První varovné příznaky
První příznaky bývají poměrně nenápadné a často se stane, že si jich ani nejbližší okolí dlouho nevšimne.
Anorexii (i bulimii) provázejí nejrůznější změny jídelních návyků. Anorektička si bere menší porce nebo jídlo pod různými záminkami odmítá; např. přijde ze školy a odmítne oběd s tím, že již někde jedla s kamarády nebo že jí není dobře. Často omezuje škálu jídel, kterou je ochotná jíst - chce jenom vegetariánskou stravu, odmítá některé potraviny, protože ji nadýmají, nedělají jí dobře, nejsou zdravé (jsou geneticky upravené) a tak podobně. Časem může dojít až k extrémní situaci, kdy se jídelníček omezí např. jen na zeleninové saláty.
Podivné může být i vlastní chování u jídla a po jídle. Anorektička se až přehnaně zajímá o vaření (může třeba začít sbírat recepty), ale potom si sama vezme jen vpravdě vrabčí porci. Používá menší talíř (porce na něm vypadají větší), pečlivě žvýká, někdy mezi jednotlivými sousty pokládá příbor nebo je zapíjí vodou, odnáší si jídlo do svého pokoje atd. Bulimičky jsou zase schopné v noci samy vyjíst celou ledničku - dokáží zkonzumovat opravdu neuvěřitelné množství jídla a to jakéhokoli, třeba kostku másla nebo syrový celer.
Kromě toho si lze všimnout i dalších změn. Anorektičky často nosí volné oblečení, aby zamaskovaly nejprve svou domnělou tloušťku, později na kost vyhublé tělo. Většinou jsou tiché, nezajímají se příliš o okolní dění a odmítají účast na různých podnicích, jako jsou výlety, kino apod. Jsou velmi nerozhodné, otázka co si vzít na sebe nebo na co se dívat v televizi se stává obrovským problémem. Pokud se zeptáte, co by chtěla dělat, nejspíš odpoví, že je jí to jedno, nebo že se přizpůsobí ostatním. Anorexie se často spojuje s depresí a postižená tak může jevit všechny příznaky deprese - je sklíčená, smutná, nekomunikuje, neusmívá se, z ničeho nemá radost, do ničeho se jí nechce a všechno je jí jedno. Depresivní lidé si také mohou ubližovat (kromě hladovění se třeba řežou nebo píchají do rukou nebo se koušou).
Hlavní příznaky
Podle mezinárodní klasifikace nemocí jsou klíčové příznaky mentální anorexie tyto:
1) tělesná váha se nachází pod normálem a je na této úrovni dobrovolně udržována, a to i drastickými prostředky. Ty se liší podle typu anorexie - u typu restriktivního (nebulimického) pacientka zkrátka nejí nebo jí velmi málo, cvičí, někdy zvrací a bere projímadla a diuretika. U typu purgativního (bulimického) dochází k záchvatům přejídání, které potom pacientka kompenzuje opět zvracením nebo užíváním projímadel.
2) pacientka má intenzivní, patologický strach z přibývání na váze
3) endokrinní poruchy - ženy v plodném věku ztrácejí menstruaci (pokud neužívají hormony), muži potenci; pokud se porucha vyvine před pubertou nebo v pubertě, zastaví se nebo výrazně zpomalí vývoj sekundárních pohlavních znaků.
Pokud některému z kritérií pacientka nevyhovuje, ale jinak celkový obraz mentální anorexii odpovídá, jde o atypickou mentální anorexii (nebo může jít také o MA počínající - dívka hladoví teprve krátce a ještě nesplňuje podmínku chorobné vyhublosti). Taková porucha se může vyvinout například i po dlouhém "tělesném" onemocnění.
Kritéria pro mentální bulimii jsou tato:
1) strach ze zvýšení hmotnosti, kterému se pacientka aktivně snaží zabránit používáním různých nepřiměřených metod (i bulimie se dělí na restriktivní a purgativní typ)
2) opakované přejídání (nejméně 2x týdně) a neustálá silná touha po jídle
3) sebehodnocení je silně závislé na vzhledu, postavě a její hmotnosti a tvaru
Kromě těchto základních poruch příjmu potravy existují i další; pokud tedy člověk má poněkud podivný vztah k jídlu, ale anorexií ani bulimií zjevně netrpí, může jít o jinou poruchu.
Infantilní mentální anorexie- anorektické chování u dětí (tedy před nástupem puberty).
Infantilní mentální anorexieSyndrom nočního přejídání - opakované nutkavé puzení v noci jíst - podobá se záchvatům přejídání u bulimiček. Občasný noční nájezd na ledničku je celkem normální, pokud se z něj stane pravidelná nutnost, je čas navštívit psychologa.
Záchvatovité přejídání - opakované přejídací záchvaty, podobné bulimickým, ale bez následujícího kompenzačního chování, tedy např. zvracení nebo cvičení (jedlík má sice výčitky, ovšem nenapadne ho, že by snad měl jídlo vyzvrátit, maximálně si slíbí, že zítra půjde za trest do práce pěšky). Vyskytuje se např. u obézních lidí, nucených držet dietu.
Emoční porucha spojená s vyhýbáním se jídlu - někteří lidé mají "mozek propojený přímo s žaludkem" - jsou-li nervózní, je jim špatně, ve stresu (ať už negativním, nebo pozitivním, například když jsou zamilovaní) nejsou schopni pozřít ani kousek jídla. To je pro poměrně velkou část populace zcela normální - ale může to přerůst (stejně jako noční přejídání) v extrém, který si žádá psychologickou intervenci.
Syndrom vybíravosti v jídle - alespoň trochu vybíravé je každé dítě, ovšem opět platí to, co v předchozích případech - všeho moc škodí. Může se stát, že dítě začne odmítat cokoliv jiného, než sladké kaše - a pak je třeba situaci řešit, protože pro dětský organismus mohou mít výživové deficity ošklivé následky.
Syndrom pervazivního odmítání-dítě systematicky odmítá cokoli dělat nebo přijímat - jídlo, pití, pohyb, mluvení, jakoukoli péči o sebe
Ruminace - specifická PPP, vyskytující se u kojenců a batolat; vyznačuje se opakovanou a častou regurgitací ("ublinkáváním") bez známek jakékoli nevolnosti nebo jiného diskomfortu.
Pika - nutkavé pojídání nestravitelných látek, např. hlíny, papíru, vlasů, odpadků. Vyskytuje se u dětí, případně mentálně retardovaných dospělých.
Nesmíme také zapomínat, že anorexii podobné chování mohou mít na svědomí nejen psychické poruchy a nemoci, ale i potíže čistě tělesného rázu. Například potravinové alergie, které se mohou rozvinout v jakémkoli věku, mívají za následek různé zažívací potíže a následně strach z jídla. Existuje také široká škála psychosomatických poruch, které svého "majitele" nutí k nestandardnímu chování - různé "žaludeční neurózy", dráždivé střevo (a další tzv. funkční kolopatie, onemocnění střev, při nichž pacient bez zjevné příčiny trpí průjmy, zácpami, nadýmáním, nevolnostmi a dalšími radostmi), chronické průjmy a zácpyatd. A příčinou může být i porucha organická, tedy žaludeční vředy, problémy se žlučníkem, vředová choroba střeva, různé chronické záněty v trávicím traktu atd.
V pokročilejší fázi si již lze všimnout i dalších příznaků, které bývají nepřehlédnutelné; tehdy také většinou dochází k "odhalení" ze strany okolí. Hlavním příznakem je většinou (někdy se vyskytovat nemusí) nápadná vyhublost - hmotnost je 15 a méně % pod normálem (nebo BMI je pod 17,5). Pod kůží znatelně vystupují kosti, především klouby, hroty obratlů, žebra.
Spolu se snížením hmotnosti na hranici podvýživy se mění pohyby - stávají se vláčnými a pomalými. Tento styl pohybů spolu s nehybným, až voskovým výrazem ve tváři je typický pro anorektičky. Nedostatkem živin trpí nehty, vlasy a pokožka - nehty se lámou a třepí, vlasy vypadávají, pokožka je dehydrovaná (pokud vezmete kůži mezi palec a ukazováček - jako byste chtěli štípnout - zatáhnete a pustíte, projeví se ztráta pružnosti pomalým návratem do původního stavu) a má šedavou, nažloutlou, zkrátka nezdravou barvu. V momentě, kdy už se základní životní funkce drží "zuby nehty", může se na povrchu celého těla objevit jemné ochlupení, zvané lanugo, které mají nenarozené děti - vypěstováním "srsti" se organismus snaží pomoci selhávající termoregulaci.
Změny v chování většinou pacientky umí výborně maskovat, nicméně všechno tajit nelze. Anorektičky a bulimičky používají různé metody, jak vyhnat z těla domnělé nadbytečné kalorie. Časté je zvracení, takže když dotyčná hned po obědě vystřelí do koupelny a třeba navíc ještě pustí vodu, aby přehlušila nepatřičné zvuky, asi to nebude samo sebou. Druhotným nežádnoucím účinkem zvracení, kterého si okolí někdy nemusí vůbec všimnout, protože postižená ho pečlivě tají, bývá oteklý krk a obličej, případně bolesti krku a porušená sklovina zubů. Oblíbené je cvičení, ovšem nejen klasické, např. aerobik - všímejte si častých vycházek, dobrovolného dlouhého venčení psa apod. Anorektičky často cvičí v noci, kdy je menší pravděpodobnost, že je někdo načape, a "cvičení" se oddávají neustále - např. šoupou nohama, hladí si rukama stehna apod., neboť mají pocit, že tak spálí více kalorií. Aby se o tom přesvědčily, často se několikrát denně váží.
Časté je zneužívání laxativ (projímadel), diuretik (látek, které odstraňují z těla vodu), někdy i jiných léků, jako jsou různé pilulky na hubnutí nebo léky na potlačení chuti k jídlu. Dávky, které si anorektičky berou, jsou zpravidla "koňské" a pravidelné a to s sebou samozřejmě nese spoustu rizik.
O chování u jídla už jsem psala výše - to všechno pořád platí. Anorektičky jídlo také různě schovávají (chleba s máslem ke svačině, který si odnesou do pokoje, nejspíš po krátkém pobytu ve skříni nebo v igelitové tašce skončí v popelnici) a jsou-li dotázány, kolik toho snědly, většinou lžou. Je za tím jednak snaha vyhnout se výčitkám a kázání a také snaha přesvědčit sama sebe, že se vlastně nic neděje, "vždyť přece jím". Pokud jsou na naléhání nuceny něco sníst, většinou si brzy začnou stěžovat na pocit přeplněného žaludku - to není výmysl, ale pravda, neboť činnost žaludku, zvyklého na téměř nulový příjem, je zpomalená a už po pár soustech reaguje nebohý orgán pocitem plnosti a nadýmání.
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(Mariohah, 17. 12. 2023 8:44)
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(Mariohah, 17. 12. 2023 7:32)
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(Mariohah, 17. 12. 2023 5:10)
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(Mariohah, 17. 12. 2023 4:00)
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(Mariohah, 17. 12. 2023 2:51)
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Setting out on a jurisprudential odyssey demands expertise, plus our veteran crew deals in safeguarding your entitlements having unwavering allegiance. From small infractions up to intricate defense charges, our counsels bring a breadth in expertise toward this table.
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(Mariohah, 17. 12. 2023 1:43)
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Setting out upon the judicial odyssey requires competence, and our seasoned crew focuses regarding defending your privileges having unwavering allegiance. Through misdemeanors to complex defense allegations, these counsels convey a wealth in experience to this discussion.
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Engage within the evaluation absent of fiscal worries – the uncommon opportunity which sets our legal offerings distinct. During such risk-absent gathering, these legal experts evaluate one's proceeding, decipher possible tactics, plus furnish perspectives regarding the legal trajectories available for one's case. Your passage in the direction of a formidable defense begins here, absent the burden from early fiscal involvement.
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Showcasing Excellence: Clarke MacCourt - One's Ideal-To Criminal Attorneys in The City of Las Vegas
(DonaldTEP, 17. 12. 2023 0:58)
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(DonaldTEP, 16. 12. 2023 22:35)
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Showcasing Mastery: Clark MacCourt - Your Go-To Defense Attorneys in The City of Las Vegas
(DonaldTEP, 16. 12. 2023 19:00)
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Within this domain of jurisprudential mastery, Clarke MacCourt towers proudly as the embodiment of distinction, especially in the dynamic city known as Las Vegas. Functioning as Criminal Counsels maestros, McCourt accompanied by his team explore the complex maze within this judicial apparatus with nuance, ensuring these patrons receive premium-notch representation.
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(DonaldTEP, 16. 12. 2023 17:51)
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(DonaldTEP, 16. 12. 2023 16:37)
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In the sphere for judicial expertise, Clark MacCourt towers proudly as the epitome denoting supremacy, particularly throughout that energetic municipality known as Las City of Las Vegas. Functioning as Criminal Lawyers extraordinaire, Clarke MacCourt and this team explore the multifaceted maze within the legal system having skill, guaranteeing these patrons obtain premium-notch representation.
The Beacon for Jurisprudential Astuteness
https://www.pinterest.com/pin/906842074953016676/
Unraveling the Legal Web
Clarke McCourt, boasting decades in skilled expertise, takes joy in elucidating those complexities of defense law. His commitment toward equity remains resolute, making Clarke MacCourt the beacon for the ones caught up in legal quandaries. Clarke MacCourt's capability covers a multitude entailing criminal matters, through small infractions to substantialstakes major violations.
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Internalizing the emotional burden jurisprudential disputes may demand, Clark MacCourt goes farther than that role of a traditional counsel. This crew offers n't only judicial expertise rather additionally the reinforcement system for patrons battling challenging periods. Such is this blend entailing legal competence plus compassion which distinguishes McCourt's practice apart.
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Revealing Excellence: Clarke McCourt - One's Ideal-To Criminal Lawyers throughout Las City of Las Vegas
(DonaldTEP, 16. 12. 2023 15:24)
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In this realm of legal expertise, Clark McCourt towers confidently constituting the quintessence denoting supremacy, especially throughout that energetic city known as The Vegas. As Criminal Attorneys extraordinaire, Clarke MacCourt and this team navigate the multifaceted web of the jurisprudential apparatus featuring nuance, guaranteeing these patrons receive top-notch representation.
A Spotlight of Legal Discernment
https://www.pinterest.com/pin/906842074953016676/
Decoding the Judicial Maze
Clark MacCourt, boasting decades in veteran expertise, bears joy regarding demystifying those nuances within defense jurisprudence. His allegiance to fairness remains steadfast, establishing Clarke MacCourt the torch for the ones ensnared in legal predicaments. Clarke MacCourt's competence covers a multitude entailing criminal matters, through small infractions up to highstakes capital offenses.
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Bespoke Methodologies Strategies regarding Every Matter
One size does n't fit all in the jurisprudential domain, and Clarke MacCourt comprehends such nuance inherently. His judicial strategies are equally dynamic as the matters he manages. From meticulous inquiries up to deliberate trial rationales, Clarke MacCourt neglects not a dimension unturned when crafting a advocacy that resonates to arbiters and juries alike.
Patron-Oriented Backing
Outside of Jurisprudential Counsel: The Helpful Collaborator
Understanding the emotional strain jurisprudential struggles may exact, Clark McCourt goes outside of that capacity for a conventional attorney. This team delivers not only judicial acumen but additionally a reinforcement framework assisting patrons confronting trying intervals. It's this blend entailing jurisprudential competence plus compassion which defines Clarke MacCourt's office apart.
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One's Collaborator in This Legal Journey
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Could one like to back Clarke McCourt's objective in offering exceptional judicial representation? One's participation may aid protect equity plus verify thus all people possess access to a equitable defense. Click <here>(https://www.buymeacoffee.com/asktojk) for express one's support.
For a conclusion, Clark McCourt accompanied by his squad of Criminal Lawyers in Las Vegas stand at the front lines for legal distinction. With the commitment for personalized tactics, patron-oriented support, and steadfast bolstering, such legal experts are one's ideal-to partners for traversing the complexities of the jurisprudential system.
Unveiling Distinction: Clark MacCourt - One's Ideal-To Defense Attorneys in Las City of Las Vegas
(DonaldTEP, 16. 12. 2023 14:13)
Searching for Justice, Protecting Rights: Clarke MacCourt's Legal Prowess
In this realm for legal expertise, Clark MacCourt towers tall as that embodiment of excellence, especially in that dynamic city known as The City of Las Vegas. Functioning as Defense Attorneys maestros, Clarke MacCourt and this team navigate the intricate web within the jurisprudential system with finesse, guaranteeing their clients receive top-notch defense.
A Spotlight for Legal Acumen
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Decoding the Jurisprudential Maze
Clarke MacCourt, having decades of seasoned expertise, bears joy in demystifying the intricacies of criminal law. His allegiance toward equity is unwavering, establishing him the spotlight for those ensnared within legal predicaments. Clarke MacCourt's proficiency covers a myriad of defense proceedings, from misdemeanors to highstakes major violations.
This Route to Triumph: Legal Strategies that Work
Personalized Approaches regarding Every Case
A single process does n't apply to everyone within the judicial realm, plus Clarke MacCourt comprehends this intrinsically. His jurisprudential strategies are equally varied as those matters Clarke MacCourt handles. From meticulous investigations up to calculated courtroom presentations, McCourt leaves not a aspect unturned when structuring the advocacy that resonates with judges plus juries equally.
Client-Focused Advocacy
Farther than Jurisprudential Advocacy: A Assisting Collaborator
Understanding that emotional strain judicial battles can exact, Clarke McCourt ventures farther than that purpose of a conventional counsel. This squad delivers not simply judicial expertise but also the reinforcement apparatus assisting patrons facing trying times. Such is the amalgamation of judicial mastery plus empathy which sets McCourt's practice aside.
Smooth Passage through Legal Challenges
One's Collaborator for This Jurisprudential Odyssey
Exploring the judicial arena can manifest as discouraging, but with Clark McCourt by your flank, one becomes not solitary. His firm's mastery stretches across assorted legal considerations, presenting a thorough approach to managing challenges. Whether one becomes battling criminal allegations, demand legal advice, alternatively seeking advocacy in hearing, McCourt's crew becomes your reliable partner.
Advocate for Clark McCourt's Legal Crusade
Join This Mission
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In summation, Clarke MacCourt and his team of Criminal Attorneys in The City of Las Vegas stand on the front lines of jurisprudential excellence. Having the devotion for personalized tactics, customer-focused support, plus resolute support, such legal experts exist as one's ideal-to partners in traversing the complexities of the jurisprudential apparatus.
Showcasing Mastery: Clarke MacCourt - One's Go-To Defense Advocates in The Vegas
(DonaldTEP, 16. 12. 2023 13:06)
Pursuing Equity, Safeguarding Rights: Clark MacCourt's Judicial Prowess
In the domain for judicial mastery, Clark MacCourt shines proudly constituting the quintessence of excellence, particularly in the vibrant city known as The Vegas. Functioning as Criminal Attorneys extraordinaire, McCourt and his team traverse that intricate web within this legal system with skill, ensuring these clients acquire premium-notch defense.
The Beacon of Legal Discernment
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Demystifying the Jurisprudential Labyrinth
Clark MacCourt, having years of seasoned experience, takes joy in clarifying those complexities of defense law. This attorney's commitment to justice is steadfast, establishing Clarke MacCourt a beacon toward those entangled within judicial quandaries. Clarke MacCourt's competence encompasses the spectrum of criminal matters, through misdemeanors up to -stakes felonies.
This Road toward Triumph: Legal Tactics that Operate
Custom Methodologies Strategies for Every Matter
A single approach can not apply to everyone in the legal domain, plus Clarke MacCourt comprehends this inherently. These jurisprudential tactics manifest as as diverse like the proceedings Clarke MacCourt directs. Through meticulous inquiries to strategic trial presentations, Clarke MacCourt leaves no dimension unexplored in crafting a advocacy that connects to arbiters plus juries alike.
Customer-Oriented Support
Farther than Jurisprudential Representation: A Assisting Ally
Appreciating that psychological burden legal disputes can take, Clarke McCourt goes beyond that capacity for a traditional counsel. This crew provides n't just legal competence but also the support apparatus for customers confronting demanding times. It's the blend of legal mastery and understanding that defines Clarke MacCourt's office apart.
Seamless Passage through Legal Hurdles
Your Collaborator in the Judicial Odyssey
Exploring this legal realm can manifest as daunting, but with Clark McCourt by your side, you're n't solitary. His practice's competence extends to assorted legal considerations, providing the comprehensive process to addressing complications. If you're confronting criminal charges, need judicial advice, alternatively pursuing advocacy within trial, Clarke MacCourt's crew becomes one's dependable ally.
Support Clarke MacCourt's Judicial Endeavor
Join the Purpose
Would you like to advocate for Clark McCourt's objective toward providing superlative jurisprudential counsel? One's contribution may aid safeguard justice plus guarantee thus all people retain recourse toward a just defense. Click <here>(https://www.buymeacoffee.com/asktojk) to show one's backing.
In summation, Clarke McCourt accompanied by his squad constituting Defense Advocates throughout The City of Las Vegas exist at the front lines of judicial supremacy. Featuring a commitment for personalized approaches, patron-oriented backing, plus unwavering bolstering, such legal experts exist as your ideal-to collaborators in traversing the complexities within the jurisprudential apparatus.
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Showcasing Outstanding Judicial Support: The Diego Criminal Defense Counsel
(Mariohah, 17. 12. 2023 15:40)