There are times when we all want to escape from situations, people and surroundings that we are in and that is possible through daydreaming but unfortunately (or maybe fortunately), that is only short lived and we soon come back to the real world. However, there are people who do experience dissociation frequently and longer term.
What is Dissociation?
If you dissociate you may feel disconnected from yourself and the world around you.
It is a way that the mind copes with too much stress, such as during a traumatic event. It is also a way of adapting to negative feelings and experiences. Children who have been physically/sexually/emotionally abused or neglected long-term are at high risk of developing a dissociative disorder. They use dissociation as a way of blocking out the trauma and may continue to use dissociation as a coping mechanism in response to stressful situations throughout their life. Children and adults who experience other traumatic events also may develop these conditions.
Dissociative disorders are a mental illness that involves experiencing a disconnection from yourself and affects the way that you behave and think.
There is a lack of continuity between your thoughts, memories, surroundings, actions and identity. It is possible to have the symptoms of dissociation without having a dissociative disorder. You may, however, have the symptoms as part of another mental illness – PTSD, depression, anxiety, schizophrenia, bipolar disorder or borderline personality disorder.
Feelings of disconnection can become so intense and can happen so frequently that it stops you from functioning in daily life. This is when you have a dissociative disorder.
Common Symptoms Of Dissociative Disorders
- Amnesia (memory loss) of personal information, certain time periods, events and people
- Feeling disconnected from yourself
- Feeling disconnected from the world around you. A perception of the people and things being distorted and unreal
- Identity confusion – you don’t know who you are
- Identity alteration
- Feeling compelled to behave in a certain way
- Concentration problems
- Losing control of your body movements (seizures, paralysis and loss of sensation)
- Loss of feelings
- Associated mental health problems – PTSD, mood swings, depression, anxiety, panic attacks, phobias, obsessive compulsive disorder, personality disorders, eating disorders.
- Suicidal thoughts/behaviours or self-harm
- Insomnia, nightmares or sleep walking
- Lightheadedness or non-epileptic seizures
- Problems handling intense emotions
- Experiencing stress or problems in important areas of your life and having the inability to cope with it.
Types Of Dissociative Disorders
There are several different types of dissociative disorder but the main 3 types are:
1) Dissociative Identity Disorder
If you are diagnosed with dissociative identity disorder, you may feel uncertain about your identity and who your are. There may be one main part of your identity which feels like you but mostly you feel like a stranger who takes on characteristics of a different person or people. You may refer to yourself as “we” rather than “I.” Your perception of things and the way you think and feel suddenly changes. People with dissociative identity disorder typically also have dissociative amnesia.
2) Dissociative Amnesia
If you have dissociative amnesia, you will have gaps in your life where you cannot remember important information about yourself or things that have happened in your life. You may even forget a learned talent or skill. This disorder is not just a case of forgetfulness, it is more serious and severe than that; it is usually caused by trauma or stress. These blank episodes may last minutes, hours or days. They can last months or even years but this is very rare. There is also a sense of being detached from yourself and your emotions. The four categories of dissociative amnesia include:
- Localised amnesia – for a time, you may have trouble recalling a traumatic event.
- Selective amnesia – you can only recall small parts of the traumatic event that took place in a defined period of time.
- Generalised amnesia – you cannot remember any part of your past life. This is a rare form of amnesia.
- Systematised amnesia – you may have a very particular and specific memory loss; for example, you may have no recollection of one relative.
3) Depersonalisation and Derealisation Disorder
Depersonalisation – You feel as though you are disconnected from parts of your body and mind. You observe actions, feelings/emotions, thoughts and self from the outside. In severe cases you may have trouble recognising familiar places, people or objects.
Derealisation – This involves detachment and a dreamlike feeling that the world is unreal and that people and things going on around you are functioning very slowly or at high speed.
How Are Dissociative Disorders Diagnosed?
Diagnosis usually involves a physical examination, assessment of symptoms, looking at your medical history and ruling out medical conditions that could cause the symptoms. This is initially undertaken by a GP who will then refer you to a mental health professional who will carry out a full assessment and testing.
During the assessment, you will be asked how you are feeling, if you have been prescribed medication or if you take recreational drugs (some can cause dissociative disorders) and whether you have had any traumatic experiences in the past. In order for a correct diagnosis to be made and for you to get the right treatment, help and support that you need, it is important for you to be honest and not feel embarrassed or ashamed.
Treatment For Dissociative Disorders
Talking therapies are often recommended for dissociative disorders. Counselling or Psychotherapy will help you to cope with your thoughts, feelings and behaviours as well as the underlying cause(s) of your symptoms (i.e. the traumatic event(s) in your life) when the time is right – helping you to understand why you dissociate as a coping mechanism. You will be helped to form new ways of coping with stressful circumstances. When you have your own toolkit and have a good, trusting relationship with your therapist, they will support you to explore your trauma in a safe space.
There are no medications that specifically treat dissociative disorders although you may be prescribed antidepressants, anti-anxiety medications or antipsychotic drugs to help control some of the symptoms associated with dissociative disorders.
Self Help For Dissociative Disorders
- Keep a journal. This will help you to remember any gaps in your memory – improving the connections and awareness between different parts of your identity
- Practise visualisations – Imagine and visualise places and situations when you can relax and feel safe
- Wear a watch – pick one which not only tells you the time but the date as well
- Keep a list of contact details for family, friends and professionals – you may like to save a photo of them and a few facts about them too
- Attend all appointments with your therapist
- Join a support group, online or offline
- Do some grounding exercises such as:
– Breathing slowly. If you are able to sit on the floor then that’s great! Bang your feet down and also put your hands down on the floor. If it’s not possible to sit, just stamping your feet a little bit and letting yourself connect with the earth will be helpful. You just want to give yourself a feeling of being grounded and any way you can do that is a good thing. Another way is simply to just walk around bare-foot!
– Holding something and trying to focus on the touch and the texture of the item also helps with feeling grounded. (A lot of our clients use crystals)
– Listening to the sounds around you
– Wrapping yourself in a blanket and feeling it around you. You may like to try a weighted blanket for extra security
- Use mindfulness techniques, meditation, yoga or other forms of exercise designed to help manage stress and reconnect with your body
- Eat a balanced and nutritious diet
- Establish a good sleep routine
- Make a personal crisis plan which will come into action if you are not well enough to make decisions about your treatment or other aspects of your life.
It is possible to make a full recovery from dissociative disorders with holistic, tailored treatment and support.
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