Dissociative Disorders

1 What are Dissociative Disorders?

Dissociative disorder is a mental condition in which a person’s feelings, emotions, perceptions, and thoughts are disconnected from reality.

The individual may feel as if the world is unreal and lose track of their identity. Dissociative disorder is often a response to a traumatic situation.

Symptoms range from mild to severe, and depend on the type of dissociative disorder. Stressful situations worsen the symptoms, and this can affect everyday life.

Psychotherapy and medications are the treatment methods for controlling dissociative disorders.

Although a complete cure for the condition is hard, treatment strategies help to improve the quality of life. 

2 Symptoms

Some of the most common symptoms of dissociative disorder include

  • Loss of memory about certain events, time, or people
  • Mental problems like depression, anxiety, and suicidal thoughts
  • Emotional numbness or feeling disconnected from one’s emotions
  • Lack of self-identity
  • Feeling disconnected from the real world

American Psychiatric Association classifies dissociative disorders into three types:

  • Dissociative amnesia – people tend to have memory loss that cannot be explained by any other medical condition. The amnesia is mostly about oneself or an event, particularly of a traumatic event. The event may be a military or intense combat, or abuse. The onset of symptom is usually sudden and the memory loss episode may last for minutes, hours, days, and in some rare cases, years.
  • Depersonalization disorder – in this type of dissociative disorder, the person feel disconnected from one’s feelings, thoughts, and perceptions, as if watching a movie. This is called depersonalization. Some people feel that others or things around themselves are unreal, a condition called as derealization. Some people may have symptoms of both depersonalization and derealization. The episodes may remain for a few minutes or return several times over the years.
  • Dissociative identity disorder – this condition is characterized by switching to an alternate identity. Earlier known as multiple personality disorder, the patient may feel as if there is more than one personalities in a body. The two identities are different in their name, history, mannerisms, and characteristics. They usually have dissociative amnesia also.
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3 Causes

Dissociative disorder is caused by a traumatic event.

It is often seen in children who are subjected to long-term sexual, or emotional abuse.

War and natural disasters are other stressful events that trigger dissociative disorder in sensitive people. It usually develops in a stage when personal identity is being developed.

A child when exposed to trauma, finds it easy to disconnect from the real world so as to escape from the consequences.

Thus, dissociative disorder becomes a coping mechanism for them to respond to the stressful situations in life. 

4 Making a Diagnosis

Complete review of symptoms and personal history give the best diagnosis of dissociative disorders.

Tests are used to rule out chances of brain injury, alcohol or drug abuse, sleep deprivation, and brain diseases that cause similar symptoms.

Diagnosis is done by a mental health specialist based on the criteria given in Diagnostic and Statistical Manual of Mental Disorders (DSM) published by American Psychiatric Association.

Dissociative amnesia is characterized by any one of the following characteristics

  • One or more episodes of memory loss, of personal information or identity, during a stressful or traumatic event
  • Episodes of memory loss are not related to any other mental disorder or medical condition like brain injury
  • Travel or experience confused wandering, during which they forget about identity or personal information
  • Symptoms affect relationships, work, and daily activities

Dissociative identity disorder is diagnosed based on the following criteria

  • Have two or more identities, each with its own sense of perception, thought, and identity
  • Memory loss of personal information, events, skills, and traumatic event
  • Symptoms that cannot be explained by any other medical condition or alcohol abuse
  • Symptoms affect relationships, work, and daily activities

Diagnosis of depersonalization disorder is based on the following criteria

  • Episodes of depersonalization or derealization
  • Awareness that depersonalization and derealization is not reality
  • Symptoms that cannot be explained by any other medical condition or alcohol abuse
  • Symptoms affect relationships, work, and daily activities

5 Treatment

Psychotherapy or counseling is a proven treatment method for correcting issues in dissociative disorders.

In this method the patient talks about the disorder with a mental health expert. The counselor helps the patient to develop new ways of coping with the condition and to understand the cause of the condition. Once the person has achieved the coping skills, he/she is encouraged to speak more about the trauma that caused the disorder.

Antidepressants, antipsychotics, and anti-anxiety medications help to control the symptoms of the disorder. Eye movement desensitization and reprocessing (EMDR) helps to reduce the symptoms of the condition. It is considered to process the traumatic memories so they have less memories of the event. 

6 Prevention

The only way to prevent dissociative disorders is to avoid traumatic events or occurrences, and sometimes this is simply impossible.

Children who are exposed to physical, sexual and emotional abuse have a high risk of developing dissociative disorder.

Talking to mental health experts, support groups, and family therapists help to reduce the impact of the symptoms.

They help to teach the child better coping mechanisms and methods to recover from the condition. 

7 Alternative and Homeopathic Remedies

Anacardium, Medorrhinum, Natrum muriaticum, Phosphorus, Staphysagria, Thuja are the common homeopathic remedies for controlling symptoms of dissociative disorders.

A range of herbal remedies are used to control this condition, but many of them lack scientific evidence. St John’s wort, kava, and vitamin E supplementation are some of the herbal supplementations used in regulating symptoms of mental disorder. 

8 Lifestyle and Coping

Having a supportive family is very essential for the person to cope with dissociative disorder.

Support groups help to understand the condition better. 

9 Risks and Complications

People with dissociative disorder have increased risk of having other mental conditions like:

  • personality disorders,
  • suicidal thoughts,
  • alcohol and drug abuse disorders,
  • eating disorders,
  • sleeping disorders,
  • depression,
  • anxiety disorder,
  • sexual dysfunction,
  • post-traumatic stress disorder. 
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