Overview Of Dissociative Disorders
A dissociative disorder is a condition that is characterized by an involuntary escape from reality, often as a reaction to previous trauma. Dissociative disorders occur as a coping mechanism for dealing with painful experiences.
Some types of dissociative disorders suppress difficult memories, others take the form of amnesia. Some people with dissociative disorders have alternate identities. Often, these conditions are made worse by stress.
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Types Of Dissociative Disorders
There are three types of dissociative disorders: depersonalization disorder, dissociative amnesia, and dissociative identity disorder. Each of these conditions is described below, but to find out whether you have a dissociative disorder, contact a professional for an evaluation.
Dissociative amnesia is characterized by severe memory loss that can’t be explained by an injury, medical condition, or medication.
People with dissociative amnesia forget things about themselves, events they have lived through, or people they have known. Sometimes people with dissociative amnesia forget everything about who they are. These episodes can last a few minutes, hours, or even years.
This condition involves an ongoing sense of being outside your own body or observing yourself from outside yourself. You may feel detached from what’s happening around you, while events occur in a way that is dream-like.
Sometimes these symptoms occur only once for a few minutes, other times patients experience these symptoms over many years.
Dissociative Identity Disorder
This condition was once called multiple personality disorder. People afflicted with this dissociative identity disorder have two or more identities that come to the surface at different times.
These personalities often have obvious differences, including varying mannerisms and tones of voice. They may even be of a different gender. Some of the identities may know the others, or may not.
Symptoms Of Dissociative Disorders
Each dissociative disorder has its own specific signs and symptoms. However, some symptoms are generalized to all dissociative disorders:
- lack of ability to cope with professional or personal stress
- out-of-body experiences
- memory loss regarding people and events; amnesia
- depression and anxiety
- lack of identity or a blurry sense of identity
- perception of the people or events taking place around you as unreal
- suicidal thoughts
- emotional numbness or detachment
People who have one type of dissociative disorder may still experience some of the symptoms of other types of dissociative disorders. This is especially true of people who are diagnosed with dissociative identity disorder.
Causes And Risk Factors
People who experience childhood traumas like emotional, physical, or sexual abuse are at particular risk for dissociative disorders. Children especially are at risk because their personal identity forms during their younger years.
A child who learns to dissociate to cope with traumatic conditions is more likely to use this coping mechanism later in life. Also at risk are people who experience war, combat, natural disasters, kidnappings, and torture.
How Are Dissociative Disorders Diagnosed?
Diagnosis of dissociative disorders is based on a professional evaluation of symptoms and personal history. Some physical conditions (head injury, for example) can cause symptoms like memory loss, so doctors must first determine that one of these conditions is not the cause.
There are also many cultural and even religious factors that affect diagnosis. For example, some meditation practices can induce a state of depersonalization. If you meditate regularly, you may experience this state; this does not mean that you have a dissociative disorder.
During your evaluation, your doctor will perform an extensive physical exam and psychiatric exam, and will also compare your symptoms to the criteria for diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Some people suffering from a dissociative disorder have an increased risk of co-occurring conditions or complications, such as:
- sexual dysfunction
- Post-traumatic stress disorder
- Personality disorders
- Substance use disorder
- suicidal thoughts
- Eating disorders
- difficult personal/professional relationships
Many of these co-occurring conditions require their own evaluation, diagnosis, and treatment. Co-occurring conditions can sometimes make diagnosis of the dissociative disorder difficult, so it’s important to work with a qualified mental health professional.
Treating Dissociative Disorders
The type of treatment that will work for you depends on your particular disorder. Most conditions require a combination of the following:
- Psychotherapy — Also known as talk therapy, psychotherapy involves long discussions with a mental health professional to explore the cause of your condition and form new coping mechanisms.
- Medication — Antidepressants, antipsychotic drugs, and anti-anxiety medications can be helpful if you’re experiencing a co-occurring condition.
- Eye movement desensitization reprocessing (EMDR) — With this type of therapy, your own rapid eye movements are used to dampen the power of your difficult memories, which can help reduce the effects of your disorder.