Dissociative disorders are one of the most secretive and least understood forms of mental illness. Dissociative disorders are an umbrella term, describing a wide range of conditions in which elements of identity (personal history, name, gender) or sensory awareness (hearing, vision) become separated from the person’s normal sense of self. Dissociation is thought to be one of the main causes of conditions such as Dissociative Identity Disorder (DID) and Dissociative Trance Disorder.
Symptoms of Dissociative disorders
Dissociative symptoms can be tough to spot, as they’re often as vague as symptoms of better-known conditions such as anxiety and depression. Dissociative symptoms include:
– Feeling disconnected from the world around you or your own body
– Having a hard time remembering things that actually happened or familiar things. Dissociation only causes memory problems when it’s severe.
– Having sudden and unexplained changes in your mood or personality, such as going from outgoing to withdrawn in a short amount of time.
– Feeling like you’re observing yourself from outside your body or that things around you aren’t real.
– Finding it hard to focus, concentrate, pay attention and make decisions. This is also associated with problems sleeping.
Types of dissociative disorder
Dissociative identity disorder (DID): This is the only dissociative disorder recognized by mental health professionals. DID involves having at least two distinct personalities or identities, each with its own pattern of perceiving, relating to and thinking about the environment and self.
– Dissociative amnesia: This involves losing memory for personal information, usually of a traumatic or stressful nature. This is very common in cases of childhood sexual abuse, where the child becomes “stuck” at the age they were when first subjected to sexual abuse.
– Depersonalization disorder: This involves feeling like you’re observing yourself from outside your body, “on autopilot” or in a dream.
– Derealization disorder: This is feeling detached from your surroundings, such as everything around you seems fake or colorless.
– Dissociative fugue: This is the sudden, unexpected and purposeful travel away from home or work, with an inability to recall some of your past.
– Dissociative motor disorders: This involves a loss of voluntary movement and feeling stuck in a particular position, such as sitting down.
– Dissociative trance disorder: This is characterized by a temporary narrowing or complete loss of awareness of your surroundings, which can take place in everyday events such as driving.
symptoms of Dissociative disorders in children
The first signs of dissociative disorders in children are often school absences, poor grades or disruptive behavior. Other indicators include:
– Refusing to go to school
– Shying away from friends and family members
– Physical complaints such as headaches, stomachaches and fatigue. These can also lead to frequent visits to the nurse’s office
– A sudden personality change, such as becoming more withdrawn or constantly irritable. These children tend to become sad and moody
– Low self-esteem and feelings of shame and guilt
– Sleep problems and nightmares
– Not wanting to talk about a traumatic event that happened in the past; for example, abuse or neglect
– Unexplained medical problems, particularly those related to their respiratory, gastrointestinal or nervous systems.
– Acting as if they have a disability or unexplained bodily sensations
– Saying things like “I’m bad” or “I’m evil”
– Difficulty concentrating and learning in school
Risk factors of dissociative disorders
Though a dissociative disorder can develop at any age, most start during the teenage years. It’s more likely to occur in people who’ve experienced physical or sexual abuse early in life, though it often occurs without a history of trauma. People with mental illnesses such as depression and anxiety also have an increased risk of developing a dissociative disorder.
– History of abuse and neglect as a child
– Sexual or physical abuse, emotional neglect or other traumatic event in childhood
– Significant stress during childhood, such as the death of a parent or other loved one, divorce or moving away from home
– Witnessing or experiencing intense violence as an adult
Individuals who have been subjected to physical or sexual abuse as children are frequently victims of dissociative identity disorder.
Suicide attempts are common with individuals having DID and is more than 20 times the rate of that in the general population.
Though rarely diagnosed in children, dissociative disorders can result due to exposure to traumatic events such as:
– Life-threatening injury in a child – Learning about a serious illness or death of someone close in a child
– Witnessing physical and sexual abuse in a child
– Witnessing domestic violence between one of their parents and another adult
– Regularly being subjected to criticism, blame, excessive demands or hostility without cause in a child
– Having parents involved in substance abuse or with mental health problems
An estimated two thirds of children who have been diagnosed with dissociative disorders will be victims of maltreatment.
Dissociative disorders Treatments
Many patients are successful in addressing the major symptoms of DID and improving their capacity to function with appropriate therapy. Generally the treatment involves psychotherapy. When dissociation is severe and longstanding, success with traditional psychoanalysis may be limited. While supporting the patient in linking traumatic events with current pain and problems, hypnosis, or a similar technique called guided imagery, is often used to access and then allow expression of the dissociated identities and their functions.
– Dissociative disorders are often treated with a combination of psychotherapy and medication. Antidepressants, anti-anxiety medications and antipsychotics may help reduce some of the dissociative symptoms such as mood swings, stress and anxiety.
An alternative technique called hypnosis is sometimes used to give patients direct and immediate access to memories of trauma.
– Dissociative disorders are typically treated with a type of therapy known as “psychodynamic psychotherapy.” In this form of treatment, the patient discusses early life experiences and relationships with the goal of understanding how they contribute to current problems. The therapist uses techniques such as hypnosis and age regression to help the patient recall forgotten memories of trauma, so they can be processed with less anxiety.
– Group therapy
– A type of psychotherapy called group therapy has been found to help some people who suffer from dissociative disorders. In this form of treatment, patients meet in a group and discuss their thoughts and feelings about their disorder and how it impacts them. This helps people learn from others as well as to better understand their illness.
– Other treatment options
– In rare cases, a psychiatrist may recommend electroconvulsive treatment (ECT). ECT can be effective for those who have severe depression, mood swings or anxiety that has not been helped by other treatments.
– Treatment resistance
When dissociative identity disorder does not respond to treatment, it is sometimes referred to as “treatment resistant”. In such cases, a specific treatment plan for this type of patient may need to be developed. A team of mental health professionals and the patient’s primary care physician play important roles in developing such a treatment plan.
Three phases of treatment are generally used for dissociative identity disorder. These three phases include:
1) stabilization, 2) trauma-focused therapy, and 3) integration.
Conclusion: Dissociative disorders are a complex, but treatable form of mental illness. If you or someone you know is suffering from this condition, don’t hesitate to contact our doctors today for help. We can provide treatment options that will best suit your needs and circumstances.Dissociative disorders