Definition A dissociative disorder is a defence mechanism in which one's identity, memories, ideas, feelings, or perceptions are separated from conscious awareness. They can't be recalled or experienced voluntarily. The following are considered types of dissociative disorders:
dissociative amnesia
dissociative fugue
dissociative stupor
trance and possession disorders
dissociative motor disorders
dissociative convulsions
dissociative anaesthesia and sensory loss
mixed dissociative (conversion) disorders
Each of these types of disorders has specific ways in which the symptoms of dissociation are shown. However, they all share the use of separation of emotions or behaviour from the person's conscious thoughts.
What is going on in the body? After a traumatic event, dissociation enables a person to numb his or her current feelings. It causes a temporary but drastic experience of feeling separate from one's self, not existing, or being in an unreal world. It can cause a dreamlike state.
What are the signs and symptoms of the condition? The signs and symptoms of dissociative disorder include:
impulsive travelling or wandering away from home
inability to remember the past
confusion as to one's own identity
intermittently experiencing 2 or more identities
feelings of detachment or estrangement from one's self
feeling as though one is living in a dream
feeling separated from self
inability to remember important personal information, such as name and address
large gaps of memory
What are the causes and risks of the condition? A dissociative disorder is thought to be the result of a person's defending against some form of trauma. Overwhelming stress usually causes dissociative disorders. The stress may be caused by experiencing or witnessing a traumatic event, accident, or disaster. It may be also caused by a person experiencing inner conflict. The mind is forced to separate unacceptable information and feelings from conscious thought. Dissociative disorders are often found among children who have experienced sexual abuse.
What can be done to prevent the condition? To help prevent dissociative disorder, prompt treatment should be given to someone who experiences a traumatic event.
How is the condition diagnosed? Diagnosis of a dissociative disorder is based on the presence of the symptoms. A complete medical examination is performed to determine if a physical condition may be causing the disorder. Also, a complete psychological history will be conducted to assess for possible sources of trauma and stress. Sometimes, psychological tests will be conducted to help make the diagnosis.
What are the long-term effects of the condition? A person with a dissociative disorder often has significant adjustment problems in all life areas. The person's ability to perform work tasks or interact interpersonally is often severely impaired.
What are the risks to others? There are no risks to others, as dissociative disorders are not contagious.
What are the treatments for the condition? Treatment for a dissociative disorder is aimed at helping the person regain a sense of identity and mastery over his or her environment. Cognitive behavioural therapy is fairly effective. A counsellor should be sensitive and empathetic. This will help the person restore a sense of self and self-esteem. Clear, direct, and non-threatening communication by the therapist to the person is essential. The therapist will establish firm boundaries for what is expected from both the person and the therapist.
In times of acute stress, a person with a dissociative disorder may require short-term hospitalisation. Occasionally, antipsychotic or antidepressant medications are used to control symptoms.
What are the side effects of the treatments? Side effects depend on the specific medications used, but may include allergic reactions and drowsiness.
What happens after treatment for the condition? A person with a dissociative disorder often requires long-term psychotherapy and supervision.
How is the condition monitored? Family members and the person's therapist can monitor the person's progress and condition. Any new or worsening symptoms should be reported to the doctor.
Author: Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 19/06/2005 Contributors Potential conflict of interest information for reviewers available on request
