Psychiatric diagnosis in the past has not always included a dissociative disorder, such as dissociative identity disorder (DID), depersonalization disorder, dissociative amnesia or dissociative fugue, yet this constellation of illnesses has been reconsidered in recent years. Part of the confusion surrounding these disorders is that they often manifest symptoms associated with other illnesses, such as depression, post traumatic stress syndrome, or eating disorders. Offering treatments for those problems doesn’t generally result in improvements for those with dissociative disorders because the actual underlying disorder isn’t addressed.
People may think of an illness involving multiple personalities when they hear about a “dissociative” disorder, but the term actually covers the four different disorders, which again are dissociative amnesia, fugue (where the person wanders away to start a new life with no memory of the past), dissociative identity disorder (or DID, the one involving multiple personalities), and depersonalization. These are not anxiety disorders, though it’s true that amnesia and fugue frequently result from some kind of trauma, and DID usually develops from ongoing childhood trauma that prevents the child from integrating their personality normally while growing up.
Current treatments for a dissociative disorder pretty much always have psychotherapy as one of the elements, though hypnosis is frequently a key method for helping the amnesia patients restore the memories of a traumatic event or remember their real identity. Certain drugs, such as the medication called Pentothal (or thiopental) can also help restore memories that have been blocked out. For DID, the primary treatment is long-term psychotherapy to explore the past traumas and resolve them so the different personalities merge into one. Sometimes if the person’s behaviour becomes too aggressive or strange, medical treatments in a hospital are used in conjunction with the psychological treatments. Depersonalization, too, is resolved with psychotherapy.
It may take considerable work, not to mention time, to see results in treating a dissociative disorder. Treating dissociative fugue can sometimes bring quick recovery, but resolving traumatic amnesia or depersonalization can take longer. And even with the best treatments, dissociative identity disorder has been known to recur sometimes, though the likelihood becomes less as the person ages. Looking at these success rates, people might become discouraged about getting treatment. Yet these disorders show so many symptoms of other problems like depression, or eating or anxiety disorders, that the underlying illness does need to be treated if the person is to have any chance at recovery.
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Diseases, Conditions and Treatments • September 24th, 2009 •