Dealing with dissociative disorders

DISSOCIATION is when there is disconnection from aspects of oneself and or the environment. It is also the lack of connection between thoughts, memories, surroundings, actions and or identity. Dissociative disorders have symptoms that can be very severe as to cause great distress to a person and his or her social and occupational functionality.

Dissociative disorders are typically and originally caused by trauma. This can be physical, sexual and emotional trauma and the dissociation becomes a way to cope with the stress and pressure being experienced.

Dissociative disorders most often form in children subjected to long-term physical, sexual or emotional abuse or, less often, a home environment that’s frightening or highly unpredictable.

The stress of war or natural disasters also can also bring on dissociative disorders to affected persons.

Here is a more detailed look at each type of dissociative disorders:

Dissociative amnesia: This type of dissociative disorder deals with the inability to recall critical personal information. Unlike many other types of amnesia, this one is not associated with physical trauma such as a blow to the head but, rather, a psychological trauma.

A person with dissociative amnesia will often not remember the trauma that caused this disorder in the first place. Additionally, dissociative amnesia has several subtypes:

Localised amnesia: People with localised amnesia have no memory from a specific period of time, usually around the trauma.

Selective amnesia: People with selective amnesia remember only parts of what happened during specific time frames. For example, an abuse victim may remember being on a boat but not the abuse that took place there.

Generalised amnesia: This is a rare form of amnesia; a complete loss of memory encompassing a person’s whole life including his or her identity.

Systemised amnesia: People with systemised amnesia cannot remember a certain category of information. For example, a person may forget all the specifics about a family member who abused him or her.

Dissociative amnesia with fugue; when the dissociative amnesia is associated with confused and bewildered wandering on or a journey of some sort, it is known as dissociative amnesia with fugue. In a fugue state (memory loss), the person is unaware of his or her identity.

Dissociative identity disorder (DID): Used to be called multiple personality disorder; it is the most famous dissociative disorder.

People with DID will dissociate from one identity only to associate with another one, possibly with its own name, gender, age, identity, accent and history. One personality state may not be aware of any others.

Depersonalisation disorder and or Derealisation: This type of dissociative disorder involves feelings of derealisation; feeling that objects from the physical surroundings are changing in shape or size or feelings that other people are inhuman; and/or feelings of depersonalisation; feeling that one is detached from one’s own life and mental processes or that one is viewing one’s life as if it were a movie.

A person with depersonalisation disorder will have persistent and recurrent episodes of life events.

Any persons or individuals with these disorders will need to have a complete psychiatric evaluation and some might need to have head scans to rule out space occupying lesions. Others will need to have an Electro-encephalograpy (EEG) to rule out epilepsy.

DISCLAIMER: This column contains information about mental health related issues. However, the information is not advice, and should not be treated as such. No liability is accepted for any consequences arising from this article.

◆ Dr S. M. Chirisa is a passionate mental health specialist who holds an undergraduate medical degree and postgraduate Master’s degree in psychiatry both from the University of Zimbabwe. He is currently working as a Senior Registrar in the Department of Psychiatry at Parirenyatwa Group of Hospitals and is also the current national treasurer of the Zimbabwe Medical association (ZiMA). He can be reached at drsmchirisa@yahoo.com