Dissociative disorders

"Dissociative disorders are mental health conditions that involve feelings of being detached from reality, being outside of your own body or experiencing memory loss (amnesia)" (Cleveland Clinic, 2023). Some dissociative illnesses have a very brief lifespan, maybe as a result of a traumatic life experience, and they go away on their own within a few weeks or months. Others have a significantly longer lifespan.

Dissociation is the state of being cut off from people, from your surroundings, or even from oneself. Dissociative identity disorder, dissociative amnesia, and depersonalization/derealization disorder are the three categories of dissociative disorders that the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) recognizes.

Types of dissociative disorders

As mentioned above, there are 3 different types of dissociative disorders: dissociative identity disorder (DID), Dissociative amnesia, and depersonalization/derealization. These three are the main types of dissociative disorder.

Dissociative identity disorder (DID)

"Is commonly called "multiple personality disorder." The main symptom of DID is switching between multiple identities. Each identity can have its own name, personality, voice, and mannerisms" (Bailey, 2021). These identities may also be referred to as alters, alternative personalities, or states of consciousness. In order to diagnose this type of disorder, there are certain criteria to be met, these include:

• Presence of 2 or more distinct identities
• Persistent gaps in memory of personal information, daily activities, and past traumas
• Significant difficulty in multiple areas of functioning
• Severe distress

Symptoms of this disorder include:

• Intense dissociation, which means that the there is a change in their perceptive personality, causing a change in memory, thoughts, and motor actions.
• Changes in behavior, acting differently due to intense dissociation.
• Gaps in memory
• Distress, those that experience this disorder, and the intense dissociation may have trouble in work force, school and other places.

Dissociative amnesia

"Dissociative amnesia causes a person to forget important facts or information about themselves and their history" (Bailey, 2021). Amnesia is known as memory loss and not being able to remember anything from a certain period of time. According to research and psychiatrists, there are 3 types of memory loss related to dissociative amnesia:

1. Localized - this is where there is a memory loss about a particular time period and cannot seem to remember anything about it, even when given clues.
2. Selective - this is where there is a memory loss on parts of a particular event, as if the brain cannot retrieve the information suddenly.
3. Generalized - memory loss about a person's whole history and identity.

Symptoms of dissociative amnesia include:

• Trouble recalling information about a particular event or knowledge that someone had learnt.
• The most difficulty in recalling information is mostly traumatic events.
• Can be about specific history or event.
• The forgotten information is usually remembered easily after a period of time, but in some cases, it may last for months even years.

Depersonalization/derealization

Depersonalization/derealization disorder causes a person to view their life from the "outside," as if they are watching a movie rather than experiencing life themselves (Bailey, 2021). Although the person with this illness may feel as though the environment and everyone around them are not real, they are nevertheless aware of reality.

1. Depersonalization - this entails sensations of disassociation from a person's mind, body, or self, or emotions of unreality. Instead of being an active participant, it seems like they are simply watching their life and the events unfold.
2. Derealization - This entails sensations of detachment from your environment or emotions of unreality. Some people and things might not appear real.

Symptoms of this type of disorder include:

• Disconnection from yourself
• Blunted emotions
• Amnesia
• Distortions from the environment
• Tactile sensations or imagery when describing something seen visually.
• Feeling that unfamiliar places are familiar, whereas, familiar places or situations are completely new.

Symptoms

Long-term (sexual, physical, and/or emotional) abuse is a common experience for kids with dissociative disorders. Children and adults may have various dissociative disorder symptoms. However, Dissociative illnesses in children are occasionally misinterpreted as learning difficulties or attention deficit hyperactivity disorder (ADHD). The key symptoms to notice regarding dissociative disorder include:

• Frequent daydreaming
• Zoning out frequently or trance-like state
• Tantrums
• Talking to Imaginary friends
• Change in voice or accent.
• Change in handwriting style
• Forgetfulness
• Anger outbursts
• Violent behavior for "no reason"

Causes

Dissociative disorders frequently result from a person's attempt to cope with a tragic incident, ongoing stress, abuse, or trauma. You may use a coping strategy to temporarily numb the pain of a distressing event by mentally detaching yourself from it. If this coping method continues to distance you from reality and erases memories of entire periods of time, it may become problematic. There may be several traumatic events that may be a cause for dissociative disorders, which include:

• Repeated physical, mental and sexual abuse.
• Accident
• Being a victim of a crime.
• Military combat

Recent research by scientists has focused on certain brain regions and processes that are connected to dissociation. They have discovered so far that deep in your brain, memory structures exhibit regular activity during dissociation, but they appear to be cut off from other areas that are in charge of cognition and planning.

Treatments

Psychotherapy (talk therapy) is often used to treat dissociative disorders in order to assist the patient in regaining control over the dissociative symptoms and process.

Psychotherapy

1. Cognitive behavioral therapy - it is a goal-oriented, systematic form of psychotherapy. You are assisted in taking a careful look at your ideas and feelings by your therapist or psychologist. You may unlearn harmful behaviors and beliefs with CBT and learn to think more positively and develop wholesome cognitive patterns.
2. Dialectical behavioral therapy - for those who feel emotions extremely strongly, DBT is well suited. The key objective is to find a balance between the advantages of change and the validation (acceptance) of who you are as well as your obstacles. To increase emotion control, your therapist will assist you in developing new abilities.

Other forms of therapy include:

1. Hypnosis - a condition of profound relaxation and laser-like concentration is induced during hypnosis (hypnotherapy). This high degree of attention and focus when you are hypnotized enables you to block out everyday distractions and be more receptive to ideas for making adjustments to enhance your health.
2. EMDR therapy - as you work through painful memories, you move your eyes in a certain way as part of an eye movement desensitization and reprocessing (EMDR) therapy. Your healing from trauma or other upsetting life events is EMDR's main objective. EMDR is a very recent therapeutic technique in comparison to previous forms.

There are no specific medications that are introduced for this form of disorder. But the health professional may recommend medications, such as antidepressants, to help treat the mental health conditions that may co-occur with dissociative disorders.

Summary

You may feel as though you aren't leading a complete, useful life if you have a dissociative condition. Reduce the disturbances to your life by seeking assistance as soon as symptoms emerge. If you are having dissociation symptoms, see a medical professional. In order to control your symptoms and address underlying emotions that could be causing your dissociation episodes, psychotherapy, often known as talk therapy, might be a helpful treatment.

You may assist yourself and those around you understand how you feel by explaining how your prior events have affected you to your spouse, family, and friends. You can go through this overcoming of the disease only by knowing that they are here to assist you.

References:

NHS (2020). Dissociative disorders. [online] nhs.uk. Available at: https://www.nhs.uk/mental-health/conditions/dissociative-disorders/ [Accessed: 13 Jul. 2023].

Cleveland Clinic (2023). Dissociative Disorders: Types, Causes, Symptoms & Treatment. [online] Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/17749-dissociative-disorders [Accessed: 13 Jul. 2023].

Bailey, A. (2021). Signs and Symptoms of Dissociative Disorders. [online] Verywell Health. Available at: https://www.verywellhealth.com/dissociative-disorder-symptoms-5211585 [Accessed: 13 Jul. 2023].

Moore, M. (2022). The 5 Types of Dissociative Disorders. [online] Psych Central. Available at: https://psychcentral.com/disorders/types-of-dissociative-disorders#recap [Accessed: 13 Jul. 2023].