Tuesday, 23 September 2014

Dissociative Disorders



               

Some people when overwhelmed by a traumatic experience, experience an altered state of consciousness which is detached from reality of what is happening. Dissociation can be seen as a coping mechanism to reduce anxiety and stress to overcome the trauma, but it interferes with active, realistic coping.
         
Dissociation often involves feelings of unreality, estrangement( being alone from group),and depersonalisation, and some times loss of or shift of self identity.Less dramatic dissociation happens to everyone when a catastrophe hits us.  We too feel everything is strange, unnatural,and different.
All dissociative disorders have large memory gap and changes in social roles. Change may happen drastically or gradually. May last only for few period or be chronic. The alteration of consciousness serves to blot out painful experiences.  Types of Dissociative Disorders are-

1.Dissociative Amnesia-
          
It extensive but selective memory loss in the absence of indications of organic change.  The memory loss occurring is too extensive than normal forgetting. Some people cannot remember anything about the past. Others can no longer recall specific events, people, places, or objects, while other memories remain intact. Usually precipitated by emotionally traumatic event or physical accident. This is the most common type of dissociative disorders. More in adolescents and young adults.
Several types of Dissociative Amnesia are-
(a)  Localized Amnesia- fail to recall events of a particular period.
(b)  Selective Amnesia- Person recalls some but not all of events in a particular period.
(c)  Generalized Amnesia- failure to recall persons entire life. Rare
(d)  Continuous Amnesia- inability to recall events after a specific time, until present.
(e)  Systematized Amnesia- Loss of memory for certain categories of Information such as memories relating to a specific person.

2.Dissociative Fugue-
           Essential feature of fugue is travel away from home and customary workplace, the assumption of a new identity, and inability to recall previous identity. The travel is more purposeful than wandering of dissociative amnesia. Such people set up a new life in some distant place as a different person. 
The fugue state ends when the person wakes up , mystified and distressed at being in different circumstances. Person generally doesn't remember what happened during fugue state and once recovered, wont reccurent.

3.Dissociative Identity Disorder-
          Often referred as multiple personality disorder. In this disorder, individual assume alternative personalities. Each personality has its own set of memories and typical behaviors. None of personality has any awareness of other. One way amnesia is also seen.
          Cases increasing now. Correlates with traumatic Childhood experiences and many clinicians think dissociative identity disorder as a psychological adaptation to traumatic experiences in childhood.  More in female. Personalities find themselves of being in different gender, age and sexual orientation. Separate styles, wardrobe, interests etc.

4. Depersonaliation-
          Its the change in self perception, and persons sense of reality is temporarily lost or changed. They feel as they are in dream, fear of losing sanity. A sense of being cut off from one’s self.

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