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Dissociative Disorders

Dissociative Disorders refers to a number of different disorders. This article has information on four dissociative disorders and what symptoms are associated with each disorder. We also include treatment options for dissociative disorders.

Dissociative disorders is a category in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) that includes four specific disorders and a category for dissociative disorder NOS (not otherwise specified). The four disorders are called Dissociative Amnesia, Dissociative Identity Disorder, Dissociative Fugue, and Depersonalization Disorder in the DSM-IV-TR. As none of these names is illuminating, let's look at what dissociative means and how each of the separate disorders is characterized.

What Does Dissociative Mean?

Dissociation refers to the psychological coping mechanism of separating thoughts, feelings, or body sensations that create anxiety from the rest of a person's psyche. Usually experiences, good and bad, are integrated into a person's history and personality, but when something so psychologically traumatic happens that a person cannot integrate it, the person may dissociate him- or herself from the memory and feelings. This is not a conscious choice, and the dissociated material is not easily accessible to the conscious mind.

Trauma is generally assumed to be at the root of the dissociative disorders, and it is therefore unsurprising that they are often seen in combination with Post-Traumatic Stress Disorder (PTSD). The types of events that can lead to dissociative disorders include chronic emotional, physical, or sexual abuse of a child, who doesn't have more mature ways of enduring this type of trauma. Other crises, such as kidnapping or war, can also be responsible.

What Are the Four Dissociative Disorders ?

Three of the four dissociative disorders have the word dissociative in their name, referring to the mechanism. The fourth has the word depersonalization, which speaks to the result of the dissociation in the person who experiences it.

Dissociative Amnesia—This is a form of amnesia that is not caused by a physical trauma, like a fall in which the head sustains a severe bump and the results are different as well. In dissociative amnesia, the memories are still present, but not available to conscious memory, in effect, shielding the person from the memories. Dissociative Amnesia used to be called psychogenic amnesia. It is often accompanied by anxiety or depression.

 • Dissociative Identity Disorder (DID)—Formerly called Multiple Personality Disorder, DID refers to a condition in which a person copes with unbearable stress by switching to an alternative identity, with an individual name, personality, and history. People who have DID, usually also suffer from Dissociative Amnesia.

ª Dissociative Fugue—This condition, which used to be known as psychogenic fugue, involves people losing their sense of identity, often spontaneously leaving their community and typical activities to go on unplanned journeys and sometimes creating new identities and lives. Alcohol and drug abuse can cause states that are similar to fugues, in which blackouts occur.

• Depersonalization Disorder—Feeling outside of oneself, observing one's situation and actions rather than experiencing them directly, is what characterizes Depersonalization Disorder. Distortion of time and the appearance of things may also occur, and a general sense of unreality may be felt. These feelings may be fleeting or recurring.

Treatment of Dissociative Disorders

Treatment usually involves psychotherapy. While medication is not useful directly, if the person is depressed or anxious, medications that treat these issues may be helpful. Cognitive and creative therapy may also help with aspects of treatment.

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