A Case Report: The Use of CBT Techniques in Panic Attacks and Dissociative Experiences Occurring After the First Use of Marijuana

Esra Canpolat, Psychologist, Psychotherapy Institute, Istanbul, Turkey

Abstract

Marijuana is the most widely used illegal drug in the world. In Turkey, the lifetime prevalence of cannabis use in the general population, between the ages of 15 and 64, is estimated to be 2.7%. There is some evidence in the literature to support that heavy and prolonged cannabis use can trigger or even worsen various psychopathological disorders such as psychosis, schizophrenia, panic disorder, and agoraphobia.However, the findings that panic attacks may occur after the first cannabis use, that the attacks can continue despite the discontinuation of cannabis use, and its relationship with dissociative symptoms are not clear. Although there is no definite information about the mechanisms by which cannabis can cause panic attacks and dissociative symptoms; having an anxiety-based personality and dysfunctional thoughts and beliefs both increase the risk of substance use and can be used to explain the symptoms that occur after cannabis use. Individuals may unrealistically transform their use of cannabis into negative scenarios, catastrophize and experience a number of physiological, psychological and behavioral difficulties in connection with it. In the literature, it is known that psychotherapy treatments in addition to drug treatment are effective in relieving panic attacks and dissociative symptoms. Cognitive behavioral therapy is the most frequently used and effective psychotherapeutic approach in the correction of erroneous information processing processes that cause negative emotions and inappropriate behavior patterns to continue. Dissociative symptoms are mostly associated with traumatic experiences, and trauma- focused CBT is a method that has been shown to be effective in patients with traumatic experiences. In this case report, the relationship between cannabis use and panic attacks and dissociative experiences is discussed in a case who had a panic attack during the first cannabis use, then continued to have attacks, developed agoraphobia, and experienced intense dissociative symptoms. At the same time, the effect of cognitive behavioral therapy on the prognosis of panic attacks and dissociative symptoms has been reported.