Teen Dissociative Disorders: Diagnosis and Treatment

Teen Dissociative Disorder | Parent Treatment Advocates

Psychopathology is the study of mental disorders. Yet, to break it down further, pathos means suffering in Greek. Pathology means the study of diseases or disorders, and psychopathology is the study of mental suffering or mental disorders.

Teen Mental illnesses that have the symptom of dissociation in common are known as teen Dissociative Disorders. Dissociation is a break in conscious awareness, memory, a sense of identity or a combination of these. Dissociative Disorders is a group of disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the standardized text used by clinicians across North America. These disorders range in severity with Dissociative Identity Disorder (DID) being the most severe. The following is a list of the dissociative disorders listed in the most recent edition of the DSM.

  • Dissociative Amnesia
  • Depersonalization/Derealization Disorder
  • Dissociative Identity Disorder (formerly known as Multiple Personality Disorder or MPD)

Although not all traumatic events cause dissociation, it is the common cause for dissociative mental illness. An experience that is considered traumatic is one that threatens the injury, death, or physical integrity, and is usually accompanied by terror and helplessness. A traumatic event could be the death of a friend or family member, sexual or physical abuse, an automobile accident, domestic violence, school violence, experiences of war, the effects of natural disasters, and acts of terrorism.

According to the American Psychological Association (APA), more than 2/3 of children report experiencing trauma before the age of 16. As a result of experiencing such an intense ordeal, along with feeling powerless to do anything about it, psychological symptoms often result. Although, each adolescent will respond to certain experiences differently, there are common indications that point to whether a mental illness exists. For instance, the symptoms that develop after experiencing trauma include:

  • Feeling numb, detached, or emotionally unresponsive
  • Amnesia of parts or all of the traumatic event
  • De-realization, a symptom in which the environment seems strange or unreal
  • De-personalization, a symptom in which thoughts and feelings do not seem real
  • Flashbacks or recurring images of the trauma
  • Feelings of reliving the traumatic event
  • Feeling high levels of stress when an object or person reminds you of the event
  • Avoiding people, objects, and places that stimulate reliving the trauma
  • Trouble sleeping
  • Irritability
  • Chronic tension
  • Easily startled
  • Difficulty concentrating
  • Inability to sit still

Dissociate Amnesia

This is a mental illness in which a teen has lost or blocked critical pieces of personal information due to the experience of a traumatic event. However, the DSM makes clear that this illness should not be made a diagnosis if there is a medical cause, such as injury to the head. The amnesia that occurs can be specific to the trauma; localized to a specific period of time, such as forgetting everything prior to the traumatic event; generalized, as in forgetting large parts of one’s life, and systematic, such as losing a specific category of information. The experience of dissociative fugue is now considered a symptom of dissociative amnesia; previously it was its own diagnosis. Dissociative fugue is when an individual takes off on a journey of some kind without later recalling how he or she arrived at a foreign place.

Depersonalization/Derealization Disorder

This disorder is characterized by feelings of detachment to one’s experience, body, or self. These feelings tend to be recurrent and chronic. Specifically, de-realization is a symptom in which the environment seems strange or unreal. De-personalization is a symptom in which thoughts and feelings do not seem real. Of all the dissociative disorders, this is the one that tends to be the most easily recognized and diagnosed frequently to those who have experienced trauma.

Dissociative Identity Disorder (DID)

Sybil and The Three Faces of Eve are popular movies with characters having multiple personalities. However, what was once called Multiple Personality Disorder (MPD) is now clinically known as Dissociative Identity Disorder (DID).

The dissociation in DID is seen as a disturbance in an individual’s identity, where two or more distinct personalities become evident and where behavior with each is clearly recognized and distinct from other personalities.  DID in teens often get misdiagnosed as schizophrenia. Treating DID usually includes psychotherapy that attempts to establish a therapeutic relationship with the alter that is self-harming. Attempts to reduce this behavior are a focus in therapy as well as trying to establish communication among the various personalities. Establishing dialogue between alters helps with retrieving memories of trauma that are then worked with to help the client heal from these early difficult experiences.

Treatment for Dissociate Amnesia and Depersonalization/Derealization Disorder include a combination of psychotherapy and medication. Because dissociative disorders are often the result of trauma, they typically co-occur with depression and anxiety. For this reason, anti-anxiety and anti-depressants are used for treatment. Additionally, psychotherapy includes a safe exploration of the trauma in order to bring to light and heal the intense, trauma-related emotions.

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