Dissociative Disorders: Symptoms, Causes and Treatment

Dissociative disorder is a disturbance in which the patient's primary symptom is a sense of detachment from the self. Depersonalization as a symptom (not as a disorder) is quite common in college-age populations. It is often associated with sleep deprivation or "recreational" drug use. It may be accompanied by "derealization" (where objects in an environment appear altered). Patients sometimes describe depersonalization as feeling like a robot or watching temselves from the outside. Depersonalization disorder may also involve feelings of numbness or loss of emotional "aliveness.

Feelings of detachment or estrangement from one’s self are signs of depersonalization. Although these feelings are difficult to describe, individuals with this disorder will report feeling as if they are living in a dream or watching themselves on a movie screen. They feel separated from themselves or outside their own bodies. People with this disorder feel like they are "going crazy" and they frequently become anxious and depressed.

Symptoms

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).

Patients may experience an extremely broad array of other symptoms that resemble epilepsy, schizophrenia, anxiety, Mood disorders, posttraumatic stress, personality, and eating disorders, with frequent misdiagnoses and ineffective treatment.Patients may experience auditory hallucinations of the various alters conversing, and may be misdiagnosed as psychotic as a result. Changes in identity, loss of memory, and awaking in unexplained locations and situations often leads to chaotic personal lives.

Sometimes dissociative disorder cannot be diagnosed until the person abruptly returns to his pre-fugue identity and is distressed to find himself in unfamiliar circumstances. The diagnosis is usually made retroactively by a doctor reviewing the person's history and collecting information that documents the circumstances before the person left home, the travel itself, and the establishment of an alternate life.

Causes

Dissociative disorders usually develop as a mechanism for coping with trauma. The disorders most often form in children subjected to chronic physical, sexual or emotional abuse or, less frequently, a home environment that is otherwise frightening or highly unpredictable.

Dissociative disorder, the patient may be referred to a psychiatrist, psychologist or other mental health professional for further evaluation and treatment. Psychotherapy is the primary treatment for dissociative disorders. In most cases, patients are encouraged to recall any trauma they may have repressed and to work through it.

Personal identity is still forming during childhood, and during these malleable years 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 reflexively use this coping mechanism in response to stressful situations throughout life.

Treatment

Since dissociative disorders seem to be triggered as a response to trauma or abuse, treatment for individuals with such a disorder may stress psychotherapy, although a combination of psychopharmacological and psychosocial treatments is often used. Many of the symptoms of dissociative disorders occur with other disorders, such as anxiety and depression, and can be controlled by the same drugs used to treat those disorders. A person in treatment for a dissociative disorder might benefit from antidepressants or antianxiety medication.

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