Dissociative disorders

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Dissociative disorders

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Borderline personality disorder p. 582

dissociative identity disorder p. 575

Depression

dissociative identity disorder p. 575

Dissociative disorders p. 575

Dissociative identity disorder p. 575

Post-traumatic stress disorder (PTSD) p. 579, 581

dissociative identity disorder p. 575

Substance abuse

dissociative identity disorder and p. 575

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Maybe you’ve had the experience of driving on “autopilot.” One minute you got in your car, and the next minute you’ve arrived at your destination, but you can’t actually remember the details of the drive. This is an example of normal, everyday dissociation, a term that describes a mental state of disconnection from what is going around you.

Normally this day-dreamy state doesn’t last very long, and most people can snap out of it if something or someone requires their attention.

But for some people, dissociation is more pervasive, and can’t be turned off so easily.

In fact, the feeling of disconnection may become so intense and happen so often that it stops a person from functioning in their daily life. When this is the case, we say the person has a dissociative disorder.

Dissociative disorders are a group of disorders that cause an impaired awareness of one’s own actions, thoughts, physical sensations, and even identity, which is a sense of who you are. Dissociative disorders tend to stem from trauma, usually early childhood abuse or neglect, and are thought to be a way of adapting to negative feelings and experiences.

Dissociative disorders are divided into three main types: depersonalization/derealization disorder, dissociative amnesia, and dissociative identity disorder. Each of these disorders fall along a spectrum of severity, with depersonalization/derealization disorder being the least severe of the dissociative disorders, dissociative amnesia falling somewhere in the middle, and dissociative identity disorder being the most severe. Typically, individuals with more severe dissociative disorders may have elements of less severe ones as well.

With v, depersonalization refers to a feeling of detachment from oneself, your own person, while derealization refers to a feeling that the world around you is not fully real.

Those with the disorder often feel as if they are watching themselves from the outside, maybe watching a movie about their life. They might feel emotionally or physically numb, or have a weak sense of self. Individuals with depersonalization/derealization disorder might speak in a deadpan manner, with little emotion, and have trouble forming relationships.

In severe cases, a person may have trouble recognizing familiar places, people, or objects, and this can make it hard to learn tasks.

Sources

  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "Diagnostic and Statistical Manual of Mental Disorders, Fifth edition (DSM-5)" American Psychiatric Association (2013)
  5. "Prevalence, Reliability and Validity of Dissociative Disorders in an Inpatient Setting" Journal of Trauma & Dissociation (2002)
  6. "Guidelines for the Evaluation and Treatment of Dissociative Symptoms in Children and Adolescents: International Society for the Study of Dissociation" Journal of Trauma & Dissociation (2004)
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