuga. Marc Lefkowitz wa California Council on Vuto Kutchova Juga nthawi zambiri amaphunzitsa oyang'anira kasino ndi ogwiritsa ntchito kuti asamayang'ane zochitika zoyipa, monga makasitomala omwe amawononga nthawi yochulukirapo komanso njuga. Alimbikitsa ma kasino kuti apatse otchova njuga mwayi woti adziletsa okha ndikuwonetsa kwambiri timabuku tofotokoza za Matigari Osadziwika ndi njira zina zochizira pafupi ndi makina AAT komanso mafoni olipira. Wokonda kutchova juga atha kukhala gwero lalikulu la ndalama kwa kasino poyamba, koma ambiri amakhala ndi ngongole zazikulu zomwe sangathe kulipira.
Shirley, yemwe tsopano ali ndi zaka 60, pakadali pano amagwira ntchito ngati mlangizi wa anzawo pantchito yothandizira otchova juga. “Sindikutsutsana ndi kutchova juga,” akutero. “Kwa anthu ambiri, ndi zosangalatsa zodula. Koma kwa anthu ena ndi chinthu chowopsa. Ndikufuna kuti anthu amvetsetse kuti mutha kukhala osuta. Ndikufuna kuwona kasino iliyonse ili ndiudindo. ”
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