Dissociative Disorders – Diagnosis and Treatment
Diagnosis
Health care professionals identify dissociative disorders through several steps. They usually start by asking about a person’s symptoms and health history.
| Area | Examples Checked |
|---|---|
| Physical causes | Head injury, brain illness, substance use |
| Psychological | Traumatic events, childhood trauma, stress |
| Symptoms | Memory gaps, shifting identities, mood changes |
Doctors perform a physical exam to rule out other causes, such as head injuries, substance use, or medical conditions that could explain memory loss or feeling detached from reality.
A mental health provider also conducts a mental health evaluation. This includes questions about trauma, stress, and symptoms like amnesia, identity changes, or feeling separated from oneself.
Family members can sometimes provide helpful information.
Common conditions considered during diagnosis include:
- Dissociative amnesia
- Dissociative identity disorder (also called multiple personality disorder)
- Depersonalization disorder
Doctors use guidelines from the DSM-5-TR to make a diagnosis. They may use tests to avoid misdiagnosis or malingering. Doctors sometimes use neuroimaging if they suspect brain injury or disease.
Treatment
Psychotherapy and Counseling
Psychotherapy, or talk therapy, is usually the first treatment for dissociative disorders. In these sessions, a person meets with a mental health provider to discuss symptoms and work through past events.
A therapist with experience in trauma can help. The therapist explains how the disorder started and teaches healthy ways to respond to stress.
Some types of therapy include cognitive behavioral therapy (CBT) or, in some cases, hypnotherapy. Over time, patients may feel safe enough to talk about traumatic memories.
Medication Options
Doctors have not found specific medicines to cure dissociative disorders. However, they sometimes prescribe antidepressants, anti-anxiety drugs, or antipsychotics to help with symptoms like depression or anxiety.
Below is a table with common medication types:
| Type of Medicine | Purpose |
|---|---|
| Antidepressants | Manage depression |
| Anti-anxiety medicines | Help reduce anxiety |
| Antipsychotics | Address severe symptoms |
Doctors usually combine these medications with therapy to help manage symptoms and improve daily functioning.
Getting Ready for Your Visit
Steps You Can Take Before Your Visit
It helps to prepare ahead of time. Making a list of your symptoms is a good first step.
Include not only how you feel right now, but also any behavior changes others noticed. This could include forgetting things, feeling detached, or acting unlike yourself.
Write down key events from your past that might be important. Include childhood experiences, especially if there was sexual abuse, emotional abuse, or neglect.
Note any other major stressful events or big life changes. Mention any times when you or a family member had similar problems.
Medical information is important. List all the conditions you have—physical or mental—including past suicide attempts.
Bring a list of any medicines, vitamins, herbs, or supplements you use, along with their doses. If you have trouble remembering, ask a family member for help or bring them with you.
Bring questions for your doctor. These could incluxde:
- What may be causing my symptoms?
- Could any other condition be the cause?
- How will the diagnosis be made?
- Is this likely to go away, or will it last?
- What treatments are available?
- How much improvement can I expect from treatment?
- How will progress be checked?
- If I have other health conditions, how can I manage them together?
- Should I see a specialist?
- Are there any easy-to-read handouts or resources I can take home?
Use a notebook, a phone, or a printed form to organize your information. You can always ask extra questions if something is unclear during your visit.
What Your Provider Will Likely Discuss
During your visit, the doctor or mental health care provider will ask several questions. They may want to know about symptoms you or your family members have noticed.
You might hear questions like:
- When did these problems begin?
- Have you ever lost your memory or struggled to recall events?
- Do you ever feel disconnected from your body or feel like someone else is in control?
- Are there confusing gaps in your memory, especially after difficult events?
- Have you ever found yourself far from home or work without knowing how you got there?
- How have your symptoms affected your school, work, or relationships?
- Are you dealing with anxiety, depression, or stress?
- Have you thought about hurting yourself or tried to do so before?
Your provider may also want to learn more about your past and family history. They may ask:
- Were you touched or hurt against your will?
- Did you experience physical abuse, emotional abuse, or neglect as a child?
- Did you see or know about abuse in your family while growing up?
- Has anyone in your family attempted suicide?
- Are you serving or did you serve in the military?
- Have you ever used drugs or alcohol?
Your provider might ask about other conditions you are being treated for, such as mental health issues or other medical problems. These topics can feel very personal.
Answering honestly helps your provider give you the best care.
