Dissociative Disorders

Dissociative disorders

Definition
We all get lost in a good book or movie. But someone with dissociative disorder escapes reality in ways that are involuntary and unhealthy. The symptoms of dissociative disorders — ranging from amnesia to alternate identities — usually develop as a reaction to trauma and help keep difficult memories at bay.

Treatment for dissociative disorders may includepsychotherapy, hypnosis and medication. Although treating dissociative disorders can be difficult, many people with dissociative disorders are able to learn new ways of coping and lead healthy, productive lives.

Symptoms
There are four major dissociative disorders:

← Dissociative amnesia

← Dissociative identity disorder

← Dissociative fugue

← Depersonalizationdisorder

Signs and symptoms common to all types of dissociative disorders include:

← Memory loss (amnesia) of certain time periods, events and people

← Mental health problems, including depression and anxiety

← A sense of being detached from yourself (depersonalization)

← A perception of the people and things around you as distorted and unreal (derealization)

← Ablurred sense of identity

If you or your child experiences abuse or another traumatic situation, talk to a doctor as soon as possible. Early intervention and counseling may help prevent the formation of dissociative disorders

Causes
Dissociative disorders usually develop as a way to cope with trauma. The disorders most often form in children subjected to chronic physical, sexual or emotionalabuse or, less frequently, a home environment that is otherwise frightening or highly unpredictable.

Personal identity is still forming during childhood, so a child is more able than is an adult to step outside herself or himself and observe trauma as though it's happening to a different person. A child who learns to dissociate in order to endure an extended period of his or her youth may usethis coping mechanism in response to stressful situations throughout life.

Rarely, adults may develop dissociative disorders in response to severe trauma.

Risk factors
People who experience chronic physical, sexual or emotional abuse during childhood are at greatest risk of developing dissociative disorders. Children and adults who experience other traumatic events, including war, naturaldisasters, kidnapping, torture and invasive medical procedures, also may develop these conditions.

Complications
People with a dissociative disorder are at increased risk of complications that include:

← Self-mutilation

← Suicide attempts

← Sexual dysfunction, including sexual addiction or avoidance

← Alcoholism and substance abuse

← Depression

← Sleepdisorders, including nightmares, insomnia and sleepwalking

← Anxiety disorders

← Eating disorders

← Severe headaches

Dissociative disorders are also associated with significant difficulties in relationships and at work. People with these conditions often aren't able to cope well with emotional or professional stress, and their dissociative reactions — from tuning out todisappearing — may worry loved ones and cause colleagues to view them as unreliable.

Tests and diagnosis
Doctors diagnose dissociative disorders based on a review of your symptoms and your personal history. As part of your evaluation, your doctor may perform tests to rule out physical conditions — including head injuries, certain brain diseases, sleep deprivation and intoxication — that can causesymptoms such as memory loss and a sense of unreality. If your doctor rules out physical causes, he or she will likely refer you to a mental health for an in-depth interview.

To help diagnose dissociative identity disorder, some doctors use medication or hypnosis. These may help your doctor identify alternate personalities or may help you describe repressed memories that played a role in the...