Dissociative disorders are range of various mental health conditions. The symptoms of experience dissociation can range from altering one’s sense of self, memory, consciousness, and the perception of a person’s surroundings. These disorders tend to usually develop as a means of traumatic events particularly in childhood, which can severely compromise people’s day-to-day lives.
Dissociative Identity Disorder is a condition where two or more distinct identity states carry out behavior having each its personal history and personality traits, which are expressed at their own, will usually following painful experience or stress.
Dissociative Amnesia is marked by significant memory loss, unexplainable by ordinary forgetfulness, affecting specific events or one’s entire identity and life history.
Epidemiology
Dissociative disorders are known to affect 1.1-1.5% and even more people, 3% of inpatients with mental health issues are reported in Europe, North America and other regions of the world. Moreover, incidences of dissociative identity disorder have been estimated to be approximately six times higher in women as compared to men.
Anatomy
Pathophysiology
Dissociation:
Psychobiological Response: It is a specific type of physiobiological change in a person’s mind due to a severe trauma.
Altered Consciousness: Dissociation is a syndrome of a disruption in, or discontinuity of the consciousness and mental functions of the normally integrated aspects such as the identity, memory, emotion, body representation and behavior.
Neuroimaging Studies:
Functional Brain Imaging: The neuroimaging experiments reveal that the brain activities in those with dissociative disorders differ significantly from normally healthy individuals, with a concentration in areas associated with self-awareness & regulation of emotions.
Structural Brain Changes: Brain structure undergoes reconstructions as well and it includes hippocampus and amygdala volume decrease.
Dysfunction in Default Mode Network (DMN): Certain research has alluded to the functioning that might be affected in the Default Mode Network which is a neurological cluster that deals with self-referential processing and one’s sense of self.
Etiology
Trauma: The prevalent view of these disorders is that they usually result from trauma such as abuse at a young age. This could be the case with physical, sexual or emotional abuse, as well as other harmful events including accidents, natural catastrophes, or armed conflicts. Stressful Life Events: Even stressful situations beyond one’s capabilities or situations that are potentially life-threatening experiences may cause dissociative symptoms in people who already show some predisposition to this illness.
Family Environment: The family dysfunction and disturbances like abuse, inadequate care and inconsistency in this regard can alter the integral part of the brain and the biochemical foundation of a person thus the development of a dissociative disorder. Sociocultural Factors: The cultural and social catalysts, such as societal attitudes about trauma, mental health and the coping strategies can influence the emergence of dissociation.
Genetics
Prognostic Factors
Early Intervention: Early detection and early pharmacological control represents a good factor for the dissociative disorders prognosis.
Severity of Trauma: The number of physical and emotional injuries that caused the dissociative disorder among other things at the onset of the dissociative disorder can play an important role in the prognosis of the disorder.
Type of Dissociative Disorder: The type of the dissociative disorder could also affects prognosis.
Clinical History
Age group:
Depersonalization-Derealization Disorder: Early adulthood & adolescence.
Dissociative Amnesia: May happen at any age.
Dissociative Identity Disorder: Usually begins in childhood and frequently as a reaction to a stressful experience. Early adolescence or late childhood may see an increase in symptoms.
Physical Examination
General Physical Examination
Neurological Examination
Age group
Associated comorbidity
Post-Traumatic Stress Disorder
Anxiety Disorders
Mood Disorders
Substance Use Disorders
Self-Harming Behaviors
Eating Disorders
Sleep Disorders
Associated activity
Acuity of presentation
Dissociative Amnesia:
Memory loss: In most cases represented by amnesia, particularly around traumatic events.
Dissociative fugue: The abrupt unannounced movement away from home or the workplace where you could not remember your past and be totally confused about the question of who owns your sense of identity or even worse, you’d get used to a new (strange) presence.
Dissociative Identity Disorder
Two or more different personas or states of personality: These are the observable features that are unique to each individual human being and can be seen from the manner of their perception and interaction with the world.
Differential Diagnoses
Post-Traumatic Stress Disorder
Acute Stress Disorder
Schizophrenia and other Psychotic Disorders
Mood Disorders
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
Medication: Psychiatric Medications: These may, on the other hand, alleviate psychosocial problems such as depression and anxiety that mostly occur. Antidepressants: SSRIs such as fluoxetine, paroxetine are commonly used drugs here in this category.
Anti-anxiety Medications: Benzodiazepines may be prescribed.
Supportive Measures:
Stabilization Techniques: The strategies, including grounding and others, and allow a person affected to manage distress and be able to be grounded and remain in the present moment.
Safety Planning: Securing the safety of the patient is of high priorities.
Psychotherapy:
Trauma-focused Therapy: Dissociative disorders most often result from the effect of trauma. Trauma-focused therapies such as:
Cognitive Behavioral Therapy (CBT): To revise and deal with the irrationality in beliefs, thoughts and mannerisms associated with the trauma.
Dialectical Behavior Therapy (DBT): Assists people in developing strategies for coping with distress, regulating emotions, and strengthening relationships. from Adversity to Resilience.
Pharmacotherapy: The pharmacotherapy includes anti-anxiety agents and antidepressants primarily.
EMDR Therapy: Eye Movement Desensitization and Reprocessing Therapy: From the point of perspective, the person greatly benefit from processing traumatic memories.
Self-Help: It is recommend for patients to engage in personal intervention and appreciate patients’ note to track their improvements. Psychoeducation: Devising and implementing an education program targeting patients and family and explains its causes, and treatment options.
Relapse Prevention: Making strategies preventing relapse and managing triggers which could bring back the stress symptoms.
Physical Safety: Make sure the environmental domain is secured from possible threat (hazards). Removal of all the triggers is necessary.
Comfort: Make sure that this area is warm and comfortable, quite with enough light. Establishing Routines and Structure:
Consistency: Show a time schedule to be resolved. Everyday routines that help us to get used to the situation can give us a sense of security.
Visual Schedule: An example of visual schedule can be of help to keep routine and minimize anxious feelings.
Support Systems:
Trusted Person: Explore a reliable person available when the affected person feels bad.
Effectiveness of SSRIs in treating dissociative disorders
Fluoxetine: Primarily used to relieve depression symptoms.
Sertaline: Sertraline, brand name Zoloft, is usually used as an anxiety reliever and antidepressant. It may be recommended in some situations where symptoms of anxiety or depression coexist with dissociative symptoms.
Use of benzodiazepines in treating dissociative disorders
Alprazolam: These medications are advised to help manage anxiety and may be used temporarily.
Evaluation and Diagnosis:
Examining symptoms of dissociation.
Diagnosing other conditions differently.
Psychoeducation:
On the topic of mental disorder of dissociation.
Knowing about trauma events and its relation to the current symptoms. Give education on mindfulness and other techniques those who are dealing with panic attacks.
Prevention and Maintenance:
Coming up with plans for stay away from them.
Should better do the same by providing counseling and support.
Dissociative disorders are range of various mental health conditions. The symptoms of experience dissociation can range from altering one’s sense of self, memory, consciousness, and the perception of a person’s surroundings. These disorders tend to usually develop as a means of traumatic events particularly in childhood, which can severely compromise people’s day-to-day lives.
Dissociative Identity Disorder is a condition where two or more distinct identity states carry out behavior having each its personal history and personality traits, which are expressed at their own, will usually following painful experience or stress.
Dissociative Amnesia is marked by significant memory loss, unexplainable by ordinary forgetfulness, affecting specific events or one’s entire identity and life history.
Dissociative disorders are known to affect 1.1-1.5% and even more people, 3% of inpatients with mental health issues are reported in Europe, North America and other regions of the world. Moreover, incidences of dissociative identity disorder have been estimated to be approximately six times higher in women as compared to men.
Dissociation:
Psychobiological Response: It is a specific type of physiobiological change in a person’s mind due to a severe trauma.
Altered Consciousness: Dissociation is a syndrome of a disruption in, or discontinuity of the consciousness and mental functions of the normally integrated aspects such as the identity, memory, emotion, body representation and behavior.
Neuroimaging Studies:
Functional Brain Imaging: The neuroimaging experiments reveal that the brain activities in those with dissociative disorders differ significantly from normally healthy individuals, with a concentration in areas associated with self-awareness & regulation of emotions.
Structural Brain Changes: Brain structure undergoes reconstructions as well and it includes hippocampus and amygdala volume decrease.
Dysfunction in Default Mode Network (DMN): Certain research has alluded to the functioning that might be affected in the Default Mode Network which is a neurological cluster that deals with self-referential processing and one’s sense of self.
Trauma: The prevalent view of these disorders is that they usually result from trauma such as abuse at a young age. This could be the case with physical, sexual or emotional abuse, as well as other harmful events including accidents, natural catastrophes, or armed conflicts. Stressful Life Events: Even stressful situations beyond one’s capabilities or situations that are potentially life-threatening experiences may cause dissociative symptoms in people who already show some predisposition to this illness.
Family Environment: The family dysfunction and disturbances like abuse, inadequate care and inconsistency in this regard can alter the integral part of the brain and the biochemical foundation of a person thus the development of a dissociative disorder. Sociocultural Factors: The cultural and social catalysts, such as societal attitudes about trauma, mental health and the coping strategies can influence the emergence of dissociation.
Early Intervention: Early detection and early pharmacological control represents a good factor for the dissociative disorders prognosis.
Severity of Trauma: The number of physical and emotional injuries that caused the dissociative disorder among other things at the onset of the dissociative disorder can play an important role in the prognosis of the disorder.
Type of Dissociative Disorder: The type of the dissociative disorder could also affects prognosis.
Age group:
Depersonalization-Derealization Disorder: Early adulthood & adolescence.
Dissociative Amnesia: May happen at any age.
Dissociative Identity Disorder: Usually begins in childhood and frequently as a reaction to a stressful experience. Early adolescence or late childhood may see an increase in symptoms.
General Physical Examination
Neurological Examination
Post-Traumatic Stress Disorder
Anxiety Disorders
Mood Disorders
Substance Use Disorders
Self-Harming Behaviors
Eating Disorders
Sleep Disorders
Dissociative Amnesia:
Memory loss: In most cases represented by amnesia, particularly around traumatic events.
Dissociative fugue: The abrupt unannounced movement away from home or the workplace where you could not remember your past and be totally confused about the question of who owns your sense of identity or even worse, you’d get used to a new (strange) presence.
Dissociative Identity Disorder
Two or more different personas or states of personality: These are the observable features that are unique to each individual human being and can be seen from the manner of their perception and interaction with the world.
Post-Traumatic Stress Disorder
Acute Stress Disorder
Schizophrenia and other Psychotic Disorders
Mood Disorders
Medication: Psychiatric Medications: These may, on the other hand, alleviate psychosocial problems such as depression and anxiety that mostly occur. Antidepressants: SSRIs such as fluoxetine, paroxetine are commonly used drugs here in this category.
Anti-anxiety Medications: Benzodiazepines may be prescribed.
Supportive Measures:
Stabilization Techniques: The strategies, including grounding and others, and allow a person affected to manage distress and be able to be grounded and remain in the present moment.
Safety Planning: Securing the safety of the patient is of high priorities.
Psychotherapy:
Trauma-focused Therapy: Dissociative disorders most often result from the effect of trauma. Trauma-focused therapies such as:
Cognitive Behavioral Therapy (CBT): To revise and deal with the irrationality in beliefs, thoughts and mannerisms associated with the trauma.
Dialectical Behavior Therapy (DBT): Assists people in developing strategies for coping with distress, regulating emotions, and strengthening relationships. from Adversity to Resilience.
Pharmacotherapy: The pharmacotherapy includes anti-anxiety agents and antidepressants primarily.
EMDR Therapy: Eye Movement Desensitization and Reprocessing Therapy: From the point of perspective, the person greatly benefit from processing traumatic memories.
Self-Help: It is recommend for patients to engage in personal intervention and appreciate patients’ note to track their improvements. Psychoeducation: Devising and implementing an education program targeting patients and family and explains its causes, and treatment options.
Relapse Prevention: Making strategies preventing relapse and managing triggers which could bring back the stress symptoms.
Safety and Comfort:
Physical Safety: Make sure the environmental domain is secured from possible threat (hazards). Removal of all the triggers is necessary.
Comfort: Make sure that this area is warm and comfortable, quite with enough light. Establishing Routines and Structure:
Consistency: Show a time schedule to be resolved. Everyday routines that help us to get used to the situation can give us a sense of security.
Visual Schedule: An example of visual schedule can be of help to keep routine and minimize anxious feelings.
Support Systems:
Trusted Person: Explore a reliable person available when the affected person feels bad.
Psychiatry/Mental Health
Fluoxetine: Primarily used to relieve depression symptoms.
Sertaline: Sertraline, brand name Zoloft, is usually used as an anxiety reliever and antidepressant. It may be recommended in some situations where symptoms of anxiety or depression coexist with dissociative symptoms.
Psychiatry/Mental Health
Alprazolam: These medications are advised to help manage anxiety and may be used temporarily.
Psychiatry/Mental Health
Psychiatry
Evaluation and Diagnosis:
Examining symptoms of dissociation.
Diagnosing other conditions differently.
Psychoeducation:
On the topic of mental disorder of dissociation.
Knowing about trauma events and its relation to the current symptoms. Give education on mindfulness and other techniques those who are dealing with panic attacks.
Prevention and Maintenance:
Coming up with plans for stay away from them.
Should better do the same by providing counseling and support.
Dissociative disorders are range of various mental health conditions. The symptoms of experience dissociation can range from altering one’s sense of self, memory, consciousness, and the perception of a person’s surroundings. These disorders tend to usually develop as a means of traumatic events particularly in childhood, which can severely compromise people’s day-to-day lives.
Dissociative Identity Disorder is a condition where two or more distinct identity states carry out behavior having each its personal history and personality traits, which are expressed at their own, will usually following painful experience or stress.
Dissociative Amnesia is marked by significant memory loss, unexplainable by ordinary forgetfulness, affecting specific events or one’s entire identity and life history.
Dissociative disorders are known to affect 1.1-1.5% and even more people, 3% of inpatients with mental health issues are reported in Europe, North America and other regions of the world. Moreover, incidences of dissociative identity disorder have been estimated to be approximately six times higher in women as compared to men.
Dissociation:
Psychobiological Response: It is a specific type of physiobiological change in a person’s mind due to a severe trauma.
Altered Consciousness: Dissociation is a syndrome of a disruption in, or discontinuity of the consciousness and mental functions of the normally integrated aspects such as the identity, memory, emotion, body representation and behavior.
Neuroimaging Studies:
Functional Brain Imaging: The neuroimaging experiments reveal that the brain activities in those with dissociative disorders differ significantly from normally healthy individuals, with a concentration in areas associated with self-awareness & regulation of emotions.
Structural Brain Changes: Brain structure undergoes reconstructions as well and it includes hippocampus and amygdala volume decrease.
Dysfunction in Default Mode Network (DMN): Certain research has alluded to the functioning that might be affected in the Default Mode Network which is a neurological cluster that deals with self-referential processing and one’s sense of self.
Trauma: The prevalent view of these disorders is that they usually result from trauma such as abuse at a young age. This could be the case with physical, sexual or emotional abuse, as well as other harmful events including accidents, natural catastrophes, or armed conflicts. Stressful Life Events: Even stressful situations beyond one’s capabilities or situations that are potentially life-threatening experiences may cause dissociative symptoms in people who already show some predisposition to this illness.
Family Environment: The family dysfunction and disturbances like abuse, inadequate care and inconsistency in this regard can alter the integral part of the brain and the biochemical foundation of a person thus the development of a dissociative disorder. Sociocultural Factors: The cultural and social catalysts, such as societal attitudes about trauma, mental health and the coping strategies can influence the emergence of dissociation.
Early Intervention: Early detection and early pharmacological control represents a good factor for the dissociative disorders prognosis.
Severity of Trauma: The number of physical and emotional injuries that caused the dissociative disorder among other things at the onset of the dissociative disorder can play an important role in the prognosis of the disorder.
Type of Dissociative Disorder: The type of the dissociative disorder could also affects prognosis.
Age group:
Depersonalization-Derealization Disorder: Early adulthood & adolescence.
Dissociative Amnesia: May happen at any age.
Dissociative Identity Disorder: Usually begins in childhood and frequently as a reaction to a stressful experience. Early adolescence or late childhood may see an increase in symptoms.
General Physical Examination
Neurological Examination
Post-Traumatic Stress Disorder
Anxiety Disorders
Mood Disorders
Substance Use Disorders
Self-Harming Behaviors
Eating Disorders
Sleep Disorders
Dissociative Amnesia:
Memory loss: In most cases represented by amnesia, particularly around traumatic events.
Dissociative fugue: The abrupt unannounced movement away from home or the workplace where you could not remember your past and be totally confused about the question of who owns your sense of identity or even worse, you’d get used to a new (strange) presence.
Dissociative Identity Disorder
Two or more different personas or states of personality: These are the observable features that are unique to each individual human being and can be seen from the manner of their perception and interaction with the world.
Post-Traumatic Stress Disorder
Acute Stress Disorder
Schizophrenia and other Psychotic Disorders
Mood Disorders
Medication: Psychiatric Medications: These may, on the other hand, alleviate psychosocial problems such as depression and anxiety that mostly occur. Antidepressants: SSRIs such as fluoxetine, paroxetine are commonly used drugs here in this category.
Anti-anxiety Medications: Benzodiazepines may be prescribed.
Supportive Measures:
Stabilization Techniques: The strategies, including grounding and others, and allow a person affected to manage distress and be able to be grounded and remain in the present moment.
Safety Planning: Securing the safety of the patient is of high priorities.
Psychotherapy:
Trauma-focused Therapy: Dissociative disorders most often result from the effect of trauma. Trauma-focused therapies such as:
Cognitive Behavioral Therapy (CBT): To revise and deal with the irrationality in beliefs, thoughts and mannerisms associated with the trauma.
Dialectical Behavior Therapy (DBT): Assists people in developing strategies for coping with distress, regulating emotions, and strengthening relationships. from Adversity to Resilience.
Pharmacotherapy: The pharmacotherapy includes anti-anxiety agents and antidepressants primarily.
EMDR Therapy: Eye Movement Desensitization and Reprocessing Therapy: From the point of perspective, the person greatly benefit from processing traumatic memories.
Self-Help: It is recommend for patients to engage in personal intervention and appreciate patients’ note to track their improvements. Psychoeducation: Devising and implementing an education program targeting patients and family and explains its causes, and treatment options.
Relapse Prevention: Making strategies preventing relapse and managing triggers which could bring back the stress symptoms.
Safety and Comfort:
Physical Safety: Make sure the environmental domain is secured from possible threat (hazards). Removal of all the triggers is necessary.
Comfort: Make sure that this area is warm and comfortable, quite with enough light. Establishing Routines and Structure:
Consistency: Show a time schedule to be resolved. Everyday routines that help us to get used to the situation can give us a sense of security.
Visual Schedule: An example of visual schedule can be of help to keep routine and minimize anxious feelings.
Support Systems:
Trusted Person: Explore a reliable person available when the affected person feels bad.
Psychiatry/Mental Health
Fluoxetine: Primarily used to relieve depression symptoms.
Sertaline: Sertraline, brand name Zoloft, is usually used as an anxiety reliever and antidepressant. It may be recommended in some situations where symptoms of anxiety or depression coexist with dissociative symptoms.
Psychiatry/Mental Health
Alprazolam: These medications are advised to help manage anxiety and may be used temporarily.
Psychiatry/Mental Health
Psychiatry
Evaluation and Diagnosis:
Examining symptoms of dissociation.
Diagnosing other conditions differently.
Psychoeducation:
On the topic of mental disorder of dissociation.
Knowing about trauma events and its relation to the current symptoms. Give education on mindfulness and other techniques those who are dealing with panic attacks.
Prevention and Maintenance:
Coming up with plans for stay away from them.
Should better do the same by providing counseling and support.
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