What is Dissociative Disorder?
Individuals with dissociative disorders often report feeling like they are outside their own body or detached from reality. The condition causes a disconnection between a person’s thoughts, memories, and behaviors, and their core identity.
In this post, we discuss what dissociative disorder is, the various forms that it comes in, the symptoms, and how to go about treating it.
What is dissociative disorder?
Dissociation is a sense of disconnection between a person’s thoughts, feelings, memories and perceptions, and who they are. Most people experience this at some point in their life, such as when they lose themselves in a book or start daydreaming.
However, for some people, more severe and persistent dissociation occurs in response to a traumatic event, such as sexual abuse or being the victim of a serious crime. Researchers believe that the brain generates dissociation in order to protect the person from emotions that they may struggle to cope with.
Types of dissociative disorder
The American Psychiatric Association describes three types of dissociative disorders:
Dissociative Identity Disorder
Dissociative identity disorder – formerly called multiple personality disorder – occurs when a person meets the following criteria:
- Two or more distinct personalities or identities accompanied by changes in thinking, memory and behavior
- Problems with remembering day-to-day events, and persistent gaps in memory regarding traumatic experiences or identity-related information
- Disruption in ability to function at work or in social situations
According to the DSM-5, the nature of the disturbance should stand outside of cultural and religious practices in which a person channels or embodies non-physical entities (such as spirits). Psychiatrists may identify two distinct personalities, or patients themselves may report them.
Dissociative amnesia occurs when a person may not remember certain details about their lives, history, or identity. Unlike conventional memory loss, it cannot be explained by a medical condition. Instead, it appears to be a psychological defense against unwanted trauma. Amnesia can be present either relating to specific events, such as criminality, or more generally about the patient’s life.
Depersonalization and Derealization Disorder
Depersonalization and derealization disorder is a condition in which patients persistently feel like they are observing themselves from the outside, instead of from within their bodies.
Patients with depersonalization have a sense that they are no longer in control of their actions, and observe themselves from a distance, as though watching a film. Those with derealization often have the sense that things around them seem slowed down or sped up, and report feeling foggy, dreamlike, and detached from the rest of the world.
The symptoms dissociative disorder patients have depend on their subtype. They might include:
- Inability to cope with stress and strong emotions
- A profound sense of detachment from the self and one’s emotions
- Periods of memory loss regarding the self, other people, events, and circumstances
- Difficulty establishing one’s own identity securely
- A sense that people and objects in the external world are somehow unreal or distorted
- Failure to cope with job stress
- Suicidal thoughts, depression, and anxiety
Risks factors and suicidal risk
Those at highest risk of dissociative disorder are victims of physical and sexual abuse in childhood. Most people who develop the condition do so as a result of repetitive abuse. Around 90 percent of patients have a confirmed history of repeated caregiver abuse and neglect.
Patients with dissociative disorder are also at a much higher risk of suicide. Research suggests that around 70 percent of outpatients with the condition attempt suicide, or have attempted it in the past.
Treatment for dissociative disorder
Diagnosis for dissociative disorders usually relies on ruling out any underlying medical conditions that could cause the observed symptoms. Doctors and psychiatrists ask patients detailed questions, consult the DSM-5 and perform psychiatric exams before coming to any conclusions.
Treatment for dissociative disorders often involves a combination of psychotherapy and medication. Talk therapy, psychosocial therapy and counseling may all be effective. Therapists help patients understand and come to terms with their condition, and then offer coping skills.
In some cases, physicians may recommend medications to relieve some of the commonly associated mental health issues, such as anxiety, depression and suicidality. In some cases, they may prescribe antipsychotic drugs to change the way the brain processes information.
**This post is not to be used as medical advice. Please consult with your physician.**