{"id":11385588,"date":"2013-05-15T00:00:00","date_gmt":"2013-05-14T22:00:00","guid":{"rendered":"https:\/\/alertdiver.eu\/uncategorized-cs_cz\/psychicka-pripravenost-k-potapeni\/"},"modified":"2013-05-15T00:00:00","modified_gmt":"2013-05-14T22:00:00","slug":"psychicka-pripravenost-k-potapeni","status":"publish","type":"post","link":"https:\/\/alertdiver.eu\/cs_CZ\/clanky\/psychicka-pripravenost-k-potapeni\/","title":{"rendered":"Psychick\u00e1 p\u0159ipravenost k pot\u00e1p\u011bn\u00ed"},"content":{"rendered":"

\u00dakol vyhodnotit psychickou p\u0159ipravenost k pot\u00e1p\u011bn\u00ed vyvol\u00e1v\u00e1 obavy ne nepodobn\u00e9 pocit\u016fm hlubokomo\u0159sk\u00e9 pr\u016fzkumnice sed\u00edc\u00ed na palub\u011b sv\u00e9ho \u010dlunu a chystaj\u00edc\u00ed se otev\u0159\u00edt pr\u00e1v\u011b vyzvednutou tajemnou truhlu, z jej\u00edho\u017e povrchu se\u0161krabuje usazen\u00e9 mo\u0159sk\u00e9 bahno a rez. Co tam najde? Je to sk\u0159\u00ed\u0148ka Pando\u0159ina, nebo tam bude poklad pir\u00e1t\u016f?<\/p>\n

Mnoho let platilo, \u017ee z\u00e1jemci o pot\u00e1p\u011bn\u00ed s mnoha r\u016fzn\u00fdmi onemocn\u011bn\u00edmi nem\u011bli \u0161anci z\u00edskat povolen\u00ed ani k rekrea\u010dn\u00edmu pot\u00e1p\u011bn\u00ed. \u010casy se v\u0161ak zm\u011bnily a v sou\u010dasnosti mohou kr\u00e1sy sv\u011bta pod vodou obdivovat i lid\u00e9 trp\u00edc\u00ed cukrovkou, astmatem, rakovinou v remisi a dal\u0161\u00edmi v\u00e1\u017en\u00fdmi zdravotn\u00edmi probl\u00e9my. Psychiatrick\u00e9 onemocn\u011bn\u00ed v\u0161ak i dnes posuzovatele \u010dasto mystifikuje, p\u0159edev\u0161\u00edm kdy\u017e hledaj\u00ed snadn\u00fd a jednoduch\u00fd n\u00e1vod pro rozhodnut\u00ed o \u017eadatelov\u011b zp\u016fsobilosti k pot\u00e1p\u011bn\u00ed.<\/p>\n

Ale co plat\u00ed pro mnoho jin\u00fdch zdravotn\u00edch stav\u016f, to plat\u00ed i pro psychickou zp\u016fsobilost k pot\u00e1p\u011bn\u00ed – jednoduch\u00e1 odpov\u011b\u010f neexistuje. Pot\u00e1p\u011b\u010d\u016fm i hodnotitel\u016fm jejich zp\u016fsobilosti by se v\u0161ak m\u011blo poradit, jak\u00e9 ot\u00e1zky (si) maj\u00ed polo\u017eit. Je to v\u0161ak velk\u00fd \u00fakol a vy\u010derp\u00e1vaj\u00edc\u00ed diskuse by daleko p\u0159es\u00e1hla rozsah tohoto sd\u011blen\u00ed, proto se spokoj\u00edme s obecn\u00fdm pojedn\u00e1n\u00edm o du\u0161evn\u00edm onemocn\u011bn\u00ed, p\u0159\u00edslu\u0161n\u00e9 l\u00e9\u010db\u011b a souvislostech s bezpe\u010dnost\u00ed pot\u00e1p\u011b\u010de, kter\u00e9mu bylo diagnostikov\u00e1no, nebo u n\u011bj prob\u00edh\u00e1 l\u00e9\u010dba. V\u011b\u0159\u00edme, \u017ee n\u00e1sleduj\u00edc\u00ed informace alespo\u0148 trochu objasn\u00ed probl\u00e9m, kter\u00fd je dosud zahalen jakousi tajemnou a bohu\u017eel i zlov\u011bstnou rou\u0161kou.<\/p>\n

Z\u00e1kladn\u00ed skute\u010dnosti <\/strong><\/p>\n

Hned na za\u010d\u00e1tku je nutno \u0159\u00edci, \u017ee v\u00e1\u017en\u00e9 du\u0161evn\u00ed poruchy, jak\u00fdmi jsou deprese, bipol\u00e1rn\u00ed porucha (maniodepresivn\u00ed psych\u00f3za), generalizovan\u00e1 \u00fazkostn\u00e1 porucha, panick\u00e1 porucha, f\u00f3bie, posttraumatick\u00e1 stresov\u00e1 porucha a schizofrenie jsou jen n\u011bkter\u00e1 z mnoh\u00fdch onemocn\u011bn\u00ed, kter\u00e1 se v sou\u010dasnosti pova\u017euj\u00ed za samostatn\u00e9 biomedic\u00ednsk\u00e9 diagn\u00f3zy, nebo\u0165 za jejich projevem stoj\u00ed zjistiteln\u00e9 zm\u011bny v organismu. Na z\u00e1klad\u011b mnoha statistick\u00fdch anal\u00fdz genetick\u00fdch, demografick\u00fdch, epidemiologick\u00fdch, biochemick\u00fdch, neuroanatomick\u00fdch a neurofyziologick\u00fdch informac\u00ed i dat z\u00edskan\u00fdch r\u016fzn\u00fdmi neurologick\u00fdmi zobrazovac\u00edmi metodami byl prok\u00e1z\u00e1n vysok\u00fd stupe\u0148 korelace mezi projevy onemocn\u011bn\u00ed a biologick\u00fdmi n\u00e1lezy. Zm\u00edn\u011bn\u00e9 korelace odli\u0161uj\u00ed nemocn\u00e9 jedince od lid\u00ed, kte\u0159\u00ed podobn\u00fdmi onemocn\u011bn\u00edmi posti\u017eeni nejsou.<\/p>\n

I kdy\u017e p\u0159i l\u00e9\u010db\u011b n\u011bkter\u00fdch shora uveden\u00fdch stav\u016f hraje psychoterapie velmi d\u016fle\u017eitou a\u017e z\u00e1sadn\u00ed roli, du\u0161evn\u00ed onemocn\u011bn\u00ed se od jin\u00fdch zdravotn\u00edch poruch nijak z\u00e1sadn\u011b neli\u0161\u00ed. U n\u011bkter\u00fdch onemocn\u011bn\u00ed, nap\u0159. u r\u00fdmy, nen\u00ed nutn\u00fd \u017e\u00e1dn\u00fd farmakologick\u00fd z\u00e1sah. U jin\u00fdch je velmi d\u016fle\u017eit\u00e1 nefarmakologick\u00e1 l\u00e9\u010dba, kter\u00e1  m\u016f\u017ee p\u0159edej\u00edt nutnosti nasazen\u00ed l\u00e9k\u016f. Takov\u00fdm p\u0159\u00edkladem m\u016f\u017ee b\u00fdt jedinec s vysok\u00fdm krevn\u00edm tlakem, kter\u00fd se \u00fasp\u011b\u0161n\u011b l\u00e9\u010d\u00ed d\u00edky programu sest\u00e1vaj\u00edc\u00edho ze sn\u00ed\u017een\u00ed t\u011blesn\u00e9 hmotnosti, v\u010detn\u011b spr\u00e1vn\u00e9 v\u00fd\u017eivy, z fyzick\u00fdch cvi\u010den\u00ed a dokonce i z meditace.<\/p>\n

Podobn\u011b m\u016f\u017ee k l\u00e9\u010db\u011b n\u011bkter\u00fdch du\u0161evn\u00edch onemocn\u011bn\u00ed sta\u010dit psychoterapie. Mnoho dal\u0161\u00edch v\u0161ak na nefarmakologick\u00e9 z\u00e1sahy odpov\u00edd\u00e1 nedostate\u010dn\u011b, nebo v\u016fbec a pou\u017eit\u00ed psychofarmak se nejen doporu\u010duje, ale je naprosto nezbytn\u00e9 k potla\u010den\u00ed p\u0159\u00edslu\u0161n\u00fdch p\u0159\u00edznak\u016f.<\/p>\n

Z\u00e1sady pro jasn\u00e9 vyhodnocen\u00ed zdravotn\u00edho stavu <\/strong><\/p>\n

Jeliko\u017e jsou du\u0161evn\u00ed onemocn\u011bn\u00ed v z\u00e1sad\u011b biologick\u00e9ho p\u016fvodu, v\u016fle, stoicismus, samol\u00e9\u010dba a neuzn\u00e1v\u00e1n\u00ed takov\u00fdch poruch b\u00fdv\u00e1 a\u017e tristn\u011b ne\u00fasp\u011b\u0161n\u00e9. \u010cast\u00fdm pr\u016fvodn\u00edm jevem b\u00fdv\u00e1 nezam\u011bstnanost, drogov\u00e1, nebo l\u00e9kov\u00e1 z\u00e1vislost, studijn\u00ed selh\u00e1n\u00ed a soci\u00e1ln\u00ed nejistota. V p\u0159\u00edpad\u011b deprese je statisticky dolo\u017eeno, \u017ee 75 procent pacient\u016f, kte\u0159\u00ed se vymanili na 50 a\u017e 99 procent z hlubok\u00e9ho depresivn\u00edho stavu, do n\u011bj znovu upadnou b\u011bhem jednoho roku. Ze stejn\u00e9ho pr\u016fzkumu vypl\u00fdv\u00e1, \u017ee jedinc\u016fm, kte\u0159\u00ed se zm\u00edn\u011bn\u00e9ho stavu zbavili na 100 procent, hroz\u00ed jeho n\u00e1vrat do jednoho roku pouze v 25 procentech. A existuj\u00ed jasn\u00e9 d\u016fkazy, \u017ee aktivn\u00ed, nebo nedostate\u010dn\u011b l\u00e9\u010den\u00e9 psychiatrick\u00e9 onemocn\u011bn\u00ed vyvol\u00e1v\u00e1 u posti\u017een\u00e9ho velk\u00e9 utrpen\u00ed, zhor\u0161uje jeho schopnosti a zvy\u0161uje n\u00e1chylnost k dal\u0161\u00edm zdravotn\u00edm poruch\u00e1m.<\/p>\n

Hodnotitel zdravotn\u00edho stavu jedince posti\u017een\u00e9ho du\u0161evn\u00edm onemocn\u011bn\u00edm stoj\u00ed p\u0159ed dv\u011bma ot\u00e1zkami? Za prv\u00e9: Ohro\u017euje onemocn\u011bn\u00ed nyn\u00ed a\/nebo pr\u016fb\u011b\u017en\u011b bezpe\u010dnost pot\u00e1p\u011b\u010de nebo jeho koleg\u016f p\u0159i pot\u00e1p\u011bn\u00ed? Za druh\u00e9: Jak\u00e9 nebezpe\u010d\u00ed s sebou nese p\u0159\u00edslu\u0161n\u00e1 medikace? Diskuse o psychologick\u00e9m p\u0159\u00edstupu k l\u00e9\u010db\u011b \u00fazkostn\u00fdch a f\u00f3bick\u00fdch stav\u016f pot\u00e1p\u011b\u010d\u016f p\u0159ekra\u010duje r\u00e1mec tohoto \u010dl\u00e1nku. Z\u00e1sady pro jasn\u00e9 vyhodnocen\u00ed zdravotn\u00edho stavu potenci\u00e1ln\u00edho pot\u00e1p\u011b\u010de s anamn\u00e9zou psychiatrick\u00e9ho onemocn\u011bn\u00ed jsou v\u0161ak pom\u011brn\u011b jednozna\u010dn\u00e9.<\/p>\n

Prvn\u00edm nutn\u00fdm p\u0159edpokladem z\u00e1jemce o pot\u00e1p\u011bn\u00ed mus\u00ed b\u00fdt remise du\u0161evn\u00edho onemocn\u011bn\u00ed. "V remisi" znamen\u00e1, \u017ee pot\u00e1p\u011b\u010d by nem\u011bl poci\u0165ovat v\u016fbec \u017e\u00e1dn\u00e9 p\u0159\u00edznaky sv\u00e9ho onemocn\u011bn\u00ed. Pokud by m\u011bl hodnotitel jeho stavu v tomto smyslu jak\u00e9koliv pochybnosti, m\u011bl by po\u017e\u00e1dat l\u00e9ka\u0159e, kter\u00fd odpov\u00edd\u00e1 za l\u00e9\u010dbu a psychick\u00fd stav p\u0159\u00edslu\u0161n\u00e9ho jedince, o konzultaci a ujistit se, \u017ee je pacient skute\u010dn\u011b v dan\u00e9m obdob\u00ed bez p\u0159\u00edznak\u016f a schopen fungovat bez jak\u00e9hokoliv omezen\u00ed. Zde m\u016f\u017ee b\u00fdt n\u00e1pomocn\u00e9, kdy\u017e si uv\u011bdom\u00edme, \u017ee psychiatrick\u00e9 onemocn\u011bn\u00ed se podob\u00e1 jin\u00fdm v\u00e1\u017en\u00fdm zdravotn\u00edm poruch\u00e1m, jejich\u017e p\u0159\u00edznaky se mohou opakovan\u011b vracet. Nap\u0159\u00edklad v dob\u011b, kdy se chce pacient trp\u00edc\u00ed astmatem, cukrovkou, rakovinou nebo n\u011bjak\u00fdm infek\u010dn\u00edm onemocn\u011bn\u00edm pot\u00e1p\u011bt, mus\u00ed b\u00fdt jeho onemocn\u011bn\u00ed v remisi. A tot\u00e9\u017e plat\u00ed o psychiatrick\u00e9m onemocn\u011bn\u00ed.<\/p>\n

Co se t\u00fd\u010de zp\u016fsobilosti k pot\u00e1p\u011bn\u00ed, psychiatrick\u00e9 onemocn\u011bn\u00ed se nijak neli\u0161\u00ed od jin\u00fdch v\u00e1\u017en\u00fdch zdravotn\u00edch stav\u016f. V ka\u017ed\u00e9m p\u0159\u00edpad\u011b plat\u00ed: Pot\u00e1p\u011b\u010d mus\u00ed b\u00fdt bez p\u0159\u00edznak\u016f. Mus\u00ed fungovat bez jak\u00e9hokoliv omezen\u00ed p\u0159i pln\u011bn\u00ed \u00fakol\u016f, kter\u00e9 vy\u017eaduj\u00ed vlastn\u00ed nebo skupinov\u00fd \u00fasudek a rozhodov\u00e1n\u00ed. Jeho pozn\u00e1vac\u00ed schopnosti nesm\u00ed b\u00fdt nijak zm\u011bn\u011bn\u00e9a jeho remise mus\u00ed trvat ji\u017e del\u0161\u00ed dobu. V\u00fdraz "ji\u017e del\u0161\u00ed dobu" m\u016f\u017ee znamenat r\u016fzn\u00e9 dlouh\u00e9 \u010dasov\u00e9 obdob\u00ed, kter\u00e9 se bude li\u0161it od pot\u00e1p\u011b\u010de k pot\u00e1p\u011b\u010di podle konkr\u00e9tn\u00ed diagn\u00f3zy i dal\u0161\u00edch okolnost\u00ed. Pr\u00e1v\u011b z tohoto d\u016fvodu b\u00fdv\u00e1 nutn\u00e1 konzultace s o\u0161et\u0159uj\u00edc\u00edm l\u00e9ka\u0159em. Pouze kdy\u017e je hodnotitel dob\u0159e sezn\u00e1men s diagn\u00f3zou i l\u00e9\u010dbou hodnocen\u00e9ho jedince (nap\u0159. hodnotitel s\u00e1m je psychiatrem), pak nemus\u00ed b\u00fdt konzultace nutn\u00e1.  <\/em><\/p>\n

Psychiatrick\u00e1 onemocn\u011bn\u00ed v remisi sama o sob\u011b nejsou kontraindikac\u00ed k pot\u00e1p\u011bn\u00ed. Hlavn\u00ed probl\u00e9m, kter\u00fd m\u00e1 hodnotitel posoudit je m\u00edra rizika, \u017ee pot\u00e1p\u011b\u010d u\u010din\u00ed chybn\u00fd \u00fasudek, ze kter\u00e9ho by vyplynulo nespr\u00e1vn\u00e9 chov\u00e1n\u00ed. Proto je d\u016fle\u017eit\u00e9 ch\u00e1pat, stav dlouhodob\u00e9  remise, jako dobu, b\u011bhem kter\u00e9 potenci\u00e1ln\u00ed pot\u00e1p\u011b\u010d nezaznamenal \u017e\u00e1dn\u00e9 p\u0159\u00edznaky sv\u00e9ho onemocn\u011bn\u00ed a norm\u00e1ln\u011b pracoval, \u0159\u00eddil auto a \u00fa\u010dastnil se r\u016fzn\u00fdch rekrea\u010dn\u00edch \u010dinnost\u00ed, kter\u00e9 vy\u017eaduj\u00ed spr\u00e1vn\u00e9 rozhodov\u00e1n\u00ed i sou\u010dinnost a spolupr\u00e1ci s jin\u00fdmi lidmi. Takov\u00fd \u010dlov\u011bk m\u00e1 v\u017edy l\u00e9ka\u0159e, kter\u00fd o n\u011bj pe\u010duje a pr\u00e1v\u011b ten by m\u011bl v p\u0159\u00edpad\u011b pochybnost\u00ed poskytnout rozhoduj\u00edc\u00ed konzultaci.<\/p>\n

Druhou nutnost\u00ed je spr\u00e1vn\u011b vyhodnotit medikaci p\u0159edepsanou pro dan\u00e9 psychiatrick\u00e9 onemocn\u011bn\u00ed. Pro rekrea\u010dn\u00ed pot\u00e1p\u011b\u010de pou\u017e\u00edvaj\u00edc\u00ed k d\u00fdch\u00e1n\u00ed vzduch ve standardn\u00edch hloubk\u00e1ch existuje jen n\u011bkolik skute\u010dn\u011b problematick\u00fdch l\u00e9k\u016f. V sou\u010dasn\u00e9 dob\u011b je k dispozici pouze m\u00e1lo skute\u010dn\u011b potvrzen\u00fdch informac\u00ed o psychiatrick\u00e9 medikaci p\u0159i pot\u00e1p\u011bn\u00ed. \u017d\u00e1dn\u00e1 data nepotvrzuj\u00ed nebezpe\u010d\u00ed selektivn\u00edch inhibitor\u016f zp\u011btn\u00e9ho vychyt\u00e1v\u00e1n\u00ed serotoninu (SSRI) a inhibitor\u016f zp\u011btn\u00e9ho vychyt\u00e1v\u00e1n\u00ed serotoninu a noradrenalinu (SNRI), ani nebezpe\u010d\u00ed skupiny l\u00e9\u010div ozna\u010dovan\u00fdch jako atypick\u00e1 antipsychotika, kter\u00e1 jsou \u010dasto p\u0159edepisovan\u00e1 pro pos\u00edlen\u00ed antidepresivn\u00ed l\u00e9\u010dby a l\u00e9\u010dbu bipol\u00e1rn\u00ed poruchy, nebo schizofrenie. Stimula\u010dn\u00ed p\u0159\u00edpravky pou\u017e\u00edvan\u00e9 k l\u00e9\u010db\u011b hyperaktivity s poruchou pozornosti (ADHD) z\u0159ejm\u011b neznamenaj\u00ed \u017e\u00e1dn\u00e9 velk\u00e9 nebezpe\u010d\u00ed; v\u011bt\u0161\u00edm rizikem se zd\u00e1 b\u00fdt nedostatek l\u00e9\u010debn\u00e9ho \u00fa\u010dinku, jestli\u017ee se l\u00e9ky neberou ve spr\u00e1vn\u00fd \u010das. Medikace proti epileptick\u00fdm z\u00e1chvat\u016fm se mus\u00ed posuzovat p\u0159\u00edpad od p\u0159\u00edpadu. U\u017e\u00edv\u00e1n\u00ed uhli\u010ditanu lithn\u00e9ho se pova\u017euje za relativn\u00ed kontraindikaci k pot\u00e1p\u011bn\u00ed kv\u016fli v\u00e1\u017en\u00e9mu nebezpe\u010d\u00ed souvisej\u00edc\u00edmu s potenci\u00e1ln\u00ed toxicitou lithia, jestli\u017ee se u pot\u00e1p\u011b\u010de rozvine deplece sod\u00edku, nebo dehydratace. U\u017e\u00edv\u00e1n\u00ed benzodiazepin\u016f a jim podobn\u00fdch slou\u010denin je kontraindikac\u00ed k pot\u00e1p\u011bn\u00ed kv\u016fli jejich sedativn\u00edm vlastnostem a negativn\u00edm dopad\u016fm na \u00fasudek a pozn\u00e1vac\u00ed schopnosti.<\/p>\n

Neexistuj\u00ed \u017e\u00e1dn\u00e9 d\u016fkazy o tom, \u017ee by rekrea\u010dn\u00ed p\u0159\u00edstrojov\u00e9 pot\u00e1p\u011bn\u00ed znamenalo mimo\u0159\u00e1dn\u00e9 nebezpe\u010d\u00ed pro ty psychiatrick\u00e9 pacienty v remisi, kte\u0159\u00ed spr\u00e1vn\u011b u\u017e\u00edvaj\u00ed vhodn\u00e9 l\u00e9ky a u nich\u017e se neprojevuj\u00ed vedlej\u0161\u00ed \u00fa\u010dinky. Potenci\u00e1ln\u00ed pot\u00e1p\u011b\u010di v remisi, se spr\u00e1vnou l\u00e9ka\u0159skou p\u00e9\u010d\u00ed, kte\u0159\u00ed funguj\u00ed bez ve\u0161ker\u00fdch omezen\u00ed, se mohou pova\u017eovat za \u0159\u00e1dn\u00e9 uchaze\u010de o povolen\u00ed k pot\u00e1p\u011bn\u00ed. K tomuto jednozna\u010dn\u00e9mu prohl\u00e1\u0161en\u00ed je v\u0161ak nutno dodat, \u017ee pou\u017e\u00edv\u00e1n\u00ed nitroxu nebo jin\u00fdch speci\u00e1ln\u00edch sm\u011bs\u00ed d\u00fdchac\u00edch plyn\u016f, jako\u017e i pot\u00e1p\u011bn\u00ed do v\u011bt\u0161\u00edch hloubek, dekompresn\u00ed pot\u00e1p\u011bn\u00ed a jin\u00e9 specifick\u00e9 okolnosti vy\u017eaduj\u00ed individu\u00e1ln\u00ed posouzen\u00ed.<\/p>\n","protected":false},"excerpt":{"rendered":"

\u00dakol vyhodnotit psychickou p\u0159ipravenost k pot\u00e1p\u011bn\u00ed vyvol\u00e1v\u00e1 obavy ne nepodobn\u00e9 pocit\u016fm hlubokomo\u0159sk\u00e9 pr\u016fzkumnice sed\u00edc\u00ed na palub\u011b sv\u00e9ho \u010dlunu a chystaj\u00edc\u00ed se otev\u0159\u00edt pr\u00e1v\u011b vyzvednutou tajemnou…<\/p>\n","protected":false},"author":1,"featured_media":11374683,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[384],"tags":[],"authors":[586],"class_list":["post-11385588","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-clanky","authors-adam-roth-m-d-cs_cz"],"acf":[],"yoast_head":"\nPsychick\u00e1 p\u0159ipravenost k pot\u00e1p\u011bn\u00ed - Alert Diver<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/alertdiver.eu\/cs_CZ\/clanky\/psychicka-pripravenost-k-potapeni\/\" \/>\n<meta property=\"og:locale\" content=\"cs_CZ\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Psychick\u00e1 p\u0159ipravenost k pot\u00e1p\u011bn\u00ed - 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