Dissociative disorder

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at May 31, 2016
StartDiseasesDissociative disorder

Dissociative disorders are serious mental health conditions in which a person experiences an involuntary break with reality. A person afflicted with a dissociative disorder suffers from a disconnection and a lack of continuity between his or her thoughts, surroundings, actions, memories, and even identity. A dissociative disorder causes serious problems in a person's ability to attend to even basic tasks of daily living.

Contents

Definition & Facts

Dissociative disorder can exhibit itself as amnesia in some cases and as the development of alternate identities in others. Laypersons have commonly referred to the latter type of dissociative disorder as multiple personality disorder though that term is no longer utilized in the medical community as a general rule; it has been replaced by the term dissociative identity disorder. Another type of dissociative disorder is depersonalization disorder.

Symptoms & Complaints

Symptoms or complaints associated with dissociative disorders vary from one individual to the next and depend on the specific disorder. A common symptom or complaint associated with dissociative disorder is memory loss of events, people or specific periods of time.

A person with a dissociative disorder may experience mental health issues that include anxiety, depression, and suicidal thoughts and even attempts at taking his or her life.

A common complaint associated with dissociative disorder is a feeling that a person is detached from himself or herself. In some cases, an individual experiences a perception that people and things are unreal or distorted in some manner.

Another potential symptom of dissociative disorder is a blurred or unclear sense of identity. In addition, a person suffering from dissociative disorder is likely to experience significant psychological stress as well as problems associated with relationships and other important aspects of his or her life.

Causes

Research is still ongoing as to the causes of dissociative disorder. In most cases, there appears to be a link between the development of a dissociative disorder and a traumatic life event. Clinical evaluations of patients with a dissociative disorder indicate that a variety of traumatic events can give rise to the condition.

Examples of these types of events or circumstances include long-term sexual, emotional or physical abuse. It's theorized that dissociative disorder develops as a coping mechanism in response to this type of abuse.

A highly unpredictable home environment can also be the underlying cause of dissociative disorder in some cases. In addition, the stress of serving in war or being involved in a natural disaster can result in a person suffering from a dissociative disorder. 

Diagnosis & Tests

The primary means by which a doctor makes a diagnosis of dissociative disorder is a review of a patient's medical history as well as a consideration of any symptoms that an individual reports. A doctor is also likely to perform certain tests. These tests are designed to rule out physical conditions that may be causing the symptoms a person experiences. 

Examples of physical conditions that may give rise to symptoms like those associated with dissociative disorder include intoxication, sleep deprivation, head injury, and certain brain diseases. Although these physical conditions may cause symptoms very similar to dissociative disorder, they are not classified as mental disorders.

In order for a diagnosis of dissociative disorder to be made, the criteria in the Diagnostic and Statistical Manual of Mental Disorders must be met. For example, for dissociative amnesia, a person must have experienced dissociation multiple times, the episodes cannot be in connection with another mental health issue, and the symptoms must cause significant stress in a person's life.

In order to be diagnosed with dissociative identity disorder, the patient must experience or other people must observe two or more distinct personalities. The patient must experience gaps in memory and the symptoms must not be the result of intoxication. In addition, the symptoms experienced by a person must cause significant stress in that individual's life.

Treatment & Therapy

The primary course of treatment recommended for a person with dissociative disorder is psychotherapy. Psychotherapy sometimes is referred to as talk therapy, psychosocial therapy or counseling. This course of treatment involves recurring sessions with a psychotherapist or similar type of mental health professional. In these sessions, the patient talks with the professional about issues and matters that may (or sometimes may not) play a part in the development and persistence of the dissociative disorder.

There exist no medications designed specifically to treat dissociative disorder. Rather, a doctor may prescribe different psychiatric medications to assist in controlling some of the symptoms associated with dissociative disorder. These medications oftentimes include antidepressants, anti-anxiety medications or antipsychotic medications.

In many cases, a patient will undergo both psychotherapy and receive certain medications to assist in controlling symptoms associated with dissociative disorder. Treatment and therapy decisions are necessarily made on a case by case basis.

If a person experiences any of the symptoms of dissociative disorder, that individual should seek medical attention promptly. The sooner medical intervention occurs, the better the odds that an individual will be able to recover from dissociative disorder. In addition, many of the symptoms of dissociative disorder are also symptoms of other diseases, illnesses and conditions -- some of which can be fatal. Ruling these out is imperative.

Prevention & Prophylaxis

Most mental health experts agree that the only real way of preventing the onset of dissociative disorder is the avoidance or elimination of traumatic experiences and events in a person's life. The reality is that one, major traumatic experience or event may result in dissociative disorder. Such an event -- like a natural disaster -- cannot be anticipated.

On the other hand, if a person is experiencing ongoing abuse, removal of that person from that situation can prevent the development of dissociative disorder. This underscores the reason why a person should not remain in abusive situations. Nonetheless, leaving an abusive environment oftentimes is far easier said than done.

In a good number of cases, people around a person afflicted with dissociative disorder first recognize the symptoms of the condition. Thus, at times family members and friends need to intercede to prevent further suffering of a person afflicted with dissociative disorder.