合併憂鬱症的恐慌症患者藥癮戒斷與療癒歷程之研究

南華大學機構典藏系統 > 人文學院 > 生死學系(生死學系碩士班,哲學與生命教育碩士班) > 博碩士論文-生死學系碩士班 > Item 987654321/29721

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题名:	合併憂鬱症的恐慌症患者藥癮戒斷與療癒歷程之研究
其它题名:	A Research of Drug Addiction Withrawal and Healing Journey for Panic Disorder Patients with Depression
作者:	江一龍 CHIANG, YI-LUNG
貢獻者:	生死學系碩博士班林原賢 LIN, YUAN-HSIEN
关键词:	恐慌症;恐慌症合併;物質成癮戒斷;療癒歷程;敘事研究 Comorbid Panic Disorder;Panic Disorder Combined;Panic Disorder Healing;Healing Process;Narrative Research
日期:	2023
上传时间:	2023-11-13 13:25:39 (UTC+8)
摘要:	本論文的中心主軸：日常生活壓力帶來焦慮感，持續高張力焦慮狀態之下併發恐慌症，透過了解合併憂鬱症的恐慌症患者療癒及治癒過程中，探究影響因素有三；其一，恐慌症合併憂鬱症發病經驗對患者生活的影響、其次，有關藥物酒精依賴成癮矛盾糾結、其後，為患者生、心理對抗之心路歷程。　　本研究旨在探究合併憂鬱症的恐慌症患者治療歷程中依賴藥物之經驗與戒斷及療癒歷程，採用質性研究方法，以半結構訪談為主要蒐集資料方法，並以敘說研究「整體－內容」分析方式進行資料彙整，而後主題分析與詮釋。研究參與者皆為三位成人因受精神官能症共病所苦，從依賴藥物成癮到完全戒斷藥物達到身心痊癒過程。研究結果如下：一、探究恐慌症共病患者的發病經驗對其生活的影響為何?(一) 壓抑的性格特質：不擅言語表達及對外求助。(二) 情緒中不斷頻繁現身：擔心、焦慮、害怕、恐懼、憂鬱、絕望。(三) 引發身體相關負向症狀：暈眩、心悸、顫抖、失眠、失能、自殺。二、研究參與者在治療過程中對酒精及藥物依賴成癮的矛盾糾結為何?(一) 成癮及戒斷產生兩難之舉，去存取捨是迷茫中的為難決定；一方面用藥及酒精可以身心舒緩，但一方面長期使用成癮之下反而使病情負向症狀加劇。(二) 用藥初期-身心回穩。中期-不斷適應反覆調整藥物病狀的起伏狀態。後期-酒精代替及病徵副作用的擴大。三、研究參與者心理對抗及生理戒斷的成功經驗為何?第一部分自我對抗的過程-從負向信念走向戒斷復原之路；(一) 因壓力困境產生的自殺信念：從自殺意圖、行為中置死地而後生。(二) 處於困境中而綻放的正向信念：激發轉化的正向動機及自我療癒力。(三) 心理諮商帶來的影響性：學習情緒管理、及如何與恐慌、憂鬱症狀共處第二部分療癒相關因子-嘗試與冒險、破除舊有框架、規律形成新的生活模式；(一) 從人際團體中得到支持力量：賽斯基金會/張老師自我探索/讀書會(二) 與大自然的接觸：五感體驗/正念呼吸/曬太陽/散步/爬山/游泳(三) 開啟興趣的一扇生命之窗：自我探索/心靈成長/興趣養成/落實執行　　最後根據研究結果做討論與提出幾點建議及限制，作為未來研究、相關實務工作者、合併精神官能症患者、及患病家人陪伴者之參考。　　Title of the Thesis: Factors Influencing the Healing and Recovery Process of Panic Disorder Comorbid with Depression　　The central focus of this thesis is the experience of anxiety caused by daily life stress, leading to the development of panic disorder in a state of persistent high-tension anxiety. Through an understanding of the healing and recovery process of patients with panic disorder comorbid with depression, three influencing factors were explored. Firstly, the impact of the comorbidity of panic disorder and depression on the lives of patients. Secondly, the paradoxical entanglement of substance and alcohol dependence. Lastly, the emotional and psychological struggles faced by patients in their journey of healing and resilience.　　The aim of this study is to explore the experiences of medication dependence, withdrawal, and the healing process among patients with panic disorder comorbid with depression. Qualitative research methods were employed, primarily using semi-structured interviews as the main data collection method. Narrative research and thematic analysis were utilized to compile and interpret the data. The participants of the study were three adults who suffered from co-occurring mental disorders, from addiction to complete abstinence and achieving physical and mental recovery. The research findings are as follows:1. Exploring the impact of panic disorder comorbidity on patients' lives:(a) Suppressed personality traits: Inadequate verbal expression and reluctance to seek external help.(b) Constant manifestation of emotional states: Worry, anxiety, fear, panic, depression, and despair. (c) Inducing negative physical symptoms: Dizziness, palpitations, tremors, insomnia, dysfunction, and suicidal tendencies.2. Understanding the contradictory entanglement of alcohol and substance dependence during the treatment process:(a) The dilemma of addiction and withdrawal: Struggling to make the difficult decision to access or give up substances; on one hand, substances and alcohol provide temporary relief, but on the other hand, long-term addiction exacerbates negative symptoms. (b) Stages of medication use: Initial stabilization of physical and mental well-being, mid-term adjustment and adaptation to the fluctuating symptoms of medication, and late-stage substitution of alcohol and exacerbation of side effects.3. The successful experiences of participants in psychological resilience and physiological withdrawal in the study are as follows: Part 1: Self-struggle process – Transition from negative beliefs to recovery and abstinence.(a) Suicidal thoughts arising from stressful situations: From suicidal intentions and actions to emerging from the brink of death.(b) Positive beliefs emerging amidst adversity: Sparking transformative motivations and self-healing power. (c) Impact of psychological counseling: Learning emotional management and coping with panic and depressive symptoms.Part 2: Healing-related factors - Attempting new experiences, breaking old patterns, and forming new lifestyles. (a) Receiving support from interpersonal networks: Seth Foundation/Teacher Zhang's self-exploration/reading clubs.(b) Connection with nature: Sensory experiences, mindful breathing, sun exposure, walking, hiking, and swimming. (c) Opening the window to interests: Self-exploration, spiritual growth, cultivating hobbies, and implementing action plans.　　Finally, based on the research findings, discussions are presented along with several suggestions and limitations for future research, relevant practitioners, individuals with comorbid mental disorders, and accompanying family members.
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