Three Issues Contributing to Problematic Substance Use

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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NURSING
Three issues demonstrated in the video, which may have contributed to problematic
substance use
The first issue that contributed to substance abuse in Mark is his inability to perform
as per his expectation in the rugby. Mark described that in 1983 he had a bad pre-season, he
was could not train himself properly leading to decelerating graph in his sports career.
Wolanin, Gross and Hong (2015) stated that inability to perform as per the expectation leads
to the generation of depression that eventually leads to substance abuse.
The second issue that contributed to problematic substance use is lack of proper
support for effective management of his consistent state of depression. Mark reported that in
1991, there was no real understanding of mental health issues at that time. Birtel, Wood and
Kempa (2017) reported that people who are drowning in depression are in an urgent need to
mental health support and in absence of this, vulnerability of substance abuse increases.
His social isolation like his self-made distance from his old friends further increased
the severity of depression. The increase in the severity of depression is reflected in incidence
like regular uptake cocaine. Matthews et al. (2016) reported that social isolation among the
young adults lead to the development of loneliness. Those who are lonely often feel
depressed leading to an increased tendency of substance abuse.
Discussion of the chosen issue with Trauma Informed Care and Practice (TICP)
According to Mental Health Coordinating Council (MHCC) (2013), TICP give
importance to both physical and emotional safety of an individual in order to promote
comprehensive recovery from trauma. The main principle of TICP includes safety,
trustworthiness, choice, collaboration and empowerment.

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Inability to perform as per expectations: Lack of Empowerment
The first identified need of Mark is inability to perform as per her expectations. This
can be linked with the TICP of empowerment. Masin-Moyer, Engstrom and Solomon (2019)
reported that interpersonal trauma generates from the lack of proper empowerment. In case of
Mark it is evident that he was suffering from inter-personal trauma and failure to perform
wisely in sport is one of the reason. Mark was found saying that, “couldn’t train properly. I
felt like I had a really bad flu. That was the start of my mental health problems”. His inability
to perform up to the mark lead to the development of depressive symptoms and is expressed
like crying in washroom before and after the warm-up session, feeling emotionally exhausted
and bursting out in tears after the game is over. Inability to perform as per expectations leads
to decrease in the self-esteem and self-confidence. As per the vulnerability model, decrease in
self-esteem is mutually exclusive with decrease in personal strength and confidence. Under
the stage of poor self-esteem and self-confidence, a person suffers from lack of empowerment
as evident from the case study of Mark. Wolanin, Gross and Hong (2015) stated when a self-
empowerment is endangered, the vulnerability of the development of depressive symptoms
generates. In order to cope with the depressive symptoms along with poor self-esteem, the
majority of the affected individuals take help of the substance abuse. The trauma-affected
individuals are of the opinion that substance abuse in order to overcome the depressive
symptoms they take help of intoxicating substance like cocaine or cannabis or alcohol. The
intoxication creates drowsiness helping them to cope with depressive symptoms.
Lack of support for effective management of depression: Lack of Collaboration
This chosen issue can be linked with the TICP of collaboration. Mental Health
Coordinating Council (MHCC) (2013) reported that for the effective recovery from the
trauma, cross-system collaboration is extremely important. This deals with collection of
information, training of the caregivers or affected individual in self-management skills.

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However, Mark failed to avail any kind of collaboration for the effective management of the
mental health complications. Mark reported that when he was suffering from mental health
complications, there was no professional support. He also failed to explain his condition to
his mother leading to failure in obtaining collaboration from his family. Mental Health
Coordinating Council (MHCC) (2013) highlighted that them the trauma remains
unrecognized and misdiagnosed and the professional services are unable to address the need
of the people, the trauma infected individual take help of the problematic substance use. In
case of Mark, his bipolar disorder remained undiagnosed until he was 43 however; he was
expressing the symptoms from the age of 18. Wu et al., (2017) stated that people affected
with trauma is presented with multiple co-morbidities (in this case, it is depression and
bipolar disorder) and requires adequate collaboration with multidisciplinary team. In the
absence of effective collaboration of the multidisciplinary team with the service users and the
primary care givers, the severity of the trauma increases.
Social Isolation and Trauma: Lack of proper safety
Mushtaq et al. (2014) reported that human beings are social animals and demand safe
and secure surroundings in order to survive. Thus, social isolation and complete detachment
from the friends in case of Mark endanger the safety quotient of healthy social life under the
TICP framework. A satisfying social relationship helps in the effective development of the
mental and physical well-being. Impaired social relationships lead to the development of
loneliness leading to the development of depression. The development of depression forces
individual to pass on into substance abuse. The re-initiation of social isolation in case of
Mark was taken as a positive approach towards his process of recovery. Mark reported that,
“And now to have someone to talk to on a daily basis − that’s been pretty important to
me.............................you have to talk to someone, you have to go and get help”. Birtel,
Wood and Kempa (2017) are of the opinion that the mental health complications is patients