Dissociative Disorders
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Dissociative Disorders
Dissociative is the adjective of the noun dissociation and the verb dissociate. From the medical perspective, Merriam Webster Dictionary defined dissociation as separation of personalities. Dissociation could occur at the level of character segments or specific mental processes from the current state of consciousness or behavior (2015, “Dissociation”). If something is dissociative, it has the characteristic of disconnection from other parts.
National Alliance for Mental Illnesses (NAMI) explained that patients of dissociative disorder disconnect from the reality. They lose their thoughts and identity, as well as consciousness and memory (2015). The abnormalities incapacitate the mental abilities of the affected. They are prevalent in all populations regardless of ethnicity, geographical regions, socioeconomic status or any other variations. NAMI pointed out that approximately 2% of the States’ population experiences the disorder. However, mild episodes of the diseases affect half of the Americans at least once in their lives. Gender influences the occurrence of the illnesses, and females are more prone to them than males (2015).Dissociativedisorder accounts for a significant percentage of the few psychiatric problems among the American population.
Signs and Symptom
In most cases, signs of dissociative disorder appear after exposure to physical or mental trauma. War and accidents are major inducers of the symptoms. Victims progressively exhibit deteriorating mental health characterized by stressful moments. Though signs and symptom vary with the specific type of the disorders, stress is a common characteristic of all types. Other common signs and symptoms as NAMI outlined include out-of-body feelings, where patients fail to understand themselves. Patients also fail to develop self-identity, emotional availability, and reliable memories.Usually, people develop anxiety and depression, and they are likely to contemplate suicide (2015).Generally, mental torture is the predominant symptom of the disorder.
Types of Dissociative Disorders
In its DSM-5 manual, the American Psychiatric Association split dissociative disorder into three categories. The three are Dissociative Identity Disorder (DID), Dissociative Amnesia, and Depersonalization Disorder. Some psychiatrists, however, identify two more types of the disorder. The additional two are Dissociative Fugue and the unspecified Dissociative Disorder.Since Dissociative Fugue has most properties seen in Dissociative Amnesia, psychiatrists often classify it under the latter (Spiegel, Fernandez, Lanius, Vermetten, Simeon, & Friedman, 2013, Pg. 299). Different types of the disorder have varied severity of symptoms, as well as thenature of their stressors (Steinberg, 2015).
Dissociative Identity Disorder
DID was commonly referred to as multiple personality disorderuntil recently. The disease mainly traces origin from childhood exposure to physical, sexual or emotional abuse. People exhibit more than one distinctive character. The affected people can assume different behavior and thoughts with time. They easily lose memories about self and experience severe mood swings. Also, patients could have attention deficit disorder impairing their ability to learn.
Diagnoses and Intervention for DID
DID is the severest of the five types of dissociative disorder. Its detection and diagnosis require specialized tests and examinations. As Steinberg explained, hidden symptoms characterize DID, and anxiety, depression or substance abuse could mask the symptoms. Again it is hard to describe the symptomatic disconnection feeling that occur with the disease (2015). The nature of the disease, therefore, makes it hard to diagnose. Psychotherapy is the first-line treatment for the disorder though medication could as well be used.
Dissociative Amnesia
Patients with dissociative amnesia suffer severe inability to recall their personal information. The brain does not have to be necessarily damaged for the condition to occur (Kikuchi, Fujii, Abe, Suzuki, Takaqi, Mukiqura, & Mori, 2010, Pg. 602) In most cases as Steinberg wrote, a single traumatic event is sufficient to cause the disorder. Experiences of disasters, violence and war are the major inducers of the disease (2015).
Diagnoses and intervention of Dissociative Amnesia
When signs of the disorder are present, the examiner would perform physical tests to close out other possible causes of the symptoms, and zero into dissociative amnesia. Treatment is crucial to help individuals restore their memories. Psychotherapy, cognitive therapy as well as medication are the commonest approaches to the problem (Goldberg, 2014, Pg. 2).
Depersonalization Disorder
Patients of depersonalization disorder experience unreal sensations. Their mind seems out of touch with their bodies. The ill cannot connect to the reality and feel as though they are dreaming. Complications of the condition are accompanied by moments of derealization. Again, depersonalization traces origin from trauma and stress.
Diagnoses and intervention of depersonalization disorder
To diagnose depersonalization, physicians perform examinations such as blood tests. Though highly prevalent, the condition is often misdiagnosed (Reutens, Nielsen, &Sachdev, 2010, Pg. 278). Drugs used with psychological counseling to manage depersonalization include clonazepam, fluoxetine and clomipramine (Mayo Clinic Staff, 2014, Pg. 8).
Support for Dissociative Disorder Patients
Patients require assistant to cope with mental instabilities created by dissociative disorder. As Halter and Varcarolis pointed out, victims of the disorder require education on best ways of managing their situation. Nurses could for instance explain to the patients that the diseases result as an adaptive means to experiences (2013, Pg. 319). People associating with the sick should treat them with care to avoid inducing more emotional stress. The patients are emotionally delicate, and they can react strangely to unfriendly stimuli. Nurses and other care givers should offer emotional availability, especially when patients recall the events that traumatized them (Varcarolis& Halter, 2012, Pg. 205).
References
Dissociation. 2011. In Merriam-Webster.com. Retrieved May 25, 2015 from http://www.merriam-webster.com/dictionary/dissociation
Goldberg, J. (2014, July 8). Mental Health and Dissociative Amnesia. WebMD. Retrieved May 25, 2015 from http://www.webmd.com/mental-health/dissociative-amnesia?page=2#1
Halter, M. J., &Varcarolis, E. M. (2013). Varcaroli’s Foundations of Mental Health Nursing. Washington, DC: Elsevier.
Kikuchi, H., Fujii, T., Abe, N., Suzuki, M., Takaqi, M., Makiqura, S.,. . . Mori, E. (2010). Memory Repression. NCBI, 22(3), 602-613 doi: 10.1162/jocn.2009.21212.
Mayo Clinic Staff. (2014). Depersonalization-derealization Disorder. Retrieved May 25, 2015 from http://www.mayoclinic.org/diseases-conditions/depersonalization-derealization-disorder/basics/definition/con-20033401
NAMI. (2015). Dissociative Disorders. Retrieved May 25, 2015 from https://www.nami.org/Learn-More/Mental-Health-Conditions/Dissociative-Disorders
Reutens, S., Nielsen, O., &Sachdev, P. (2010). Depersonalization Disorder. NCBI, 23(3), 278-283 doi: 10.1097/YCO.0b013e3283387ab4.
Spiegel, D, Loewenstein, R. J., Fernandez, R., Sar, V., Simeon, D., Vermetten, E., . . .Dell, P. F. (2011). Dissociative Disorders in DSM-5. NCBI, 28(2011), 824-852
Steinberg, M. (2015). Understanding Dissociative Disorders. Psych Central. Retrieved May 25, 2015 from http://psychcentral.com/lib/in-depth-understanding-dissociative-disorders/1377/
Varcarolis, E. M., & Halter, M. J. (2012). Essentials of Psychiatric Health Nursing. Washington, DC: Elsevier
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