Dissociative Disorders

Dissociative disorders are characterized by an involuntary escape from reality by a disconnection between thoughts, identity, consciousness and memory. 

Dissociation is a coping mechanism that a person uses to disconnect from a stressful or traumatic situation, or to separate traumatic memories from normal awareness. By dissociating painful memories from everyday thought processes, a person can maintain a level of functioning, as though the trauma had not occurred. It's a form of denial, as if "this is not happening to me". 

It becomes a problem when the environment is no longer traumatic but the person still acts and lives as if it is, and has not dealt with or processed the event. 

Symptoms & Signs 

There are three important types of dissociative disorders : 

 

Dissociative Amnesia
  • The main symptom is difficulty remembering important information about one’s self or events in past life or forgetting a learned talent or skill. It is usually sudden and may last minutes, hours or days. In rare cases, they can last months or years.
  • Some people with dissociative amnesia find themselves in a strange place without knowing how they got there.

 

Depersonalization and Derealization disorders
  • Depersonalization: feeling of being outside yourself and observing your actions, feelings or thoughts from a distance.
  • Derealization : feeling like people and things in the world around them are unreal.
  • Symptoms can last just a matter of moments or return at times over the years. The average onset age is 16.

 

 

 

Dissociative Identity Disorder
  • The existence of two or more distinct identities (or “personality states”). The distinct identities are accompanied by changes in behavior, memory and thinking. The signs and symptoms may be observed by others or reported by the individual.
  • It is characterized by alternating between multiple identities. A person may feel like one or more voices are trying to take control in their head. Often these identities may have unique names, characteristics, mannerisms and voices.

Diagnosis

Doctors administer specific tests to rule out physical causes (such as head trauma, brain tumors, epilepsy, intoxication). The effects of certain substances, including some recreational drugs and medications, can cause dissociative symptoms. 

Mental illnesses such as obsessive-compulsive disorder, panic disorder and post-traumatic stress disorder may cause similar symptoms to a dissociative disorder. 

Treatment

There is no specific drug to treat dissociation, but it's possible to get better with a combination of medication and psychotherapy. 

Psychotherapies used include cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and eye movement desensitization and reprocessing (EMDR). 

​Medications such as antidepressants can treat symptoms of related conditions.