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Understanding Dissociative Disorder: Symptoms and Treatment

Dissociative Disorders

Clinically Reviewed by: Charee Marquez, LMFT

Dissociative Disorder

Dissociative Disorders, once commonly referred to as Multiple Personality Disorder, are complex mental disorders that involve disruptions in memory, identity, and consciousness. These disorders often stem from severe childhood trauma, such as physical, sexual, or emotional abuse. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM) by the American Psychiatric Association, there are three major dissociative disorders: Dissociative Identity Disorder (DID), Depersonalization/Derealization Disorder, and Dissociative Amnesia. Mental health professionals, especially those who specifically treat dissociative disorders, play a crucial role in diagnosing and managing these conditions. This blog will explore the symptoms, causes, and treatment options for dissociative disorders, focusing on how mental health specialists approach these complex cases to help individuals adopt healthier thinking patterns and improve their quality of life.

What is Dissociative Disorder?

Dissociative Disorders are mental health conditions characterized by disruptions in consciousness, memory, identity, or perception, typically resulting from trauma. Key types include Dissociative Amnesia, which involves an inability to recall important personal information, often related to traumatic events. Dissociative Identity Disorder (DID) is marked by the presence of two or more distinct identities or personalities within a single individual. Depersonalization/Derealization Disorder involves persistent feelings of being detached from oneself (depersonalization) or from the world around (derealization). Treatment for these disorders usually involves psychotherapy aimed at addressing trauma and integrating dissociated aspects of identity. Medication may also be prescribed to manage associated symptoms such as anxiety and depression.

 

What Causes Dissociative Disorder?

Dissociative Disorders are primarily caused by severe trauma, particularly during early childhood. This trauma can include physical, sexual, or emotional abuse. The intense stress and fear experienced during these events lead the mind to dissociate as a coping mechanism, creating a disconnection in thoughts, memories, and identity. Other contributing factors may include prolonged stress, exposure to natural disasters, war, or significant life disruptions. The mind uses dissociation to escape or compartmentalize the traumatic experiences, which can result in the development of dissociative symptoms and disorders.

 

Can Dissociative Disorder Be Cured?

Dissociative Disorders can be managed and symptoms can be significantly reduced with appropriate treatment, but a complete “cure” varies from person to person. Treatment typically involves psychotherapy, which aims to address and process the underlying trauma, integrate dissociated parts of the personality, and develop healthy coping mechanisms. Cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and other therapeutic approaches can be effective. In some cases, medication may be prescribed to manage associated symptoms like anxiety and depression. Long-term treatment and support can lead to substantial improvement, helping individuals regain control over their lives and function more effectively. However, the process can be complex and requires a personalized approach.

 

Is Dissociative Disorder Hereditary?

Dissociative Disorders are not typically considered hereditary. They are primarily caused by severe trauma, especially during childhood, such as physical, sexual, or emotional abuse. While genetic factors may play a minor role in predisposing someone to mental health conditions, the development of Dissociative Disorders is more strongly linked to environmental factors and traumatic experiences.

 

Dissociative Disorder Prognosis

The prognosis for Dissociative Disorders varies widely and depends on factors such as the severity of symptoms, the individual’s history of trauma, and the quality of treatment received. With appropriate and consistent treatment, including psychotherapy and sometimes medication, individuals can see significant improvements in symptoms and quality of life. However, the process can be lengthy and requires ongoing support. Some people achieve substantial symptom reduction and functional improvement, while others may continue to experience challenges but can learn to manage their symptoms effectively.

 

Types of Dissociative Disorder

The main types of Dissociative Disorders are:

  1. Dissociative Amnesia: Inability to recall important personal information, often related to trauma.
  2. Dissociative Identity Disorder (DID): Presence of two or more distinct identities or personalities within an individual.
  3. Depersonalization/Derealization Disorder: Persistent feelings of being detached from oneself (depersonalization) or feeling that the external world is unreal (derealization).
  4. Other Specified Dissociative Disorder (OSDD): Symptoms of dissociation that don’t fully match the criteria for the other specific disorders but still cause significant distress or impairment.

 

Effects of Dissociative Disorder

Dissociative Disorders can have a wide range of effects on an individual’s life, including:

  1. Memory Problems: Frequent gaps in memory, including personal history and significant life events.
  2. Identity Confusion: Difficulty maintaining a consistent sense of self, often leading to identity fragmentation.
  3. Emotional Distress: High levels of anxiety, depression, and emotional instability.
  4. Impaired Functioning: Difficulties in daily activities, work, and relationships due to dissociative symptoms.
  5. Depersonalization/Derealization: Persistent feelings of detachment from oneself or the external world, creating a sense of unreality.
  6. Trauma Re-experiencing: Flashbacks or intrusive memories related to past trauma.

These effects can significantly impair the individual’s ability to lead a normal life and require comprehensive treatment to manage.

 

Risks of Dissociative Disorder

The risks associated with Dissociative Disorders include:

  1. Emotional Distress: High levels of anxiety, depression, and emotional instability.
  2. Self-Harm: Increased risk of self-injurious behaviors and suicidal thoughts or actions.
  3. Substance Abuse: Greater likelihood of using drugs or alcohol as a coping mechanism.
  4. Relationship Problems: Struggles in maintaining healthy relationships due to identity confusion and emotional distress.
  5. Impaired Functioning: Difficulties in daily activities, work, and social interactions.
  6. Re-traumatization: Risk of re-experiencing trauma through flashbacks or dissociative episodes.
  7. Misdiagnosis: Potential for being misdiagnosed, leading to ineffective treatment.

 

Dissociative Disorder Prevalence

Dissociative Disorders are relatively rare, with varying prevalence rates depending on the specific disorder and population studied. Estimates suggest that Dissociative Identity Disorder (DID) affects about 1% of the general population, while Dissociative Amnesia and Depersonalization/Derealization Disorder are somewhat more common. Overall, it is believed that around 2-3% of the general population may experience some form of dissociative disorder in their lifetime. These conditions are often underdiagnosed due to their complex nature and overlap with other mental health issues.

 

How Is Dissociative Disorder Diagnosed?

Dissociative Disorders are diagnosed through:

  1. Clinical Interviews: Discussing symptoms, history, and trauma.
  2. Psychological Assessments: Using tools like the Dissociative Experiences Scale (DES).
  3. Medical Examination: Ruling out medical conditions.
  4. Observation: Monitoring symptoms over time.
  5. Collateral Information: Gathering input from family or close associates.

 

Signs and Symptoms of Dissociative Disorder

Signs and symptoms of Dissociative Disorders include:

  1. Memory Gaps: Inability to recall important personal information or past events.
  2. Identity Disturbance: Presence of multiple distinct identities or personalities (DID).
  3. Depersonalization: Feeling detached from oneself, as if observing from outside the body.
  4. Derealization: Perception that the external world is unreal or distorted.
  5. Emotional Distress: High levels of anxiety, depression, and emotional instability.
  6. Flashbacks: Reliving traumatic events as if they are happening again.
  7. Disorientation: Confusion about time, place, or identity.
  8. Self-Harm: Engaging in self-injurious behaviors.

These symptoms can significantly impair daily functioning and quality of life.

 

How Do You Help a Loved One with Dissociative Disorder?

To help a loved one with Dissociative Disorder:

  1. Educate Yourself: Learn about the disorder to understand their experiences.
  2. Be Supportive: Offer emotional support, patience, and understanding.
  3. Encourage Treatment: Support them in seeking professional help and attending therapy.
  4. Create a Safe Environment: Ensure they feel safe and secure.
  5. Be Patient: Recovery can be a long process; offer consistent support.
  6. Avoid Triggers: Help them avoid situations that may cause stress or trigger dissociation.
  7. Listen: Be an empathetic listener without judgment.

Your support can make a significant difference in their recovery process.

 

Dissociative Disorder Treatment Options

Treatment options for Dissociative Disorders include:

  1. Psychotherapy: The primary treatment, involving techniques such as:
    • Cognitive Behavioral Therapy (CBT): To address negative thought patterns and behaviors.
    • Dialectical Behavior Therapy (DBT): To manage emotions and improve relationships.
    • Eye Movement Desensitization and Reprocessing (EMDR): To process traumatic memories.
  2. Medication: Prescribed to manage symptoms like anxiety, depression, or insomnia.
  3. Hypnotherapy: Used to help access and integrate dissociated memories.
  4. Support Groups: Providing peer support and shared experiences.
  5. Creative Therapies: Art, music, or drama therapy to express and process emotions.

A comprehensive, individualized treatment plan can significantly improve symptoms and quality of life.

 

Inpatient and Outpatient Treatment Options for Dissociative Disorder 

Inpatient Treatment Options for Dissociative Disorder

  1. Hospitalization: For severe cases involving self-harm or inability to function daily, providing 24/7 care and safety.
  2. Residential Treatment Programs: Long-term facilities offering intensive therapy and a structured environment.
  3. Specialized Dissociative Disorder Units: Hospitals or centers with specific programs that specifically treat dissociative disorders.

 

Outpatient Treatment Options for Dissociative Identity Disorder

  1. Regular Therapy Sessions: Weekly or bi-weekly sessions with a psychologist or therapist specializing in the treatment of dissociative disorders.
  2. Day Treatment Programs: Intensive programs where patients participate in therapy during the day but return home at night.
  3. Medication Management: Regular appointments with a psychiatrist to manage medications.
  4. Support Groups: Peer support groups to share experiences and coping strategies.
  5. Teletherapy: Online therapy sessions for convenience and accessibility.

Both inpatient and outpatient treatments aim to provide comprehensive care tailored to the severity and needs of the individual.

 

Common Prescription Medications for Dissociative Disorder

  1. Antidepressants: Such as SSRIs (e.g., fluoxetine, sertraline) to manage depression and anxiety.
  2. Anti-anxiety Medications: Such as benzodiazepines (e.g., clonazepam) for short-term anxiety relief.
  3. Antipsychotics: Such as risperidone or olanzapine for severe symptoms like dissociation or mood swings.
  4. Mood Stabilizers: Such as lamotrigine or valproate to manage mood fluctuations.

These medications are typically used in conjunction with psychotherapy to help manage symptoms.

 

Dosage Guidelines for Dissociative Prescription Medication

Dosage guidelines for medications prescribed for Dissociative Disorders vary based on the specific medication, the individual’s needs, and their response to treatment. Here are general guidelines for common medications:

Antidepressants (SSRIs)

  • Fluoxetine (Prozac): Start with 10-20 mg daily, can increase to 40-60 mg.
  • Sertraline (Zoloft): Start with 25-50 mg daily, can increase to 100-200 mg.

Anti-anxiety Medications (Benzodiazepines)

  • Clonazepam (Klonopin): Start with 0.25-0.5 mg twice daily, can increase to 1-4 mg.

Antipsychotics

  • Risperidone (Risperdal): Start with 1-2 mg daily, can increase to 4-6 mg.
  • Olanzapine (Zyprexa): Start with 5-10 mg daily, can increase to 10-20 mg.

Mood Stabilizers

  • Lamotrigine (Lamictal): Start with 25 mg daily, can increase to 100-200 mg.
  • Valproate (Depakote): Start with 250 mg twice daily, can increase to 750-1500 mg.

Important Note: Dosages should be adjusted based on individual response and under the supervision of a healthcare provider. Always follow the prescribing doctor’s recommendations and report any side effects or concerns promptly.

 

Does Insurance Cover Dissociative Disorder Treatment?

Yes, many insurance plans cover treatment for Dissociative Disorders, including psychotherapy, medications, and inpatient or outpatient care. Coverage details vary by plan, so it’s important to check with your insurance provider to understand specific benefits, including any co-pays, deductibles, and network restrictions.

 

Common Insurance Plans Used for Addiction and Mental Health Treatment

Common insurance plans used for addiction and mental health treatment include:

  1. Medicare: Federal health insurance for people over 65 or with certain disabilities.
  2. Medicaid: State and federal program providing coverage for low-income individuals and families.
  3. Private Insurance Plans: Offered by employers or purchased individually, including:
  • Blue Cross Blue Shield
  • Aetna
  • Cigna
  • UnitedHealthcare

Marketplace Plans: Health insurance plans available through the Health Insurance Marketplace, created by the Affordable Care Act (ACA).

These plans typically offer varying levels of coverage for mental health and addiction treatment services.

 

Is Dissociative Disorder Treatment Right for Me?

If you experience symptoms such as memory gaps, identity disturbances, or feelings of detachment from yourself or reality, and these symptoms impact your daily life, seeking treatment for Dissociative Disorder might be right for you. Consulting with a mental health professional can help determine the best course of action and whether treatment is appropriate for your specific situation.

 

Conclusion

Dissociative Disorders, including the well-known Dissociative Identity Disorder (previously called Multiple Personality Disorder), are serious mental health problems often rooted in past traumatic events. Mental health professionals utilize various treatment methods, such as talk therapy and other therapy techniques, to help individuals integrate their separate identities and manage their symptoms. Diagnosing dissociative disorders involves a thorough understanding of an individual’s personal history and the presence of specific symptoms outlined in the Diagnostic and Statistical Manual of Mental Disorders. With appropriate treatment and support, people with dissociative disorders can learn to cope with their traumatic experiences, adopt healthier thinking patterns, and lead fulfilling lives. Understanding the impact of severe stress and trauma on mental health is crucial in providing effective care and support for those affected by these challenging conditions.

 

Seeking Treatment? Our Mental Health Professionals Can Help!

Does Insurance Cover Dissociative Disorder Treatment?

Yes, many insurance plans cover treatment for Dissociative Disorders and other mental health conditions, including psychotherapy, medications, and inpatient or outpatient care.

At California Prime Recovery, as an in-network provider we work with most insurance plans, such as:

If you or a loved one are struggling with mental health challenges or substance abuse, reach out to California Prime Recovery today. Our team of compassionate professionals is here to support your journey towards lasting well-being. Give us a call at 866-208-2390

FAQs

Dissociative Disorders involve disruptions in memory, identity, consciousness, and perception, often as a response to severe trauma.
They are primarily caused by severe trauma, particularly during childhood, such as physical, sexual, or emotional abuse.
Symptoms include memory gaps, identity disturbances, feelings of detachment from self (depersonalization) or surroundings (derealization), and emotional distress.
Diagnosis involves clinical interviews, psychological assessments, medical examinations, and observation of symptoms.
Risks include emotional distress, self-harm, substance abuse, relationship problems, impaired functioning, and re-traumatization.

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