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Dissociative Disorders
Table of Contents
Everyone has painful memories or difficult situations that he or she would love to escape. But for someone who suffers from a dissociative disorder, the need to forget or to flee takes on an unhealthy intensity that interferes with normal life. Dissociative disorders often stem from a traumatic event in your past, and they increase the risk that you will turn to drugs or alcohol to numb the pain of these experiences.
Dissociating from reality now and then can be healthy, but a persistent sense of detachment from the world around you is a sign of a mental health disorder that requires professional treatment. If you abuse alcohol or drugs in an effort to forget the past or distance yourself from the world, you may also have a substance use disorder. An integrated drug rehab program that offers specialized treatment in co-occurring disorders can help you regain a healthy sense of reality as you develop coping skills in recovery.
The Diagnostic and Statistical Manual of Mental Disorders(DSM-IV), a publication of the American Psychiatric Association, identifies five basic types of dissociative disorders. All of these categories are characterized by abnormalities in the way you remember events, perceive your identity or interpret the world around you:
- Depersonalization disorder. People with this disorder experience episodes of feeling that the world around them is far away or unreal. They may have the sense that they’re standing outside of themselves, watching life happen to them, yet they’re usually aware that this is a psychological state and not a reflection of reality.
- Dissociative amnesia. A sudden loss of memory that can’t be explained by an injury, illness or another psychiatric condition could be a sign of dissociative amnesia. This disorder is usually caused by a traumatic event, such as childhood abuse.
- Dissociative fugue. A fugue state is a literal escape, in which the individual suddenly leaves his or her current reality and flees somewhere else, often as the result of a traumatic incident. People in the grip of a dissociative fugue have been known to travel for miles to distant locations, where they may even establish a whole new identity. A fugue may last for months, days or hours, and the individual will typically wake up with no memory of what happened during that time.
- Dissociative identity disorder. Once known as multiple personality disorder, dissociative identity disorder is a rare, severe psychiatric condition in which an individual displays more than one personality. These separate personalities have distinct characteristics and may fulfill different needs for the individual, such as protection, ego validation and sexual gratification. The individual with the dominant identity may have no memory of the activities of the secondary identities.
- Dissociative disorder not otherwise specified. The DSM-IV has established a separate category, “dissociative disorders not otherwise specified,” for dissociative conditions that don’t fit these diagnostic criteria.
Signs and Symptoms
Dissociative disorders are not common, but for individuals who suffer from these conditions, they can be devastating. A dissociative disorder can interfere with your ability to work, form relationships or establish a consistent sense of who you are. The following symptoms may indicate that you or someone you care about has a dissociative disorder:
- An unstable sense of identity
- Episodes of memory loss, especially of specific events or people
- A feeling of being detached from other people, places or experiences
- A history of other mental health conditions, such as generalized anxiety disorder or bipolar disorder
- The inability to sense a boundary between yourself and other people or things
- A tendency to turn to drugs or alcohol to erase specific memories or to regain a sense of contact with the rest of the world
According to WebMD, the prevalence of dissociative identity disorder ranges from 0.1 to 1 percent of the population; however, the prevalence of undiagnosed dissociative disorders may be as high as 7 percent. Many of us experience one or more symptoms of dissociative disorder at some time in our lives, especially if we’ve been the victim of sexual assault, a severe accident or a violent altercation. In many cases, these experiences create the ideal environment for substance abuse, chemical dependence and addiction.
Causes and Risk Factors
The exact cause of dissociative disorders is unknown, but these conditions are often linked to a history of trauma. The Mayo Clinic notes that this trauma usually occurs in childhood, when your sense of identity is still developing. Children who are exposed to sexual, physical or verbal abuse may learn to “split off” from the world around them in order to cope with an environment that’s frightening and dangerous. In the case of dissociative identity disorder, they may develop personalities that help them confront difficult feelings like anger, grief or sexual desire.
- Detachment from reality
- Memory loss
- Social withdrawal
The Journal of Psychoactive Drugs notes that substance abuse is a common condition in people with dissociative identity disorder. However, addiction treatment specialists may not recognize the signs and symptoms of dissociative identity disorder in patients who are being treated for drug or alcohol abuse. Mental health professionals who specialize in addiction treatment should be cross-trained in the diagnosis and treatment of dissociative disorders in order to help these patients reach a true state of recovery.
Treatment for Dissociative Disorders
Recovering from a dissociative disorder can be extremely challenging, especially if you are also battling addiction. Dissociation and depersonalization are powerful defense mechanisms that arise from deep pain and fear. Unlearning these natural responses requires time, patience and the help of compassionate mental health professionals. According to the National Alliance on Mental Illness, treatment for dissociative disorders may include:
- Stress psychotherapy
- Antidepressant medication
- Anti-anxiety medication
- Cognitive behavioral therapy
If you have the signs or symptoms of a dissociative disorder combined with a substance use disorder, it’s important to have a full psychological evaluation before you enter treatment. Your chances of recovering from drug addiction are much greater if you also receive treatment for the mental disorder that underlies your substance abuse.
At Axis, we tailor our treatment programs to the needs of the individual client. We provide personalized care for clients with co-occurring conditions like dissociative identity disorder and depersonalization disorder. If you’re ready to begin rebuilding your life on a more stable, solid foundation, we’re here to help you start the process. Call us at any time for a confidential discussion with one of our compassionate intake counselors.