Theory of the Problem
Over the years, there has been an increase in individuals with psychological disorders. Most of these disorders are linked to substance abuse. According to studies by Zvolensky et al. (2006), at least 10% to 40% of people who abuse alcohol have panic disorder. As a result, substance usage plays a critical role in starting a panic. Existing evidence suggests clinically significant bidirectional relationships between panic disorders and potential premorbid risks for such disorders, including cigarette, alcohol, and marijuana consumption. According to Cowley (1992), there is a strong link between panic illness and drinking or drug usage, particularly cocaine and tranquilizers. Panic can develop from extended use or detoxification of liquor or other substances and from consuming or sedative usage. The link between panic and the usage of other drugs has received far less attention. Because of characteristics that make data interpretation challenging, summarizing research endeavors is difficult. Diverse demographics (for example, epidemiologic vs. clinical), limited numbers of individuals, adoption of different definitions for school and drug misuse, and chance in delineating specific panic disorders are only a few of them. Koob and Volkow (2010) mentioned other reasons include not regulating the third disorder (stimulant usage) and, probably most importantly, not accounting for withdrawal phenomena. For example, in Marshall’s (1997) investigations, up to 80% of alcohol-dependent men claimed to have repeated panic episodes during alcohol withdrawal. Most patients with psychological conditions believe that self-medication is right. However, they fail to understand that these medications come with a risk of dependence and may cause other adverse effects. In severe cases, patients under antidepressants may experience panic attacks or suicidal thoughts (Haron & Noor, Hanim, 2021).
Additionally, substance abuse and panic attacks are correlated in that substance abuse may cause panic attacks to be more severe or frequent in a person who has a preexisting terror disorder. Once they stop using these substances, individuals abusing drugs may have the panic attacks return or worsen. Misuse of drugs also tends to influence the presentation of panic disorder by either exaggerating or intensifying the symptoms.
Most individuals suffer from panic attacks which is a disorder that is characterized by terror attacks. It is estimated that at least 4.7 % of Americans will experience a panic attack once in their lifetime (Afsin et al., 2020). The national mental wellbeing council established that out of these adults with panic attacks, at least 8 percent of these conditions are linked to substance abuse. A panic attack linked to substance abuse and anxiety is generally termed a comorbid condition affecting the drug abusers. A comorbidity is a condition that arises when two or more disorders co-occur in a patient (Afsin et al., 2020). It can also be referred to as a dual diagnosis. Some drugs, such as marijuana, can worsen or trigger the symptoms of panic attacks.
Alcohol has both stimulant and depression effects that affect the individuals who use alcohol. When an individual is intoxicated, they lose control over their body which triggers or accelerates panic attacks. Additionally, most patients who previously abused drugs often have withdrawal symptoms that occur as panic attacks. This factor may lead to most patients relapsing because they are afraid to encounter withdrawal symptoms (Perna & Caldirola, 2018). Alcohol is usually absorbed directly into the bloodstream. Once the concentration in the system exceeds the minimal amount, the patient may experience symptoms almost similar to those of panic disorder.
Avoidance behaviors usually occur in groups that are related to fear. For instance, an individual afraid of riding a bicycle on the main road will always avoid the main route. Panic disorder and avoidance behaviors may limit the quality of life of individuals (Mendlowicz and Stein (2000). Panic disorders are portrayed as diseases that severely impair quality of life and psychological adjustment in the papers evaluated by Mendlowicz and Stein (2000) and Locke et al. (2015). People with subthreshold panic disorders might also show significant impairments. Individuals with specific phobias, panic disorder, and posttraumatic anxiety disorder have been proven to benefit from effective pharmaceutical or psychotherapy treatment. The Epidemiologic Catchment Area (ECA) research is a valuable resource for information on panic disorder epidemiology and the effect of panic illness on life quality. According to this research, the panic disorder affects 1.5 percent of people at some point in their lives (Markowitz et al. 1989). The personal reporting of health, psychological adjustment, and set of financial were the dimensions of quality of life that were evaluated. Quality-of-life indicators in people with lifetime panic syndrome were compared to those with lifetime severe depression disease with well-documented psychosocial morbidity (Wells et al. 1989)—and healthy people. Avoidance behavior may increase to a level that the person becomes homebound. Analysis of the regularity, harshness and period of panic attacks concerning the first onset and the estimation of panic occurrence and avoidance behavior throughout treatment implies that getaway is not merely a part of terror (Haron & Noor, Rahmat, 2021). Factors such as mastery, demand in society, and the possibility for secondary gain are the factors perceived as significant for nurturing avoidance behavior. Other factors include auxiliary earnings, protection notifications, and over anticipation of the chance of the panic attack to occur.
Individuals with panic disorder consider avoidance behavioral to sidestep fearful thoughts, the bad feelings of dread, and the general anxiety-related symptoms. Sufferers are frequently nervous since they are afraid of another assault. They become too sensitive to indicators that warn of the probability of danger by focusing their concentration on the feelings and memories of their anxieties (MacLeod et al., 2002). They may become unclear of what is causing their arousal, comparing it to events that are not the cause. Individuals with panic disorder have a tendency to perceive even little physical sensations negatively, which leads to more ironically and worry more physical feelings, producing a panic loop (Craske & Barlow, 2008). The individual may start to avoid various circumstances or behaviors that cause the same physiological responses as when the panic event first started. Someone who has a rapid heartbeat throughout a panic attack should prevent exercise and caffeine, while someone with choking feelings should avoid donning high-necked jumpers or jewelry. Interoceptive avoidance refers to avoiding these internal physiological or somatic indications for terror (Craske & Barlow, 2008). Dealing with panic disorder often can take on avoidance behaviors that will limit the fear of panic disorders. When individuals have panic disorder, they experience a range of unpleasant emotions that prevent them from carrying on with their everyday lives (Perna & Caldirola, 2018). Therefore, avoidance becomes the reward and reinforces avoidance behavior among this group of individuals. Studies establish that avoidance causes worsening of the signs and symptoms of panic disorder since individuals tend to get worse symptoms that they are trying to avoid.
Provided that drug abuse, a significant health concern in Turkey and around the world, is on the rise not only among teenagers but also among primary school learners, Uzun and Kelleci (2018) conducted a study to determine high school students’ self-efficacy in the avoidance of drug abuse and recognize linked factors. According to the research, adolescents take substances for several reasons, including amusement, emotional needs, and meeting social, fleeing problems, finding excitement, or challenging their surroundings. A vast number of risk variables have been found that prepare the ground for teenagers to drink, smoke, and use narcotics, highlighting that the existence of more of these characteristics in adolescents produces a high likelihood of addiction. Self-efficacy is a type of self-confidence that grows over the period of a person’s trust and self-assessment in their ability to cope effectively with potential future obstacles. Other people’s observations and knowledge of other folks’ remarks are essential factors in its growth. According to Uzun & Kelleci (2018), young people’s self-efficacy beliefs influence the initiation and duration of drug use. It is well understood that avoidance and earlier treatment are the most effective approaches to addressing the problem of drug abuse. As a result, it is considered that developing young folk’s self-efficacy in avoiding substance abuse issues is critical in preventing drug usage. To be effective, drug addiction treatments must first recognize the kids and teenagers who are at risk and understand individual and ecological risk and mitigating variables for drug consumption in adolescence.
Excessive alcohol consumption among the learners in colleges may lead to brain damage that affects them mentally and may even lead to miss behavioral activities within the institution (Perna & Caldirola, 2018). Learners should be guided occasionally while in colleges on the effects of drug abuse in order to avoid the use of alcohol which may encourage strikes in the institution. Controlling gender inequalities, peer pressure, drinking motives, and more strong values is significant in minimizing the avoidance rate among those experiencing avoidance behavior. There is little consistency in behavior with marijuana avoidance and minimized use of marijuana, and less drug abuse.
According to the findings of Uzun and Kelleci’s (2018) study, high school teenagers are in danger of starting and continuing drug use, and more research into increasing self-efficacy is needed. The study demonstrates that students with drug consumers in their surroundings who have a low self-efficacy for drug prevention, are 17 or older, male, attending vocational schools, residing in family breakdown, having low academic achievement, with parents who have a low educational level, a background of illness, poor familial relationships, explaining themselves as assertive, and being unsatisfied with their school experience. School nurses and guidance instructors need to keep a closer eye on these children.
Most victims with psychological disorders assume that self-medication is right. However, they fail to understand that these treatments come with a danger of reliance and may result in other unfavorable impacts. In severe cases, patients under antidepressants may experience panic attacks or suicidal thoughts. Moreover, substance misuse and panic attacks have pertained in that substance abuse may cause panic attacks to be more drastic or frequent in a person who has a preexisting terror disorder. The status of the getaway of certain situations determines the anticipation of panic. Factors such as proficiency, need in society, and the possibility for derivative profit are the components perceived as significant for nurturing avoidance behavior. There are other facets such as secondary income, safety notifications, and apprehension about the possibility of a panic attack. Guidance of learners in institutions on how alcohol affects them is a suitable method of helping them in avoiding the use of drugs within the colleges. Controlling gender indices, peer pressure, drinking motives, and more strong values are significant in minimizing the avoidance rate among those experiencing avoidance behavior.
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