Dissociative Disorders: Maligned, Misunderstood and Misdiagnosed

Dissociative Disorders are, in general, not well understood by mental health professionals.  In fact, many mental health professionals either do not recognize dissociation when it’s occurring in people, and/or they dismiss it as unimportant or as a form of drama or malingering in people.  I know this because I worked as a mental health therapist in hospital settings for several years.  I also know it because I was diagnosed with a Dissociative Disorder a few years ago, at almost 50 years old.  Since my own diagnosis, I’ve improved my understanding of dissociation and I’m receiving expert treatment.  And I’m on the road of finding myself at long last.

Sidran Traumatic Stress Institute lays out the features of Dissociative Disorders, in an excellent article on their website titled, “What is a Dissociative Disorder?”

Some notes from the article are included below; however,  I recommend giving it a full read.  For example, if you are new to the concept of dissociation, you will find an excellent and easy to understand explanation of it by reading the Sidran article in full.  I  have also discussed dissociation in some of my other blog posts, for example, here (although I still recommend the Sidran article for a full explanation of the concept).

• “People with Dissociative Disorders often spend years with the wrong diagnoses.  They change from therapist to therapist and from medication to medication, getting treatment for symptoms but making limited or no actual progress.  It takes an average of seven years in the mental health system before a person will be diagnosed correctly with a Dissociative Disorder.”
• This is common because people who have Dissociative Disorders may also experience depression, panic attacks, sleep disorders, addictions, interpersonal problems, etc.  Although the person with a Dissociative Disorder may get expert treatment for the more common secondary issues, if the Dissociative Disorder is not addresssed, then recovery is generally short-lived.
• Dissociative Disorders are now known to be common effects of severe trauma in childhood.  The most common cause of Dissociative Disorders is “extreme, repeated physical, sexual and/or emotional abuse”
• Although often missed and undiagnosed by healthcare professionals, Dissociative Disorders occur relatively frequently compared to other mental health problems and can be included as one of the four major mental health problems.  The others are anxiety, depression and schizophrenia.
• “Most people with Dissociative Disorder work hard to hide their dissociation.  They can often function so well, especially under controlled circumstances, that family members, coworkers, neighbours and others… may not know they are chronically dissociating.  People with Dissociative Disorders can hold highly responsible jobs, contributing to society in a variety of professions, the arts and providing services.”
• Some people experience dissociation so frequently that it results in “serious pathology, relationship difficulties and an inability to function, especially when under stress.”
• Most people who have a Dissociative Disorder also have PTSD (post-traumatic stress disorder)
• Dissociative Disorders are diagnosed most frequently in women.  But they may be as prevalent in men, but less frequently diagnosed. “Men with Dissociative Disorders are most likely to be in treatment for other mental illnesses or drug and alcohol abuse or they may be incarcerated.”
• Dissociative Disorders respond well to treatment.  In fact, Dissociative Disorders may carry the best prognosis for treatment, if proper treatment is undertaken and completed. (emphasis added) The course of treatment is long-term, intense and painful, as it generally involves remembering and reclaiming the dissociated traumatic experiences.

Based on my experiences, I would make an important addition to the Sidran information.  That is, that it is very possible for a person to be dissociative but not realize they are dissociative, especially if this has been their default way of being since early childhood.  In other words, people who are suffering from Dissociative Disorders may not have adequate awareness and language to describe what they are experiencing, because it’s what they’ve always known and they don’t know what it would be like to be any different.

Thank you for reading.  And please, let’s get the word out about Dissociative Disorders.  As noted in one of the bullet points above, Dissociative Disorders respond well to proper treatment.  My hope is that fewer people will have to suffer needlessly as more education is provided about this mental health issue and its causes.  The road to medical — and public — acceptance of the Dissociative Disorders is no doubt, not easy (and the reasons for this are a whole other potential blog post, if not a book).  But, we are stronger together, and we can at least give it a try.

Yours in healing,

Annie.