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Post-traumatic stress disorder, commonly known as PTSD, is an anxiety disorder that develops in reaction to physical injury or severe mental or emotional distress. Although this disorder is widely acknowledged, few know about other disorders that are the aftermath of a traumatic event.
Dissociative disorders are mental disorders in which an individual experiences a disconnection and lack of continuity between thoughts, memories, surroundings, actions and identity. Usually developing as a reaction to sexual or physical abuse during childhood, the disorder is a way for the individual to distance themselves from traumatic memories (Mayo Clinic, 2022). Although much research has been conducted on dissociative disorders, and three different disorders are acknowledged in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a large portion of the social world continues to be uneducated on them, causing significant stigma.
Dissociative disorders have a long history of being grossly misunderstood, especially throughout history, often being labelled as hysteria. However, once the disorder was defined in the DSM-3, it started being treated as a new disorder. Sigmund Freud, the founder of psychoanalysis, and Pierre Janet, a pioneer in the field of dissociation and traumatic memory, were heavily influenced by dissociative phenomena in their creation of their theories of the human mind. The acknowledgement of these disorders in modern day psychiatry allows for clinicians to understand mental conditions better and identify a population that has been misdiagnosed for years (Okano, K. 2011).
Three major dissociative disorders are defined in the DSM-5, a manual published by the American Psychiatric Association which serves as a reference book on mental health and brain related conditions and disorders.
The first is known as dissociative amnesia, characterised by memory loss that is more severe than normal forgetfulness and that cannot be attributed to a medical condition. With this disorder, an individual may not remember information about themselves or the people and events in their life, especially relating to the time of the trauma. Dissociative amnesia can be both specific to a certain time or involve complete memory loss about oneself. Episodes of amnesia occur suddenly, and may last from minutes to, rarely, up to months or years.
The second dissociative disorder is known as Dissociative Identity Disorder (DID). Previously known as multiple personality, it is characterised by switching to alternate identities, and feeling the presence of two or more people talking and living inside one’s head. Each identity may have a unique name, history, and characteristics, as well as gender, mannerisms, and even physical qualities such as the need for eyeglasses. Individuals suffering from DID often experience dissociative amnesia as well.
People with DID exist on a spectrum, and while some are able to maintain a stable family and work life, others are severely disabled by their condition and may have little control of their trauma-based parts and the switching between those parts. Since DID is often accompanied by other PTSD symptoms such as flashbacks and difficulties with sleep, it is not surprising that daily life can be extremely challenging for individuals struggling with this disorder (Spring, 2012).
The third disorder is known as depersonalisation-derealisation disorder, characterised by an ongoing or episodic sense of detachment or being outside oneself. An individual with this disorder may feel they are observing their actions and feelings from a distance, and other people may feel foggy or dreamlike. Symptoms of this disorder can be profoundly distressing and may last from a few moments to many years.
The treatment of each disorder may vary, but generally involves both psychotherapy and medication. Psychotherapy refers to a variety of treatments that help an individual identify and change certain emotions and behaviours. Psychotherapy can occur individually, in a one-on-one setting with a mental health professional, or in groups. In this case, the professional may help to elaborate the trauma and find new coping mechanisms for the stressful situations an individual may experience. The medication that may be prescribed does not specifically treat dissociative disorders but may allow for reduction of their symptoms. Commonly prescribed medication to individuals struggling with dissociative disorders includes anti-depressants, anti-anxiety medications or antipsychotic drugs. Although these disorders are well documented, the stigma surrounding them is still strong. Movies like ‘Split’, a Hollywood thriller about a man who has 23 alter egos and kidnaps three teenagers, breeds misinformation and unhealthy discourse surrounding the disorder. Not only that, but they inspire fear of people who have these disorders, causing them to potentially hide their diagnosis out of fear or embarrassment. As these disorders are already not discussed enough, it is important to acknowledge them in the right way and change the discourse to positive, education-oriented discussion, rather than unrealistic and offensive points of view.
By Carlotta Menozzi
Dissociative disorders – Diagnosis and treatment – Mayo Clinic. (2022, December 13). Dissociative Disorders – Diagnosis and Treatment – Mayo Clinic. Retrieved January 26, 2023, from https://www.mayoclinic.org/diseases-conditions/dissociative-disorders/diagnosis-treatment/drc-20355221
C. (n.d.). Dissociative Identity Disorder: What Is It, Symptoms & Treatment. Cleveland Clinic. Retrieved January 26, 2023, from https://my.clevelandclinic.org/health/diseases/9792-dissociative-identity-disorder-multiple-personality-disorder
Spring, C. (2012, July 1). What is dissociative identity disorder (DID)? | Carolyn Spring. Carolyn Spring. Retrieved January 26, 2023, from https://www.carolynspring.com/blog/what-is-dissociative-identity-disorder-did/
[Dissociative disorder–the concept and its history] – PubMed. (2011, January 1). PubMed. Retrieved January 26, 2023, from https://pubmed.ncbi.nlm.nih.gov/22117394/