Dissociative Disorders – What are they?

•What are Dissociative Disorders? – Dissociative Disorders are mental illnesses that affect the brain and make people feel detached from themselves and/or the outside world. •Dissociative Disorders – Dissociative Disorders are also known as psychogenic fugue, multiple personality disorder, dissociative amnesia, depersonalization disorder, or dissociative identity disorder.

They are often caused by extreme stress or trauma. The cause, types, and severity of Dissociative Disorders vary widely among individuals, and there is no standard treatment protocol.

About dissociative disorders

Dissociative disorders involve disruptions or breakdowns of memory, awareness, identity, and/or perception. For example, someone may not remember things that happened recently or in their past. Someone else may not recognize themselves in a mirror.

Others may experience sudden shifts in personality and/or sense of self. Common dissociative disorders include dissociative amnesia, dissociative fugue, and depersonalization disorder.

Other dissociative disorders include dissociative identity disorder, a condition formerly known as multiple personality disorder. Dissociative identity disorder is a type of dissociation marked by at least two distinct and relatively enduring identities or dissociated personality states that alternately show in a person’s behavior.

Each identity has its own way of thinking about himself or herself and interacting with others. There is often an appearance of partial amnesia that goes along with each change.

Types of dissociation

Dissociation is a common condition that exists in varying degrees, rather than as a distinct classification. Dissociation is thought to have many causes and can present itself differently in different people. The DSM-5 separates dissociation into four categories of disorders:

Depersonalization/derealization disorder (DDD), dissociative amnesia, dissociative fugue, and dissociative identity disorder (DID). Among these conditions, DID has been most thoroughly researched and documented.

Depersonalization is a dissociative disorder that involves episodes of feeling detached from one’s sense of self. The term depersonalization refers to a feeling of detachment from one’s identity and body, while derealization means perceiving others and the world around you as less real than they actually are. Both disorders can occur separately or together, and their symptoms can be mild or severe.

What are Dissociative Disorders?

Dissociative disorders are a group of mental health conditions that cause disruptions in memory, perception, identity, or consciousness. Each dissociative disorder has its own unique set of symptoms and treatments.

Dissociative amnesia involves an inability to recall important personal information, usually as a result of trauma.

Dissociative Disorders
Dissociative Disorders

The person may be unable to remember their own name or identity. Dissociative fugue involves traveling away from home with no memory of past events and often taking on a new identity.

Depersonalization disorder involves feeling like one is outside of his or her own body and perceiving himself or herself as an outside observer.

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Isolated or Depersonalization disorder

The first dissociative disorder we’ll discuss is Isolated or Depersonalization disorder. While you may have heard of Dissociative Identity Disorder (formerly called Multiple Personality Disorder), people with Depersonalization experience a feeling of detachment from their identity and surrounding environment. dissociation and dissociative disorders

For example, someone experiencing depersonalization might feel like he or she is observing themselves from outside their body.

What Causes Isolated or Depersonalization Disorder? While it’s not entirely understood what causes dissociative disorders, it’s thought that biological factors, psychological trauma, and environmental stressors can all contribute to its development.

Pathophysiology

Dissociative disorders develop when a person’s ability to make sense of their surroundings and experiences is disrupted or split off. This causes abnormal functioning in how someone experiences their self, their identity, memory, or perception of reality.

These disorders include dissociative amnesia, dissociative fugue, depersonalization disorder, and dissociative identity disorder (formerly multiple personality disorder). Read more about what causes these illnesses and how you can tell if you have a dissociative disorder.

Although there is no specific test for dissociative disorders, your doctor can perform a physical exam and psychological evaluation to determine if you have symptoms consistent with one of these conditions. structured clinical interview for DSM-iv dissociative disorders If it’s determined that you do have a dissociative disorder, you’ll be asked to undergo additional diagnostic tests.

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Statistics and Incidences

The National Alliance on Mental Illness (NAMI) states that over one million Americans suffer from a dissociative disorder at some point in their lives. These disorders include dissociative amnesia, depersonalization disorder, dissociative fugue, and other related conditions.

It’s important to understand that these disorders can be associated with other illnesses such as post-traumatic stress disorder (PTSD), major depressive disorder, and eating disorders.

A study by The National Institute of Mental Health (NIMH) found that 10-15% of people who have PTSD also suffer from a dissociative disorder.

Causes

The causes of dissociative disorders are varied. Some individuals develop symptoms as a result of a history of severe and repeated trauma, such as childhood abuse or military combat.

Others may experience dissociation due to another mental illness, such as major depression or PTSD (post-traumatic stress disorder). dissociative disorders are characterized by Individuals with a borderline personality disorder may also experience dissociation in response to stressors.

However, not all cases of dissociation stem from trauma; sometimes it can be caused by physiological factors or drug abuse.

Symptoms of dissociation also vary depending on what type of disorder a person has. Those with depersonalization disorder often describe feeling like their mind is outside of their body or watching themselves act in a film.

People with dissociative identity disorder (previously known as multiple personality disorder) may feel like there are different people inside them.

Somatoform disorders

Dissociative symptoms may also be present in individuals diagnosed with somatoform disorders. Somatoform disorders are mental illnesses that involve physical symptoms that aren’t linked to any identifiable medical condition or disease (see question 2).

Dissociation can be one of several factors that contributes to somatoform disorders; it also occurs in some individuals with a dissociative identity disorder.

A dissociative disorder is a mental illness characterized by disruptions or breakdowns in an individual’s awareness of his environment, memory, and sense of identity. Symptoms can range from mild to severe and may include both psychological and physical signs.

There are several different types of dissociative disorders; some examples include depersonalization disorder, dissociative amnesia, dissociative fugue, and dissociative identity disorder (DID). DID is sometimes referred to as multiple personality disorder.chronic complex dissociative disorders

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Clinical Manifestations

In dissociative disorders, two or more distinct identities, or personality states, dominate a person’s behavior at different times. The various identities have an effect on mood, consciousness, and memory.

Consciousness can be clouded to such an extent that persons with dissociative identity disorder may not remember important personal information (e.g., names of close relatives or childhood friends). They may refer to themselves by different names or show inconsistent knowledge about their background and personal history.

Dissociative disorders can be associated with stressful life experiences, including severe trauma (e.g., childhood physical or sexual abuse, car accidents).

The symptoms of dissociative identity disorder can also develop after a general medical condition (e.g., stroke) or a medication-induced state. The prevalence of dissociative disorders is not known and has been estimated at less than 1% of adults in most countries that have reported such data.

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Medical Management

In most cases, dissociative disorders can be managed medically. The primary treatment for dissociative disorders is psychotherapy, also known as talk therapy or psychodynamic therapy. etiology of dissociative disorders This type of treatment involves an ongoing conversation between a client and a trained professional counselor in which issues causing distress in daily life are uncovered and discussed at length.

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Nursing Management

Patients with dissociative disorders may be more vulnerable to other medical conditions, including fevers and infections, since their immune systems may be compromised. Patients with dissociative identity disorder (DID) may also suffer from comorbid psychiatric disorders such as depression or anxiety.

Nurses must be alert to all of these potential risks and work closely with physicians to ensure that patients receive proper treatment and care.

Nursing Care Planning and Goals

Dissociative disorders can be diagnosed and treated in a variety of settings. If a client has a dissociative disorder, it’s important to discuss with his or her doctor about all of these symptoms so treatment can begin as soon as possible.

A physician will give you specific instructions about your client’s condition and how to treat him or her based on your role in providing care. Planning for nursing care is especially important if your client takes psychoactive drugs since these medications should be monitored closely when used with other medication types.

Amnesia – what it is and isn’t

Amnesia is a tricky concept to grasp; in fact, it’s one of those things that most people think about only when it happens to someone else.

But what is amnesia and what isn’t it? Amnesia is an inability to recall information about yourself or your environment.

Most people associate amnesia with memory loss due to brain injury or disease, but there are actually several different types of amnesia caused by several different factors. For example, there’s transient global amnesia, which affects a person’s recent memory only.

Another type is a dissociative fugue, in which a person moves away from home and adopts a new identity.

Depersonalization and derealization
Defined as feelings of detachment from one’s self, depersonalization and derealization disorders usually occur in response to a traumatic or extremely stressful event.

People who experience these symptoms might feel like their consciousness is detached from their body, observing their surroundings as if watching a movie.

Many times, people suffering from such disorders believe that what is happening to them is not real.

Some describe feeling as though time has slowed down or sped up, colors have changed, or sounds have become sharper than normal; others find it difficult to move. It can be frightening for those experiencing dissociation because it occurs unexpectedly.

There is no set treatment for cases of dissociation (though medication can be used), but experts suggest reassurance and comforting words to help those suffering cope with their disorder.

Dissociative fugue
The DSM-IV defines a dissociative fugue as a sudden, unexpected journey away from home or one’s customary place of work with amnesia for personal identity, including one’s name, home, and other personal information. Often travelers can be found wandering aimlessly in unfamiliar surroundings. Travelers often have no recollection of their past and do not take useful things with them like money, identification, or appropriate clothing. dissociative disorders list

The disorder is relatively rare and occurs in approximately 0.5% of community populations. It typically occurs in individuals who have been exposed to a stressful event or series of events (e.g., the sudden death of a family member, domestic violence).

There is also some evidence that traumatic childhood experiences may be a risk factor for developing dissociative fugue in adulthood.

Treatment for dissociative disorders
The three main dissociative disorders, Dissociative Identity Disorder (formerly Multiple Personality Disorder), Depersonalization/Derealization Disorder, and Other Specified Dissociative Disorder, can usually be treated effectively with medication and psychotherapy.

Treatment is often very effective; recovery rates as high as 85% to 90% have been documented in recent studies of patients treated for Dissociative Identity Disorder. No single type of treatment is best for all people with dissociative disorders.

Patients with dissociative disorders may benefit from participating in trauma-focused cognitive-behavioral psychotherapy, such as trauma-focused cognitive behavioral therapy (TF-CBT) or eye movement desensitization and reprocessing (EMDR).

People who have dissociative disorders may also benefit from group therapy that addresses traumatic stress. Other types of treatment for dissociative disorders include medication, such as antidepressants and antipsychotics.

Identity disturbances
This is when a person experiences confusion about their identity, resulting in behaviors and feelings that may seem erratic or out of character.

A person with an identity disturbance may feel unreal or as if they’re living in a dream-like state. They may also feel disconnected from their past experiences, relationships, and future expectations.

It’s possible to be diagnosed with both a dissociative disorder and another mental health condition. If you suspect that you may have an identity disturbance, please make an appointment with your physician or therapist as soon as possible.

Multiple personality disorder (MPD) /Dissociative identity disorder (DID)
People with multiple personality disorder (MPD) or dissociative identity disorder (DID) have two or more distinct personalities, each with their own way of thinking and perceiving things.

These personalities dissociate from each other, feeling like separate people living inside one body.

For example, one personality may seem to be taking care of routine tasks like driving to work while another personality can’t remember how to make a sandwich.

The condition has also been referred to as split personality, but that term is no longer used because it’s misleading.

People with MPD or DID don’t have split personalities. Rather, their personalities shift between being highly dissociated (detached) and relatively integrated.

Nursing Interventions

Treating Dissociative Identity Disorder (Multiple Personality Disorder): If you’re responsible for treating someone with DID, then it’s your job to be an expert on dissociation. Interventions for DID should focus on restoring a sense of self, so taking stock of cognitive-behavioral strategies that can help integrate multiple personas is a must.

Though DID is less common than other dissociative disorders, like depersonalization/derealization disorder and Dissociative Amnesia, it’s still vital to be prepared for its symptoms. Other conditions may also have similar symptoms to DID, which can result in misdiagnosis—so it’s important to know all of your options. Read on to find out more about treating DID so you can better serve patients and improve their quality of life.

Evaluation

Dissociative disorders are classified by two major criteria: (1) disruption of consciousness and (2) presence of two or more personality states. It is also helpful to know that dissociation is not a unitary phenomenon, but rather, it exists on a continuum. Dissociation ranges from mild to severe and may be acute or chronic.

Not everyone who experiences dissociation has a dissociative disorder. Dissociation is often seen in individuals with other disorders, such as panic disorder, post-traumatic stress disorder (PTSD), major depressive disorder (MDD), attention deficit hyperactivity disorder (ADHD), and substance use disorders.

In addition, Most dissociative symptoms occur more frequently in patients with other psychiatric conditions than those without them. The one exception to that is depersonalization/derealization.

What are the 5 dissociative disorders?

A dissociative disorder is a mental illness that involves disruptions or breakdowns of memory, awareness, identity, or perception. It’s important to note that there is no single treatment protocol for these disorders and they may need to be treated by a number of different professionals.

The five dissociative disorders are Dissociative Amnesia, Dissociative Fugue, Depersonalization Disorder, Dissociative Identity Disorder (DID), and Other Specified Dissociative Disorder. Each of these may also be referred to as a type of disorder.

What is the most common dissociative disorder?

The most common dissociative disorder is Dissociative Amnesia. Dissociative amnesia can be described as an inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness. Dissociation often results in gaps in memory and blackouts so severe that no memory exists of important personal information. A person with dissociative amnesia may not remember his or her own name, home, past events, or family.

What are the signs of dissociation?

A dissociative disorder causes severe disruptions in a person’s ability to remember, feel and sense. Dissociation is often triggered by a stressful event such as sexual abuse or combat. People with dissociative disorders often hear voices and have trouble distinguishing what is real from what is imaginary. They may feel disconnected from their bodies and take on different personalities or alters at will.

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