What are Dissociative Disorders?
Dissociative disorders are a group of psychiatric conditions characterized by an involuntary escape from reality involving a disconnection between thoughts, identity, consciousness, and memory. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) by the American Psychiatric Association, people with dissociative disorders have a severe and persistent disruption or discontinuity in their sense of self and emotional, cognitive, or sensory functions.
The DSM-5 categorizes several specific types of dissociative disorders, including:
1. Dissociative Identity Disorder (formerly known as Multiple Personality Disorder): Characterized by the presence of two or more distinct personality states or an experience of possession and recurrent episodes of amnesia. This disorder is often a result of severe trauma during early childhood, usually extreme, repetitive physical, sexual, or emotional abuse.
2. Dissociative Amnesia: The main symptom is difficulty remembering important information about one's self. This disorder can be specific to events in a certain period, a particular event, or more general. Dissociative amnesia has several subtypes: Localized amnesia for a specific event or time period, Selective amnesia for specific details of an event, Generalized amnesia for identity and life history.
3. Depersonalization/Derealization Disorder: Involves a persistent or recurrent feeling of being detached from one’s body or mental processes, like an outside observer of their life (depersonalization), and/or a sense of unreality of one’s surroundings (derealization). The individual is aware that this is only a feeling and not a reality.
The diagnosis of dissociative disorders is complex and often involves detailed psychological evaluations and exclusion of other potential medical causes. The symptoms must cause significant distress or impairment in social, occupational, or other important areas of functioning.
Treatment for dissociative disorders typically involves psychotherapy, with cognitive-behavioral therapy and dialectical behavioral therapy being commonly used approaches. Sometimes medications may be used to treat concurrent symptoms like depression or anxiety, though there are no medications specifically approved for the treatment of dissociative disorders. Therapy focuses on integrating the dissociated parts of identity, improving healthy coping mechanisms, and processing the trauma that triggered the dissociation.
Frequently Asked Questions
Services
What types of services do you provide?
We provide two main services: psychopharmacology evaluations and medication management. First, you’ll meet with a provider for an evaluation to determine your treatment plan, which may include medication, therapy, lifestyle changes, or other recommendations. Second, if medication is appropriate, our providers will help you manage and adjust your medication to make sure it works effectively.
What is the difference between therapy and medication management?
Therapy, sometimes called “talk therapy,” involves talking with a mental health professional to address mental health issues through dialogue and behavioral strategies. Medication management, on the other hand, is a medical approach where a mental health professional prescribes, monitors, and adjusts psychiatric medication to treat mental health conditions to address your physiological symptoms. Often, a combination of talk therapy and medication management is beneficial.
Does this replace my need for a therapist?
Our providers are here to address your concerns and offer support, but it’s important to note that they are not meant to replace a licensed therapist. Evidence suggests that for many mental health conditions, a combination of medication and psychotherapy is the most effective approach.
How does online psychiatry work?
Virtual psychiatry works just like in-person psychiatry, except instead of sitting in a doctor’s office, you’ll talk to your provider during live video appointments.
What to Expect
What should I expect during a mental health assessment or evaluation?
You’ll connect 1:1 with your new provider to discuss your needs. If appropriate, they’ll prescribe medication and send it to your pharmacy of choice. Regular check-ins will help you track how you’re feeling and any side effects, and your provider will make any needed adjustments.
How do I prepare for my first appointment? How long are typical appointments?
Before your scheduled appointment, you’ll receive new patient forms, which you’ll need to complete in advance. We will also ask for your insurance information, a valid form of identification, a list of any of your current medications, and any relevant medical records or previous psychiatric evaluations.
Typical appointment times vary depending on the nature of your visit and your treatment plan. Initial consultations usually last around 60 minutes, during which you'll have an in-depth discussion with your provider. Follow-up appointments are typically shorter, ranging from 15 to 30 minutes, but this may be adjusted based on your specific needs and progress.
What should I do in case of an emergency or crisis?
If you’re having a medical or mental health emergency, call 911.
Call or text 833-773-2445 for 24/7 Crisis and Mental Health Support from the Massachusetts Behavioral Health Help Line.
Appointments
How do I schedule an appointment?
To schedule an appointment, please fill out our Appointment Request Form. Someone from the Monomoy Health team will contact you for more information and to help schedule your first appointment. We look forward to working with you!
Do you offer virtual/online appointments?
Yes, we offer virtual appointments. That means you can meet with your provider from the comfort of your home. We recommend choosing a well-lit and quiet space for your meeting.
Are my appointments and information confidential?
Yes. We adhere to the highest standards of privacy and confidentiality to ensure that your personal and medical information is safe, and privacy is a top priority in our practice. For more information, please download our HIPAA policy.
Our providers specialize in…
For more information about each of these conditions, click on each word in the list.
- Addiction and Substance Use Disorder
- Dementia and Alzheimer’s Disease
- Anxiety Disorders
- Attention-Deficit/Hyperactivity Disorder (ADHD)
- Autism Spectrum Disorder
- Bipolar Disorder
- Depression
- Disruptive, Impulse-Control and Conduct Disorders
- Dissociative Disorders
- Eating Disorders
- Gender Dysphoria
- Hoarding Disorder
- Obsessive-Compulsive Disorder
- Opioid Use Disorder
- Perinatal Depression (formerly Postpartum)
- Personality Disorders
- Post-Traumatic Stress Disorder (PTSD)
- Prolonged Grief Disorder
- Schizophrenia
- Seasonal Affective Disorder (SAD)
- Sleep Disorders
- Somatic Symptom Disorder
