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Çrregullimi i Stresit Post-Traumatik Kompleks (cPTSD): Një Udhëzues i shkurtër.

Çfarë është CPTSD?
Çrregullimi i stresit post-traumatik kompleks (CPTSD) është një crregullim kompleks mendor dhe i sjelljes që lind si rezultat i ekspozimit te zgjatur ose te përsëritur ndaj një sërë ngjarjesh traumatike, nga të cilat personi sheh pak ose aspak mundësi për t’u shpëtuar. Trauma kronike mund të përfshijë abuzim fizik, emocional ose seksual në fëmijëri, dhunë në familje, robëri, trafikim njerëzor, apo situata të tjera të cilat shkaktojnë stres ekstrem dhe të vazhdueshëm.

Ndryshe nga çrregullimi i stresit post-traumatik (PTSD), CPTSD është rezultat i ekspozimit të zgjatur dhe perserites ndaj traumës dhe ka simptoma më të ndërlikuara që prekin aspekte të shumta të jetës.

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Simptomat kryesore të CPTSD

Simptomat e CPTSD janë të ngjashme me ato të PTSD-së, por përfshijnë elemente shtesë që ndikojnë në rregullimin emocional, identitetin dhe funksionimin ndërpersonal të individit. Simptomat kryesore përfshijnë:

1. Simptomat tradicionale të PTSD.(Traumatrias-3 simptomat )

1. Rikujtime të dhimbshme (intrusione, flashback-e, makthe): Përjetimi i përsëritur i traumës përmes kujtimeve të pakontrollueshme apo ndjesisë sikur trauma po ndodh përsëri.

2.Gjendje alarmi dhe hipervigjilencë: Ndjenja e përhershme e kërcënimit dhe alarmit apo reagime të trupit ndaj stimujve të jashtëm edhe kur nuk ka me nje kercenim real.

3.Shmangia e kujtimeve dhe ndjenjave: Individët me CPTSD shmangin situatat, vendet dhe personat që u kujtojnë traumën.

• Shpesh, ndryshime në humor dhe mendime: Përjetimi i mendimeve negative për veten dhe botën, ndjenja e fajit dhe turpit.

2. Vështirësi në rregullimin e emocioneve

Personat me CPTSD kanë vështirësi të mëdha në përpunimin dhe rregullimin e emocioneve. Kjo mund të shfaqet në formën e:

• Zemërimit të papritur dhe shpërthimeve emocionale.
• Ndjenjës së thellë të turpit dhe fajit kronik.
• Episodave të mpirjes emocionale, ku individi nuk arrin të ndiejë emocione të caktuara.

3. Ndryshime në ndjenjën e identitetit

• Ndjenja e padenjësisë dhe mungesa e vetëbesimit.
• Perceptimi i vetes si i/e dëmtuar ose i/e pavlefshëm/e.
• Ndjenja e izolimit dhe ndarja nga të tjerët për shkak të bindjes se askush nuk do ta kuptonte përvojën e tyre.

4. Probleme në marrëdhëniet ndërpersonale

• Vështirësi për të besuar të tjerët.
• Frikë nga intimiteti emocional e fizik ose, përkundrazi, varësi emocionale e tepruar.
• Rikrijimi i dinamikave toksike (te pashendetshme) në marrëdhënie si rezultat i traumës së kaluar, etj.
• Te tjera:
• Ndryshime te tjera: siç janë amnezia ose kujtimi i i ngjarjeve traumatike, episode të disociimit, depersonalizimi/derealizimi dhe përjetimi i përsëritur i përvojave (qoftë në formën e simptomave intruzive të PTSD-së ose në përfshirje të vazhdueshme me mendime te perseritura.
• Somatizimi etj.

5. Humbja e ndjenjës së qëllimit ose shpresës

Shumë njerëz me CPTSD përjetojnë një ndjenjë boshllëku dhe mungesë kuptimi për jetën e tyre. Kjo shpesh lidhet me depresionin bashkeshoqerues dhe ndjenjën e vazhdueshme te dëshpërimit.

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Shkaqet dhe Faktorët e Rrezikut

CPTSD zhvillohet zakonisht si pasojë e ekspozimit të vazhdueshëm ndaj situatave traumatike, të cilat mund të përfshijnë:

• Abuzimi kronik në fëmijëri (fizik, emocional, seksual, apo neglizhim i nevojave emocionale te individit).
• Dhunë në marrëdhënie apo familje, veçanërisht në marrëdhënie ku personi nuk ka patur mundësi të largohet.
• Robëri, trafikim njerëzor, ose jetë në kushte ekstreme të shtypjes dhe dhunës.
• Jeta në zona lufte ose si refugjat me trauma të vazhdueshme etj.

Faktorët që mund të rrisin rrezikun e zhvillimit të CPTSD përfshijnë:

• Fillimi i hershëm i traumës (p.sh., gjatë fëmijërisë).
• Mungesa e mbështetjes emocionale dhe sociale.
• Përvoja të përsëritura të braktisjes ose refuzimit.
• Faktorë gjenetikë dhe neurobiologjikë që mund të ndikojnë në rregullimin e stresit dhe emocioneve.

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Si Trajtohet CPTSD?

Trajtimi i CPTSD zakonisht kërkon një qasje të kombinuar që përfshin terapi psikologjike, mbështetje sociale dhe, në disa raste, trajtim farmakologjik.

1. Terapia psikologjike

Terapia psikoterapeutike e traumes është metoda kryesore e trajtimit dhe përfshin teknika te ndryshme, si:

• Terapia e Përpunimit Kognitiv (CPT) dhe Terapia kognitive e sjelljes and trauma-focused CBT– ndihmon mbi te gjitha individët të sfidojnë dhe ndryshojnë mendimet e shtrembëruara që lidhen me traumën.
• Terapia e Ekspozimit të Zgjatur (PE) – përballja graduale me kujtimet traumatike për të zvogëluar fuqinë e tyre emocionale.
• Desensibilizimi dhe Përpunimi i kujtimeve përmes lëvizjeve të syve. (EMDR) – ndihmon në përpunimin e kujtimeve të dhimbshme dhe lehtesimin e simptomave intrusive.
• Terapia Dialektike e Sjelljes (DBT) – veçanërisht efektive për rregullimin emocional dhe menaxhimin e marrëdhënieve.
• Ka dhe teknika te tjera qe do i sqaroj me specifikisht ne nje artikull tjeter. (psh.Terapie e ekspozimit narrativ: Narrative exposure therapy (NET))

2. Mjekimi

Edhe pse nuk ka një mjekim specifik për CPTSD, mjekët psikiater shpesh përdorin:

• Antidepresivët (pergjithesisht SSRI, SNRI) për të ndihmuar në menaxhimin e simptomave depresionit dhe ankthit.
• Medikamente te tjera stabilizuese të humorit në rastet ku individi përjeton luhatje të mëdha emocionale, simptoma te renda deri ne kufi te psikozes apo ka mendime mbi vetevrasjen.

3. Mbështetja sociale dhe vetëkujdesi

Përveç terapisë dhe mjekimit, mbështetja nga miqtë dhe familja është jetike për shërimin. Aktivitetet si meditimi,Mindfulness, ushtrimet fizike dhe teknikat e relaksimit ndihmojnë në menaxhimin e simptomave.

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Si të mbështesni dikë me CPTSD?

• Bëhuni të durueshëm dhe të mirëkuptueshëm – CPTSD është një çrregullim kompleks dhe kërkon kohë për t’u shëruar.
• Dëgjoni pa gjykuar – Njerëzit me CPTSD shpesh ndihen të keqkuptuar. Ofrojuni hapësirë për të folur.
• Mos e minimizoni përvojën e tyre – Shprehje si “harroje atë që ka ndodhur” nuk ndihmojnë, përkundrazi, mund ta përkeqësojnë gjendjen.
• Mbështetini në kërkimin e ndihmës profesionale – Terapia mund të jetë thelbësore në shërimin e tyre.

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CPTSD është një gjendje e vështire dhe sfiduese, por trajtimi dhe mbështetja e duhur mund të ndihmojnë individët të rindërtojnë jetën e tyre dhe të gjejnë një ndjenjë stabiliteti dhe shprese. Nëse ju ose dikush që njihni po përballet me këtë çrregullim, kërkimi i ndihmës nga një profesionist i shëndetit mendor është hapi i parë drejt shërimit.

Ndiq ne Instagram dhe TikTok apo Youtube: @euroalbanianpsychiatry.

E juaja, Dr. Dorina

Jam menduar shumë gjatë përpara se të bëj këtë shkrim. Nuk dua të përdor më emra konkretë, më duket kaq e turpshme të shoh se si përdhoset emri dhe figura e dikujt në emër të “mirësisë” publike dhe përmbushjes së kënaqësive apo përfytyrimeve individuale të dikujt apo disa personave a turmës aty jashtë.

Nuk është cështje kurioziteti publik se çfarë rrethanash e çuan një person të jetojë jetën që ai bën dhe nuk më duket ama normale që ne (“bamirësit” publikë) të zgjedhim për të dhe t’i diktojmë jetën e re.  

Një person që mund të vuajë nga çrregullime të shëndetit mendor duhet të trajtohet me shumë kujdes, sensibilitet dhe përkushtim nga specialistët e shëndetit mendor. Mënyra se si u trajtua kjo çështje është e frikshme, po aq e frikshme histeria kolektive në media, pa pasur një minimum etike në trajtimin e dikujt me dinjitet, qoftë edhe në mjerimin e tij emocional, në pikën më të ulët të jetës së tij.

Më vjen kaq keq dhe kam një revoltë të brendshme kur shoh video e video pa fund, “argëtime”, seria e re me historinë e rastit dhe me ndarje online të çikërrimave e detajesh të një njeriu që ka nevojë të dukshme për ndihmë e që mbase nuk e kupton mjaftueshëm dhe përmasat e asaj çfarë po ndodh.

Unë nuk vë dhe as nuk pretendoj të vë diagnoza nga larg,por domosdoshmëria për ndihmë dhe asistencë psikiatrike/psikologjike është e qartë dhe e dukshme. 

Në shumë raste, duhet verifikuar fakti nëse personi është I vetëdijshëm dhe I aftë të vendosë ose jo mbi veten e tij. Në këto raste është ekspertiza psikiatrike ajo që e vendos dhe nëse duhet edhe një mbështetje ligjore në këtë rast. Nuk mund të bëhet një person me një shqetësim emocional , nje marionetë që ne e lyejmë veshin e stisim sipas dëshirës dhe e shfaqim para publikut sipas orës të “show-t!

Sa turp, sa dhimbje e sa mjerim kam ndjerë këto ditë!!!!

Nëse keni pak respekt e ndjeshmëri njerëzore, lëreni me kaq. Jepini asaj si dhuratë qetësinë që shpirti I saj I trazuar meriton. Ndihmojeni duke e bërë në heshtje, jepini aksesin tek profesionistët dhe qëndroni shpirtërisht (e nëse doni dhe materialisht) pranë saj pranë një rrugëtimi që për të mbase do të jetë I gjatë (e jo brenda ditës) për të rigjetur veten. 

Mos u nxitoni t’a nxirrni kudo e të bëni të këndojë, nuk mund të këndojë dikush kur I dhemb shpirti. Hajdeni, ju lutem me këmbë në tokë dhe jini të mëshirshëm në “dashamirësinë e bamirësinë” tuaj. 

Mos u bëni hero, aty ku heroizmi juaj nuk bën punë. Jini të përulur dhe bëni aq sa mundeni duke njohur kufijtë tuaj dhe respektuar sidomos ato të tjetrit!

Traveling isn’t just about seeing new places; it’s about engaging deeply with the local culture and community. As a psychiatrist and avid traveler, I’ve discovered that immersing yourself in local cultures can have profound mental health benefits. Here’s a closer look at how this aspect of travel enhances well-being:

1. Enhancing Cognitive Flexibility

 Immersing yourself in a new culture forces you to adapt to different customs, languages, and social norms. This cognitive flexibility is crucial for mental resilience and creativity.When I engage with local traditions, whether learning a new language or participating in a cultural festival, my brain is stimulated to think in novel ways. This mental exercise enhances your problem-solving skills and adaptability.

2. Reducing Stress Through Distraction

Cultural immersion often involves engaging activities that divert your focus from daily stressors. By participating in local events or exploring unfamiliar environments, you temporarily escape routine stress. Visiting local markets, trying traditional foods, or attending cultural ceremonies distracts us from everyday concerns, providing a refreshing mental break and reducing overall stress levels.

3. Building Empathy and Understanding

Engaging with diverse cultures deepens empathy and broadens your perspective on human experiences. Understanding different ways of life fosters greater emotional intelligence and compassion.Interacting with locals and learning about their daily lives helps me appreciate the diversity of human experiences. This enhanced empathy translates into a more nuanced and compassionate approach in both my personal and professional life.

4. Fostering Social Connections

Cultural immersion often involves connecting with local residents, which can lead to meaningful social interactions and relationships. These connections provide social support and combat feelings of loneliness. Building relationships with people from different backgrounds enriches our travel experience and provides a sense of belonging, even in unfamiliar places. These interactions often lead to lasting friendships and a stronger social network.

5. Promoting Mindfulness Through New Experiences

 Engaging fully with a new culture requires mindfulness, as you are present and attentive to the novel experiences around you. This mindfulness can reduce stress and improve emotional well-being. Participating in traditional ceremonies or observing local customs makes you more aware of the present moment. This mindfulness practice helps you stay grounded and reduces anxiety, enhancing overall mental health.

6. Boosting Self-Esteem and Confidence

Successfully navigating a new culture and adapting to different social norms can significantly boost self-esteem and confidence. Overcoming cultural challenges reinforces a sense of accomplishment. Mastering a few phrases in a new language or successfully participating in local traditions gives you a sense of achievement. This boost in confidence positively impacts your self-esteem and encourages a more optimistic outlook.

7. Encouraging Personal Growth

Immersing yourself in local cultures often challenges pre-existing beliefs and biases, leading to personal growth and a more open-minded perspective. Encountering diverse viewpoints and practices encourages me to reflect on my own beliefs and values. This introspection fosters personal growth and a more inclusive worldview.

8. Stimulating Emotional Well-being

New cultural experiences can evoke a range of positive emotions, from excitement to joy and wonder. These emotional responses contribute to improved mood and overall emotional health.The excitement of discovering a new culture and the joy of participating in local traditions elevate my mood and contribute to a more positive outlook on life.

9. Creating Lasting Memories

Engaging deeply with a culture often results in memorable experiences that you cherish long after the trip ends. These positive memories can provide comfort and joy in everyday life. The memories of exploring new cultures and participating in local events are cherished and provide lasting happiness. These experiences are a source of personal joy and a reminder of the richness of life.

10. Enhancing Life Satisfaction

Cultural immersion enriches your travel experience, leading to greater life satisfaction. The sense of fulfillment from engaging with different cultures adds depth to your personal and professional life. The satisfaction of fully experiencing a new culture adds meaning to my travels and enhances my overall sense of fulfillment. This enriched perspective positively impacts my well-being and quality of life.

Immersing yourself in local cultures while traveling offers a multitude of mental health benefits. From enhancing cognitive flexibility to fostering empathy and social connections, cultural engagement provides a holistic boost to mental well-being. As a person who values the profound impact of travel, I encourage everyone to embrace cultural immersion as a path to personal growth and emotional health. By diving into new experiences and connecting with different cultures, you can enrich your life in ways that extend far beyond the trip itself.

So, where to next? 😉

Physical Appearance and Mental Health- 10 Thoughts on the Meaning of Beauty for Mental Health

What does taking care of your appearance mean to you? What does physical beauty signify in your life?

(For those who believe that appearance doesn’t matter, you can stop reading here. I’m not saying that physical appareance is the only thing that matters, but I’m not a hypocrite who doesn’t appreciate both, outer and inner beauty in all its forms, no matter how subjective it may be.)

Maintaining your appearance and feeling attractive isn’t about vanity—it’s about self-care and also mental health. By investing time in looking after yourself, you nurture not just your outward appearance but also your inner well-being. Everyone, regardless of their looks, can benefit from these practices, as they foster confidence, emotional resilience, and a positive self-image.

10 Thoughts on the Meaning of Beauty for Mental Health

1. Boosting Self-Confidence: Taking care of your appearance—whether through grooming, fashion, or skincare—can significantly boost self-confidence. When you feel good about how you look, it often translates into a more positive mindset. I believe we’ve all experienced this feeling at some point.

2. Empowerment Through Self-Care: Engaging in beauty routines is a form of self-care that empowers you to take control of your well-being. Caring for yourself reinforces a sense of agency and self-worth.

3. Enhancing Mood: Looking your best can improve your mood and overall outlook on life. Simple acts like wearing your favorite outfit or getting a fresh haircut or hair color can bring a sense of joy and satisfaction, contributing to mental well-being. We all know the power of good makeup or a great hairstyle. (Though, it’s rare to feel completely satisfied! If you know, you know!)

4. Social Connection and Acceptance: Feeling attractive and well-groomed can enhance social interactions. When you feel good about your appearance, you’re more likely to engage confidently with others, fostering positive connections that support mental health. It also gives a sense of belonging; our style or external representation makes us feel more connected and similar to others.

5. Encouraging Routine and Structure: Maintaining a beauty and self-care routine provides structure and a sense of normalcy, especially in times of stress or uncertainty. This routine can be grounding, helping to reduce anxiety and improve mental clarity. I’m sure we all remember the COVID period and how important these daily structures became for us.

6. Promoting Positive Self-Image: Regularly caring for your appearance can lead to a more positive self-image. Even small efforts, like choosing flattering clothing or practicing good hygiene, reinforce the idea that you are worthy of your care and attention. And we all know the feeling we get when we take care of some aspect of ourselves.

7. Reducing Stress: Beauty routines, like skincare or hair care, can be therapeutic, offering moments of relaxation and stress relief. These rituals create a calming effect, reducing tension and contributing to better mental health.

8. Supporting Emotional Resilience: Feeling good about yourself can help you navigate challenging situations with more emotional resilience. When you feel good about yourself, you’re better equipped to handle setbacks without them taking a toll on your self-esteem.

9. Celebrating Individuality: Personalizing your beauty routine allows you to express your individuality, which is essential for mental well-being. Whether through makeup, hairstyles, or fashion, expressing your unique style can increase self-acceptance and happiness.

10. Breaking Negative Thought Patterns: Engaging in beauty care can disrupt negative thought patterns. When you actively work to enhance your appearance, you’re investing in yourself, which can shift focus away from self-criticism toward self-appreciation.

And remember, taking care of yourself isn’t just about looking good—it’s about feeling good. So go ahead, pamper yourself a little. After all, no one ever complained about having too many good hair days!

P.S.: Of course, you should also work on your emotional and intellectual growth, not just the physical. But looking good never hurt anybody. 😉😄

Aging is a universal experience, something we all face as time goes on. I’ve spent a lot of time reflecting on what it means to grow older.

Here are 10 thoughts that have surfaced during my journey:

1. Aging Brings Wisdom, But Also New Questions

It’s true that as time passes, you become more mature and certainly accumulate a valuable set of skills and human knowledge compared to years past. However, the flip side of aging is the emergence of new questions. For example: Have I lived a meaningful life so far? What were and what should be my priorities? How do I want to live the coming years? What do I want to leave behind, both in terms of spiritual and other legacies?

Okay, if you’ve already started to feel scared, hold on because I haven’t even started yet.

2. The Fear of Physical Changes

There’s no point in telling you something you already know and experience every day in your own skin. Of course, we experience physical changes at every moment, which may not be so noticeable in daily life, but they become evident when we look at photos from even just a little while ago. And I’m not just talking about hair color, but also about those first signs of aging around the eyes, the skin that starts to sag, and (let’s be honest) that cellulite that becomes harder to keep under control than before.

The more I see the changes in my body of various kinds, I inevitably clash with one of my fears (perhaps a superficial one, but still): How will I look or feel in 10 years? What about 20? And after 30 years?

This makes the desire and will to stay physically and mentally fit through sports and other activities that provide the right physical and cognitive stimuli even more present. We have a saying in Albanian: “People age when they want to,” and there’s some truth to it. If we don’t continuously care for our bodies and minds and nourish them with the right stimuli, the signs of aging will certainly be more noticeable.

3. The Universality of Aging

Well, let’s say that a comforting thought is that we all, without exception, will age. Have you seen that movie with Meryl Streep and Goldie Hawn (“Death Becomes Her”) where the two actresses don’t age and never die because they drank the elixir of eternal life? For one reason or another, I’ve always loved that movie since I was little. Not just because there was something mystical and strange about the way the film was presented, but because it made me curious about aging and its consequences even back then. I saw how no one was exempt from this process and how even the effort to stop it led to fatality (a harsh truth even today).

It’s somewhat fair that we all age; it makes us more alike and helps us appreciate each moment more. This brings us to the next point:

4. A Deeper Appreciation for the Present

Yes, as the years go by, we value the present more, along with the people and unforgettable moments with them. Understanding how short life can be, we start to live more without worrying about what others think or want. What matters is what *you* want!

Ask yourself: What do *you* want? What do *you* desire from this moment? The moments become more valuable, and you begin to see your priorities through a different lens.

5. Navigating the Fear of Loss and the Fear of Death

This is a very special and difficult point, intertwined with the general fear of death. Each of us believes in something when it comes to our relationship with death, and this is a personal and intimate subject that I don’t want to delve into too much. Every adult has formed their relationship with this over time.

However, it’s hard to constantly think about the inevitable end, so I try to appreciate and love every moment with my loved ones more. The awareness of our temporary existence has given me a greater desire to live and experience every moment in all its nuances, and to cherish spending valuable time with my loved ones. What makes me fear death is the thought of whether I will have achieved my goals in life (not material ones). This is my only fear, along with whether I will be proud of how I spent my time on earth.

6. Shifting Focus to Inner Growth

And here we come to the part where we need to invest in ourselves. This is where education and reading are the most important things each of us should prioritize, in my opinion. We need to see how each day we learn something new, develop further, and how experiences with new people, places, or situations (travel, new people, hobbies, and new passions) give us more than we think. Spend time on yourself and nourish yourself with good spiritual food, whatever that may be for you. Discover it and start now!

7. The Value of Self-Acceptance

And the more you develop and learn, the more you start to recognize all the corners of yourself and your mind. The more you know them, the more you start to love them or even improve them—not by judging, but by accepting them as the first step in improving and loving yourself.

8. The Power of Connection

I have contradictory thoughts about this because I’ve also had trouble with the aspect of belonging to a certain group, especially when you’re very different from what is expected of you. Over time, I realized that this too is a group in itself, and it’s perfectly okay to be different and feel different. What’s important is to find people who understand you in a certain way and to see this diversity in yourself not as a mistake that needs to be corrected, but as a positive trait of a very genuine person who doesn’t compromise who they are.

Find people around you who inspire you and make you want to be more of *you*, just as you are!

9. Embracing the Journey

Embrace yourself now and in the next 30 or more years. Think about how you are unique in this world and deserve to be happy. Give yourself the happiness you deserve, free yourself from judgments, and live happily in your own skin at every moment. Being true and authentic to yourself is what leads to a long and happy life, always investing in improving yourself.

Think about how the only constant in our life is that we age, and consider changing the things you can: read, eat well, exercise, and spend time with loved ones, etc.

(For more on this, read other people’s blogs.)

Believe in yourself—it’s rejuvenating!

There were actually 10 points, but I seem to have combined one into another. So, here’s a bonus:

10. P.S.: Never forget SPF! (And i mean it!) 🙂

With Love,

Doc D.

Hello world! 🌍 

I’m ( let just say a name) Doc.D , a Psychiatrist in Germany and being occupied with my own deep thoughts on a boring, gray weekend I got the sudden idea  to maybe  blog some thoughts.

Of course, a reasonable question, would be: why should these thoughts be interesting for other people?

I have seen in my everyday experience that really often many myths about psychiatry and psychiatrists persist among people.  People come into contact with us when they really need us (willingly or not).

We are mostly a community that is usually very private (psychiatrist’s habit!) and whom continue to practice our job keeping a low profile.

Of course, in order to have a different perspective (and also partly to feed my narcissistic parts), I thought about maybe displaying a different perspective on psychiatry.  Psychiatrists are also humans, we are also doctors who  have doubts and insecurities in many cases.  Everyday we are  confronted with challenging questions and not every decision comes easily, straightforward  from a comfortable „Freud’s“ sofa.

Therefore, allow me to present, a humble  attempt to answer many of your questions and to show a different point of view, from the eyes of other party in this patient-doctor communication.

I would be really happy if you decide to follow along my storytelling towards a  hopefully  nice and eye opening journey into the world of psychiatrists and even especially within the human mind.

Are you ready?  😊🧠👀