• If you dissociate you might have symptoms such as not feeling connected to your own body, or developing different identities.
• Dissociative disorders are a mental illness that affects the way you think. You may have the symptoms of dissociation, without having a dissociative disorder. You may have the symptoms of dissociation as part of another mental illness.
• There are lots of different causes of dissociative disorders.
• You may get medication and talking therapies for dissociative disorders.
• who you are,
• what happened to you, or
• how you felt at the time of the trauma.
This is not the same as simply forgetting something. It is a memory ‘lapse’. This means you cannot access the memories at that time, but they are not permanently lost.
With dissociative amnesia you might still engage with other people, such as holding conversations. You might still remember other things, and live a normal life. But you might have flashbacks, unpleasant thoughts or nightmares about the things you struggle to remember.
You may have dissociative amnesia with dissociative fugue. This is where someone with dissociative amnesia travels or wanders somewhere else, related to the things they can’t remember. You may or may not have travelled on purpose.
If you have DID you might seem to have 2 or more different identities, called ‘alternate identities’. These identities might take control at different times.
You might find that your behaviour changes depending on which identity has control. You might also have some difficulty remembering things that have happened as you switch between identities. Some people with DID are aware of their different identities, while others are not.
There is a lot of disagreement between researchers over the notion of DID. While we think of someone with DID as having different identities, some researchers think that these are actually different parts of one identity which are not working together properly. They suggest that DID is caused by experiencing severe trauma over a long time in childhood. By experiencing trauma in childhood, you take on different identities and behaviours to protect yourself. As you grow up these behaviours become more fully formed until it looks like you have different identities, when in fact the different parts of your identity don’t work together properly.
• You dissociate regularly and have done for a long time. You might dissociate in separate, regular episodes. Between these episodes you might not notice any changes.
• You have dissociation from coercion. This means someone else forced or persuaded you. For example, if you were brainwashed, or imprisoned for a long time.
• Your dissociation is acute. This means that your episode is short but severe. It might be because of one or more stressful events.
• You are in a dissociative trance. This means you have very little awareness of things happening around you. Or you might not respond to things and people around you because of trauma.
Psychiatrists use this diagnosis when they choose not to give a reason that you have the symptoms. Or if they do not have enough information for a specific diagnosis. For example, after a first assessment in accident and emergency.
• there is a lack of information about it,
• some patients do not report their symptoms, and
• doctors who don’t know enough about it, meaning they under-report the condition.
With DPDR you might have symptoms of depersonalization or derealization or both.
With depersonalization you might feel ‘cut off’ from yourself and your body, or like you are living in a dream. You may feel emotionally numb to memories and the things happening around you. It may feel like you are watching yourself live.
There are different things that can cause you to dissociate. For example:
• traumatic events,
• difficult problems that cause stress, and
• difficult relationships.
Other researchers have suggested that the use of cannabis may be a cause of depersonalization/derealization disorder (DPDR).
Dissociative disorders are managed through various therapies including:
• Psychotherapies such as cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT)
• Eye movement desensitization and reprocessing (EMDR)
• Medications such as antidepressants can treat symptoms of related conditions
If you are needing a referral to a psychologist, psychiatrist or support group, please can you call The South African Depression and Anxiety Group (SADAG) on 011 234 4837 or 0800 20 50 26 and speak to a trained counselor who can assist you further.
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