Dissociative Disorder Treatment and Recovery
What Are Dissociative Disorders?
We’ve all felt a little disoriented and out of touch with our surroundings when we feel overwhelmed. Sometimes, waking up after a stressful dream can have you questioning if the things around you are even ‘real.’ Usually, these feelings go away after some time, and we get back to our daily routines. But for some people, these symptoms persist because of a dissociative disorder. Although it affects a small minority of people, symptoms can be very difficult to manage. If you’re experiencing dissociation and think you have a disorder, here’s what you should know about the condition and treatment options.
According to the American Psychiatric Association, it’s a category of disorders that are characterized by disturbances in your perception, sense of self, emotions, and behavior. Dissociation is best described as a disconnection between your feelings, thoughts, actions, and a sense of who you are.
When it occurs occasionally, dissociation is a normal part of the human experience, such as daydreaming or immersing yourself in a good book or movie. However, having a disorder means that you experience it much more frequently and experience distress or impairment due to symptoms.
Who Do Dissociative Disorders Affect?
People who are exposed to traumatic or stressful events, especially during childhood, are more likely to develop a dissociative disorder. In the absence of other coping strategies, children rely on dissociation as an automatic response to stressful events. Current research indicates that women are more likely to receive a diagnosis of dissociative disorder. This could be due to the fact that women have a higher chance of experiencing trauma at a young age, such as sexual abuse.
How are Dissociative Disorders Diagnosed?
Your mental health practitioner must conduct certain tests to diagnose you with a dissociative disorder. During this process, they’ll also rule out whether your condition results from a medical condition or substance use.
Typically, an interdisciplinary team of physicians, therapists, and psychiatrists will determine your diagnosis through the following:
Medical Evaluation:
Your physician reviews your symptoms and looks at your medical history to see if there’s a medical reason for your symptoms. This can include sleep deprivation, a brain disease, or head injury. They’ll also test your blood for traces of alcohol or substances that could cause memory loss or a feeling like you’re ‘outside your body.’
Psychiatric Evaluation:
Then, a mental health expert will ask you about your feelings, behaviors, and the thoughts leading up to your behaviors. They may also ask to speak with family members to get additional information about observable symptoms.
Diagnostic Criteria:
Finally, your psychiatrist will assess your symptoms to see if they meet the criteria mentioned in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. In it, the American Psychiatric Association lays out specific criteria for time and impairment and differential diagnoses so that your mental health practitioner can make an informed decision.
Once they confirm your diagnosis, they will recommend suitable options for treatment or refer you to a therapist.
Symptoms of Dissociative Disorders
According to the Diagnostic and Statistical Manual of Mental Disorders, dissociative disorders are a category of three diagnoses. Each one has separate symptoms and differentiators that mental health experts use to tell one from the other.
Dissociative Identity Disorder (DID)
Previously known as multiple personality disorder, its defining feature is that you have two or more distinct personality states. Transitioning from one personality to another one leads to changes in your memory, perception, behavior, and emotional affect. Usually, the alternate personalities are distinctly different from your own, which is why some cultures may describe it as ‘being possessed.’
You may be unable to recall certain events or personal information, and the gaps in memory aren’t better explained by forgetfulness. Besides memory loss, some common symptoms among people with dissociative identity disorder are:
- depression
- anxiety
- suicidal thoughts
- substance abuse
- disorientation
The symptoms should result in significant impairment in your ability to function.
Dissociative Amnesia
The second diagnosis, dissociative amnesia, refers to the inability to remember personal information about who you are. Usually, this is because recalling the information is stressful or traumatic in some way.
Therefore, the main symptom is memory loss, but not being able to recall certain memories can lead to symptoms like anxiety or stress. For a diagnosis, the symptoms should lead to impairment in occupational and social functioning. Moreover, the symptoms shouldn’t be the result of a medical condition (for example, a brain injury, transient amnesia, or seizures) or substance use.
You may also experience dissociative fugue, which means traveling or wandering to find personal information.
Depersonalization/Derealization Disorder
When you have depersonalization/derealization disorder, you experience either one or both symptoms.
- Depersonalization is when you feel detached from your thoughts, actions, and feelings as if you’re outside your body. Common signs of depersonalization include feeling physically or emotionally numb, like you’re unreal or ‘not really here,’ or having a distorted sense of time.
- Derealization is when you feel detached from your surroundings. For instance, the objects or people around you feel distorted, lifeless, or unreal.
For a diagnosis, your mental health practitioner must ensure that you’re not experiencing these symptoms due to another disorder, substance use, or medical condition. They’ll also ask you whether the symptoms cause significant distress or dysfunction.
Causes and Risk Factors of Dissociative Disorders
There’s no specific cause behind dissociative disorders. Depending on genetic or environmental factors, you may or may not be more vulnerable to developing symptoms. Risk factors include experiencing a traumatic or stressful event.
Long-term sexual, physical, or emotional abuse as a child can lead to complex trauma. Similarly, events such as kidnapping, natural disasters, or living in a warzone can cause a person to start dissociating.
How Are Dissociative Disorders Treated?
Evidence-Based Therapy
These are therapies such as cognitive behavioral therapy, dialectical behavioral therapy, and eye movement desensitization and reprocessing therapy. They’ve been tested in various settings and are proven to alleviate symptoms. Your therapist may select different therapies depending on your coping skills and personal history.
Complementary Therapies
During inpatient treatment, you can opt for certain alternative therapies along with psychotherapy. These include relaxation treatments such as meditation, therapeutic massage, and acupuncture that you can rely on to cope with stress. They’re designed to alleviate stress and promote a sense of well-being.
Medication
Depending on the severity of your symptoms and how they affect your mental state, your psychiatrist may also prescribe medication. The medication serves to alleviate the low mood, anxiety, or psychotic symptoms that accompany some dissociative disorders.
However, keep in mind that there’s no medication to treat depersonalization, derealization, or other dissociative symptoms. Rather, medication is only prescribed to stabilize your mental state and make you receptive to therapy.
Inpatient Dissociative Disorder Treatment
Having a dissociative disorder can increase the risk of experiencing complications and other negative symptoms, such as depression. To treat the mental health symptoms of living with a dissociative disorder, you may need constant supervision and support in addition to professional care.
Specifically, you’ll need inpatient treatment, which involves a residential program at a mental health center. These programs are suitable for anyone looking to recover in a peaceful and comfortable environment.
At the same time, an inpatient program, such as at URP Behavioral Health, is essential to improve the well-being of people who live with dissociative disorders. That’s because experiencing symptoms of dissociative amnesia, depersonalization, or derealization can be stressful and impair your ability to function.
Dialectical Behavior Therapy
Based on CBT, DBT is adapted for people who experience intense emotions. The therapy is made up of four components, namely distress tolerance, emotional regulation, mindfulness, and interpersonal effectiveness. Dialectical behavioral therapy is used to prevent impulsive behaviors that may occur because of stressful symptoms.
Psychodynamic Psychotherapy
Most cases of dissociative disorder occur as a result of repressed traumatic memories. Using psychodynamic therapy is an effective method to access those memories and uncover hidden conflicts safely. Once you access those memories, your therapist will help you reprocess them so they no longer hurt you.
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR is a form of psychotherapy that uses bilateral stimulation, such as eye movements, to help your brain process traumatic memories. Your therapist will adapt the technique to address dissociative symptoms so you can access traumatic events safely and experience emotions directly without any defense mechanisms.
Psychotherapy for DID
When you have dissociative identity disorder, you have two or more separate identities that control your behavior. Psychotherapy, also known as talk therapy, involves speaking to a mental health professional about your condition and symptoms. Your therapist will talk to you about stressful experiences to understand the cause and help you build the necessary coping skills to deal with the stress of confronting traumatic memories.
Cognitive Behavioral Therapy
CBT is an effective psychotherapy for people with a dissociative disorder. In this method, your therapist helps you identify and change negative perceptions. The therapy can treat dissociative disorder by helping you re-interpret symptoms in a way that doesn’t threaten your sense of well-being. You’ll be encouraged to monitor your symptoms and engage in certain safety behaviors to reduce avoidance and feel independent.
References
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9162402/
- https://onlinelibrary.wiley.com/doi/abs/10.1002/adsp.12036
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6968572/
- https://pubmed.ncbi.nlm.nih.gov/16005701/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293140/
- https://pubmed.ncbi.nlm.nih.gov/15022041/
FAQ for Dissociative Disorders
Here are some of the most commonly asked questions about dissociative disorders.
Research indicates that transient symptoms of depersonalization derealization have a lifetime prevalence rate of up to 74 percent, making them common among the general population. However, very few people meet the full criteria for a chronic episode, that’s important for diagnosing a dissociative disorder.
It’s best to see your healthcare provider if you’ve felt like you couldn’t remember important information on more than one occasion. Usually, what you can’t remember is something stressful or traumatic, and the memory loss is too significant to result from being forgetful. Moreover, the disturbance from the episode should be enough to impair functionality.
Dissociative disorders are characterized by disturbances in perception, memory, behavior, and sense of self. There are no specific medications used to treat symptoms like depersonalization or derealization. However, your psychiatrist may prescribe antipsychotic or antidepressant medication to alleviate the other mental health symptoms that occur because of the condition.
When you develop a dissociative disorder, you experience symptoms upsetting symptoms that can lead to anxiety. One example is failing to remember some aspects of who you are or something that happened to you. In this case, your psychiatrist may prescribe antianxiety medication to reduce anxious thoughts.
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