What is dissociative disorder?

Dissociative disorder is a mental health condition in which a person experiences a disconnect from reality.

What Is Dissocial Disorder?

In dissociative identity disorder, a person’s balance and congruence between behaviors, thoughts, memories, and personality are affected. This disconnection can often endanger the physical well-being of those who suffer from it, making it difficult for them to carry on with their daily activities normally.

Dissociative disorders are the result of a kind of defense mechanism that hides traumatic events, causing them to be forgotten or leading to the creation of an alternate identity.

Each person can develop these disorders differently and with varying intensity. In most cases, they arise in children who have been physically and emotionally abused for a long time, have lived through wars, or have been victims of accidents or natural disasters.

There are three types of dissociative disorders:

• Dissociative Amnesia Episodes: This amnesia is characterized by the selective loss of memory regarding traumatic events.
• Dissociative Identity Disorder (or Multiple Personality Disorder): Its main feature is the creation of two or more alternative identities. The person feels the presence of more people in their mind that express and coexist, taking control of the patient at times. They also often suffer from dissociative amnesia.
• Depersonalization-Derealization: The main symptom is a disconnect from oneself (depersonalization), where one becomes an observer of their own life. Derealization is a feeling of unreality about situations, which can be very distressing.

Although symptoms vary depending on the type of dissociative disorder a person has, some of the most common are:

• Selective amnesic episodes of traumatic events, people, or aspects of oneself that one wants to forget.
• Mental confusion.
• A disconnect from reality.
• Emotional and professional stress, as well as an inability to cope with it.
• Suicidal ideation.
• Confused identity.
• Distorted perception of things and people.
• Problems in personal, social, and work relationships.
• A feeling of being separated from oneself.

Additionally, dissociative disorders can trigger other conditions such as:

• Drug and alcohol addiction.
• Self-harm or mutilation.
• Seizure-like episodes.
• Sexual problems.
• Insomnia and sleepwalking.
• Eating disorders.
• Personality disorders.
• Depression.
• Anxiety.
• Suicide.

The diagnostic criteria for this condition are established in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) and vary according to the specific type of dissociative disorder.

Diagnosis is made through a comprehensive clinical evaluation carried out by a mental health professional, which includes structured clinical interviews and the use of specific scales to help identify the presence and severity of dissociative symptoms.

In addition, detailed information about the patient’s medical, psychiatric, and traumatic history is collected, as many cases are associated with experiences of abuse or trauma in early life.

It is also essential to rule out other medical or neurological causes through complementary studies.

To determine the specific type of disorder, criteria such as the presence of identity or memory disturbance, recurrent symptoms, significant distress, substance use or lack thereof, and the presence of other possible mental disorders can be used.

The treatment of dissociative disorder focuses mainly on psychotherapy, which aims to integrate the fragmented aspects of identity, improve emotional regulation, and address underlying traumas.

For this purpose, cognitive-behavioral therapy is often used, adapted to the specific needs of the patient. Trauma-based therapy, dialectical behavior therapy, or psychodynamic therapy may also be used.

The use of medication is not usually specifically indicated for the treatment of dissociative symptoms, but it can be used to manage co-morbid symptoms such as depression, anxiety, or sleep disorders, for example.

It is essential that the treatment includes a multidisciplinary approach if necessary.

At the Neurological Center of Centro Médico ABC, we can provide you with specialized care. Contact us!