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Dissociative Disorders - Medical Malpractice
Dissociative disorders are a collection of mental disorders in which a person has varying degrees of lack of awareness of who they are or what their personality is. It can range from a simple amnesia to a complex disorder called dissociative identity disorder, in which a person has a range of distinct personalities all residing in the same person. Dissociative identity disorder used to be called multiple personality disorder. All of the dissociative disorders are believed to originate in prior mental trauma that the person cannot integrate with his or her conscious self.
Symptoms of dissociative disorders can overlap with other mental disorders including post-traumatic stress disorder, obsessive compulsive disorder and panic disorder. There are four main dissociative disorders identified by the DSM-IV Diagnostic and Statistical Manual of Mental Disorders. These include dissociative identity disorder, dissociative amnesia, dissociative fugue and depersonalization disorder. In all of these disorders, there is a loss of memory of certain events, times or individuals, depression, anxiety, a sense of being detached from your personality, a blurry sense of identity and a perception of people and events being unreal (also called derealisation).
With dissociative identity disorder, there is switching of alternate identities that can occur at any time of the day or night and can relate to stressors. You can feel as though there are others living inside your head or talking inside your head. They may each have a different name, different characteristics, and a different personal history. Gender and mannerisms can change with the different personalities. The entities may or may not interact with each other. Dissociative amnesia is often coexisting with DID.
Dissociative amnesia involves symptoms of memory loss that is unexplainable by any other means. It often follows a traumatic event, such as a car accident. You can also fail to remember sexual and physical or emotional trauma from childhood. Dissociative amnesia is not caused by head trauma or other medical disorder. The memories that are forgotten are almost always traumatic ones. The amnesia can be selective or generalized to the person's entire life. There can be specific memories blotted out, such as memories of a specific family member.
In dissociative fugue, the person may abruptly leave their life and "run away". You can forget who you are and possibly find a new identity elsewhere. The fugue episode can last only a couple of hours or as long as several months and then end as quickly as it began. You may not remember at all what has happened to you during the fugue state. The person may be completely unaware of who they are and may be confused about that or they can develop a new persona (which is rare).
In depersonalization disorder, you may feel as though you are outside of yourself, watching your activities from a distance. It may feel as though you are watching a movie. Your own body size and shape and the size and shapes of other things may seem distorted. Time may seem to slow down and everything may seem completely unreal. It may last momentarily or last off and on for several years. You can feel as though everything is far away and detached from you. You can feel "spaced out" or can feel as though you have no control over your emotions and actions. You can feel as though the entire external world is distorted or unreal.
The cause of dissociative disorders is almost exclusively the result of psychological trauma, usually trauma you are exposed to in childhood. It can be sexual abuse, emotional abuse or physical abuse. It is almost always associated with feelings of depression and/or anxiety.
The treatment of dissociative disorders involves intense psychotherapy and medications to control anxiety and depression. Psychotherapy often focuses on the trauma and on the resolution of feelings surrounding the trauma. Those with dissociative identity disorder may go through an integration process in which the personalities are united. Supportive psychotherapy around the depression and anxiety may be ongoing for several years.LEGAL HELPLINE: ☎ 855 804 7125
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here