Dissociative Disorders

Overview

Dissociative disorders are a group of mental health conditions characterized by a disruption or disconnection from one's thoughts, memories, feelings, surroundings, and sense of identity. These disorders help individuals cope with overwhelming or distressing situations by mentally separating themselves from the experience. The American Psychiatric Association recognizes three major dissociative disorders: Depersonalization/derealization disorder, dissociative amnesia, and dissociative identity disorder. Each type has specific symptoms, causes, and treatment approaches.

Understanding the disease

Symptoms

Symptoms of dissociative disorders may include:

1. A sense of being separated from oneself and emotions.
2. Perceiving people and surroundings as distorted or unreal.
3. Blurred sense of personal identity.
4. Difficulty coping with stress in relationships, work, or other important areas.
5. Memory loss or amnesia related to certain time periods, events, people, or personal information.
6. Co-occurring mental health issues such as depression, anxiety, and suicidal thoughts. Dissociative disorders can arise due to long-term abuse, traumatic events, or other significant stressors. They may lead to complications such as depression, anxiety, PTSD, sleep disorders, physical symptoms, eating disorders, substance abuse, and relationship issues.

Risk Factors

The risk factors for developing dissociative disorders include experiencing long-term physical, sexual, or emotional abuse during childhood, having gone through shocking, distressing, or painful events, such as war, natural disasters, kidnapping, torture, or extensive early-life medical procedures. These events can lead to a loss of connection between thoughts, memories, feelings, surroundings, behavior, and identity, causing problems in managing everyday life.

Development

Dissociative disorders develop as a coping mechanism in response to severe stress, trauma, or overwhelming events. They help individuals disconnect from their thoughts, memories, feelings, and surroundings to escape from the reality of their situation. The disorders arise primarily in response to prolonged physical, sexual, or emotional abuse during childhood, although they can also develop in individuals who have experienced war, natural disasters, kidnapping, torture, extensive early-life medical procedures, or other distressing events. The three major dissociative disorders are:

1. Depersonalization/derealization disorder: This disorder involves a distorted perception of reality, with the individual feeling detached from their body, thoughts, or surroundings.
2. Dissociative amnesia: This disorder involves memory loss or gaps in memory, ranging from specific events to entire periods of time.
3. Dissociative identity disorder: This disorder involves the presence of two or more distinct identities or personality states, often accompanied by memory loss or disconnection from certain aspects of one's life. It is important to note that dissociative disorders can be challenging to treat, but with proper therapy and support, individuals can learn new coping mechanisms and improve their overall well-being.

Assessment and Diagnosis

Triage

If you or a loved one is experiencing symptoms of a dissociative disorder and safety is not a concern, it is recommended to contact your doctor or other healthcare professional for help. If the symptoms are severe or involve impulsive behavior, seeking care in an emergency department at a hospital may be necessary. If you or someone you know is experiencing suicidal thoughts or behavior, call 911 or your local emergency number immediately or go to an emergency department.

Diagnosis

To diagnose dissociative disorders, the process usually involves discussing your symptoms and ruling out any medical conditions that could cause them. Diagnosis may include a physical exam, a mental health exam, and possibly tests or imaging studies to rule out other conditions with similar symptoms. A mental health professional, such as a therapist with experience in working with trauma, is often involved in the diagnosis and treatment of dissociative disorders.

Management and Treatment

Complications

Potential complications of dissociative disorders may include: depression and anxiety, post-traumatic stress disorder, sleep disorders, physical symptoms such as lightheadedness or seizures that are not due to epilepsy, eating disorders, problems with sexual function, problems with alcohol and drug use, personality disorders, major problems in personal relationships, at school, and at work, self-injury or high-risk behavior, and suicidal thoughts and behavior.

Home Remedies

Seeking professional help is highly recommended for individuals dealing with dissociative disorders. A mental health professional, such as a psychiatrist, psychologist, or therapist, can provide appropriate diagnosis, treatment, and support.

Treatment

Treatment for dissociative disorders may include talk therapy, also called psychotherapy, and medicine. Talk therapy can help individuals learn new coping mechanisms and address the underlying causes of their dissociative symptoms. Medications may be used to treat associated conditions like depression, anxiety, or sleep disorders. Treating dissociative disorders can be challenging, but many people find relief and improvement in their symptoms with the right treatment approach.

Preparing for medical consultation

To prepare for an appointment for dissociative disorders, you can follow these steps:

1. Make a list of your symptoms: Before your appointment, make a list of any symptoms you have experienced, including feelings of detachment, disconnection, or memory loss. Also, mention any recent behavior that has caused confusion or concern for you or your loved ones.
2. Gather personal and medical information: Prepare a list of your personal and medical history, including any past or current mental health conditions, traumatic experiences, or major stressors. Share this information with your healthcare professional during the appointment.
3. Include a list of medications and supplements: Make a list of all medications, herbs, vitamins, or other supplements you are currently taking, including the doses. This information will help your healthcare professional understand your overall health and potential interactions with any prescribed treatments.
4. Bring a family member or friend: Consider bringing a family member or friend with you to the appointment. They can help remember important details and provide additional information that may be helpful for the healthcare professional to know.
5. Compile a list of questions: Prepare a list of questions you want to ask your healthcare professional during the appointment. This can help ensure you receive the information you need and make the most of your appointment time. Remember, the primary focus will be on discussing your symptoms and ruling out any potential physical causes. If necessary, your healthcare professional may refer you to a mental health professional for further evaluation and treatment.