Dissociative Disorders

March 5th, 2023 is recognized as Dissociative Disorder Awareness Day. NAMI (National Alliance on Mental Illness gives great insight into the symptoms, treatment, and management of several dissociative disorders.

Dissociative disorders are an involuntary escape from reality characterized by a disconnection between thoughts, identity, consciousness and memory. People from all age groups and racial, ethnic and socioeconomic backgrounds can experience a dissociative disorder.

Up to 75% of people experience at least one depersonalization/derealization episode in their lives, with only 2% meeting the full criteria for chronic episodes. Women are more likely than men to be diagnosed with a dissociative disorder.

The symptoms of a dissociative disorder usually first develop as a response to a traumatic event, such as abuse or military combat, to keep those memories under control. Stressful situations can worsen symptoms and disrupt functioning in everyday activities. However, the symptoms a person experiences will depend on the type of dissociative disorder they have.

Treatment for dissociative disorders often involves psychotherapy and medication. Though finding an effective treatment plan can be difficult, many people are able to live healthy and productive lives.

Symptoms and signs of dissociative disorders include:

• Significant memory loss of specific times, people and events

• Out-of-body experiences, such as feeling as though you are watching a movie of yourself

• Mental health problems such as depression, anxiety and thoughts of suicide

• A sense of detachment from your emotions, or emotional numbness

• A lack of a sense of self-identity

The symptoms of dissociative disorders depend on the type of disorder that has been diagnosed. There are three types of dissociative disorders defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM):

• Dissociative Amnesia. The main symptom is difficulty remembering important information about one’s self. Dissociative amnesia may surround a particular event, such as combat or abuse, or more rarely, information about identity and life history. The onset for an amnesic episode is usually sudden, and an episode can last minutes, hours, days, or, rarely, months or years. There is no average for age onset or percentage, and a person may experience multiple episodes throughout their life.

• Depersonalization disorder. This disorder involves ongoing feelings of detachment from actions, feelings, thoughts and sensations - someone experiencing this disorder may feel as if they are watching a movie (depersonalization). They may feel like people and things in the world around them are unreal (derealization). A person may experience depersonalization, derealization or both. Symptoms can last a matter of moments or return at times over the years. The average onset age is 16, although depersonalization episodes can start anywhere from early to mid-childhood. Less than 20% of people with this disorder start experiencing episodes after the age of 20.

• Dissociative identity disorder. Formerly known as multiple personality disorder, this disorder is characterized by alternating between multiple identities. A person may feel like one or more voices are trying to take control in their head. Often these identities may have unique names, characteristics, mannerisms and voices. People with DID will experience gaps in memory of everyday events, personal information, and trauma. Women are more likely to be diagnosed, as they more frequently present with acute dissociative symptoms. Men are more likely to deny symptoms and trauma histories, and commonly exhibit more violent behavior, rather than amnesia or fugue states. This can lead to elevated false negative diagnosis.

Dissociative disorders usually develop as a way of dealing with trauma. Dissociative disorders most often form in children exposed to long-term physical, sexual, or emotional abuse. Natural disasters and combat can also cause dissociative disorders.

Doctors diagnose dissociative disorders based on a review of symptoms and personal history. A doctor may perform tests to rule out physical conditions that can cause symptoms, such as memory loss and a sense of unreality (for example, head injury, brain lesions or tumors, sleep deprivation, or intoxication). If physical causes are ruled out, a mental health specialist is often consulted to make an evaluation.

Campbell County Health Behavioral Health Services offers treatment and diagnosis for dissociative disorders. We know that it can be difficult to reach out for help, but we are here to walk with you every step of the way.

If you or someone you love is in a mental health crisis, call the BHS crisis line at 307.688.5555 or call/text the National Suicide Prevention Lifeline at 988.

Source: Dissociative Disorders | NAMI: National Alliance on Mental Illness