What is a Dissociative Disorder and How is it Treated?

Dissociative disorders are understood by the deterioration of consciousness, memory, identity, emotion, perception, behaviour and integrity of perception of the environment and are not associated with any physical disease or brain damage. People experiencing such problems at Moodist Psychiatry and Neurology Hospital are supported by methods such as psychotherapy and medication.

Dissociative disorders are grouped under four main headings: ‘Multiple Personality Disorder’, ‘Dissociative Amnesia’, ‘Dissociative Fugue’ and ‘Depersonalization-Derealization Disorder’. Dissociation means ‘separation, dispersion, dissolution, rupture ’. Dissociative disorders are not associated with any physical disease or brain damage. It is the deterioration of consciousness, memory, identity, emotion, perception, behaviour and integrity of perception of the environment. Dissociative disorders may be sudden or gradual, temporary or chronic. Dissociation usually addresses‘ division ‘, but it should be kept in mind that it is also a process in which one tries to achieve the spiritual integrity one feels incomplete.

Dissociation occurs in order to overcome recurrent traumatic experiences in adolescence or preadolescence, and after a while, it begins to disrupt one’s perceptual integrity. In Moodist Psychiatry and Neurology Hospital, many treatment methods such as psychotherapy and drug therapy are applied in the solution of dissociative disorders.

Types of Dissociative Disorders

Multiple Personality Disorder: The person develops multiple identities and each identity developed has a separate name, socioeconomic status, cultural characteristics and own feelings, thoughts or behaviours. In multiple personality disorder, the different identities created have very different properties than the real identity. The main personality, called ‘the host’, is quiet, reserved, compliant, while others can be extroverted and free. The person can switch from one identity to another in a very short time and is under the influence of the identity he/she assumes at that moment and cannot remember his/her behaviours usually under the control of another character.

Dissociative Amnesia: It is the most common group of dissociative disorders. Personal information that causes stress or is traumatic in a person’s life suddenly disappears and is not remembered without any brain disorder. Dissociative amnesia cannot be explained as a simple forgetfulness, and memory about general information is not affected. In addition, one’s ability to learn new information continues. Apart from these symptoms, there is no impairment in the functionality of the person.

Dissociative amnesia: limited, common, selective, and persistent amnesia. Limited amnesia is a type of amnesia associated with several hours or several days of events, widespread amnesia, selective amnesia associated with all one’s life experiences, and forgetting about some events and individuals. Continuous amnesia, on the other hand, is the type of amnesia that has a beginning and is immediately forgotten after the events that have occurred since then.

Dissociative Fugue: It is very rare among dissociative disorders. It is the sudden departure of the person from his/her home and work by forgetting his/her past and important identity information. The person is not aware of the memory loss related to his/her identity and may develop a new identity. In this process, traveling for a long time in the form of wandering is seen. Dissociative fugue is usually short-term.

Depersonalization Derealization Disorder: It is the feeling of constant and repetitive separation from one’s body by feeling like one is watching oneself from the outside or in a dream. Symptoms such as leaving the body, feeling like you are not living, looking at yourself from the outside, feeling like a robot, feeling that your hand foot has changed, not being able to recognize yourself may be seen.

Derealization, on the other hand, is the perception of one’s environment in an unrealistic way. These symptoms may recur, last several hours, or be seen continuously. It can be defined as situations in which the person becomes alienated from himself/herself and his/her environment. In both disorders, there is no impairment in people’s ability to evaluate the truth. Depersonalization and derealization are frequently seen together and may be accompanied by some psychiatric disorders.
Symptoms of Dissociative Disorders: People with dissociative disorder may experience physical complaints, chronic pain, fainting, tantrums, suicidal thoughts and inability to remember any event during the day without an organic cause. In addition, these people may behave inappropriately and disproportionately in their relationships such as sudden sadness, laughter, and being aggressive. The most common symptom is fainting, which can be in the form of struggle and contraction similar to epileptic seizure.

In such cases, the experts of Moodist Psychiatric Emergency Service, which is open 24/7, make the necessary intervention immediately. 

Where do Dissociative Disorders Come From?

Some of the most important causes of dissociative disorder are traumatic events such as physical (beating, severe punishment), sexual and emotional (failure of the caregiver to meet basic needs, continuous negligence) in childhood. Disosion, which was developed as a defense mechanism after these traumatic events, provides escape from trauma and delays the effect of trauma on a person’s life. These dissociative disorders require careful and scientific approaches. 

The Medical Team of Moodist Psychiatry and Neurology Hospital manages the treatment process with multifaceted scientific approaches and patience.

How are Dissociative Disorders Treated at Moodist?

Moodist Psychiatry and Neurology Hospital plans treatment in accordance with the subjective psychological needs of the person with the most advanced treatment facilities and expert psychiatrist and psychologist staff that provide the conditions required by science and technology in mental and brain health related diseases.

Treatment methods and supportive approaches used at Moodist Psychiatry and Neurology Hospital include: 

  • Drug Treatment
  • Psychometric Tests
  • Psychotherapies (CBT, EMDR, Psychodynamic, Mindfulness, Hypnotherapy, Psychotherapy, Schema, Family, Group)
  • Ergotherapy (Music, Painting, Marbling Art, Ceramics, Handicrafts, Body and Motion Therapy, Sports, Kitchen Workshop)
  • Psychological Education
  • Somatic Treatments (ECT, TMS)
  • Rehabilitation Programs
  • Inpatient Treatment

There are two main approaches to treatment, which are drug and psychotherapy collaboration. 
At Moodist Psychiatry and Neurology Hospital, firstly, patients and patient relatives are told how to follow a path in accordance with the determined treatment method.

Moodist Psychiatry and Neurology Hospital specialists can consult various psychological tests to make the correct diagnosis and to create an effective treatment plan. These psychometric tests performed by specialist psychiatrists and psychologists are scientifically based measurement and evaluation tools.

The place of psychotherapies is very important in coping with dissociative disorder, recognizing symptoms, early detection, increasing treatment compliance and social-occupational functionality. In the treatment of dissociative disorders by Moodist Medical Team; Cognitive Behavioural Therapy, EMDR (desensitization and reprocessing with eye movements), Psychodynamic, Mindfulness, Hypnotherapy, Psychodrama, Schema as well as individual psychotherapies such as family and group therapies are also applied. In therapy, the person is assisted in the causes, how, and in what situations the condition begins.

In Moodist Psychiatry and Neurology Hospital, ergotherapy activities including music, dance, marbling art workshop, painting, sports and ceramics are also carried out to help patients recover, socialize and lead a healthy life, to improve their self-confidence and abilities and to enable them to use these developments in daily life.

It is seen that there are problems in the family as a result of dissociative disorders. For this reason, Moodist Hospital Medical Team includes family members in the treatment process and conducts informative psych education studies on eating disorders for families. Thus, it was observed that the rates of discontinuation of treatment decreased and the deadlock in the relationships of the family with the patients was defined and the compliance within the family increased.

ECT (Electro Convulsive Therapy) and TMS (Transcranial Magnetic Stimulation) treatment can be applied in Moodist Psychiatry and Neurology Hospital when necessary. Electroshock is given to the anterior part of the brain under general anesthesia with ECT during periods of intense resistance to treatment and disease. Since the person is under anesthesia, he/she does not experience ECT treatment exactly. With this treatment, rapid release of brain biochemicals is seen. Clinical improvement is achieved by applying TMS to predetermined areas related to mental illnesses and creating electrophysiological changes there. During the application, the coil forming the magnetic current is placed over the scalp to the point where the target brain region is located. It is applied over the scalp without any intervention to the body. According to the diagnosis of psychiatric disease, the target area and the severity of the magnetic current to be applied are determined.

Treatment of dissociative disorders can be sustained in many ways. Inpatient treatment is also very important. In severe cases deemed necessary, the patient should receive inpatient treatment. 

Patient safety and comfort are at the forefront of Moodist.

Moodist Psychiatry and Neurology Hospital has a 75-bed psychiatric inpatient service where patients will be treated comfortably and reliably. Medical surveillance and interventions are at the forefront in the services where patients do not undergo any additional intervention other than the restrictions deemed necessary by their own doctors and where patients can move to their own rooms and common areas of their own free will.

Technical equipment and arrangements are designed with unbreakable glass and soft-angled furniture to eliminate the possibility of patients harming themselves and their surroundings in these services. Experienced psychiatrists, psychologists, nurses and auxiliary health personnel are available 24 hours a day. There is a multi-purpose hall, 1 activity room and 1 smoking room shared by the patients in the service. Inpatients can participate in many studies such as morning meeting accompanied by psychologists and nurses, music, dance, marbling art workshop, painting, sports and ceramics. If the doctors deem it appropriate, the patients can spend free time in the private gardens owned by the hospital at certain times and see their relatives within the scope of the specified visiting hours.

The information on this page has been prepared by the Moodist Psychiatry and Neurology Hospital Medical Team.

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