What Is Dissociation?

What is dissociation and dissociative identity disorder (DID)?

What Is Dissociation?

There are different types of dissociative disorder. There is more information on each of these below.

It‘s important to remember that you could have the symptoms of dissociation without a dissociative disorder. There is also a lot of disagreement among professionals over dissociative disorders.

What is dissociative amnesia?

If you have dissociative amnesia you might not remember things that have happened to you. This may relate to a stressful or traumatic event, but doesn’t have to.

In severe cases you might struggle to remember:

  • who you are,
  • what happened to you, or
  • how you felt at the time of the trauma.

This isn’t the same as simply forgetting something. It is a memory ‘lapse’. This means you can’t access the memory at that time, but they are also not permanently lost.

With dissociative amnesia you might still engage with other people, such as holding conversations. You might also still remember other things and live a normal life. But you might also have flashbacks, unpleasant thoughts or nightmares about the things you struggle to remember.

You may have dissociative amnesia with dissociative fugue. This is where someone with dissociative amnesia travels or wanders somewhere else, related to the things they can’t remember. You may or may not have travelled on purpose.

What is dissociative identity disorder (DID)?

Dissociative identity disorder (DID) is sometimes called ‘Multiple Personality Disorder. But we have called it DID on this page.

If you have DID you might seem to have 2 or more different identities, called ‘alternate identities. These identities might take control at different times.

You might find that your behaviour changes depending on which identity has control. You might also have some difficulty remembering things that have happened as you switch between identities. Some people with DID are aware of their different identities, while others are not.

There is a lot of disagreement between researchers over the notion of DID.

We think of someone with DID as having different identities. But some researchers think that that these are actually different parts of one identity which aren’t working together properly.

They suggest that DID is caused by experiencing severe trauma over a long time in childhood. By experiencing trauma in childhood, you take on different identities and behaviours to protect yourself. As you grow up these behaviours become more fully formed until it looks you have different identities. When in fact the different parts of your identity don’t work together properly.

What is other specified dissociative disorder?

With this diagnosis you might regularly have the symptoms of dissociation but not fit into any of the types.

A psychiatrist uses this diagnosis when they think the reason you dissociate is important.

The reasons they give include the following.

  • You dissociate regularly and have done for a long time. You might dissociate in separate, regular episodes. Between these episodes you might not notice any changes.
  • You have dissociation from coercion. This means someone else forced or persuaded you. For example, if you were brainwashed, or imprisoned for a long time.
  • Your dissociation is acute. This means that your episode is short but severe. It might be because of one or more stressful events.
  • You are in a dissociative trance. This means you have very little awareness of things happening around you. Or you might not respond to things and people around you because of trauma.

What is unspecified dissociative disorder?

This diagnosis is used where you dissociate but do not fit into a specific dissociative disorder.

Psychiatrists also use this diagnosis when they choose not to specify the reasons why you do not fit into a specific disorder.

Or if they don’t have enough information for a specific diagnosis. For example, after a first assessment in accident and emergency.

What are dissociative seizures?

Dissociative seizures are hard to get diagnosed. They are regularly wrongly diagnosed as epilepsy.

Dissociative disorders can also be known as non-epileptic attack disorder (NEAD).

It can be hard to tell the difference between a dissociative and epileptic seizure. An EEG can read epileptic seizures but can’t read dissociative seizures. An EEG is a test that detects electrical activity in your brain using small, metal discs attached to your scalp.

Dissociative seizures happen for psychological reasons not physical reasons.

What is depersonalisation/ derealisation disorder (DPDR)?

The feelings of depersonalisation and derealisation can be a symptom of other conditions. It has also been found among people with frontal lobe epilepsy and migraines.

But it can also be a disorder by itself. This means it is a ‘primary disorder’. There is some disagreement among professionals whether DPDR should be listed with the other dissociative disorders at all.

DPDR has some differences to other dissociative disorders. In DPDR you might not question your identity or have different identities at all. You may still be able to tell the difference between things around you. And there may be no symptoms of amnesia. Instead, with DPDR you might feel emotionally numb and questions what it feels to live. We have explained this in more detail below.

You might have these feelings constantly rather than in episodes. It doesn’t have to have been caused by a traumatic or stressful event.

Many people think that this disorder might be more common than previously thought. This might be because of:

  • a lack of information about it,
  • patients who didn’t report their symptoms, and
  • doctors who don’t know enough about it, meaning they underreport the condition.

With DPDR you might have symptoms of depersonalisation or derealisation or both.

Depersonalisation
With depersonalisation you might feel ‘cut off’ from yourself and your body, or you are living in a dream. You may feel emotionally numb to memories and the things happening around you. It may feel you are watching yourself live.

The experience of depersonalisation can be very difficult to put into words. You might say things ‘I feel I don’t exist anymore’ or ‘It’s as if I’m watching my life from behind glass’.

Derealisation
If you have derealisation you might feel cut off from the world around you. You might feel that things around you don’t feel real. Or they might seem foggy or lifeless.

Источник: https://www.rethink.org/advice-and-information/about-mental-illness/learn-more-about-conditions/dissociation-and-dissociative-identity-disorder-did/

Dissociative disorders

What Is Dissociation?

Dissociative disorders are a range of conditions that can cause physical and psychological problems.

Some dissociative disorders are very shortlived, perhaps following a traumatic life event, and resolve on their own over a matter of weeks or months. Others can last much longer.

Symptoms of dissociative disorder can vary but may include:

  • feeling disconnected from yourself and the world around you
  • forgetting about certain time periods, events and personal information
  • feeling uncertain about who you are
  • having multiple distinct identities
  • feeling little or no physical pain

Dissociation is a way the mind copes with too much stress.

Periods of dissociation can last for a relatively short time (hours or days) or for much longer (weeks or months).

It can sometimes last for years, but usually if a person has other dissociative disorders.

Many people with a dissociative disorder have had a traumatic event during childhood.

They may dissociate and avoid dealing with it as a way of coping with it.

There are several different types of dissociative disorder.

The 3 main types are:

  • depersonalisation-derealisation disorder
  • dissociative amnesia
  • dissociative identity disorder

Depersonalisation-derealisation disorder

Depersonalisation is where you have the feeling of being outside yourself and observing your actions, feelings or thoughts from a distance.

Derealisation is where you feel the world around is unreal. People and things around you may seem «lifeless» or «foggy».

You can have depersonalisation or derealisation, or both together. It may last only a few moments or come and go over many years.

Dissociative amnesia

Someone with dissociative amnesia will have periods where they cannot remember information about themselves or events in their past life.

They may also forget a learned talent or skill.

These gaps in memory are much more severe than normal forgetfulness and are not the result of another medical condition.

Some people with dissociative amnesia find themselves in a strange place without knowing how they got there.

They may have travelled there on purpose, or wandered in a confused state.

These blank episodes may last minutes, hours or days. In rare cases, they can last months or years.

Dissociative identity disorder

Dissociative identity disorder (DID) used to be called multiple personality disorder.

Someone diagnosed with DID may feel uncertain about their identity and who they are.

They may feel the presence of other identities, each with their own names, voices, personal histories and mannerisms.

The main symptoms of DID are:

  • memory gaps about everyday events and personal information
  • having several distinct identities

Someone with a dissociative disorder may also have other mental health conditions, such as:

They may also have problems sleeping (insomnia).

The causes of dissociative disorders are not well understood.

They may be related to a previous traumatic experience, or a tendency to develop more physical than psychological symptoms when stressed or distressed.

Someone with a dissociative disorder may have experienced physical, sexual or emotional abuse during childhood.

Some people dissociate after experiencing war, kidnapping or even an invasive medical procedure.

Switching off from reality is a normal defence mechanism that helps the person cope during a traumatic time.

It's a form of denial, as if «this is not happening to me».

It becomes a problem when the environment is no longer traumatic but the person still acts and lives as if it is, and has not dealt with or processed the event.

A GP may examine you and do some tests to check if another illness might be the cause of your symptoms.

They may also refer you to a mental health specialist for a full assessment.

Assessment

The specialist who carries out your assessment should have a good understanding of dissociative disorders.

The assessment may include:

  • a physical examination to rule out things a head injury or drug or alcohol misuse
  • questions about your thoughts, feelings, behaviour and your symptoms

It's important to be honest about your symptoms and not to feel ashamed or embarrassed, so you can receive the help and support you need.

Many people with a dissociative disorder make a full recovery with treatment and support.

Talking therapies

Talking therapies are often recommended for dissociative disorders.

The aim of talking therapies such as counselling is to help you cope with the underlying cause of your symptoms, and to learn and practise techniques to manage the periods of feeling disconnected.

Medicines

There's no specific medicine to treat dissociation, but medicines antidepressants may be prescribed to treat associated conditions  depression, anxiety and panic attacks.

If you have thoughts about taking your life, it's important you ask someone for help.

It's probably difficult for you to see it at this time, but you're not alone or beyond help.  

There are people you can talk to who want to help:

  • speak to a friend, family member or someone you trust, as they may be able to help you calm down and find some breathing space
  • call the Samaritans free 24-hour support service on 116 123
  • go to your nearest A&E and tell the staff how you're feeling
  • contact NHS 111
  • make an urgent appointment to see a GP

Find out more about getting help if you're feeling suicidal

What to do if you're worried about someone

If you're worried that someone you know may be considering suicide, try to encourage them to talk about how they're feeling.

Listening is the best way to help. Try to avoid offering solutions and try not to judge. 

If they have previously been diagnosed with a mental health condition, such as depression, you can speak to a member of their care team for help and advice.

If you have a dissociative disorder, getting help and support is an important part of the recovery process.

Talking to your partner, family and friends about how your past experiences have affected you can help you come to terms with what happened, as well as helping them understand how you feel.

Mental health charity Mind has more information on dissociative disorders and a list of support organisations.

Reading about other people with similar experiences may also help.

You can read people's personal accounts of living with a number of different mental health conditions on healthtalk.org.

Источник: https://www.nhs.uk/conditions/dissociative-disorders/

Dissociative Identity Disorder: What Is It, Symptoms & Treatment

What Is Dissociation?

Dissociative identity disorder (DID) is a mental health condition. People with DID have two or more separate identities. These personalities control their behavior at different times. Each identity has its own personal history, traits, s and diss. DID can lead to gaps in memory and hallucinations (believing something is real when it isn’t).

Dissociative identity disorder used to be called multiple personality disorder or split personality disorder.

DID is one of several dissociative disorders. These disorders affect a person’s ability to connect with reality. Other dissociative disorders include:

How common is DID?

DID is very rare. The disorder affects between 0.01 and 1% of the population. It can occur at any age. Women are more ly than men to have DID.

DID is usually the result of sexual or physical abuse during childhood. Sometimes it develops in response to a natural disaster or other traumatic events combat. The disorder is a way for someone to distance or detach themselves from trauma.

What are the signs and symptoms of DID?

A person with DID has two or more distinct identities. The “core” identity is the person’s usual personality. “Alters” are the person’s alternate personalities. Some people with DID have up to 100 alters.

Alters tend to be very different from one another. The identities might have different genders, ethnicities, interests and ways of interacting with their environments.

Other common signs and symptoms of DID can include:

There isn’t a single test that can diagnose DID. A healthcare provider will review your symptoms and your personal health history. They may perform tests to rule out underlying physical causes for your symptoms, such as head injuries or brain tumors.

Symptoms of DID often show up in childhood, between the ages of 5 and 10. But parents, teachers or healthcare providers may miss the signs. DID might be confused with other behavioral or learning problems common in children, such as attention deficit hyperactivity disorder (ADHD). For this reason, DID usually isn’t diagnosed until adulthood.

Some medications may help with certain symptoms of DID, such as depression or anxiety. But the most effective treatment is psychotherapy. A healthcare provider with specialized training in mental health disorders, such as a psychologist or psychiatrist, can guide you toward the right treatment. You may benefit from individual, group or family therapy.

Therapy focuses on:

  • Identifying and working through past trauma or abuse.
  • Managing sudden behavioral changes.
  • Merging separate identities into a single identity.

Can hypnosis help with DID?

Some healthcare providers may recommend hypnotherapy in combination with psychotherapy. Hypnotherapy is a form of guided meditation. It may help people recover suppressed memories.

There’s no way to prevent DID. But identifying the signs as early in life as possible and seeking treatment can help you manage symptoms. Parents, caregivers and teachers should watch for signs in young children. Treatment soon after episodes of abuse or trauma may prevent DID from progressing.

Treatment can also help identify triggers that cause personality or identity changes. Common triggers include stress or substance abuse. Managing stress and avoiding drugs and alcohol may help reduce the frequency of different alters controlling your behavior.

There is no cure for DID. Most people will manage the disorder for the rest of their lives. But a combination of treatments can help reduce symptoms. You can learn to have more control over your behavior. Over time, you can function better at work, at home or in your community.

A strong support system can make living with DID more manageable. Make sure you have healthcare providers, family members and friends who know about and understand your condition. Communicate openly and honestly with the people in your support system, and don’t be afraid to ask for help.

If a friend or family member has DID, how can I help?

Having a loved one with DID can be confusing and overwhelming. You may not know how to respond to their different alters or behaviors. You can help by:

  • Learning about DID and its symptoms.
  • Offering to attend family counseling or support groups with your loved one.
  • Staying calm and supportive when sudden behavior changes occur.

When should I call my doctor about DID?

If you or someone you know has DID and exhibits any of the following symptoms, seek medical attention right away:

  • Self-harm.
  • Suicidal thoughts.
  • Violent behavior.

You can call the National Suicide Prevention Lifeline at 800.273.8255. This hotline connects you to a network of local crisis centers that provides free and confidential emotional support. The centers support people in suicidal crisis or emotional distress 24 hours a day, 7 days a week. In an emergency, call 911.

A note from Cleveland Clinic

Dissociative identity disorder (DID) is a mental health condition. Someone with DID has multiple, distinct personalities. The various identities control a person’s behavior at different times. The condition can cause memory loss, delusions or depression.

DID is usually caused by past trauma. Therapy can help people manage their behaviors and reduce the frequency of identity “switches.” It’s important for anyone with DID to have a strong support system.

Healthcare providers, family members and friends can help people manage DID.

Last reviewed by a Cleveland Clinic medical professional on 05/25/2021.

References

Источник: https://my.clevelandclinic.org/health/diseases/9792-dissociative-identity-disorder-multiple-personality-disorder

What Is Dissociation?

What Is Dissociation?

Dissociation can feel very scary, especially when we don’t know what it is we’re experiencing. By learning more about it, we can begin to understand what we’re going through and develop ways to manage it.

The dictionary definition of dissociation is ‘the splitting off of a group of mental processes from the main body of consciousness.’ Another definition is ‘the action of separating yourself, or considering yourself to be separate from something or someone’.

Reading a definition doesn’t always help us to picture it, though. It can be hard to put an abstract concept into words.

We’ve probably heard the term ‘association’ at some point. If we’re associated with someone or something, we usually talk about being linked to them. If one of our associates does something we don’t agree with, then we might choose to ‘dissociate’ from them. We could also describe this as ‘separating ourselves from them’.

In a mental health context, when we dissociate we feel separate or disconnected from ourselves and the world around us. We might not be aware of our actions and could find that we chunks of time that we can’t remember; also known as ‘blanks’. We don’t know where we were, what did, who we saw, or what we said. This can be really scary.

Symptoms Of Dissociation

Feeling disconnected isn’t the only symptom associated with dissociation.

We might struggle to process intense emotions. Mood swings can be common. Sometimes it can lead to depression or anxiety. Our memory is often affected, as are other areas of our cognition such as concentration.

We might feel compelled to behave a certain way, struggle with our identity, and be confused about who we are which can further affect our behaviour. Some of us will struggle to remember personal things. We could feel confused, spacey, dazed, foggy-headed, lost, and ‘un-anchored’.

The world might not feel real. We could experience ‘confused, dazed wandering’ also known as ‘dissociative fugue’.

Dissociative disorders

Dissociation can part of an existing mental health diagnosis such as depression, anxiety, an eating disorder, obsessive compulsive disorder or post-traumatic stress disorder. But we could be diagnosed with a dissociative disorder in its own right.

There are a few different types of dissociative disorder, but each of them features dissociation at their core. As well as the diagnoses listed below, we could also experience dissociation as part of an ‘unspecified dissociative disorder’ or an ‘other specified dissociative disorder’.

Dissociative Amnesia

If we live with dissociative amnesia, we will have no memory of certain events or past experiences. We might also struggle to remember information about ourselves. In some instances, we might forget some of the skills we’ve learned.

‘Bewildered wandering’ or ‘purposeful travel’ can be a symptom of dissociative amnesia. For example, we might find that we’ve walked to a friend’s house but not be able to remember leaving our house, walking to their house, or the reason for visiting this friend.

We might have memory blanks that last days, weeks, months, or even years. Sometimes we’ll be aware of these memory blanks. But there might be times when we have no idea that we’ve forgotten certain things until someone talks about a memory that we have no recollection of.

Dissociative amnesia isn’t the same as forgetfulness or ‘not knowing where the time has gone’. We all have times when we’re super-engrossed in our work and haven’t noticed it getting dark around us. ‘Where has the time gone?!’ is a phrase many of us utter now and again. But neither of these situations mean that we’ve been dissociating.

Dissociative Identity Disorder (DID)

Another name for Dissociative Identity Disorder (DID) is ‘multiple personality disorder’.

If we live with it, then we might struggle to pin down our identity or form a picture of who we are. We might write in different styles, talk about ourselves as if we’re a group (eg. ‘we went to the park’ as opposed to ‘I went to the park), behave character, feel as though there are multiple people within us, or feel a stranger to ourselves.

For a diagnosis, we need to have at least two distinct ‘personality states’.

Depersonalisation/Derealisation Disorder

Depersonalisation describes a state where we feel totally detached from ourselves. We could feel as though we’re ‘floating’ above ourselves, watching ourselves do things. Time might feel strange and we might not be able to connect with things we’re feeling emotionally or physically.

Derealisation is a state where we feel detached from our surroundings. The world around us can feel foggy, distorted, and ‘dream’

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Living With Dissociation

Dissociation can bring up all sorts of different emotions.

Sometimes it’s scary. It’s not nice to feel as though we’re not in control of our body or mind. Being unable to remember things is tough, especially when others can remember them. Sometimes our lack of memory can feel embarrassing or shameful.

There are times when we get frustrated or angry. Dissociation isn’t necessarily within our control and can take up a lot of our time. If we’ve planned or day and then dissociate for six hours, then we’re probably not going to be able to fit everything in. Sometimes we almost want to shake ourselves.

Dissociation can impact all areas of our life. It could crop up when we’re working, relaxing, looking after our kids, walking down the street, or doing the weekly shop. It can create problems within our relationships. For some of us, it can be incredibly disabling.

What Causes Dissociation?

We still have a lot to learn about dissociation. At the moment, our understanding is that it’s a way for our mind to cope with too much stress.

It’s often linked with trauma, for example, a car crash, abuse, war, kidnapping, medical procedure, assault, bereavement, or anything else that resulted in us fearing for our safety and/or being seriously injured or violated. A traumatic experience doesn’t have to have affected us directly.

We may have witnessed it, learned that it’s happened to a close family member or friend, or we might be repeatedly exposed to details of traumatic events (for example, if we’re a counsellor). Substance misuse can also cause dissociation.

Dissociating can be a way to switch off or detach ourselves from an awful event. It can be a coping strategy to help us get through traumatic situations. To a point, it can help us to protect ourselves from the full impact of a bad experience. The problem is that if we continue to dissociate once we’ve reached a place of safety, then it can be distressing and interfere with our life.

It’s important to remember that not everyone who goes through a traumatic event will develop a mental health problem or a dissociative response. There are lots of factors that can affect how we respond to things including any previous traumas we’ve had, other life stressors, genetics, how much support we have, our neurology, and any existing mental health conditions we live with.

Triggers

We might have heard the term ‘trigger’. It’s a term we often use when talking about things flashbacks or panic attacks but can also be used for dissociation.

If we think about a standard anxiety-provoking event and view our stress levels as a curve on a graph, it might look a hill. We start off totally chilled. Then, if we encounter a ‘trigger’, our stress levels can begin to rise. As they rise, we start to feel the physical symptoms of anxiety.

This is a normal, human response, and helps us to perform to the best of our ability. At the top of the curve, we’re at peak performance. Adrenaline is flooding our body and we’re feeling stressed, but it feels manageable.

For most people, once the ‘trigger’ has passed our stress levels will drop again.

When we’re ‘triggered’, we fly past the manageable peak of this curve. Our stress levels keep climbing until we reach the ‘I don’t think I can cope’ zone. At this point, our brain shuts off. We can’t take any more. So we disconnect and dissociate.

Common triggers include stress, lack of sleep, loud or sudden noises, sensory overload, conflict, change, overwhelm, or something that reminds us of a previous traumatic incident.

Things That Can Help When We Dissociate

There are a range of things we can do to help with dissociation.

Grounding can be really helpful when we dissociate. It’s a way of keeping ourselves connected to ourselves and our environment.

There are loads of different grounding techniques. They include things naming one thing for each ‘sense’ something you can see, hear, touch, smell and taste.

We could try to find something in the room for each letter of the alphabet or each colour of the rainbow. Using fidget toys can give us something tactile to focus on.

We might find it helpful to write affirmations or facts about ourselves and then read them when we start to struggle.

If we’re someone who dissociates on public transport or when in public places, we might want to speak to a friend or family member about it. They could accompany us when we go out if that would help us to feel safer.

For some of us, dissociation will affect our ability to drive. If we start to dissociate when rushing down the motorway at 70mph, it’s not safe. In the UK, if we have a medical condition that affects our ability to drive then we need to tell the DVLA.

Wider Things That Can Help

There are some things we can do ‘in the background’ to try and reduce how often we dissociate.

If we don’t meet our basic needs, we probably won’t feel our best. Making sure we get our basic self-care sorted can provide a strong foundation. This includes things getting into a sleep routine, drinking enough water, and eating a varied diet.

Keeping a log of times when we slip into dissociation can help us to identify patterns or triggers that commonly occur. We can use this information to make adjustments to our lives and hopefully start to reduce the number of times we dissociate.

Dissociation is linked to stress, so anything that can help us relax and ‘de-stress’ can help. This could include things making sure we take our breaks at work, listening to calming music, practising mindfulness or meditation and having a calm space that we can retreat to on an evening.

Treatment Options For Dissociation

Talking therapies can help us to work through the underlying causes of our dissociation. We might need specific trauma therapy or trauma-informed care. Therapy can also help us to learn new skills and techniques to manage our dissociation.

Sometimes medication is an option. There aren’t any specific dissociation medications but sometimes  antidepressants might be appropriate.

Getting Support With Dissociation

We don’t have to live with dissociation alone. Our GP would be happy to speak to us about it, or we could contact our local mental health team if that’s an option in our area. If we feel really unsafe, we could ring 111 or in emergencies, go to A&E or 999. We deserve help and support.

Please help us to help others and share this post, you never know who might need it.

Источник: https://www.blurtitout.org/2020/08/13/dissociation/

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