Dissociative Disorder
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 include psychotherapy, 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 defined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DMS), published by the American Psychiatric Association:
• Dissociative amnesia
• Dissociative identity disorder
• Dissociative fugue
• Depersonalization disorder
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)
• A blurred sense of identity
When to see a doctor
If you or someone you love has significant, unexplained memory loss or experiences a dramatic change in behavior when under stress, talk to a doctor. A chronic sense that your identity or the world around you is blurry or unreal also may be caused by a dissociative disorder. Effective treatment is available for these conditions. Seek medical help.
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 emotional abuse 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 of himself or herself 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 use this coping mechanism in response to stressful situations throughout life.
Though it’s rare, 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, natural disasters, 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
• Sleep disorders, 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 to disappearing — may worry loved ones and cause colleagues to view them as unreliable.
If you have fantasies about hurting yourself or someone else, go to an emergency room or call 911 or your local emergency number immediately.
Prevention
Children who are physically, emotionally or sexually abused are at increased risk of developing mental health disorders, including dissociative disorders. If stress or other personal issues are affecting the way you treat your child, seek help. Talk to a trusted person such as a friend, your doctor or a leader in your faith community. Ask for his or her help locating resources such as parenting support groups and family therapists. Many churches and community education programs offer parenting classes that also may help you learn a healthier parenting style.
If your child has been abused or has experienced another traumatic event, see a doctor immediately. Your doctor can refer you to mental health providers who can help your child recover and adopt healthy coping skills.
