Dissociative Disorder - An Overview

Introduction:

Dissociative disorder is a type of mental health condition that involves a disruption in a person's sense of identity, consciousness, memory, and/or perception of the world around them. Dissociation is a defense mechanism that the brain uses to cope with overwhelming or traumatic experiences. There are several types of dissociative disorders, including dissociative identity disorder (DID), formerly known as multiple personality disorder, dissociative amnesia, depersonalization/derealization disorder, and other specified dissociative disorders. Other types of dissociative disorders include dissociative amnesia, where a person has significant gaps in their memory of their past, and depersonalization-derealization disorder (a person may experience feelings of detachment from their own body or a sense of unreality in their surroundings).

What Are the Causes?

The causes of dissociative disorders are not fully understood. Some of the causes of the development of dissociative disorders include:

• Childhood Trauma: Individuals who have experienced significant trauma, particularly during childhood, may be at higher risk of developing dissociative disorders.

• Genetics: Although there is no solitary gene that has been linked to dissociative disorders. Many research suggests a strong genetic predisposition is linked to these conditions.

• Neurobiological Factors: There is evidence that alterations in brain function and structure may be involved in the development of dissociative disorders.

• Coping Mechanisms: Dissociation may be a coping mechanism that some individuals use to deal with overwhelming stress or trauma.

• Cultural and Societal Factors: Some researchers have suggested that cultural and societal factors may play a role in the development of dissociative disorders, particularly in relation to the experience and expression of emotions.

What Are the Signs and Symptoms?

• Memory Loss: This may include gaps in memory, particularly for important personal information or traumatic events.

• Dissociation: This may involve feeling detached from one's own body or surroundings, feeling as if one is in a dream, or watching oneself from a distance.

• Identity Confusion: This may involve feeling as if one has multiple identities or personalities.

• Depersonalization: This may involve feeling as if one is not in control of one's own body or actions.

• Derealization: This may involve feeling as if the world around one is not real or is distorted.

• Mood Changes: These may include sudden and dramatic shifts in mood or emotional numbness.

• Anxiety and or Depression: This may include excessive worry and sadness.

• Substance Abuse: Some individuals with dissociative disorders may choose drugs or alcohol to survive the disorder.

How to Diagnose?

The diagnosis of dissociative disorders is made by a psychologist or psychiatrist, who will carry out a comprehensive evaluation. This may involve a physical exam, a psychological assessment, and/or an interview to gather information about the individual's symptoms, medical history, and personal history. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides specific criteria for diagnosing dissociative disorders, including:

1. Dissociative Identity Disorder (DID): The manifestation of two or more distinct personality states, accompanied by recurring lapses in the recollection of everyday events, significant personal details, and/or traumatic experiences.

2. Dissociative Amnesia: In dissociative amnesia the patient cannot recall important information related to him or her, often related to a traumatic event or stressful situation .

3. Depersonalization or Derealization Disorder: Persistent and recurrent experiences of depersonalization and/or derealization.

4. Other Specified Dissociative Disorder: Symptoms of dissociation that do not meet the criteria for other specific dissociative disorders.

5. Unspecified Dissociative Disorder: Symptoms of dissociation that do not fit into any other specific category.

What Are the Treatment Options?

The treatment of dissociative disorders will involve a mix of psychotherapy, medication, and other supportive interventions.

• Psychotherapy: Psychotherapy, particularly cognitive-behavioral therapy (an evidence-based therapeutic approach that targets the identification and modification of negative thought patterns and behaviors) and/or dialectical behavior therapy (a form of therapy that integrates components of cognitive-behavioral therapy with mindfulness techniques) is the primary treatment for dissociative disorders. Therapy may focus on exploring the underlying trauma or stressors that contributed to the development of dissociation, as well as developing coping mechanisms and tools to manage dissociative symptoms.

• Medication: Although there is no medication specifically sanctioned for the treatment of dissociative disorders, medications may be used to address comorbid conditions such as anxiety, depression, or sleep disturbances.

• Supportive Interventions: Other supportive interventions, such as group therapy, art therapy, or relaxation techniques, may also be helpful in managing dissociative symptoms and improving the overall quality of life.

It is crucial to emphasize that the management of dissociative disorders may take time, as individuals with these conditions may have difficulty trusting others and may be hesitant to share their experiences.

What Is the Role of Society?

The role of society in addressing dissociative disorders is important. Society can contribute to the well-being of individuals with dissociative disorders in the following ways:

• Raising Awareness: Increasing public awareness of dissociative disorders can help reduce stigma and promote understanding of these conditions. This can help individuals with dissociative disorders feel more comfortable seeking treatment and support.

• Providing Support: Community organizations, support groups, and advocacy groups can provide individuals with dissociative disorders and their families with information, resources, and emotional support.

• Promoting Access to Mental Health Services: Societal efforts should be done to improve access to mental health services, particularly for underserved populations, can help ensure that individuals with dissociative disorders receive the care they need.

• Advocating for Policies That Support Mental Health: Public policies that prioritize mental health, such as funding for research and treatment, can help reduce the burden of dissociative disorders on individuals, families, and society as a whole.

• Reducing Environmental Stressors: Societal efforts to reduce environmental stressors, such as poverty, violence, and discrimination, can help prevent the development of dissociative disorders by reducing the occurrence of traumatic experiences.

Conclusion:

Dissociative disorders are complex and challenging conditions that can significantly influence an individual's mental well-being and quality of life. These disorders are often linked to past trauma and manifest symptoms like memory loss, depersonalization, and identity confusion. The good news is that dissociative disorder is a treatable condition. Effective treatment of dissociative disorders involves a collaborative and individualized approach that includes psychotherapy, medication, and other supportive interventions. It is also important for society to play an active role in addressing dissociative disorders by promoting awareness, providing support, and advocating for policies that prioritize mental health.